Need to know Difference between Life and Health Insurance

Insurance – In this era of the Covid-19 Pandemic, people are starting to realize the importance of having insurance as protection for you and your family. Currently, there are several very good insurance products in Indonesia, namely health insurance and life insurance. Still confused about insurance products? Let’s see the discussion here.

Difference between Life and Health Insurance

Health and life insurance are two different products. However, there are still many people who think that these two insurance products are the same. However, both are important to provide protection against various risks. Well, for those who are still confused, health insurance and life insurance have 4 important points that distinguish the two.

Risk borne

Health insurance is a product that offers cost coverage when you, as a policyholder, experience health problems such as illness and/or accident. Health insurance issuers will pay for inpatient, outpatient, medication, doctor’s fees, and even surgery based on the policies listed on your insurance policy.

The difference with life insurance is that the insurance issuer will harm you financially, if the policyholder suffers from mental disability, lifelong disability, and even death. The amount of financial coverage will be given to the designated heirs in the insurance agreement and depends on the amount of premium given by the insurance holder.

Based on benefits and goals

The difference between health insurance and life insurance is the benefit and purpose. The benefits and objectives of health insurance are:

Outpatient services, including consultation with general practitioners and specialists, prescription drugs, doctor fees, preventive measures, laboratory fees, drug costs, and other costs. However, insurance issuers usually limit the use of funds each year for policyholders.
Inpatient services, including labor costs, anesthesia fees, operating rooms, hospital fees, emergency services, doctors, and so on. Insurance companies generally have various policies in determining the cost of renting inpatient rooms per day and the classes obtained by customers.
and/or critical illness that is life threatening and should be treated as soon as possible.

Unlike health insurance, life insurance protects the policyholder from such events: Dead, Old Age Savings,
Permanent disability or job loss due to an accident at work, Having health insurance means providing protection to the policyholder, while having life insurance means providing protection to the policyholder to continue to have a source of income.

Payment Policy

The life insurance policy will be paid to the heirs when the customer dies, is permanently disabled, and/or loses his job due to permanent disability. So it can be said that life insurance provides benefits as financial protection for the heirs of the policy holder so that when a disaster occurs, they do not lose their source of income

Meanwhile, in health insurance, the beneficiaries are the people who are insured according to the policy. Usually the insured is also the policy holder himself. Benefits will be obtained when the insured has to undergo medical treatment in a hospital as compensation for costs incurred by the customer.

Policy Claims Stream

In health insurance, to make a policy claim, there are two claim options, namely with a replacement and a cashless system. Both differ in payout. The following is a health insurance claim payment flow.

Replacement system
Participants can freely choose any hospital or clinic.
Participants received medical treatment.
Participants pay medical fees and request the necessary documents to the hospital or clinic.
Participants send claim documents to the insurance company no later than 30 days from the end of maintenance.
The insurance company will process participant claims that have met the requirements and will usually be processed within 7 working days after the documents arrive at the insurance headquarters.

Cashless system

The health insurance payment model is a card so that it requires policyholders to use the card when making transactions at the hospital. Like a debit card, participants only need to swipe the card at the hospital to pay for all services received and medicines redeemed. However, the payout value is limited. Therefore, if the fee is less than the ceiling, the cardholder has to pay the rest in cash to the hospital.

As for life insurance policy claims, to file a policy claim, the policyholder or heir must report this provision. The next stage of filing a life insurance claim.

  • Request a claim form and a doctor’s certificate form from the hospital’s customer service.
  • Complete the claim form and prepare supporting documents such as laboratory results, x-ray results, ctscan and others. Then send it to the insurance issuing company.
  • Insurance issuers verify data and analyze proposed policy claims.
  • If the claim submission is rejected, the insurance company will send a rejection letter to the participant. If the claim is approved, the insurance company makes the claim payment.

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So here’s an article about the difference between Life and Health Insurance. Don’t forget to protect yourself and your family with Life Insurance or Health Insurance. Hopefully the following article can help you, and thank you for your visit.

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