Best Health Insurance Plan

Introuduction

       Different types of health insurance schemes with different names, are introduced by insurers. Broadly speaking, all these schemes have certain common basic features. this chapter deals with these features of some major schemes availble in the market.

Mediclaim Policy  (Individual)

   1. the policy provides for reimbursement of Hospitalisation/ Domiciliary hospitalisation expenses for     illness   / disease suffered or accidental injury sustained during the policy  period.

 The policy pays for expenses incurred under the following heads:

  a. Room, Boarding Expenses in the Hospital/ Nursing Homes

  b. Nursing expenses

 c. Surgeon,Anaesthetist, Medical Practitioner, Consultants, Specialist fees

d. anaesthesia, blood,oxygen,operation theatre charges, surgical appliances, medicines and drugs, Diagnostic materials,  and x-ray, dialysis, chemotherapy, Radiotherapy, cost of pacemaker, Artificial limbs and cost of organs and similar expenses.

2.  The liabilty in respect of all claims admitted during the period of insurance shall not exceed the sum insured for the person as mentioned in the schedule.

   The company will pay through the party administrator named in the Schedule of the policy to the hospital/nursing home or the insured person reasonable and necessary expenses incurred in respect of medical/surgical treatment.

  Reimbursement is allowed only when treatment is taken in a hospital or nursing home which satisfies the specified in the policy.

 The criteria refer to registration with the local authorities or provision of number of in - patient beds, operation theatre and qualified doctors and nursing staff round the clock.

Expenses on Hospitalisation for minimum period of 24 hours are admissible. However, this time limit is not applied to specific treatment Dialysis, Chemotherapy, Radiotherapy, Eye Surgery,Dental Surgery, Lithotripsy, D&C , Tonsilectomy taken in the hospital/ Nursing Home and the Insured is discharged on the same day, the treatment will  be considered to be taken under Hospitalisation Benefit.

Relevant medical expenses incurred during period upto 30 days prior to and period of 60 days after hospitalisation are treated as part of the claim.

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Car Insurance

 For purpose of insurance, motor vehicles are classified into three broad categories.


1. Private cars

2. Motor cycles and motor scooters

3. commercial vehicles,further classified into  types

   a. Goods carrying vehicles.

   b. Passenger carrying vehicles

       - Motorised rickshaws
       - Taxis
       - Buses.

  c. Miscellaneous Vehicles,

      - Ambulances 
      - Cinema film Recording and Publicity vans
      - Mobile dispensaries etc

Act of : Motor Vehicles ACT,1988

 The motor  Vehicles Act passed in 1939 and amended in 1988 and 1994.
 Insurance of motor vehicles against damage is not made compulsory,but the insurance of third party liability arsing out of the use of motor vehicles in public places is made compulsory. No motor car vehicle can ply in a public place without such insurance.

The Liabilities which require compulsory insurance are as follows

a. death or bodily injury of any person including owner of the goods or his authoriesed representative carried in the carriage
b. damage to any property of a third party
c. death of bodily injury of any passenger of a public services vehicle
d. liability arising under Workmens compensation Act,1923 in respect of death or bodily injury of

     1.paid driver of the vehicle

    2.conductor, or ticket examiner

    3. workers, carried in a goods vehicle

The policy of insurance should cover the liability incurred in respect of any one accident as follows :

   In respect of death of or bodily injury of third party or passenger of a public service vehicle the amount of liability incurred (if without limit).

Introduction to Insurance

 Need of Insurance

  Assets are insured because they are likely to be destroyed or made non-functional, through an accidental occurrence , such possible occurrences are called perils, fire, floods, breakdowns,lightning,earthquakes,and etc. are perils. The damage that these perils may cause the asset, is the risk that the asset is exposed to.

The risk means that there is a possibility of loss or damage. it may or may not happen.There has to be an uncertainty about the risk. if there is no uncertainty about the occurrence of an event, it cannot be insured against.

There are other meanings of the term risk. to the ordinary man in the street risk means exposure to danger. in insurance practice, risk is also used to refer to the peril or loss producing event. for example, it is said that fire insurance covers the risks of fire, explosion,cyclone,flood etc. again it is used to refer to the property covered by insurance for example, a timber construction is considered to be a bad risk for fire insurance purpose.

The mechanism of insurance is very simple. people who are exposed to the same risks come together and agree that, if any one of the members suffers a loss, the other will share the loss and make good to the person who lost. all people who send goods by ship sinking,piracy, etc. Those owning factories are not exposed to these risks,but they are exposed to different kinds of risks like fire, hailstorms, earthquakes,
lightning,burglary,etc like this, different kinds of risks can be identified and separate groups made,including those exposed to such risks, by this method,the risk is spread among the community and the likely big impact on one is reduced to smaller manageable impacts on all.

The manner in which the loss is to be shared can be determined before hand. it may be proportional to the likely loss that each person is likely to suffer, which is indicative of the benefit he would recevive if the peril befell him. the shares could be collected from the members after the loss has occurred or the likely shares may be collected in advance, at the time of admission to the group. insurance companies collect in advance and creat a fund from which the losses are paid.

Mainly Two Types of Insurance

Life Insurance

The greatest factor in having life insurance is providing for those you leave behind. This is extremely important if you have a family that is dependent on your salary to pay the bills. Industry experts suggest a life insurance policy should cover "ten times your yearly income." This sum would provide enough money to cover existing expenses, funeral expenses and give your family a financial cushion. That cushion will help them re-group after your death. 


 When estimating the amount of life insurance coverage you need, remember to factor in not only funeral expenses, but also mortgage payments and living expenses such as loans, credit cards and taxes, but also child care, and future college costs. 


 LIMRA, formerly known as the Life Insurance Marketing & Research Association, says that if the primary wage earner dies in a family with dependent children that family will only be able to cover their living expenses for a few months, and four in 10 would have difficulty immediately. 


 The two basic types of life insurance are Traditional Whole Life and Term Life. Simply explained, Whole Life is a policy you pay on until you die and Term Life is a policy for a set amount of time. You should seek the advice of a financial expert when planning your life insurance needs. There are considerable differences between the two policies. In deciding between these two, consumers should consider their age, occupation, number of dependent children and other factors to ensure they have the coverage necessary to protect their families. (For additional reading, see What To Expect When Applying For Life Insurance.) 

Health Insurance

A recent Harvard study noted that statistically, "your family is just one serious illness away from bankruptcy." They also concluded that, "62% of all personal bankruptcies in the U.S. in 2007 were caused by health problems and 78% of those filers had medical insurance at the start of their illness." 


 Those numbers alone should urge you to obtain health insurance, or increase your current coverage. The key to finding adequate coverage is shopping around. While the best option and the least expensive is participating in your employer's insurance program, many smaller businesses do not offer this benefit. 


 Finding affordable health insurance is difficult, particularly without an employer-sponsored program or if you have a pre-existing condition. According to the Kaiser/HRET survey, the average premium cost to the employee in an employer sponsored health care program was around $4,100. With rising co-payments, yearly deductibles and dropped coverage's, health insurance has become a luxury less and less can afford, yet even a minimal policy is better than having no coverage. The cost for a day in the hospital can range from $985 to $2,696. Even if you have minimal coverage, it can provide some monetary benefit for your hospital stay.


 As the health care debate continues in Washington, approximately 48 million Americans are without insurance coverage. Check with your employer regarding health care benefits, inquire of any occupational organizations that you belong to regarding possible group health coverage. If you are over age 50, AARP has some health insurance offers available.

Vehicle insurance in the United States

An excess payment, also known as a deductible, is a fixed contribution that must be paid each time a car is repaired with the charges billed to an automotive insurance policy. Normally this payment is made directly to the accident repair "garage" (the term "garage" refers to an establishment where vehicles are serviced and repaired) when the owner collects the car. If one's car is declared to be a "write off" (or "totaled"), then the insurance company will deduct the excess agreed on the policy from the settlement payment it makes to the owner.
If the accident was the other driver's fault, and this fault is accepted by the third party's insurer, then the vehicle owner may be able to reclaim the excess payment from the other person's insurance company.

Compulsory excess
A compulsory excess is the minimum excess payment the insurer will accept on the insurance policy. Minimum excesses vary according to the personal details, driving record and the insurance company.

Voluntary excess
To reduce the insurance premium, the insured party may offer to pay a higher excess (deductible) than the compulsory excess demanded by the insurance company. The voluntary excess is the extra amount, over and above the compulsory excess, that is agreed to be paid in the event of a claim on the policy. As a bigger excess reduces the financial risk carried by the insurer, the insurer is able to offer a significantly lower premium.

Basis of premium charges

Main article: auto insurance risk selection

Depending on the jurisdiction, the insurance premium can be either mandated by the government or determined by the insurance company, in accordance with a framework of regulations set by the government. Often, the insurer will have more freedom to set the price on physical damage coverages than on mandatory liability coverages.
When the premium is not mandated by the government, it is usually derived from the calculations of an actuary, based on statistical data. The premium can vary depending on many factors that are believed to have an impact on the expected cost of future claims.Those factors can include the car characteristics, the coverage selected (deductible, limit, covered perils), the profile of the driver (age, gender, driving history) and the usage of the car (commute to work or not, predicted annual distance driven).

Gender
On 1 March 2011, the European Court of Justice decided insurance companies who used gender as a risk factor when calculating insurance premiums were breaching EU equality laws.The Court ruled that car-insurance companies were discriminating against men.

Age
Teenage drivers who have no driving record will have higher car insurance premiums. However, young drivers are often offered discounts if they undertake further driver training on recognized courses, such as the Pass Plus scheme in the UK. In the US many insurers offer a good-grade discount to students with a good academic record and resident-student discounts to those who live away from home. Generally insurance premiums tend to become lower at the age of 25. Some insurance companies offer "stand alone" car insurance policies specifically for teenagers with lower premiums. By placing restrictions on teenagers' driving (forbidding driving after dark, or giving rides to other teens, for example), these companies effectively reduce their risk.
Senior drivers are often eligible for retirement discounts, reflecting the lower average miles driven by this age group. However, rates may increase for senior drivers after age 65, due to increased risk associated with much older drivers. Typically, the increased risk for drivers over 65 years of age is associated with slower reflexes, reaction times, and being more injury-prone.[citation needed]

U.S. driving history
In most U.S. states, moving violations, including running red lights and speeding, assess points on a driver's driving record. Since more points indicate an increased risk of future violations, insurance companies periodically review drivers' records, and may raise premiums accordingly. Laws vary from state to state, but most insurers allow one moving violation every three to five years before increasing premiums. Accidents affect insurance premiums similarly. Depending on the severity of the accident and the number of points assessed, rates can increase by as much as twenty to thirty percent. Any motoring convictions should be disclosed to insurers, as the driver is assessed by risk from prior experiences while driving on the road.

Marital status

Statistics show that married drivers average fewer accidents than the rest of the population so policy owners who are married often receive lower premiums than single persons.

Vehicle classification

Two of the most important factors that go into determining the underwriting risk on motorized vehicles are: performance capability and retail cost. The most commonly available providers of auto insurance have underwriting restrictions against vehicles that are either designed to be capable of higher speeds and performance levels, or vehicles that retail above a certain dollar amount. Vehicles that are commonly considered luxury automobiles usually carry more expensive physical damage premiums because they are more expensive to replace. Vehicles that can be classified as high performance autos will carry higher premiums generally because there is greater opportunity for risky driving behavior. Motorcycle insurance may carry lower property-damage premiums because the risk of damage to other vehicles is minimal, yet have higher liability or personal-injury premiums, because motorcycle riders face different physical risks while on the road. Risk classification on automobiles also takes into account the statistical analysis of reported theft, accidents, and mechanical malfunction on every given year, make, and model of auto.

Distance
Some car insurance plans do not differentiate in regard to how much the car is used. There are however low-mileage discounts offered by some insurance providers. Other methods of differentiation would include: over-road distance between the ordinary residence of a subject and their ordinary, daily destinations.

Reasonable distance estimation
Another important factor in determining car-insurance premiums involves the annual mileage put on the vehicle, and for what reason. Driving to and from work every day at a specified distance, especially in urban areas where common traffic routes are known, presents different risks than how a retiree who does not work any longer may use their vehicle. Common practice has been that this information was provided solely by the insured person, but some insurance providers have started to collect regular odometer readings to verify the risk.

Odometer-based systems
Cents Per Mile Now (1986) advocates classified odometer-mile rates, a type of usage-based insurance. After the company's risk factors have been applied, and the customer has accepted the per-mile rate offered, then customers buy prepaid miles of insurance protection as needed, like buying gallons of gasoline (litres of petrol). Insurance automatically ends when the odometer limit (recorded on the car's insurance ID card) is reached, unless more distance is bought. Customers keep track of miles on their own odometer to know when to buy more. The company does no after-the-fact billing of the customer, and the customer doesn't have to estimate a "future annual mileage" figure for the company to obtain a discount. In the event of a traffic stop, an officer could easily verify that the insurance is current, by comparing the figure on the insurance card to that on the odometer.
Critics point out the possibility of cheating the system by odometer tampering. Although the newer electronic odometers are difficult to roll back, they can still be defeated by disconnecting the odometer wires and reconnecting them later. However, as the Cents Per Mile Now website points out:
As a practical matter, resetting odometers requires equipment plus expertise that makes stealing insurance risky and uneconomical. For example, to steal 20,000 miles [32,200 km] of continuous protection while paying for only the 2000 in the 35000 to 37000 range on the odometer, the resetting would have to be done at least nine times, to keep the odometer reading within the narrow 2,000-mile [3,200 km] covered range. There are also powerful legal deterrents to this way of stealing insurance protection. Odometers have always served as the measuring device for resale value, rental and leasing charges, warranty limits, mechanical breakdown insurance, and cents-per-mile tax deductions or reimbursements for business or government travel. Odometer tampering, detected during claim processing, voids the insurance and, under decades-old state and federal law, is punishable by heavy fines and jail.
Under the cents-per-mile system, rewards for driving less are delivered automatically, without the need for administratively cumbersome and costly GPS technology. Uniform per-mile exposure measurement for the first time provides the basis for statistically valid rate classes. Insurer premium income automatically keeps pace with increases or decreases in driving activity, cutting back on resulting insurer demand for rate increases and preventing today's windfalls to insurers, when decreased driving activity lowers costs but not premiums.

GPS-based system
In 1998, the Progressive Insurance company started a pilot program in Texas, in which drivers received a discount for installing a GPS-based device that tracked their driving behavior and reported the results via cellular phone to the company. Policyholders were reportedly more upset about having to pay for the expensive device than they were over privacy concerns.[citation needed] The program was discontinued in 2000. In following years many policies (including Progressive) have been trialed and successfully introduced worldwide into what are referred to as Telematic Insurance. Such 'telematic' policies typically are based on black-box insurance technology, such devices derive from stolen vehicle and fleet tracking but are used for insurance purposes. Since 2010 GPS-based and Telematic Insurance systems have become more mainstream in the auto insurance market not just aimed at specialised auto-fleet markets or high value vehicles (with an emphasis on stolen vehicle recovery). Modern GPS-based systems are branded as 'PAYD' Pay As You Drive insurance policies, 'PHYD' Pay How You Drive or since 2012 Smartphone auto insurance policies which utilise smartphones as a GPS sensor,

OBDII-based system
The Progressive Corporation launched Snapshot to give drivers a customized insurance rate based on recording how, how much, and when their car is driven.[26] Snapshot is currently available in 38 US states.[26] Driving data is transmitted to the company using an on-board telematic device. The device connects to a car's OnBoard Diagnostic (OBD-II) port (all petrol automobiles in the USA built after 1996 have an OBD-II.) and transmits speed, time of day and number of miles the car is driven. There is no GPS in the Snapshot device, so no location information is collected. Cars that are driven less often, in less-risky ways, and at less-risky times of day, can receive large discounts. Progressive has received patents on its methods and systems of implementing usage-based insurance and has licensed these methods and systems to other companies.

Credit ratings
Insurance companies have started using credit ratings of their policyholders to determine risk. Drivers with good credit scores get lower insurance premiums, as it is believed that they are more financially stable, more responsible and have the financial means to better maintain their vehicles. Those with lower credit scores can have their premiums raised or insurance canceled outright.[27] It has been shown that good drivers with spotty credit records could be charged higher premiums than bad drivers with good credit records.[28]

Behavior-based insurance
The use of non-intrusive load monitoring to detect drunk driving and other risky behaviors has been proposed.[29] A US patent application combining this technology with a usage based insurance product to create a new type of behavior based auto insurance product is currently open for public comment on peer to patent.[30] See Behavior-based safety. Behaviour based Insurance focusing upon driving is often called Telematics or Telematics2.0 in some cases monitoring focus upon behavioural analysis such as smooth driving.

Repair insurance

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The examples and perspective in this section deal primarily with the United States and do not represent a worldwide view of the subject. Please improve this article and discuss the issue on the talk page. (September 2012)
Auto repair insurance is an extension of car insurance available in all 50 of the United States that covers the natural wear and tear on a vehicle, independent of damages related to a car accident.
Some drivers opt to buy the insurance as a means of protection against costly breakdowns unrelated to an accident. In contrast to more standard and basic coverages such as comprehensive and collision insurance, auto repair insurance does not cover a vehicle when it is damaged in a collision, during a natural disaster or at the hands of vandals.[citation needed]
For many it is an attractive option for protection after the warranties on their cars expire.
Providers can also offer sub-divisions of auto repair insurance. There is standard repair insurance which covers the wear and tear of vehicles, and naturally occurring breakdowns. Some companies will only offer mechanical breakdown insurance, which only covers repairs necessary when breakable parts need to be fixed or replaced. These parts include transmissions, oil pumps, pistons, timing gears, flywheels, valves, axles and joints.