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HDFC General Insurance Ltd.
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Types of Insurance
FAQs

 

 
General Insurance
1. Why do I need insurance?

Insurance is a hedge against the occurrence of unforeseen incidents. Insurance products help you in not only mitigating risks but also helps you by providing a financial cushion against adverse financial burdens suffered.

Accidents... illness... fire... financial securities are the things you'd like to worry about any time. General Insurance provides you the much-needed protection against such unforeseen events. Unlike Life Insurance, General Insurance is not meant to offer returns but is a protection against contingencies. Under certain Acts of Parliament, some types of insurance like Motor Insurance and Public Liability Insurance have been made compulsory.

 
2. How can I buy a policy?

Insurance is the subject matter of solicitation. IRDA allows insurance to be sold primarily through following:

Channels

  • Agents representing an insurance company
  • Insurance brokers are allowed to sell products of more than one insurance company
  • Company websites
  • Buying on phone. It depends upon individual company
  • Banks, retail houses or any other commercial ventures which are channel partner of these insurance companies

Process

  • Approach the insurance company with a duly filled up proposal form, through any of the above mentioned channels
  • Seek an approval from the company on the intention of underwriting your policy. (i.e. evaluating  your risk and exposures. Risk involves consideration of material facts on the basis of which company will take a decision whether to accept the risk and if so at what rate of premium.)
  • Seek premium & other relevant details
  • Pay the premium and take premium receipt and cover note/risk held note
  • Wait for documents
  • Check for its correctness on receipt and store it carefully till the policy expiry date
  • Ensure that you renew the policy well in time, before the expiry of the policy
 
3. What is the difference between an agent and a broker?
Agents represent an insurance company and sell products of that insurance company only. Whereas, insurance brokers are allowed to sell products of more than one insurance company.
#FAQ
Motor Insurance
Generic
1. What is auto insurance?

Auto Insurance is also known as Motor Insurance or Car Insurance. It is the insurance of vehicles like cars, two wheelers, trucks, and other vehicles.

Auto Insurance provides protection from losses resulting from owning and/or operating Motor Cars.

 
2. Is it mandatory in India to have auto insurance?
Yes, Auto Insurance is mandatory in India. Having compulsory liability insurance is a statutory requirement of the Motor Vehicles Act, 1988.
 
3. What are the different kinds of auto insurance available in India?

There are two kinds of insurance:

  • Liability only Policies ( covering only the Third Party Liability)
  • Package (Comprehensive) Policies ( also covers damage to the motor vehicles)
 
4. I own a vehicle which recently met with an accident, but I was not driving it. Can I still make a claim?

You can make a claim in following conditions:

  • Insurance Policy for that vehicle should exist,
  • If you have paid premium for paid driver or, it would be payable, if the car is being driven with your permission.
  • The person driving the car is duly licensed as the premium is taken based on the seating capacity, which also includes the person on the driver?s seat.
 
5. What can I do to reduce my auto premium?

You can reduce your premium in following ways:

  • If you are a member of any Automobile Association
  • If you have fitted anti theft device in your vehicle, duly certified by ARAI, Pune
  • If you opt for Voluntary deductibles (you agree to bear a certain sum of the damage charges)
  • Ensure that your policy is ?Claim-free? i.e., You can earn a ?No Claim Bonus?

A reduction in premium is allowed for each & every section mentioned above.

 
6. Can I change my insurance provider?
Yes, if you are not satisfied with the services of the existing insurance provider you can cancel the policy midway and take a policy with another provider. However, you would be refunded an amount after retention of premium on short period rates. Else you could change the insurance provider on renewal, if the provider is really competitive and quoting a lower premium.
 
7. What is a No Claim Bonus (NCB)?
A No Claims Bonus is a discount given by an insurer to policyholders who do not claim on their policy in the policy period of car insurance. Typically this starts at 20% in the first claims free policy period of Car Insurance.
 
8. What will happen to the insurance if I sell my vehicle?
  1. If you sell your vehicle, your policy comes to an end, because the vehicle does not belong to you any more.
  2. However, the liability section of the policy gets automatically transferred to the new buyer (transferee) from the date of selling of the car.
  3. If the new owner wants to continue with the existing policy, he should submit a fresh proposal form to the insurer alongwith a specific request in writing from the transferor within 14 days of the transfer.
  4. On submission of acceptable proof of sale, old certificate of insurance, transfer fee & recovery of NCB as per eligibility, policy could be transferred into the new name.
 
9. What is IDV?
IDV stands for the Insured's Declared Value which is deemed to be the sum insured of the vehicle. The IDV of the vehicle is to be fixed on the basis of manufacturers? listed selling price of the brand and model, minus depreciation based on the age of the vehicle.
 
10. What is salvage and total loss?
Salvage is the value of wreck after a vehicle meets with an accident resulting in total loss, whereby retrieval of the vehicle into its initial condition is not possible.
 
11. How do I make changes in my policy?
You can make changes in the policy through requests (either in mail, application or fax) by giving documentary evidence to that effect. Accordingly an endorsement to the policy would be made.
 
12. Can I cancel my policy midway?
Yes, the policy can be cancelled before the expiry date. You may cancel your policy due to any reason provided the further proof of insurance of the vehicle is submitted to us.
#FAQ
Product specific
13. What are the exclusions under the Motor Policy?
Specific Exclusions:
  • Any accident outside the geographical area of operation
  • Consequential loss, normal wear and tear
  • Driving without a valid licence for that class of vehicle
  • Damage to tyres and tubes unless the vehicle is damaged at the same time
  • Driving under the influence of liquor / drugs
  • Vehicle not being used as per Limitations to use and
  • Mechanical or electrical breakdown, failure etc which fall under the specific exclusions
General exclusion:
Radioactive contamination, nuclear fission, war invasion.
 
14. How is the premium calculated and on what basis?
  • The premium rate is computed on the IDV based on certain parameters like age, branch location, cubic capacity of the car, NCB on the car etc.
  • There are other parameters also like manufacturer, model, vehicle segment, fuel type, claims free years, policy age, age/ type of the policyholder, profession of the policyholder as well as the sourcing channel.
 
15. Which documents do I need to submit while buying insurance for my vehicle?

Following is the list of documents that needs to be submitted while buying insurance:

  • Proposal form
  • Copy of the Invoice ( for a new car)
  • Previous insurance policy (if applicable)
  • No Claim Bonus Reserving Letter ( if applicable)
 
16. Do you offer any age and occupational discounts?
Yes, age and occupation are also considered in our pricing parameters, favourable age as well as occupation would warrant a discount or a reduction in premium.
 
17. I lost my policy document. What should I do?
Apply for a duplicate policy document with a letter substantiating the reason for the loss of the policy document. You would get the duplicate policy after payment of the requisite fees.
 
Health Claims
 
1. What is cashless claim and reimbursement claim?
Cashless claim: "Cashless claim" means when insured gets hospitalized in a network hospital/nursing home, he or she, need not have to pay for the covered medical expenses, with the hospital/nursing home, up to the sum insured specified under the Policy, provided the claim is intimated and Insurance company has approved the request as per the terms and condition of the Policy. The Insurance Company, co-ordinates with the hospital/nursing home directly and settles the bill after the discharge of the patient. All non -medical expenses and/or co-payment or medical expenses over and above the sum insured has to be borne by insured at the time of discharge from hospital.

Reimbursement claim: "Reimbursement claim" means, insured gets hospitalized in any of the hospital/nursing home within India, which meets the hospital criteria as mentioned in the Policy, pays the medical expenses at the time of discharge and lodge the claim with insurance company for the amount due under the Policy. Insurance company would process the claim as per the terms of the Policy and reimburses the covered medical expenses to insured if the claim is admissible.
 
2. What steps should I follow to avail cashless claim?
Cashless claim can be of two types – Planned hospitalization or Emergency hospitalization.
Planned hospitalization: This happens when you have some time to plan your admission to the hospital. For example, if the doctor advises hospitalization for treatment, it gives you time to plan your admission.

Step 1: Call the toll free number and provide the claim intimation.

Step 2: Immediately after reaching hospital, fill the Cashless pre - authorization form, available at the Insurance helpdesk / Cashless counter at the hospital. The pre-authorization form should be filled with information viz. the provisional / final diagnosis, estimated treatment expense, length of stay & past medical history (if any) and needs to be duly signed by the treating doctor. Along with it please attach the following documents:
  • Pre-admission Prescriptions & Medical Reports (if any)
  • Copy of Photo-Id & Health Card
Step 3: Take admission on the preferred date.
Step 4: Counter sign all the medical papers on the day of discharge, pay all expenses towards inadmissible items and retain copy of the medical documents before leaving the hospital.

Emergency hospitalization: This happens typically in case of medical emergencies where there is no time for claim intimation and admission has to be immediate.

Step 1: Take immediate admission into the hospital.

Step 2: Once insured is stable, insured/family member/friends should call the toll free number and provide the claim intimation.

Step 3: Immediately after reaching hospital, fill the Cashless pre - authorization form, available at the Insurance helpdesk / Cashless counter at the hospital. The pre-authorization form should be filled with information viz. the provisional / final diagnosis, estimated treatment expense, length of stay & past medical history (if any) and needs to be duly signed by the treating doctor. Along with it please attach the following documents:
  • Pre-admission Prescriptions & Medical Reports (if any)
  • Copy of Photo-Id & Health Card
Step 4: Counter sign all the medical papers on the day of discharge, pay all expenses towards inadmissible items and retain copy of the medical documents before leaving the hospital.

Note: The above is applicable only if the cashless is approved. In case of denial or insured admitted in non-network hospital, insured should self pay and claim on reimbursement mode.
 
3. What is pre-authorization form?
Pre authorization form is the form which is sent to the Insurance Company to avail cashless service, after being duly filled by the insured and the attending doctor. You get this form at the insurance helpdesk/cashless counter in the hospital.
 
4. What is "network hospital"?
Network hospital means all such Hospitals / nursing homes in which Cashless facility may be availed by the Insured/Insured Person for treatment as provided herein. The list of Network Hospitals is subject to amendment from time to time and shall be available with the Company.
 
5. What are the documents that should be carried while availing cashless facility?
Following documents should be carried to hospital at the time of availing cashless facility:
  1. Health card of Insured
  2. All pre-hospital medical papers, report and prescription.
  3. Commencement of the ailment.
  4. Policy copy.
  5. Any photo ID viz. Pan card, Passport, Election ID, Employee ID , Driving license etc
 
6. Will my claims be reimbursed even if I do not get myself treated at a network hospital?
Yes, you are eligible to lodge the claim with us. Please note, hospital/nursing home should meet the criteria as defined in the Policy. Your claims will be assessed on reimbursement basis subject to other terms and condition of the Policy.
 
7. What medical expenses are covered?
The health policy covers medical expenses incurred towards the ailment subject to the condition that the ailment is admissible under the Policy.  Following are the broad heads of expense.
  1. Hospital (Room & Boarding and Operation Theatre) charges,
  2. Fees of Surgeon, Anesthetist, Nurse, Specialists.
  3. Cost of diagnostic tests, medicines, blood, oxygen, internal appliances like pacemaker and organs as long as these are Medically Necessary.
 
8. Under what circumstances my cashless request can be turned down by Insurance Company?
Cashless request can be turned down under the following circumstance:
  1. If the information provided at the time of cashless request is insufficient to judge the admissibility of the possible claim.
  2. If the hospitalization is in non-network hospital.
  3. If the claim attracts any of the standard exclusion of the policy including pre-existing and waiting period clause.
  4. If there is violation of terms and condition of the Policy.
  5. Policy invalid at the time of claim or sum insured exhausted due to previous claims under the Policy.
 
9. What if the cost for treatment exceeds the approved sum in cashless claim?
In such case, the hospital will request Insurance Company to increase the amount approved if needed during the treatment. The request will be assessed by Insurance Company and additional approval will be given subject to terms and condition of the Policy and availability of the sum insured.
 
10. How to intimate a claim? Or Whom should I contact in case of claim?
Claim notification: Intimation of claim must be done at least 72 hours prior to hospitalization in case of planned hospitalization and within 24 hours of hospitalization in case of an emergency hospitalization. Emergency claims can be notified by family members/friends once the insured is stable.

In order to intimate a claim, please choose the following options:
  • Calling the toll free no. 1800-209-5846 or
  • Web intimation by login at www.hdfcgi.com  à click health claim tracker à Intimate claim
  • Writing at healthclaims@hdfcgi.com or by post at the address mentioned in the Policy.
Health Claims Department
HDFC General Insurance Limited
Stellar IT Park Tower – 1,
5th Floor, C-25,
Sector-62
Noida – 201 301,
Uttar Pradesh
 
11. What information should be provided at the time of intimation?
Following information should be provided while intimating the reimbursement claim.
  1. Contact Numbers ( Caller)
  2. Policy Number and Health card number (as reflecting on the Health Card)
  3. Name of Insured /Patient.
  4. Nature of Sickness/Accident.
  5. Date & Time, in case of accident
  6. Name of the Hospital and contacts.
 
12. What is the time period within which I should submit my claim?

The claim documents duly completed should be submitted at the following address as early as possible not later than 30 days from the date of discharge.

Health Claims Department
HDFC General Insurance Limited
Stellar IT Park Tower – 1,
5th Floor, C-25,
Sector-62
Noida – 201 301,
Uttar Pradesh
 
13. Is there any time period for filing pre and post hospital claim?
The claim documents duly completed should be submitted at the following address within 15 days from the date of completion of treatment or expiry of the post hospitalization period as per the Policy, whichever is earlier. However, if the insured chooses to submit the bills in part, the same is also accepted.

Health Claims Department
HDFC General Insurance Limited
Stellar IT Park Tower – 1,
5th Floor, C-25,
Sector-62
Noida – 201 301,
Uttar Pradesh
 
14. What are the documents that should be submitted for reimbursement claim?

Documents required for processing of the claims:

  1. Claim form duly filled in and signed.
  2. Prescription of doctors
  3. Discharge card issued by hospital
  4. Original bills and receipts of hospital, medicine, medical investigation, doctors etc.
  5. Medical Investigation reports
  6. Any other relevant medical papers relating to the current ailment.
 
15.When my reimbursement claim may be turned down by Insurance company?

Reimbursement claims may not be admissible under the following circumstance:

  1. If the claim attracts any of the standard exclusion of the policy including pre-existing and waiting period clause
  2. If there is violation of terms and condition of the Policy
  3. Policy invalid or the sum insured exhausted due to previous claims under the Policy
  4. Non-submission of any mandatory documents
  5. Any malpractice noticed in the claim
 
16. How do I submit original documents in both the insurance companies?
You need to submit original documents to one of the insurance cos.  After settlement of the claim, you need to obtain certified true copy of the documents along with a settlement letter and submit to the other insurer for claim.  
 
17. How long will you take to process my claim?
Reimbursement claims:  
We shall convey our decision within 6 working days from receipt of complete documents.

Complete documents means – submission of all medical documents as mentioned in the claim procedure along with all previous treatment papers (if any).

Cashless request:
We shall convey our decision on the cashless mode within 6 business hours from the receipt of complete details.
Complete details means – submission of pre-authorization form with information viz. provisional / final diagnosis, estimated treatment expense, length of stay & past medical history (if any) and duly signed by the treating doctor. Along with it following documents is sent:
  • Pre-admission Prescriptions & Medical Reports (if any) and Past Medical history supported by medical documents (if any)
  • Copy of Photo-Id & Health Card
 
#FAQ
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care@hdfcgi.com
 
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