Policy Excess Deductible

[Narayanan Venkateshwaran]

Dear sri Mohan

In IBA group insurance policy ,is there anything stated as above? 

The insured is supposed to bear a portion of claim before balance amount is taken up for reimbursement by TPA as per the above

It is supposed to be a sort of copay. No insured is clear about modalities and percentage of recovery  in the absence of policy copy. 

Would  you be in a position to post a copy of policy document issued by any one bank for benefit of members. 

Meanwhile please clarify the point if you can

Txs and regards

CVNARAYANAN

7Th june 2025

[MOHAN P]

Dear Mr Narayanan Venkiteswaran,

01.IBA Group Medi Insurance base policy issued through National Insurance Company for 2024-25 define about deductible as follows under the policy.

See below:

"2.11 DEDUCTIBLE is a cost sharing requirement under a Health Insurance Policy that provides that the Insurer will 

not be liable for a specified rupee amount in case of Indemnity policies and for a specified number of 

days/hours in case of hospital cash policies which will apply before any benefits are payable by the insurer. 

A deductible does not reduce the sum insured."

What are the eligible amount covered under above policy has been specifically mentioned in the policy Document and except few ineligible  expenses IBA policy covers in full and no deductible applicable there.

02.Where as in few other Health Insurance policies , where the the deductible (also referred to as "excess" or "voluntary deductible") that is the amount , the policyholder, must pay out-of-pocket for medical expenses before your insurance coverage begins. This means the insurance company will only cover the claim amount after you have met the deductible. 

When you receive medical care, you'll initially pay for those expenses out-of-pocket. 

Once your medical expenses exceed the deductible amount, your insurance company will begin paying for the remaining costs. 

Regards

Mohan.P

A copy of Policy issued by National Insurance Company(2024-25) under IBA GMIS to UBI is attached for your ready  reference 

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[Narayanan Venkateshwaran]

Mohanji

Txs a lot for clarification and copy of group policy

Narayanan

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