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18-10-2021 10:50 AM
18-10-2021 10:50 AM
We have registered a claim under Health Suraksha policy and amount received is less then claim amount, why has co-pay deducted?
Solved! Go to Solution.
21-10-2021 11:32 AM
21-10-2021 11:32 AM
SolutionThere could be 2 reasons for co-pay deduction in your policy:
1. If you have opted for co-payment at the time of issuance / renewal of the policy. This information is available on the policy Schedule or
2. The city where you were hospitalized maybe different from your city of residence.
If you belong to Tier 1b ,then copay is applicable if treatment is availed in Tier 1a
If your city of residence falls under Tier 2 and treatment was undergone in Tier 1a or Tier 1b, then copay is deducted.
The Tier type is as per your city of residence, details of which should be available in the policy Schedule.
You may refer policy terms and conditions for Tier distribution of regions.
21-10-2021 11:32 AM
21-10-2021 11:32 AM
SolutionThere could be 2 reasons for co-pay deduction in your policy:
1. If you have opted for co-payment at the time of issuance / renewal of the policy. This information is available on the policy Schedule or
2. The city where you were hospitalized maybe different from your city of residence.
If you belong to Tier 1b ,then copay is applicable if treatment is availed in Tier 1a
If your city of residence falls under Tier 2 and treatment was undergone in Tier 1a or Tier 1b, then copay is deducted.
The Tier type is as per your city of residence, details of which should be available in the policy Schedule.
You may refer policy terms and conditions for Tier distribution of regions.