Thread by @anexcommie

#Insurance_Agents_HospitalInsurancedesks_insurers_patientandattendants, and let's add #IRDA the most useless body - as bad as the banking ombudsman: #MyExperiences2 , the intentions of this tweet is to make one aware of the ground reality as it exists and how people get played.

The saddest part is at the end of the day, the patient and attendants having undergone ignominy, humiliation, leave and they don't dare to raise their voice. This will be in 2or3parts,would be long and I hope people have the patience to go through it.
Never get carried away,with

what the intermediary,tells you about the policy,the insurer ,the premium benefit and above all the real facts: #Rule1 never buy your health insurance through your bank, how much ever they hard and soft sell,including the so called tax benefits - tax benefits are automatic. Once

sold ,the bank will wash it's hands off,saying it's the business of the insurer and the bloody agent who sits in the branch gives you a concotion of deceit,conceit and pack of lies, including comparative study report which is bonus tissue paper; secondly if an agent is referred

to you ,your first check point should be how many people he helped out with in overcoming the voluminous paper hassles rather than his success hit rate of policies sold by him - he will talk only of that and make you forget reality. BE MENTALLY PREPARED FOR COPAY: there are

Companies which offers no copay at increased premium, ask them if they'll allow advance release of X amount termed as pre authorization, and, you'll see them squirming. The insurance desk at the hospital will admit you, with a clause, subject to approval,and believe me,this is a

Ploy to get you in, and once you're in there's no way out,without paying up in full, you left holding the shit pot in your hands:once admitted ,whatever the prognosis are,series of tests ,minor ones will begin to happen, this ploy is to make you feel comfortable that the desk is

Perusing your case ,which is a make believe illusion created by the hospital itself. No hospital has morals,they're in business and just that. No business is run on charity- all business is profit oriented; next comes,lets say one is admitted for cardio related angiography is the

beginning of your nightmares - you're mentally prepared for it, you're all set ,but nothing moves ,till you see a well dressed gentle lady, walking up to inform you, approvals are yet to reach, and since procedure has been set up,pay part amount (normally this depends on the size

of the hospital,it's market reputation etc.,) You're assured that the part amount paid IN CASH will be adjusted against the bills to be paid by the insurer and you're stuck in a catch 22 situation - you get your angiography done ,the full bill is added to your room rent plus keep

Adding up, and reports come in, and, if surgery is needed and confirmed, you'll hear them telling you that the insurer has refused authorisation - this is normal as insurer retains his rights ,as per the policy documents which you've never read,because of faith; now the situation

Is grim, surgery is a must, yet insurance is denied and the hospital is after your pound of flesh which they own like shylock. Just remember not everyone is blessed to have a Portia in their lives . Mostly rejections are made because the 1st policy of an insurer is to deny their

commitment , secondly at the insurance desk of the hospital is not qualified for that chair. Insurance asks for doctors support form,which is based on AtoZ clauses of the policy,which no doctor is aware of, and they base their recommendations on their assessment of the patients

needs of the moment. At no point anyone takes care of the needs of the patient - agony/anguish/pain/trauma ,the humiliation caused does not matter to any of them. He/she survives on belief and faith. The attendant is in turmoil and the whole issue is such a ruckus at the end,beg/

borrow the patient is made to suffer. After all these fiasco,the modus operandi changes its face - from grim they offer you a little solace , state that they can go ahead, as the papers are represented and approvals will come - you breathe a sigh of relief ,without realising

You're being suckered into,a larger trap which will come post surgery before discharge: all goes well, the patient is well, bills presented to the insurance for clearance, all set , the gentle lady this time becomes a gentleman, suited and booted will politely present a nice

Excel sheet, filled with fancy numbers and under various heads, informs you insurance has paid up X amount as against the bill amount of Y and you need to pay the small difference between Y-X and this may be few thousands to lacs - but you mentally being prepared ,all you want is

to reach home, and the new bonus shit pot given to you ,is that the difference can be claimed as reimbursement from the insurer ,which is pure shit made of platinum. This folks is the healthcare insurance in India and believe me, even person of Salve's stature can't help you as

All these are a vicious circle called insurance Mafia. They're polite, cordial,sincere all smiles but beneath all these their cruel malefic intentions stay buried,deep. It requires helluva lot of grit to take them on; another ploy used by the insurer is to raise a request for

Advance assurance (part of what's totally needed,as specified by the hospital , quitely,and silently they'll cancel the request made with no information whatsoever - one company which specialises in this ploy is ADITYA BIRLA HEALTH INSURANCE , part of the @AdityaBirlaGrp

Of which @abhealthin is an integral part. I was under the impression that @StarHealthIns was bad - not as bad as the other players. I need to concede that with great humility and being subservient. I need to write about Star raising their bar and about the people who got

Involved , which I'll by a separate thread: #LESSONSTOBEFOLLOWED: never get into an hospital / minor or major without first obtaining details in WRITING FROM THE INSURER before you get in. At the admission point insist on them giving a copy they've received from the insurer. Most

Important don't panic and raise questions for the hospital will raise bills ,beyond what you've agreed to. Cross check at every level. #STAYSAFE_STAYALIVE My experiences in life 3.

@raaga31280 forgot to tag you