How Health Insurance is Different from Other Insurances?

Health Insurance provides coverage for medical and surgical expenses incurred from sickness, disease, injury or pays to the care provider. The insurance covers total coverage related to health such as Pre-hospitalization, Post-hospitalization, In Patient hospitalization, Day Care Treatments, Room charge, ICU charges, Health Check-up, Ambulance Cover, Domiciliary hospitalization, Organ Donor cover and more. This insurance is different from all other insurances such as home insurance, fire insurance, theft insurance, travel insurance.

“How health insurance is different from other insurances?” This topic covers the information for this question. Mainly two parties are involved in other insurances such as:

1)  Insurer

Insurer is the one who provides insurance. Generally, insurance company comes in this category.

2)   Insured

Insured, who is covered under certain risk policy example: life, health, travel insurance etc.

Third Party in Health Insurance

While in Health Insurance, there is one more party “The Healthcare Provider”. The provider decides and provides the clearances for medical benefits and expenses claimed by insured to the insurer. In the absence of provider insured losses all benefits. The Healthcare Provider evidences:

• Which type of the health services is used by policy holder or insured?
• How long the medical services are used?
• How much the cost is covered in using medical services?

Let’s discuss Third Party role in Health Insurance by an example:

A person named Sunil met with an accident while going to another place via car and had serious injuries. Sunil was hospitalized for eight days in a XYZ hospital.

He was not worried for paying heavy medical expenses to the hospital at the time of discharge. The reason behind is health insurance. Sunil has covered with health insurance policy earlier.

When he claimed his expenses to the insurer, they (insurer) said Sunil that it will take some time to get processed Sunil’s claim. The reason is that they will inquire the details from Sunil’s healthcare provider (XYZ hospital).

The XYZ in this case is the third party other than Sunil (insured) and insurance company (insurer). Third party i.e. XYZ will provide all the details to the insurer about the services used by Sunil, Duration and Cost of the services. This evidences become the basis for the insurer to clear the claim filed by Sunil.

Want to know more information, click Health Insurance Policy