Root canal treatment covered under IBA medical insurance or not

[T R Kartik]

Dear All,

One of my relatives has undergone Root canal treatment. I want to know if it is covered under IBA medical insurance or not? Can any1 pls provide any leads in this regard?

Thanking You,

Yours,

Kartik

Sender notified by Mailtrack

28/10/23, 13:20:13

[mohan p]

Mr Kartik,

Dental Surgery comes under, Domiciliary Treatment which is covered under IBA GMIS.

Regards,

--
Visit our blog site http:://bankpensioner.blogspot.com
---
You received this message because you are subscribed to the Google Groups "bankpensioner" group.
To unsubscribe from this group and stop receiving emails from it, send an email to bankpensione...@googlegroups.com.
To view this discussion on the web visit https://groups.google.com/d/msgid/bankpensioner/CAM-eYm5%3D_bKbTSpWk_ctVuqZhOc8O%3DUtFkMYwfJK53-1%3DgbkOQ%40mail.gmail.com.

[Kyesraj Raj]

Dental treatment is not covered under any Health Insurance policy.

However, any dental corrective surgery or treatment necessitated 

due to any accident is covered.

[Narayanan Venkateshwaran]

Dental procedures other than that occuring due to accident does not get cover

C V Narayana

--

[KSR]

Dental treatment is not covered under any Health Insurance policy.

However, any dental corrective surgery or treatment necessitated 

due to any accident is covered.

--

[Hans Raj Manuja]

No; it is not covered !

To view this discussion on the web visit https://groups.google.com/d/msgid/bankpensioner/CAMCbyDSVUa7vs5ER%2BCsD7mjyJnmTYQfS2NzH8jk3MxkR03rQqQ%40mail.gmail.com.

[Ramaswamy S]

I trust that ordinary/routine dental surgery for implantation of teeth/tooth comes under cosmetic surgery and not eligible for medi claim.  

However, implantation of tooth/teeth in cases of accident is covered under medi claim policy.

I may be corrected in this regard.

S.RAMASWAMY

To view this discussion on the web visit https://groups.google.com/d/msgid/bankpensioner/CAMCbyDSVUa7vs5ER%2BCsD7mjyJnmTYQfS2NzH8jk3MxkR03rQqQ%40mail.gmail.com.

[vika...@gmail.com]

Respected Sir,

This treatment is treated under and as Day Care Treatment, and please advise whether it covers  under Without Domiciliary Treatment of IBA GMIS ?

=V. K. Sanghvi...

To view this discussion on the web visit https://groups.google.com/d/msgid/bankpensioner/CAMCbyDSVUa7vs5ER%2BCsD7mjyJnmTYQfS2NzH8jk3MxkR03rQqQ%40mail.gmail.com.

[Narayanan Venkateshwaran]

Reimbursement for root canal treatment under IBA POLICY appears bleak for want of specific clause.

Domiciliary by definition is hospitalisation  at home. It may cover Doctors visit, Oxygen cylinder ,Nursing Charges and of course medicine.etc .Root canal treatment is done outside home in a dental clinic and hence possible disallowance. Even root canal treatment done in a Dental Hospital

(NOT DENTAL CLINIC) claiming it as DAY CARE PROCEDURE will not find favour with Insurers Those in the know of things better  can clarify.

C V Narayanan

[Ashok Shrikhande]

DearSir

The clause 4.16 under exclusions state as under

4.16 Dental treatment or surgery of any kind which are done in a dental clinic and those that are
cosmetic in nature.

Similarly the root canal does not fall under disease, accident or ailment.

As such the Root Canal treatment is not covered.

Regards

Ashok Shrikhande

To view this discussion on the web visit https://groups.google.com/d/msgid/bankpensioner/1609390349.101876.1698500251191%40mail.yahoo.com.

[kds nair]

Root Canal treatment and treatment for recovery from accident are covered.

To view this discussion on the web visit https://groups.google.com/d/msgid/bankpensioner/1609390349.101876.1698500251191%40mail.yahoo.com.

[Ashok Shrikhande]

Dear Sir

The clause 4.16 under exclusions state as under

4.16 Dental treatment or surgery of any kind which are done in a dental clinic and those that are
cosmetic in nature.

Similarly the root canal does not fall under disease, accident or ailment.

As such the Root Canal treatment is not covered.

Regards

Ashok Shrikhande

To view this discussion on the web visit https://groups.google.com/d/msgid/bankpensioner/CALP-JsPLeBLG3050gNidTBg_dEayQBBxeAbiazyx6ie4yvGHsw%40mail.gmail.com.

[vika...@gmail.com]

Exclusion clarifies treatment taken in Dental Clinic for RCT is not eligible for reimbursement, but there is one opinion that if such treatment is taken in multispeciality hospital, same is eligible..WILL ANYBODY HAVE OPINION OTHERWISE....

= V. K. SANGHVI

Sent from Yahoo Mail on Android

To view this discussion on the web visit https://groups.google.com/d/msgid/bankpensioner/CAB5i73RAkjy%3DHfdLuftDEVCQ%2B2%2BPvZWw-PhXRFSceQVRDmrxhA%40mail.gmail.com.

[Ashok Shrikhande]

Dear Sanghvi sir

Any treatment of Root canal is not covered as Root canal is not a disease but it is sort of cosmetic in nature. The treatment taken due to an accident in a hospital, dental treatment is covered.

Regards

Ashok

[Narayanan Venkateshwaran]

Dental treatment excepting those arising out of accident is not covered by any insurers except some private players with high premium.

Medi claim cover is for hospitalisation.That way also any treatment in a clinic does not fit the bill

Day care procedure avenue in hospital is also shut as it is for specified items in policy.

As for domiciliary it is virtual hospitalisation at home.

Clinic is not home away home even by remote chance

we argue out the case for root canal

We are helpless and toothless

CVNarayanan 

To view this discussion on the web visit https://groups.google.com/d/msgid/bankpensioner/CAJLsgTfy%2BwNwFutX%2BGo-dxsOX5HXc7F-pr%3Dw5RPScQ%2BGQB9YMw%40mail.gmail.com.

[Rajender Sharma]

Sir,

So far as my knowledge goes,day care treatment requires hospitalization 

though may be less than 24 hours.But dental treatment does not require

such hospitalization and no room is allotted for performing the RCT procedure.

Hence RCT will not qualify for coverage under IBA policy.

R.K.Sharma

[vika...@gmail.com]

Respected All,

I forward herewith one PDF for Award of Ombudsman Office pertaining to Dental Treatment, which is co incidence of our GMIS, ofcourse insurance co. is United India Insurance,, pl. go through the same, though in almost all cases all insurance cos. are declining such cases, but nobody cares for further representations  etc.. any way PDF may be considered for academic knowledge...With kind regards to all..

To view this discussion on the web visit https://groups.google.com/d/msgid/bankpensioner/CAJev%3Da98PNwwJLm41Qy6WtaiyMYu-0CGvgLrD5QTaQJKRK5isg%40mail.gmail.com.