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Posted 12/3/2019

Settling Health Insurance claim from multiple insurers: Here’s some good news for you

The IRDAI recently notified the (Amendment) Regulations, 2019. It has introduced several new provisions.

Here we take a look at two of them and what they mean for the insured persons:

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Facing The Heat: Treatment in pvt hospitals costs much but doesn't matter to those who prefer quality

Posted 7/9/2015

It's official: Treatment in pvt hospitals costs an arm and a leg

Everybody can now acknowledge this fact that private hospitalization is prohibitively costly.

On an average, a private hospital admission would be more than three times as costly than in a government hospital.

In some cases, private hospitals can cost up to 6.5 times more than government ones, and for an obstetrics or neonatal case, 7 times. Childbirth costs 8.5 times more in private hospitals. These findings are part of a latest National Sample Survey Organization survey report.

People go to private hospitals as government ones are few and over crowded. In rural areas, about 58% of all hospitaliza tion cases go to private facilities. This is up from about 56% in 1995-96. In urban areas, 68% cases go to private hospitals, up from 57% twenty years ago, the report says.

About 86% of the rural and 82% of urban population isn't covered by any health expenditure support, whether government funded or private insurance covered. This means that high hospitalization costs would substantially affect a family's budget in a majority of cases as incomes are not very high.

The report found that the main source of meeting hospitalization expenses was savings from income.

In rural areas, a quarter of households borrowed money to meet hospital-related expenditure.

In urban areas too, over 18% people had to borrow to meet hospitalization costs.

Also It has been noted that quality of treatment is often compromised in government managed hospitals as even kids keep waiting for treatments and even many children are turned away daily due to shortage of beds. While government hospitals turn away dozens of children due to unavailability of beds or equipment every day , even those who get admitted are at risk of hospital-acquired infections and poor sanitation in the crowded wards.

When paediatric emergency unit is visited at RML Hospital, it usually swarm with people. Families were eating lunch on patients' beds. “The attendants do not have clean water to drink.They stay in inhuman conditions for their children .

At Kalawati Saran Hospital, one of Asia's biggest health facilities for children, doctors said they always have 5-6 patients for every four beds. During monsoon, when infections are more common, the ratio goes up to two patients to a bed.

“The paediatric emergency and ICU at our hospital has more than 20 beds. But there are less than five ventilators.MRI and echocardiogram tests are not available. Those who can pay are asked to get these tests done outside, the others are sent to G B Pant and RML hospitals,“ said a senior doctor. The hospital also faces acute shortage of nurses. The rule is to have two nurses for each newborn but at Kalawati and most other public hospitals there's just one for 10 patients.

RML has a nursery for children born there and a paediatric emergency block for newborns and infants admitted with different medical conditions from outside.“When the child who died was brought to the hospital, there was no bed available in the newborn ICU (NICU). We could not admit it in the general ward because it does not have ventilator facility or warmers, which are needed to regulate temperature.Newborns can die of hypothermia in an air-conditioned room,“ a doctor at RML said.

“This child's case was highlighted because he was taken to various hospitals in a CATS ambulance. Many poor parents bring their newborns in an autorickshaw or a private vehicle. No one knows how many such children who are refused admission survive,“ said Dr Ajay Gambhir, president of National Neonatology Forum.He said most private nursing homes that deliver babies don't have facilities or medical expertise to take care of ill children. “They refer them to the big hospitals without making enquiries about the availability of beds.“

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10% of Indians prefer AYUSH over allopathy

Posted 7/8/2015

Alternative Curing More Popular With Urban Men

Despite the government's attempt over the years to popularize AYUSH (ayurveda, yoga or naturopathy , unani, siddha and homoeopathy), the people at large are still inclined towards allopathy treatment both in rural and urban India.

The NSSO survey has found higher inclination towards allopathy treatment-around 90%-in both rural and urban areas. Only 5 to 7% usage of `other' type of treatment including AYUSH has been reported both in rural and urban areas.

Interestingly , a higher usage (1.5 percentage point) of AYUSH treatment by urban males than their rural counterparts was noted, while less usage of the same (0.8 percentage point) by urban females as compared to rural females was observed.

The use of allopathy was also most prevalent in treating the hospitalized cases of ailments both in rural and urban settings of the country irrespective of gender. Surprisingly , use of AYUSH for hospitalized treatment in urban areas (0.8% for male and 1.2% for female) was more than rural areas (0.4% for male and 0.3% for female).

Moreover, un-treated spell was higher in rural (both for male and female) than urban.

The relationship between the percentages of untreated spells of ailments and level of living was also revealed. Untreated spell was less in those with usually higher monthly per capital expenditure for both rural and urban sector.

The survey found that private doctors were the most important single source of treatment in both rural and urban areas. More than 70% (72% in rural areas and 79% in urban areas) spells of ailment were treated in the private sector, consisting of private doctors, nursing homes, private hospitals and charitable institutions. The number of people reporting sick is more in urban India compared to rural areas, found the survey .


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Sugary drinks kill 1.84 Lac people every year globally

Posted 7/2/2015

Up Diabetes, Heart Disease, Cancer: Study

Sodas, fruit drinks and other sugary beverages may lead to an estimated 1,84,000 adult deaths each year worldwide from diabetes, heart disease and cancers, researchers, including one of Indian-origin, have found.

“Many countries in the world have a significant number of deaths occurring from a single dietary factor -sugar-sweetened beverages. It should be a global priority to substantially reduce or eliminate sugar-sweetened beverages from the diet,“ said Dariush Mozaffarian, senior author of the study from Tufts University in Boston. In the first detailed global report on the impact of sugar-sweetened beverages, researchers estimated deaths and disabilities from diabetes, heart disease and cancers in 2010.

In this analysis, sugar sweetened beverages were defined as any sugarsweetened sodas, fruit drinks, sports energy drinks, sweetened iced teas, or homemade sugary drinks such as frescas, that contained at least 50 kcal per 8 ounces serving. 100% fruit juice was excluded. Estimates of consumption were made from 62 dietary surveys including 611,971 individuals conducted between 1980 and 2010 across 51 countries, along with data on national availability of sugar in 187 countries and other information.

Based on meta-analysis of other published evidence on health harms of sugar-sweetened beverages, researchers calculated the direct impact on diabetes and obesity-related effects on cardiovascular disease, diabetes and cancer.

Researchers estimate that consumption of sugar-sweetened beverages in 2010 may have been responsible for approximately 133,000 deaths from diabetes, 45,000 deaths from cardiovascular disease, 6,450 deaths from cancer.

“There are no health benefits from sugar-sweetened beverages, and the potential impact of reducing consumption is saving tens of thousands of people every year,“ Mozaffarian said. Of the 20 most populous countries, Mexico had the highest death rate attributable to sugar-sweetened beverages with an estimated 405 deaths per million adults (24,000 total deaths) and the US ranked second with an estimated 125 deaths per million adults (25,000 total deaths). About 76% of the estimated beverage-related deaths occurred in lowor middle-income countries. PTI

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In death, man saves four lives

Posted 6/30/2015

AIIMS' 9th Cadaver Donor This Year Was Killed By A Stroke

A 42-year-old man, who was declared brain dead at a private hospital in Delhi, has become the ninth cadaver donor at AIIMS this year. Institute director Dr M C Misra said the man's heart, liver and two kidneys have been transplanted in the bodies of four recipients, while his corneas have been preserved.

“The patient was admitted to Rockland Hospital in Qutab Institutional Area with complaints of severe headache and pain in the right side of the body on June 23. A sudden haemorrhagic attack left him brain dead,“ said Rajeev Maikhuri, senior organ transplant coordinator, Organ Retrieval Banking Organization at AIIMS. A patient is termed brain dead when he or she has suffered complete and irreversible loss of all brain functions and are clinically and legally dead.

Maikhuri said that that the patient's family agreed to donate his organs when neurosurgeons explained about the condition. “On June 24, the neurosurgeon called up the AIIMS director and informed about the family's decision after which the patient was transferred to Trauma Centre of AIIMS,“ he added.

The 42-year-old man's heart was transplanted into a 48year-old male suffering from dialectic cardiomyopathy , while his kidneys went to two different males. Due to nonavailability of a suitable recipient at AIIMS, his liver was offered to Institute of Liver and Biliary Sciences and transplanted into a 54-year-old man suffering from acute and chronic liver failure. “His corneas have been preserved at AIIMS eye bank for future use,“ he added.

Aarti Vij, chief of ORBO, said cadaver donation in India have improved significantly from the past but a great deal needs to be done to ensure more people come forward to donate.

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Top Ramen follows Maggi off the shelves

Posted 6/30/2015

The noodle industry in India has found itself tied up in knots again after the central food safety regulator on Monday ordered Japanese firm Indo Nissin to withdraw its Top Ramen brand from the market.

This comes at a time when the Indian food industry has hit the panic button with multinationals having to withdraw popular products due to food safety and regulatory issues. Earlier this month, Swiss food giant Nestle had recalled around 30,000 tonnes of its instant noodles brand Maggi due to excess lead content and mislabelling of monosodium glutamate content on its packs.

Subsequently , Hindustan Unilever withdrew and stopped production of its Chinese range of Knorr instant noodles because of pending product approval with FSSAI. American cafe chain Starbucks stopped using certain ingredients in its products not approved by the regulator. Indo Nissin's product approval for Top Ramen is pending with FSSAI, according to Gautam Sharma, MD, Indo Nissin Foods, the Indian arm of Japan's instant noodle maker Nissin Foods Holding.

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HEALTH CONCERN : Chemicals in pastes too have ill-effects

Posted 6/25/2015

28-Nation Study Flags Common Drugs, Chemicals

A staggering range of commonly used chemicals  from insecti cides to plastic additives to some common medications  used even in very low quantities are likely to cause cancer.

This was the conclusion reached by a massive study involving 174 scientists from 28 countries -including In dia --who researched the chemical actions of these chemicals. The study says that it is possible the combined effect of many of these working simulta neously may further enhance the risk of cancers developing.

This is the first study of its kind that investigated cancer causing pathways of common chemicals otherwise not known to be carcinogenic, that is, cancer causing. The researchers investigated 85 chemicals for their effect on 11 essential features that define cancer. Of them, 50 were found to have a low dose effect on cancer causing features, called `hallmarks of cancer'.

Another 13 had a threshold dose beyond which they started having cancer generating effects. Put together, these dangerous made up nearly three quarters (74%) of the chemicals studied. The remaining 22 chemicals were not found to have any known effects. Some commonly used chemicals discovered to have potential to cause cancer include popular insecticides, fungicides, pesticides, additives to plastic, PVC and polycarbonate products like food containers and water bottles, biocides used in hand washes and cosmetics, some commonly used drugs like phenobarbital and acetaminophen, flame retardants used in paints, construction material, aircraft, and stain repellants used in fabrics and carpets.

The research only shows that there is a possibility that these chemicals may cause cancer once accumulated in the body , Yasaei clarified.

“We are not claiming that these compounds listed in this review are causing cancer. We are hypothesizing that they may have the possibility to initiate cancer when aggregated in the body at low doses,“ he stressed.
Many of these chemicals like BPA (used in plastics) or triclosan, used in toothpastes, are known to have other ill-effects. But their cancer causing potential has come as a surprise to many .The study investigated the chemicals by checking out previous research on how they behave in relation to the so-called hallmarks of cancer, which include the ability of cancer cells to multiply indefinitely , resist aging, creating disturbance in metabolism, developing genetic mutations, and others.

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Doctors say tight clothes can cause numbness

Posted 6/24/2015

Tight-fitting jeans led to a 35-year-old woman in Australia being hospitalized after she was found sprawled on the ground and unable to walk because of numbness in her feet. Experts in Delhi warned such cases couldn't be ruled out in the city.

Doctors reported that her calves were so swollen that her jeans had to be cut off. She couldn't move her ankles or toes, and had lost feeling in her lower legs. The case was cited in a study , published in the Journal of Neurology , Neurosurgery and Psychiatry , that highlights the dangers of what's become a fashion staple among the young -skinny jeans. Doctors say squatting in skinny jeans can restrict blood supply to nerves and muscles in the lower leg, leading to swelling, impaired sensation and difficulty in walking. In the hours before the woman fell, she had been helping a family member move house.It involved prolonged squatting to empty the cupboards while wearing skinny jeans. She was put on an intravenous drip and could walk again only after four days.

“The condition could have been caused due to prolonged compression of the muscle and nerve fibres in lower legs while squatting, which her tight jeans had made worse,“ said experts in the study .

“The jeans had prompted the development of compartment syndrome--reduced blood supply to the leg muscles, causing swelling of the muscles and compression of the adjacent nerves,“ the study added.

TOI spoke to neurologists in Delhi who said they had come across instances of momentary sensation loss and numbness in people wearing tight clothes but the Australian woman's case represented a new neurological complication.

“Jeans are made of tight fabric that restrict blood flow. On squatting, it exerts extra pressure on the nerves and muscles.People should avoid wearing such clothes if it causes discomfort. Fashion comes later,“ said a senior doctor.

Previous studies have also linked tight jeans with increased risk of fungal infections, bladder weakness and urinary tract infections.

“I have been wearing jeans for years but never faced such problem. Nonetheless, given this report I would be extra careful about wearing tight-fitting clothes. This is shocking,“ said Geetanjali Sharma, a student.

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New Post Title

Posted 7/28/2014

Have you sufficiently covered your FAMILY with adequate MEDICAL HEALTH COVER...?

Are you ready to face sudden un-foreseen MEDICAL cost that you may have to incur on providing QUALITY HEALTH TREATMENT to your loved on ?

Never rely on your employer provided cover.... Be ready with your personal MEDICAL PLAN...

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Health policy claim can't be rejected for delay in lodging

Posted 7/8/2014

The stipulation to lodge a claim within 30 days of discharge is not mandatory but to facilitate expeditious settlement

Insurance companies take their own time to process claims, ignoring the time frame stipulated under the Protection of Policyholders Interest Regulations. But when there is a delay on the part of the insured in making the claim, the insurance company promptly rejects the claim for not having been lodged in time. This is unfair and detrimental to consumer interest.

Claim cannot be rejected for failure to intimate hospitalization in a medical em ergency . Consumer forum directs recovery of compensation from erring officials Background: A mediclaim policy requires intimating the insurance company or the TPA about a hospitalization. But during an emergency, the priority is to get the patient admitted.

In such a case, the company attempts to capitalize on the non-intimation. This is not permissible, held the South Mumbai District Consumer Forum in the case of Consumer Welfare Association & Anr v/s United India Insurance Co & Anr.

The claim was rejected on the sole ground that it had not been lodged within one month of discharge from the hospital but after a delay of 17 days.

Alleging the rejection of the claim was not justified and constituted a deficiency in service, Rita filed a complaint before the Additional Consumer Forum for Mumbai Suburban District against Health India TPA Services as well as New India Assurance.

The TPA did not care to appear, but the insurance company contested the complaint. It argued the terms of the insurance contract provided that a claim must be lodged within 30 days, and since Rita had not done so, she had forfeited her right to make a claim.

The Forum observed the delay of 17 days caused due to weakness and Rita's health condition could be condoned. The stipulation to lodge a claim within 30 days of discharge is not mandatory but to facilitate expeditious settlement. So this clause cannot be used against the insured to repudiate the claim. The Forum relied on the decisions of the Maharashtra State Commission in the case of New India Assurance versus Nanasaheb Jadhav, and also of the National Commission in the case of State of Maharashtra versus ICICI Lombard, where it was observed that the claim should not be rejected on the basis of such technicalities.

The Forum concluded the claim was payable. The TPA and the insurance company were jointly and severally directed to pay Rita Rs 1.27 lakh along with 10 per cent interest from the date of filing the complaint. Additionally Rs 10,000 was awarded towards compensation for mental harassment and Rs 5,000 as costs.

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