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Are congenital deformities covered under the insurance policy?

Q: I have a daughter aged 6 years. Since birth, she has a minor deformity in her ear. When I contacted two-three child specialists they said there is no problem and a minor surgery will correct it and also suggested that it should be done at the age of 9-10 years. I want to know whether this surgery can be covered in a Mediclaim policy or not? Please advise me which cash less health insurance policy should I buy for my entire family?

A:Any surgery to rectify congenital defects is not covered under the Mediclaim policy. Cash less service is available with most of the policies in health insurance currently available in the market today. You may choose any such policy, either offered by the private insurers or the PSU insurers, depending upon your requirement of the sum insured and the premium amount that you may want to pay. My advise would be that you should choose the TPA first who will provide you the cash less service and then choose on the insurance company that has empanelled that TPA.


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