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Reasonable and customary clause

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11 Sep, 2021 by  brij goenka

Almost all companies have mentioned this point of reasonable and customary clause in their policy wordings some where or other... Some very clearly under hospital benefits or some under the preamble... Howevr on talking with the company executives either they act ignorant or they say this clause is not applicable on me and is mentioned juat to evade unnecessary hikes by the hospital or doctors colluding with the patients to raise exorbitant bills as its been paid by the insurer... Should i buy their logic...? Only hdfc secure plans policy wordings does not have this clause mentioned... Should i consider this caluse as a deal breaker or not...? Should i choose policies without this clause, however how rare it might be or i shudn give much weight to it and choose policies with the clause such as max reassure, care advantage, tata medicare which all are good policies except for this clause

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Health Insurance

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12 Sep, 2021

Hi Brij,


The team of Beshak had written an exhaustive piece on 'reasonable and customary charges in health insurance' last month. I am sharing the URL of their article for your easy reference. This may answer your questions in good detail. Feel free to ask follow up questions after reading this article. Thanks


https://www.beshak.org/insurance/health-insurance/articles/health-insurance-reasonable-and-customary-charges


Best Wishes,

Asad Akbar

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12 Sep, 2021
brij goenka
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12 Sep, 2021
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12 Sep, 2021
brij goenka
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