These days, due to high medical costs, you pray day of not getting sick and even if you do with some illness which can be at times financially devastated, for them we take medical policies. Sometimes one does not get what one is promised by the agent. Understand the policy well so that you know how much the claim would support you.

THE SECTOR
Public sector companies are New India Assurance, LIC, United India, National and Oriental Insurance. Private Insurance Companies are TATA AIG, Bajaj, Cholamandalam, Reliance, ICICI Prudential, Birla, and Royal Sundaram. Most public sector companies now charge more than private companies because they have a burden of bad cases, which have not been medically checked.
Private companies reject bad cases. They offer more personalized service.

TPA
TPAs are teams of professionals that include specialist doctors, who not only liaise with the insurance company but also advise consumers on specific ailments and prevent both parties from being taken for a ride by unscrupulous clients. TPAs get 6% of your premium, and can be an annoyance or a boon, depending on your personal experience.

COVERAGE
Most insurance programmes limit coverage regarding some aspect of medical care. For example certain diagnoses (ADHD), procedures (cosmetic surgery) and chronic conditions may not be covered. It makes sense to read the fine print carefully so that you know about the omissions.

MEDICAL CHECK UP
A medical checkup is essential especially if you are over 45. One has to go to a hospital specified by the insurance company, who sends your reports directly to it. Special attention is paid to the knee and the eyes to rule out existing diseases. It makes sense to get health insurance before 45. Yet even younger clients who show a history of heart disease or diabetes will have to undergo a checkup. If you have a scheduled date for hospital admission, ask your agent or TPA for a list of hospitals which allow you to be admitted without a deposit and so bypass a hefty admission deposit, subsequent payments and lengthy reimbursement wrangles with the agent.
You need to get a form from your agent, which has to be filled out and signed by your doctor, detailing your ailment and its treatment. This form has to present to the hospital that will fax it to your Insurance Company which in turn will get it confirmed by the TPA. Your treatment will not start until this confirmation is received. Else you have to pay the deposit, which will be refunded later.

THE LIMIT
Several limits on the claim amount have been placed since 3rd, July, 2007. Like you can spend only 1% of your sum insured on your room costs. There are also fixed charges for the operation and your room. Different companies have different limits. Do check the limits before taking up the policy. For instance United India offers for Major surgery/treatment such as cardiac problems, valve replacement, Bypass surgery, joint replacement, cancer, brain tumor: 70% of sum insured or maximum 2 lakhs. Some insurance companies have no ceilings for major illnesses.