I have doubt in the medical claim: Whether medical insurance is different from Medical Reimbursement?
For example: I incurred the expenditure 50000/-to my parents
whether i can claim from my company or i have to claim from insurance company
or company reimbusement 15000/- only for the year
please suggest me
Regards
Hari

From India, Hyderabad
Dear Hari,
Medical Reimburesement is different from Medical Insurance.
Medical insurance is that your company has done from any Insurance company and you will be allouted a specific medical limit that you can use in the whole year.
Medical reimburesement is when you had a medical claim you got treatment from a hospital that is not on the panel of your Insurance company then you will submitt the medical claim and the insurance company will pay you the amount equivelent to your expenditures.
While if you go to the panle hospital under the Insurance company then you will have to spend nothing and insurance company will directly pay to the hospital where you were under treatment.
Best of luck
Regards
Asma Bano


hi Asman Bano for example: my father got operation and i incurred 60000 for his treatment, whether i can claim 60,000+15000 as reimbursement expenses Please suggest me Regards Harinath A
From India, Hyderabad
No you didn't understand my point. I said for a specific medical limit provided to you. If this limit in your company is just 15,000/- that is very very minimal amount for medical thatshould not be, you will only be reimbursed 15,000/- by the company and the remaining amount will have to be borne by you.
For Example:
I am insured from an insurance company and my insurance limit is 2.5K per year and my room limit is 1500k.
In case of panel hospital i will be reimbursed nothing all the expense amount like 60,000 you said will be reimbursed to the hospital.
In case of non panel hospital, all this expenditure amount will be reimbursed to you only 60,000/- from this 2.50k.
it is not like 2.5k+60,000
it is 250,000-60000
Best Regards


Dear Hari,
Most of the company provides the medical insurance facility to their employees. Under which , it depends upon the company's agreement with the insurance company that What would be the limit of sum assured for the different employees because all employees are comes under different grades of the company.
Higher grade the higher sum assured limit ( Pls see the co. policy)
accordingly, If you incurred Rs 60000/- for your father, Just check what is your limit to be reimbursed. Submit a claim form along with all the supporting docs to HR ( for supporting docs, cont. your HR)
And, there might be some expenses which are not covered under the policy, then those expenses would not be reimbursed.
So, if your limit is 15000/- ( which is a very low & unexpectable limit) then you may get the reimbursement of the said amount only.
For good understanding, Just contact with your HR.
Best Regards
Haider Abbas


Hi,

The term medical reimbusement & medical insurance is two different meaning. Medical reimbursement can be part of you salary negotiations part. It will be paid by your organisation. As per IT act Rs.15,000/- per year is allowed as tax free medical reimbursement. But it depends on your organisation policy.

Secondly medical insurance is welfare measure provided by your organisation. Generally this facility is provided to those employee who are out of ESIC coverage. In this orgainasation contact to any insurance agency & decides premium amount. At that time it is also decided by management wether youy immediate family(i.e.spouce & children) will also be covered. Depends on management policy. For each individual employee & his family sum will assured for expenses. When you or your family member is hospitalised due to illness either cashless benefit will be provided by hospital or you have to paid the bill & give it in your organisation for reimbursement. It is restricted only up to your sum assured. If you have sum assured of Rs.20000/- insurace will check the claim paper & after verfication if any deduction is there from there part, they will send the cheque to your orgainsation & your organisation will reimburse to you.

Medical reimbusement facility will also be provided for those employees also who's names are in the mediclaim. This will depend on your management decision.

Regards

Vinay

9850062122


Hi Abbas, Can I claim the medical insurance for cosmetic surgery or we shuld claim medical insurance only if we have some serious health realted problems.
From India
Hi
My organization gives me a family cover of Rs. 1 lac, which includes pregnancy cover as well (Reliance Mediclaim). Recently my wife suffered from a pregnancy-related complication and had to be briefly hospitalized. The total bill for the same came to approx 9k.
Should I claim this amount via mediclaim or is this reimbursable by my organization under any law? I have been told that one should not claim under Rs. 15k..is that true?
Need urgent help as I need to put my papers for processing.

From India, Faridabad
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