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Common Exclusions of a Family Health Plan

By Finserv MARKETS - May 2,2019
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Common exclusions of a family health plan

The primary reason why most people choose to invest in Family Health Insurance plans is that it provides coverage for all the members of a family under a single plan. With Family Health Plans, there’s no need to manage multiple premium payments or claims. You can manage the entire healthcare costs of your family members under one plan. However, like all insurance policies, Family Health policies also entail certain exclusions. Most of us tend to look at the policy inclusions or coverage rather than the exclusions when buying a policy. However, understanding the policy exclusions is crucial as it will assist you in rationalizing claims in the hour of need. To ensure that you are well informed, here are some of the most common exclusions of Health Insurance plans for family: –

Pre-Existing Medical Conditions

If you happen to suffer from any medical conditions before buying Health Insurance, it is important to declare the same. If you fail to declare pre-existing diseases, they will not be covered. However, if you declare them beforehand, they will generally be covered at the end of a specified lock-in period depending on your insurance provider.

Conditions Caused Due To Consumption Of Injurious Substances

Health conditions or injuries resulting from consumption of injurious substances such as alcohol, drugs or cigarettes are not covered by Family Health Plans. For e.g.- lungs diseases caused due to smoking or liver cirrhosis resulting from the consumption of alcohol.

Cosmetic Treatments

Although an increasing number of people are opting for cosmetic treatments these days, they are not covered under Family Health Insurance. However, medically recommended cosmetic procedures such as plastic surgery to treat an accident or injury will be covered. The Family Health Insurance plan available on Finserv MARKETS offers Bariatric Surgery cover of up to Rs. 5 Lakh.

Dental Treatments

Most Family Health plans do not cover dental treatments. However, many insurance providers offer dental coverage in the form of riders.

Medical Treatments Resulting From War Or Act Or War

In case you are injured during a war or an act of war, your medical treatment costs will not be covered by a Family Health Insurance plan.

Injuries Caused Due to Suicide Attempt

Treatment of injuries resulting from any kind of self-harm or suicide attempt are not covered under Family Health plans.

Treatment of Sexually Transmitted Diseases(STD)

The cost of treating sexually transmitted diseases like AIDS are not covered by most health Insurance plans.

Mental Disorders

Treatment of mental disorders is generally not covered by Health Insurance companies.

Regardless of the exclusions, one cannot deny the fact that availing Family Health policy is one of the most convenient ways to secure quality healthcare at a reasonable cost. At Finserv MARKETS, we offer wide coverage and additional health insurance benefits like quick claim settlement, cashless facility and much more. To know more about Family Health Insurance plans, visit Finserv MARKETS.

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Bajaj Finserv Direct Limited ("BFDL"), erstwhile Bajaj Financial Holdings Limited is a registered corporate agent of Bajaj Allianz Life Insurance Company Limited and Bajaj Allianz General Insurance Company Limited under the IRDAI composite registration number CA0551 valid till 10-Apr-2021. BFDL also renders services to Bajaj Finance Limited (‘BFL’) and Bajaj Housing Finance Limited (‘BHFL’) (referred hereinafter as ‘Lending Partner’) in sourcing of customers, providing preliminary credit support activities, fulfilment services and post-acquisition customer services related to lending business. Registered Office: Bajaj Auto Limited Complex, Mumbai – Pune Road, Akurdi, Pune – 411 035 CIN: U65923PN2014PLC150522