Health Insurance Companies क्यों नहीं दे रहीं 100% क्लेम, IBAI Data से हुआ बड़ा खुलासा

Рет қаралды 100,240

Күн бұрын

Health Insurance Claim में हेराफेरी देखी जा रही है. Insurance Broker Association Of India ने साल 2022-23 का डाटा जारी किया है. जिसमें ये खुलासा हुआ है कि इंश्योरेंस कंपनियां 100 फीसदी क्लेम नहीं दे रही हैं, क्या है इसका सच देखें ये खास रिपोर्ट.
#HealthInsuranceClaim #HealthInsurance #MedicalInsurace #InsuranceCompanies
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Пікірлер: 356

@ashishyadav4182 2 ай бұрын

इस पर केंद्रीय वित्त मंत्री श्रीमती निर्मला सीतारमण जी बोल सकती हैं कि " वे स्वास्थ्य बीमा नहीं ली है "।

@Prince_1944 2 ай бұрын

Exactly....😂😂

@S.Singh-fj8ct Ай бұрын

@@ashishyadav4182 वित्त मंत्री का इलाज सरकारी खर्च पर होता है अपने टेंट से कुछ नहीं देना है

@ajeetsinghrathore8076 2 ай бұрын

सरकारों को इस क्षेत्र को नियंत्रित करना चाहिए। फरजी हेल्थ इंश्योरेंस कंपनी और फर्जीवाड़ा करने वाले अस्पताल पर कठोर कार्यवाही हो ।

@amitkumar-im7rp 2 ай бұрын

Government mili hui hoti hai inn companies ke sath sab chor hai

@annAdafc 2 ай бұрын

Ye sali companiya har jagah ghotala,scam,fraud karke ,garibi fools bana ke,unke paise lutate h..inka alag hi gang chal rha h Puri planning se

@IndianBoy77 2 ай бұрын

Mai bhi yahi comment karne wala tha, abhi andva bhakt ayenge gaali dene bhale unka khud ka nuksaan ho lekin sach nahi bolenge

@satyajitrajbanshi3620 2 ай бұрын

@@IndianBoy77yehanpe Andh bhakt ho ya Islam bhakt ho.. Saare govt same hi hai.. Health insurance is a fraud

@mukeshkumarthakur4503 2 ай бұрын

10rs ka cotton 100rs me loot hai

@JaiHanuman9936 Ай бұрын

Cotton 10Rs ka mile ya phir 1000Rs ka ho..ushe customer se koi matlb nhi hona.. insurance company govt aur hospital samjhe apna..

@barejagaurav 2 ай бұрын

honesty is the best policy → applicable to customer only. Company too kuch bhi karegi 😢😢

@tarkeshwarmishra6840 2 ай бұрын

There is a criminal nexus among TPA,MEDICAL INSURANCE CO. and Private Nursing home.If there is cashless claim,then the rate of treatment becomes exorbitant.

@aloks3959 2 ай бұрын

Eye opener. Hope media will indulge in such meaningful issues instead of divisive agenda 😮

@AlokChoudhary-q2k 2 ай бұрын

इंश्योरेंस कंपनी के द्वारा जिन आइटम्स पर क्लेम नहीं दिया जाता है तो उन आइटम्स के बिना बीमारी का इलाज हो सकता है क्या,यदि नहीं और वे आइटम बीमारी के इलाज के लिए ज़रूरी है तो उनका क्लेम दिया जाना चाहिए.

@S.Singh-fj8ct 2 ай бұрын

अस्पताल वाले बिल बढ़ा कर देते हैं। इस धांधली में इंश्योरेंस कंपनी वाले भी शामिल होते हैं अंदर अंदर लेन देन खूब होता है 😅

@RaviGupta-z1z Ай бұрын

Gov ko kewal apna hafta chahiye

@piku.2023 2 ай бұрын

सरकार से निवेदन है सरकारी को इतना अच्छा और बेहतर बना दो कि प्राइवेट वाले ग्राहक का इंतजार करते रहें और मेडिकल इंडस्ट्रीज पर थोड़ा ध्यान दे ताकि जनता का विश्वास बना रहे इस इंडस्ट्री पर

@parulchaduary Ай бұрын

Butbsariari wale doctoro ko tameej ni hoti bat kerne ki sochte h ki vo doctor h to baki wale chutiye h

@ParamYuvraj 2 ай бұрын

रूम रेंट के हिसाब से दवाइयों का दाम कैसे बढ़ जायेगा? डॉक्टर की फीस बढ़ सकती है, उसमे अलग से अटेंडेंट का चार्ज बढ़ सकता है, या अलग से जो सुविधाएं दी जा रही हैं उसका एक्स्ट्रा पैसा बढ़ सकता है। लेकिन दवाई, सुई या ऑपरेशन का दाम कैसे दोगुना तिगुना ही जायेगा? ये तो गलत बात है।

@nitinanizwal2282 2 ай бұрын

Sabhi log best health insurance ka pata karein aur share karein, janta ko hi ek doosre ki help karni padegi kyonki sarkar aur companies toh hume marne pe tuli hui hain

@rajeshmoza6504 2 ай бұрын

My friend is suffering from colon cancer, he is undergoing memo therapy in the shape of tablets and has to shell out 40,000 per month. He had done star insurance for 14.00 lakhs against diseases like cancer, but Insurance company is not reimbursing him the cost of the medicine. This speaks volumes about Health Insurance in India. No reimbursement through Ayushman Bharat. So people with chronic diseases are on their own.

@Iamniyas17 2 ай бұрын

Health insurance normally doesn’t cover medicine costs unless specified in the policy. Policy padke dekhiye if it’s there then you’ll get compensation from the insurer by complaining to IRDAI.

@rajeshmoza6504 2 ай бұрын

@Iamniyas17 What you said are technicalties, which a normal person doesn't understand. This is not just any medicine. This is life saving drug, which is made of cancer cells. These insurance frauds people dont understand. People understand that they pay premium year on year to protect them against chronic diseases.

@Shaelkumar00 2 ай бұрын

Raise this issue in the supreme court.

@RaviGupta-z1z Ай бұрын

They all are the same

@Virus19902 2 ай бұрын

नीलेश sir ने जो बताया ओ सही है , मगर इसमे से 95% insorance कॉम्पाने नहीं मानती,

@varunsaless3171 2 ай бұрын

भाई 150000rs का हेल्थ क्लेम था उसमें से 58000 हजार रुपए कंपनी का रही है कि आपको देने हैं यह है आज की हकीकत मेडिकल क्लेम कंपनियों की और गवर्नमेंट इस पर कोई कार्रवाई नहीं करती

@skggupta9944 2 ай бұрын

Insurance company sarkar ko mota donation deti hai. Isliye sarkar janta ko Marti hai.😢

@NASIRKHAN-mf7pm 2 ай бұрын

Cort jao pakka payment milega

@nagrawal1144 2 ай бұрын

50% give to agent of fast premium of health insurance. In different ways. Cash .traveling abroad etc.

@nishantpandit2487 2 ай бұрын

Hospital se tie up rahega....2 lakh ka bill 4 lakh ka bana do aur 2 lakh patient se lo.... company ko kuch nhi dena

@Dr.RKRanjan 2 ай бұрын

@HP-qx9xw 2 ай бұрын

कहने का अर्थ ये है कि सारी शर्तें गोलमाल है.... ग्रीन शर्ट वाले अंकल के सारे जवाब इसी तरफ इशारा करते हैं😂

@virendrachhabra 2 ай бұрын

Good attempt keep continue, yeh aam aadmi ki samasya hai....

@shashank8189 2 ай бұрын

India, we can't escape lootmaari here....n we want to be a global power like this....

Ай бұрын

5 litter economy

@Ourcomunity1231 2 ай бұрын

Irda is not good for us

@nemichandjain1359 Ай бұрын

धन्यवाद, आदरणीय नीलेश जी, आपने बता तो दिया। क्या उपचार जो बीमा कंपनी अमान्य करती है उनके बिना उपचार सम्भव है। दुसरा मुद्दा मेडिसिन कीम्मत।जेनरीक दवाईयां डॉक्टर लिखते ही नहीं। आपने नितिगत बता दिया।जो व्यावहारिक नहीं - शासन को चाहिए बीमा कम्पनी पर हस्तक्षेप किया जाना आवश्यक है।

@Him2433 2 ай бұрын

Modi hai tho mumkin hai 💯🙌

@balgondapatil Ай бұрын

Ab modi aake tume insurance lene bola kya? 😂 Fobia bahut bimar kar sakta hai get treated under free government scheme

@parulchaduary Ай бұрын

Tere jaise chutiyo ki vjah s ehinmedical ki dukan chal ri h

@RaviGupta-z1z Ай бұрын

Tujh jaise boka log ke karan literate logo ki jan bhi khtre me h@@balgondapatil

@vipulbakade7764 2 ай бұрын

I was shocked to listen that if room rent capping is increased beyond the limit then all the charges including optional cover, medicine etc, gets multiplied accordingly and then the customer gets less claim settlement from insurance company. No body tell us this basics not even agents. I think IRDAI should give all details in their website regarding "ALL IFS AND BUTS" and what will happen if so and so things gets exceed, what will be the impact, then people will carefully read and will take the policy

@rajkumargarg6242 2 ай бұрын

Medicine bill is allowed without deductions

@UmeshKumar-pb4hx Ай бұрын

Agents ko bhi nahi pata hota to kaise batayega....aur agents ko to bas policy sell Krna hota hai

@vikrantverma4772 2 ай бұрын

Neva bupa aur tata health insurance are very genuine companies...ek Paisa nahi dena padega

@barejagaurav 2 ай бұрын

Education and medical, if cost is 10, then profit is 10000 गंदा हैं । धंदा हैं

@chanchoolakumari3055 2 ай бұрын

Ji han ye hmare sath v hua hi

@annAdafc 2 ай бұрын

Ye sali companiya har jagah ghotala,scam,fraud karke ,garibi fools bana ke,unke paise lutate h..inka alag hi gang chal rha h Puri planning se

@JaiHanuman9936 Ай бұрын

Customer should get 100% claim..if there is problem then govt insurance company and hospital should understand among themselves

@ভারতভ্রমন-ম৮গ 4 күн бұрын

Total fraught. My claim amount 93000 pay me 53000. my policy 4 year old. My total amount pay 15000×4 year=60000 pay. Company pay me 53000. company profit 7000+interest My loss 7000+interest

@BirendraKumar-ep8qw 2 ай бұрын

सरकार अभी अमृतकाल में भक्ति में डूबे हुए हैं और स्वर्ग में जगह सुरक्षित करने में लगे हैं, अभी उन्हें फुर्सत नहीं है कि इंसोरेंस वाले कंपनी से जवाबतलब करेंगे😢

@parulchaduary Ай бұрын

To aap kya ker rahe dharne par baito ...ya q bjok rahe court m case q ni dala abhi tak khud to kuch kiya ni aa gye bheemte bhokne ..phle reservation chod reservation mafiya or brabri par h

@BirendraKumar-ep8qw Ай бұрын

मतलब धरने पर नागरिक बैठेगी तभी सरकार के अधिकारी सुनेंगे, फिर इतना पढ़ा लिखा युग होने का कोई मायने नहीं है 🤔 जब भी कोई सिस्टम बनता है उसके रख रखाव और प्रकिया चलाने के नियम बनते हैं जिसे सरकारी अधिकारी जांच तलब करते हैं, ना कि धरना पर बैठने का इंतजाम करते हैं किसी सिस्टम को गतिमान रखने के लिए😮

@SROYAVK 15 күн бұрын

@@parulchaduary bhai jiske sath bitati h. usi ko dard hota h. upar wala aapke sath na kre kbhi esa.

@ashishverma9215 2 ай бұрын

Very insightful

@durgeshkumarsrivastav4003 2 ай бұрын

Informative video sir jee. 👌👌🙏

@mohinderaastropal1240 2 ай бұрын

🙏आदरणीय बुरा ना माने निजी अस्पतालों में health पॉलिसी को देखकर दवा दारू और इलाज का बिल बनाया जाता है l यह देश का सर्वोत्तम दुर्भाग्य है☹️😢❗ सारे देश में चिकित्सा सुविधा एकदम निशुल्क होनी चाहिए🙏, जिससे डोनेशनरूपी डॉ नागरिकों को न लूट सकें जी🙏 l

@Ashishkumar-ce7dl 2 ай бұрын

Jab bhi insurance company se baat kar kar yah kaho ki main IRDA mein complaint karunga to insurance company wale karte hain kar lo Idea mein complaint kya kar lega IRDA

@skeducation9326 2 ай бұрын

Insurance company a business h.isiliye inse bacho

@dr.sushilkumarojha7386 2 ай бұрын

Eye opening video but one thing will be clear to you brother- Medications are not related to room rent catagory means medications are advised as per disease not as per room eligibility catagory like general ward, pvt room, deluxe room , suite room. Thanks

@pandeykuldip 2 ай бұрын

Bahut achhi jankari

@indiantracker6586 Ай бұрын

जिस तरीके से कार का एक्सीडेंट होने में इंश्योरेंस कंपनी से मिल जाता है उसी तरीके से गवर्नमेंट को भी इसमें सिस्टम बनाना चाहिए कि अगर किसी ने इंश्योरेंस लिया है तो उसको इंश्योरेंस मिल जाए

@pramodmani4552 2 ай бұрын

इन्हीं हेल्थ बीमा के वजह से इलाज महंगा हो गया, हॉस्पिटल वाले मन मानी बिल बनाती है, सब मिले हुए रहते है सरकार इस नेटवर्क पे सही काम करे, इंसान बीमारी के वजह से बिक जाता है, हर प्राइस का लिस्ट लगानी चाहिए हॉस्पिटल के बाहर दवा भी दस रुपए का सौ दो सौ ले ते हैं,

@NokeJhok Ай бұрын

Thankyou sir irdai, Sir Neelesh saathe

@daniramsharma5831 27 күн бұрын

Very good information

@satyajitrajbanshi3620 2 ай бұрын

Toh room rent hospital jada lega toh isme patient ka kya galti hai? Overall claim Mein dikkat kyun hona chahiye? Isme patient ka toh koi galti hai hi nahi.. Ab road pe rakhe kya patient ko?... Faltu ka logics Saare medical insurance companies ka😠😡

@akhilpal 2 ай бұрын

निलेश जी ने बताया 80 रुपए जो क्लेम मिल रहा है वह काम नहीं है अरे चाचा एहसान थोड़ी कर रहा है ।

@PresenjeetBodh Ай бұрын

Yes with my mother, there was a claim paid partially , 50% only Ye uncle bahot purani policy bta rahe hai companies aaj ki date me bolkar chalti hai ki consumables items bhi claim degi.

@deepakpatel1524 12 күн бұрын

मेडिक्लेम इंश्योरेंस कंपनी रुपए २५,००० वार्षिक प्रीमियम पे ५ से ७ लाख रुपए का कवर देती है तो कंपनी को सभी तरह के खर्च कम करने के बाद मुनाफा बहुत कम बचता है तो इतनी बड़ी क्लेम कैसे देगी.

@mohdiqbal-of5wz 2 ай бұрын

1 - 2 program or kariye logo ki jankari badhegi

@Ashishkumar-ce7dl 2 ай бұрын

Yah IRDA ki nakamyabi se jyada IRDA ka prabhawhin hona hi hai

@sur66161 2 ай бұрын

Go Digit insurance company is one among this. I got 60 k against 2.71 lakh. More than 50 %cases of consumer forum are against insurance companies taking 4 to 5 years. They do not disclose at time of premium collection.

@chiluxr250 2 ай бұрын

go to court directly cousumer courts are not good.

@faizkhan-dj9ti 2 ай бұрын

I got digit insurance and when it was a time of claim, they rejected my claim and even they cancelled the whole policy. They are a big fraud.

@neerajgupta9202 2 ай бұрын

My Father had a policy with Oriental Health Ins. Since 2012 without any lapse and any claim history, in feb. 2022 he got admitted to Metro hospital Faridabad For Prostate & Stone removal surgery, he had confirmed with the hospital and Oriental ins. Co. As well before getting admitted that he will only have to pay 10% co-pay as per his policy which we fully agreed to pay and is acceptable but is because we had 3 lakh policy at that time with 10% co payment the estimate bill was 1L pre surgery and hospital gave us bill 90 k around at time of discharge with 30% co payment after which Me and my father got shocked, after many efforts we got some discount from the hospital, but still have to pay 35k from our pocket to get discharged, after soughting clarity from the ins. Co. They told us that they increased co-psy from 10 to 30% on modern and advance treatment which they did not bother to update us about and neither did our agent, lastly we have to suffer the immediate monetary burden, we filed our case in consumer forum and it still going on.

@ShahidKhan-mm7mi 2 ай бұрын

Health plan me pahle hi mentioned hota hai.. consumable cover bhi hote hai kuch policies me..

@chandanpal4087 2 ай бұрын

Sbi health insurence, मेरे भाई ने लिया था, बाद मे एक operation हुआ तो, उसके आदमी एक दिन आये और एक पेपर पर sign karwa कर ले गए और claim nhi दिया।। mirzapur up मे ये case हुआ है

@praveenkushwah255 2 ай бұрын

Sabse pehle ek law banana cahiye gvt ko k sabhi health insurance companies ko customer ka Medical check UP karwana hoga Policy lete samay taake customer ki bimari unhe pata chale jo woh Policy form mai bhare taki customer ko sahi claim ki rashi mil paaye

@panwarpangy 2 ай бұрын

Mera to pertinity claim only 30% hua

@mdsulib3 2 ай бұрын

HDFC ERGO paid 20000 against 80000 to me. In June 2024.

@pgtgeogleadguitarist9799 Ай бұрын

ये बीमा कंपनी प्रीमियम से ज्यादा देती ही नही। कुछ कुछ अड़ंगा लड़ देगी।।

@parveenjain8039 2 ай бұрын

कुछ समय बाद निजी स्वास्थ्य बीमा कंपनियों ने पैनल अस्पताल की संख्या कम कर दी

@vijaythapa3064 2 ай бұрын

My parent has HDFC ergo insurance.. Medical non consumables are not covered in policy.. There is rider/ add on pack is available... during policy renew u can add this pack in some amount and during claim they will claim 100% amount...

@sanjibmaity401 Ай бұрын

Health insurance companies ke against me government ko action lena chahiye

@sanjaypriyadarshi 2 ай бұрын

I got 100% in 2021 during peak covid times and my parents cataract operations in 2024 ..one thing I have observed if treatment is from a lesser known hospitals then insurance companies knows that many costs are just added to inflate the final bills and here’s the problems.. corruption is from both side ..

@avinashfulari1832 29 күн бұрын

Ha mere sath bhi aisa hua hai

@risethrive11 2 ай бұрын

Nice information by ndtv

@ajeshturi131 2 ай бұрын

Thank you!

@AmritaTraders 2 ай бұрын

Har company ka yahi haal hai.mai bhee prashaan hu. Recently mere sath bhi hua hai asian hospital me

@rajkumargarg6242 2 ай бұрын

First hospital ask whether covered under insurance and bill is raised according to this, always bill is inflated keeping TPA and hospital margins

@mukeshbharti7841 2 ай бұрын

Full body check up karke ye company Kyun nehi insurance karwati hai.agar kuch problem hai to kuch jyada paisa lo

@kamleshnagrani3126 2 ай бұрын

We can't take rider by adding consumables this is a must

@FarhanKhan-hu7gr 2 ай бұрын

Cash me 45000/- bataye the Hospital ne or Insurance Claim me 1,00,000/- ka bill bana diya jisame se claim pass 75000/- ka hi hua or 25000/- fir bhi bharna pade or ha bar-bar counter ke chakkar lagao wo alag

@ShahidKhan-mm7mi 2 ай бұрын

Room rent ki capping hoti hai...customer ko policy wordings acche se study karni chahiye...hospital are also responsible

@vipulbakade7764 2 ай бұрын

What you are saying is correct, but nobody explains to a customer, if room rent goes beyond the capping then what. I was shocked to listen that if room rent capping increased then all the charges including optional cover, medicine etc, gets multiplied accordingly and then the customer gets less payment from insurance

@AbhijitDas-wo3bp Ай бұрын

One thing I couldn't understand how the bills of Hospitals is proportionally related to room rent.😢

@tirathkashyap7966 2 ай бұрын

Sab mile hue hai, jab pura premium bhara hai to claim bhi pura milna chahiye

@GKS55SKS Ай бұрын

Itna naitanki kya chiz ka kar rahi hai insurance company wale... Full kharcha dena cahiye .. and all and everyone should be covered.. health care is and should must be Right of every citizen.

@sur66161 2 ай бұрын

Nobody asks customers not inform anything.

@vinaygupta5234 Ай бұрын

Why don’t we have a professional regulating body for health sector ? To regulate hospitals and Health insurance as a separate entity…

@amazingstory1983 2 ай бұрын

सभी कंपिनयों के द्वारा ग्राहकों के साथ छल करती है।😮

@79MD 2 ай бұрын

Companies doing UNETHICAL things and assuming that DISHONESTY is NORMAL. Time will pay back..

@parveenjain8039 2 ай бұрын

केयर हेल्थ कंपनी अपने पैनल अस्पतालों को दिन-ब-दिन कम करती जा रही है

@MukeshSharma-ez5ry 24 күн бұрын

Care health insurance company se Maine Bima karvaya tha Abul Kalam de hi nahin Rahi jabki policy meri AU Bank ne banvae thi

@HarishKumar-go2vc 2 ай бұрын

He is hidden agent of insurance companies......

@kundanlal4133 14 күн бұрын

प्राइवेट कंपनी लूट रही है सरकार मुख्य दर्शक बनी है

@prashantfattepur 15 күн бұрын

Blades ke bina operation kaise hoga...... Cotton ke bina treatment kaise hota hai

@arunkumarm18 2 ай бұрын

Please tell about honest health Insurance.

@santunubhaduri5353 2 ай бұрын

Is it better to get reimbursement or go cashless during treatment?

@faltugyan338 2 ай бұрын

Health Insurance INDIA ka sabse bada Fraud hai 🙄🙄🙄🙄🙄🙄🙄🙄🙄🙄🙄🙄🙄🙄

@mdsulib3 2 ай бұрын

No details provided by the HDFC ERGO. Even medicines bills not paid.

@seetindian5771 2 ай бұрын

बीमा मरीज़ों का गैर जरूरी जाँच इलाज भी कर दिया जाता है I

@subhankarkonar4826 2 ай бұрын

Are bhai Medical insurance na la kar Mutual fund me Health emergency ke liya nibesh karma chahiye isse Capital jaldi barega uske sath compounding hoga

@chhanditachakraborty9863 Ай бұрын

হেলথ ইন্সুরেন্স, লাইফ ইন্সুরেন্স গুলির টার্মস এন্ড কন্ডিশন গুলি এমন হওয়া উচিত যাতে সহজেই ক্লেইমার লাভ পেতে পারে ঠিকসময়ে।রিজেক্ট না হয়।

@naveenmarwah1809 Ай бұрын

Sab ko consumer court Jana chaiye ...ya court aar irda mean complaint karna chiye jab 80 % customer bhi chale gaye to jaroor inko akal aa jayege ..warna inke pass to bahane he bahane hi

@neerajpathak14 Ай бұрын

Always buy no room rent capping And please add on consumables

@abcdeggh 2 ай бұрын

No ifs no buts. Claim should be paid if insurance available.

@mixvidios7250 2 ай бұрын

Good vidio

@sidhartha6704 4 күн бұрын

Mera acident hua tha . Care health ka insurance tha mil gaya

@murlidharpahilwani6755 2 ай бұрын

अस्पताल में ये जो अलग से चार्ज होते है वो भी फिक्स नहीं होते है मार्केट से कई गुना ज्यादा रेट लगाते है और वो भी रूम की केटेगरी के हिसाब से कम ज्यादा होता है ये खुलेआम लूट है

@prashantshah1396 2 ай бұрын

In sahab ke jaise employees the IRDAI mein isi liye companies manmaani karti hai aur claims mein cut karti hai aur yeh bolte hain ki logon ko claim ka part policyholder ko pay karna chahiye. Kyon bhai? To log premiums bhi bhare aur claim bhi bhare aur companiyan aise hi profits badhati jaaye aur login ki Jeb aise hi khali hoti jaaye to kya IRDAI ka kaam kya hai? Companies ka profits badhana ki policyholders ko protect karna?