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Question Regarding the reassure or restoration

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10 Sep, 2021 by  harivansh agrawal

There is a lot of hype for the Max Bupa Reassure plan as this is the one of kind feature (restore covering same illness unlimited times )but when I was reading the policy wording in Reassure section it was stated as


The maximum liability under a single claim under this benefit shall not be more than Base Sum Insured

Now we know during the cashless claim the insurer will approve some amount they will keep on increasing the authorized amount as requested by the hospital as time passes


so my question is does it mean that each claim mean each authorization or a Single hospitalization(i.e. multiple authorizations considered as single claim) in the case of a Cashless claim

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Health Insurance

1 Answer

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11 Sep, 2021

The entire period of hospitalization is treated as a single claim regardless of the number of times pre-authorized limits are extended.


In fact, in health insurance, any relapse within 45 days of discharge is considered as one illness. You should clarify from Max Bupa how they will treat such instances of relapse. If they treat it as one claim, then the expenses incurred during the follow up stay at the hospital may not be admissible as per their policy wordings (in the event the base Sum Insured was exhausted during the first stay).


Best,


Asad

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