Cashless health insurance

            The facility of cashless claims in health insurance tries to remove the problems associated with settling hospital bills and making lump-sum payments for hospitalisation. The facility can be availed of only if the hospital, where the patient is to be treated, figures among the hospitals approved by the insurer. The list of network hospitals can be obtained from the TPA (third-party administrator) either from its website or by calling its toll-free number. The details of TPA are available in the health insurance policy.

Informing the hospital
            The hospital needs to be informed at the time of admission that the patient is covered under cashless health insurance policy and the insurance card needs to be submitted at the admission desk for this purpose.

Pre-authorisation form
            The form is available with the hospital and has to include the approximate hospitalisation cost based on an estimate from the admission desk. If the hospitalisation is planned, it is advisable to finish the pre-authorisation procedure beforehand.

Process
            On receiving the pre-authorisation form, theTPA checks the policy limits, eligibility and riders applicable in order to accept or reject the claim. After approval, the TPA sends an initial authorisation by fax to the hospital.

Settlement
            At the time of discharge, the insured has to sign the discharge form and all the bills and forms, which are sent by the hospital to the TPA for authorisation. If this authorised amount is less than the hospital bill, the difference needs to be paid by the policyholder to the hospital.

Points to note
 

·         Even if a pre-authorisation request is denied by the TPA, the insured can go ahead with treatment, settle the bills and then apply to the insurer for a possible reimbursement.

·         In case of an emergency hospitalisation, the pre-authorisation form has to be faxed to the TPA in the duration specified.

Non-medical bills and expenses not covered must be settled directly by the insured before discharge.

When to exit your mutual fund

Five situations which may warrant redemption of your fund units.

    People spend a lot of time trying to identify the right mutual fund to invest in. While choosing a good scheme is important, knowing when to exit is as crucial. This is because even though you may be holding the right mix of mutual funds at a given point in time, you may want to alter the holding pattern by disposing of some funds in the future. How do you decide when to do this? Here are five situations where you may need to consider getting rid of your investment.

Consistent underperformance

Gross underperformance of any scheme is the first signal for you to consider moving out. However, don’t dump a fund based on the performance over a short span of time. Move out only if it continues to perform poorly over three to four quarters. Remember to compare the scheme’s performance with that of its benchmark or category, not with a fund belonging to another category.

Exit of a capable fund manager

A change in the fund manager should normally not be reason enough to dump your fund. Even if a star manager leaves a fund house, it should not make you press the panic button. Instead, keep a watchful eye on the new fund manager for some time. Track his investment style, churning frequency, stock selection, asset allocation strategy, etc. If you are satisfied with his approach, stay put. If the fund house has a robust investment processes in place, the fund is likely to do well regardless of who is steering it.

Change in scheme attributes   

Investors should typically opt for a fund only if its objectives or investment mandate are aligned with their needs. So if you suddenly find that your fund has deviated from its stated objective or revised its investment mandate, you should consider exiting it. Over time, some fund managers take investment calls that do not match the stated objective of the scheme. If this happens too often, it’s time to get rid of the fund. Besides, whenever there is a change in the fundamental attributes of a scheme, the fund house is required to provide the investors an exit window, wherein those who wish to move out can do so without incurring any exit load.

Achievement of an investing goal

Financial planners advise that you should invest with a goal in mind. Once your investment reaches the targeted amount, you should redeem it. There’s no point in continuing with the investment for you will be exposing your investment to further risk. Don’t get greedy and wait for the fund to go that extra mile.

Rebalancing of the portfolio

Asset allocation is the key to success in investing. It ensures that your portfolio does not deviate from its original path, putting your goals at risk. So if you find that your equity allocation has grown beyond comfortable levels, consider redeeming the funds. A change in life stages would be another reason to change you asset allocation and consider switching to a fund that matches your needs. As you near retirement, you might want to consider more conservative funds.