Letter To Insurance Company Requesting Coverage: Fill & Download for Free

Yes, they can.In 2003 I was involved in a car accident where I rear-ended another car. Totally my fault as I looked up into the rearview mirror at my 10-year-old (at the time) daughter. The car in front of me had stopped to wait for a chance to make a left turn. I didn't realize this and when I did realize they were stopped, I slammed the brakes and cranked my steering wheel hard to the right to hopefully avoid a collision. Didn't work. I clipped their rear bumper hard at about 20-25 mph.At the time I thought I had auto insurance but they refused coverage, saying they had cancelled my policy a few weeks before unbeknownst to me.So I was on the hook for damages to their beater vehicle and the passengers' ambulance ride and ER bill. Almost $20,000. I was unemployed at the time barely surviving on public assistance and could not afford the bill.Their insurance company went to court for a judgement against me that I wasn't aware of. I had never been served with any court papers.After a few years, I was sent a letter from the Washington State Department of Licensing that my driver's license had been suspended for nonpayment of the judgement against me. To get my license reinstated I had to set up a payment plan with the collection agency of the other driver's insurance company, file an SR-22, and pay the $75 reinstatement fee.17 years later the amount owed has ballooned to over $80,000 and I have given up on ever being able to pay it off.

I have spent few days reading articles, talking to insurance agents, online agencies gathering information to find the right insurance policy for my family. These factors have helped me identify the best one among so many in the market today.Following are some of my key takeaways. Every point also includes the corresponding information from the policy I have chosen for my family.1. MAXIMUM HEALTH COVERAGE - Always prefer a plan that offers maximum health coverage and maximum amount for the treatment. Today, simple heart surgery can cost between 5-10 lakhs which triples if you end up in some suite room of a good hospital. People say go for a lesser cover if you are young, however, the rate at which critical illnesses are detected even among the youth today, it would be prudent to opt for a higher cover.I am 33 and have taken an insurance cover of Rs. 25 L for me and my family. Comes to approximately 2300/- per month.2. FAMILY FLOATER - If you are a family person, it is better to opt for a family floater plan which covers your family. It means, anyone can utilize the total cover during medical treatment.I have opted for a Family Floater.3. NO SUB-LIMITS - Most insurance policies come with sub-limits on per day medical expenses, room rent in case of hospitalization etc. Consider those plans that offer the highest slab on room rent or other health care expenses. For example, the room-rent may be capped at 1 percent of the sum insured or only an AC Room and not suite. So, irrespective of the total sum insured of the policy, one may have to pay out-of-pocket hospital bills unless one sticks to the limit.I have opted for a policy with no cap on room rent. So it doesn’t matter if it’s a suite or AC room or shared.4. RESTORE BENEFIT – This is the most important feature of any insurance policy. A comprehensive health insurance policy usually covers hospitalization expenses up to the total sum insured. Considering the rising health-care costs, it is quite possible that the entire sum insured gets exhausted in a single hospitalization and this is when ‘restore benefit’ in a health insurance feature comes in. Restoration benefit is a feature that reinstates the total sum assured if it is used up in any given policy year. However, the premium for policies with restore benefits is also high.In my policy, there is an instant addition of 100% Basic Sum Insured on complete or partial utilization of existing Policy Sum Insured and No claim bonus (if applicable) during the Policy Year. The Restore Sum Insured can be used for all claims under the Inpatient Benefit.5. NO CLAIM BONUS (NCB) - In case you do not claim, insurance companies provide a bonus by increasing your coverage on renewal. Increase in your coverage is very useful as the medical costs keep rising by almost 15% every year. No-claim bonus typically comes in two different forms.Discount on the premium amount charged for a policyCumulative benefits offered in the form of higher sum insured amountI recommend option 2 as a few rupees discount in yearly premium is hardly even worth the comparison.NCB for my policy which gives me both discount as well as cumulative benefits. Details below:A bonus is applied by enhancing the renewed policy’s Sum Insured by 50% of the Basic Sum Insured of the previous year’s Policy. The maximum bonus will not exceed 100% of the Basic Sum Insured in any Policy Year.A discount is applied at each renewal if the insured member achieves the average step count target on the mobile application provided by us in the specified time interval (calculated from the policy risk start date) as per the grid in the policy document6. INCURRED CLAIM RATIO (ICR) - The ICR metric indicates a general insurer’s ability to pay a claim. For instance, an ICR of 85% implies that the company has spent Rs 85 on claims for every Rs 100 collected as premium. An ideal ICR range recommended by experts is between 60 - 90%, which indicates a healthy settlement of claims by the insurer against the premium collection.My policy provider has an ICR of 62.47 % as per IRDA Annual report for 2017-20187. CO-PAYMENT – Most providers don’t charge anything till the age of 65. After that, it is generally 10-20% of the total bill. I believe that is the age when one would be treated more often and apply for claims. Also, I don’t want the headache of paying anything irrespective of the age.My policy has no co-payment charges at any age.8. HOSPITAL NETWORK - Network listed hospitals are cashless, non-network is reimbursable – Opt for a policy that has the most number of hospitals in its network.My provider has 4500+ network hospitals in Bangalore which is pretty decent. There are other companies which have 8000+ hospitals in their network.9. TYPE OF INSURANCE COMPANIES: There are 2 types of Insurance providers. Standalone and General Insurance companies. Standalone is better than General Insurance providers because of the faster approval process. When a claim request is made – hospitals write a pre-authorization letter to the insurance company for cashless approvals. A general insurance company takes longer time for approvals when compared to standalone companies where the same comes within an hour.My policy is from a standalone health insurance company.10. PRE-EXISTING ILLNESSES – The lesser the waiting period the better.My policy covers them after 3 years.11. BUYING ONLINE vs AGENTS – They say it’s good to have a face associated with the insurance provider and that’s why people recommend taking via agents. However, there is no guarantee that person will be available for you in your time of emergency. With online, you will have all your documents in one place and better customer support through dedicated helplines. Either way, you will be paying the same premium.I bought my policy online through Coverfox for convenience purposes.12. OTHER GOOD TO HAVE FEATURES (my corresponding policy cover detail)Eye cover (Not covered)Pregnancy Cover (Not covered)Dental Cover (Not covered)Health Checkup (Covered)Critical Illness Cover (Not covered)13. GENERAL FEATURES - covered by most policiesDaycare treatments (Covered)Expenses before and after hospitalization (Covered)Daily hospitalization allowance (Covered)Emergency Ambulance expenses (Covered)OPD expenses (Not covered)I hope this analysis is helpful for you to determine the insurance plan that best suits your needs. I don't want to promote any insurance company on a public forum like Quora.———— ——————————————UPDATE23 Dec, 2020- I have not been active on Quora and haven't been able to respond to your Insurance queries.However, Finshots have come up with an easy tool called DITTO to understand your chosen Insurance policy. Do explore, as it will help answer most of your queries.Health Insurance Analysis - understand, compare and review Health insurance | Ditto

The other driver has insurance. That is good. In his insurance policy, under “Conditions” he is contractually obliged to cooperate with his insurance company during a claim. His insurance company cannot pay claims to random people (you), who make claims just because you said he admitted fault, and were in an accident with him. They actually have to verify that it was a driver they insure, that it was a car they insure, and what the accident facts are before they can pay a claim. This is why they need to talk to their insured. This isn’t some sort of delay tactic to make you go away.If their insured does not return calls, or “cooperate” with them, then he is in violation of his policy contract, and his insurance company no longer has an obligation to pay claims on his behalf.What can you do?If you have his name and number, you might call and ask him to call his insurance company so that you can get your car fixed. Sometimes, people don’t realize they are holding up the process.If there is an accident report, get a copy, and send it to his insurance company. Sometimes, they can verify the driver, vehicle, and accident facts based on that, and they will pay the claim. This doesn’t always work, but it can.Request a letter from his insurance company that says they are “denying coverage for non-cooperation” from their insured. Once this is received, you should be able to file an “Un-Insured Motorists claim” on your insurance policy (assuming you pay for that coverage).If you do not have coverage to repair your car thorough your own insurance company, your best course is to document the damage, have it repaired, and then file a Small Claims Court lawsuit against the other guy. This is a fairly simple thing to do, and your city or county website should have step by step instructions on how to do it. By doing this, you will force his insurance company to either step in and pay the claim without his cooperation, or possibly he will suddenly become very cooperative with his insurance company when he has a lawsuit delivered to him. If his Insurance company does not help him, then you will hopefully win the suit, and he will owe you the money directly by a judgement.Good Luck.