Tax Planning (GST-Practitioner)

We are one of the leading Tax Return Preparer and GST Practioner (appointed and authorised) by the Govt of India’s Income Tax Department.
Hi, in our tax experts section we indulge in filing and liasoning work of Income Tax Returns, GST etc. We have a team of qualified Tax experts, comprises of qualified Chartered Accountants and Tax Return Preparer’s(TRP) authorized by Income Tax Department(Govt. of India). Our experts provide you one window service related to all kinds of Income Tax, GST related all works. We have strongly bonded and tie-ups with so many multinational companies, Govt department’s, Hospital for doctors for assisting their tax-related queries and helped them to filing E-Returns and other tax related works. We assure and committed the best services all the time. We provide you best Tax-Planning advice and consultation, and help to prevent from any unforeseen concern from Income Tax and related departments.

GOODS AND SERVICES TAX – AN OVERVIEW

Benefits

1. GST is a win-win situation for the entire country. It brings benefits to all the stakeholders of industry, government and the consumer. It will lower the cost of goods and services give a boost to the economy and make the products and services globally competitive. GST aims to make India a common market with common tax rates and procedures and remove the economic barriers thus paving the way for an integrated economy at the national level. By subsuming most of the Central and State taxes into a single tax and by allowing a set-off of prior-stage taxes for the transactions across the entire value chain, it would mitigate the ill effects of cascading, improve competitiveness and improve liquidity of the businesses. GST is a destination based tax. It follows a multi-stage collection mechanism. In this, tax is collected at every stage and the credit of tax paid at the previous stage is available as a set off at the next stage of transaction. This shifts the tax incidence near to the consumer and benefits the industry through better cash flows and better working capital management.

2. GST is largely technology driven. It will reduce the human interface to a great extent and this would lead to speedy decisions.

3. GST will give a major boost to the ‘Make in India’ initiative of the Government of India by making goods and services produced in India competitive in the National as well as International market. Also all imported goods will be charged integrated tax (IGST) which is equivalent to Central GST + State GST. This will bring equality with taxation on local products.

4. Under the GST regime, exports will be zero-rated in entirety unlike the present system where refund of some taxes may not take place due to fragmented nature of indirect taxes between the Centre and the States. This will boost Indian exports in the international market thus improving the balance of payments position. Exporters with clean track record will be rewarded by getting immediate refund of 90% of their claims arising on account of exports, within seven days.

5. GST is expected to bring buoyancy to the Government Revenue by widening the tax base and improving the taxpayer compliance. GST is likely improving India’s ranking in the Ease of Doing Business Index and is estimated to increase the GDP growth by 1.5 to 2%.

6. GST will bring more transparency to indirect tax laws. Since the whole supply chain will be taxed at every stage with credit of taxes paid at the previous stage being available for set off at the next stage of supply, the economics and tax value of supplies will be easily distinguishable. This will help the industry to take credit and the government to verify the correctness of taxes paid and the consumer to know the exact amount of taxes paid.

7. The taxpayers would not be required to maintain records and show compliance with a myriad of indirect tax laws of the Central Government and the State Governments like Central Excise, Service Tax, VAT, Central Sales Tax, Octroi, Entry Tax, Luxury Tax, Entertainment Tax, etc. They would only need to maintain records and show compliance in respect of Central Goods and Services Tax Act and State (or Union Territory) Goods and Services Tax Act for all intra-State supplies (which are almost identical laws) and with Integrated Goods and Services Tax for all inter-State supplies (which also has most of its basic features derived from the CGST and the SGST Act).

Salient Features of GST

The salient features of GST are as under:

(i) The GST would be applicable on the supply of goods or services as against the present concept of tax on the manufacture or sale of goods or provision of services. It would be a destination based consumption tax. This means that tax would accrue to the State or the Union Territory where the consumption takes place. It would be a dual GST with the Centre and States simultaneously levying tax on a common tax base. The GST to be levied by the Centre on intra-State supply of goods or services would be called the Central tax (CGST) and that to be levied by the States including Union territories with legislature/Union Territories without legislature would be called the State tax (SGST)/ Union territory tax (UTGST) respectively.

(ii) The GST would apply to all goods other than alcoholic liquor for human consumption and five petroleum products, viz. petroleum crude, motor spirit (petrol), high speed diesel, natural gas and aviation turbine fuel. It would apply to all services barring a few to be specified. The GST would replace the following taxes currently levied and collected by the Centre:

• Central Excise Duty
• Duties of Excise (Medicinal and Toilet Preparations)
• Additional Duties of Excise (Goods of Special Importance)
• Additional Duties of Excise (Textiles and Textile Products)
• Additional Duties of Customs (commonly known as CVD)
• Special Additional Duty of Customs (SAD)
• Service Tax
• Central Surcharges and Cesses so far as they relate to supply of goods and services

(iii) State taxes that would be subsumed under the GST are:

• State VAT
• Central Sales Tax
• Luxury Tax
• Entry Tax (all forms)
• Entertainment and Amusement Tax (except when levied by the local bodies)
• Taxes on advertisements
• Purchase Tax
• Taxes on lotteries, betting and gambling
• State Surcharges and Cesses so far as they relate to supply of goods and services

(iv) The list of exempted goods and services would be common for the Centre and the States.

(v) Threshold Exemption: Taxpayers with an aggregate turnover in a financial year up to Rs.20 lakhs would be exempt from tax. Aggregate turnover shall be computed on all India bases. For eleven Special Category States, like those in the North-East and the hilly States, the exemption threshold shall be Rest. 10 lakhs. All taxpayers eligible for threshold exemption will have the option of paying tax with input tax credit (ITC) benefits. Taxpayers making inter-State supplies or paying tax on reverse charge basis shall not be eligible for threshold exemption.

(vi) Composition levy: Small taxpayers with an aggregate turnover in a financial year up to Rest. 50 lakhs shall be eligible for composition levy. Under the scheme, a taxpayer shall pay tax as a percentage of his turnover during the year without the benefit of ITC. The rate of tax for CGST and SGST/UTGST each shall not exceed

• 2.5% in case of restaurants etc.
• 1% of the turnover in a state/ UT in case of a manufacturer
• 0.5% of the turnover in state/UT in case of other suppliers.

A taxpayer opting for composition levy shall not collect any tax from his customers nor shall he be entitled to claim any input tax credit. The composition scheme is optional. Taxpayers making inter-State supplies shall not be eligible for composition scheme. The government, may, on the recommendation of GST Council, increase the threshold for the scheme to up to rupees one crore.

(vii) An Integrated tax (IGST) would be levied and collected by the Centre on inter- State supply of goods and services. Accounts would be settled periodically between the Centre and the States to ensure that the SGST/UTGST portion of IGST is transferred to the Destination State where the goods or services are eventually consumed.

(viii) Use of Input Tax Credit: Taxpayers shall be allowed to take credit of taxes paid on inputs (input tax credit) and utilize the same for payment of output tax. However, no input tax credit on account of CGST shall be utilized towards payment of SGST/UTGST and vice versa. The credit of IGST would be permitted to be utilized for payment of IGST, CGST and SGST/UTGST in that order.

(ix) HSN (Harmonised System of Nomenclature) code shall be used for classifying the goods under the GST regime. Taxpayers whose turnover is above Rs. 1.5 crore but below Rs. 5 crore shall use 2-digit code and the taxpayers whose turnover is Rs. 5 crore and above shall use 4-digit code. Taxpayers whose turnover is below Rs. 1.5 crore are not required to mention HSN Code in their invoices.

(x) Exports and supplies to SEZ shall be treated as zero-rated supplies. The exporter shall have an option to either pay output tax and claim its refund or export under bond without tax and claim refund of Input Tax Credit.

(xi) Import of goods and services would be treated as inter-State supplies and would be subject to IGST in addition to the applicable customs duties. The IGST paid shall be available as ITC for further transactions.

GST Council

The mechanism of GST Council would ensure harmonization on different aspects of GST between the Centre and the States as well as among States. It has been specifically provided that the GST Council, in its discharge of various functions, shall be guided by the need for a harmonized structure of GST and for the development of a harmonized national market for goods and services. The GST Council shall establish a mechanism to adjudicate disputes arising out of its recommendation or implementation thereof.

Minimal Interface

The physical interface between the taxpayer and the tax authorities would be minimal under GST. Certain important provisions in this regard are illustrated as under:
a. There will be cross-empowerment of officers belonging to Central and State Governments. Officer of CGST will be empowered to act as proper officer of SGST and vice versa.
b. Registration will be granted on line and shall be deemed to have been granted if no deficiency is communicated to the applicant within 3 common working days by the tax administration which has been allotted the examination of the application. Such allotment is to be done one each alternately between the Central and the State Tax administration.
c. Taxable person shall himself assess the taxes payable (self-assessment) and credit it to the account of the Government. The return filed by the tax payer would be treated as self-assessed.
d. Payment of tax shall be made electronically through internet banking, or also through credit card and through the modes of Real Time Gross Settlement (RTGS) or National Electronic Funds Transfer (NEFT). Smaller taxpayers shall be allowed to pay tax over the bank counter. All challans for payment of tax shall be generated online on the Goods and Services Tax Network (GSTN).
e. The taxpayer shall furnish the details of outward supplies electronically without any physical interface with the tax authorities. Inward supply details would be auto-drafted from the supply details filed by the corresponding suppliers.
f. Taxpayers shall file, electronically, monthly returns of outward and inward supplies, ITC availed, tax payable, tax paid and other prescribed particulars. Composition taxpayers shall file, electronically, quarterly returns. Omission/incorrect particulars can be self-rectified before the last date of filing of return for the month of September of the following year or the actual date of filing of annual return, whichever is earlier.
g. For mismatched invoices, reversal and reclaim of input tax credit shall be done electronically on the GSTN portal without any tax payer contact. This electronic system would also prevent, inter alia, input tax credit being taken on the basis of fake invoices or twice on the same invoice.
h. Taxpayers shall be allowed to keep and maintain accounts and other records in electronic form.

Input tax credit

Taxpayer is allowed to take credit of taxes paid on inputs (input tax credit), as self-assessed, in his return. Taxpayer can take credit of taxes paid on all goods and services, other than a few items in the negative list, and utilize the same for payment of output tax. Credit of taxes paid on inputs can be taken where the inputs are used for business purposes or for making taxable supplies. Full input tax credit shall be allowed on capital goods on its receipt as against the current Central Government and many State Government practice of staggering the credit in more than one installment. Unutilized input tax credit can be carried forward. The facility of distribution of input tax credit for services amongst group companies has been provided for through the mechanism of Input Service Distributor (ISD).

Refund

Time limit for claiming online refund has been increased from one year to two years. Refund shall be granted within 60 days from the date of receipt of complete application. Interest is payable if refund is not sanctioned within the stipulated period of 60 days. If the refund claim is less than Rs. 2 lakhs, there is no need for the claimant to furnish any documentary evidence to prove that he has not passed on the incidence of tax to any other person. Only a self-certification to this effect would suffice. Refund of input tax credit shall be allowed in case of exports or where the credit accumulation is on account of inverted duty structure (i.e. where the tax rate on output is higher than that on inputs).

Demands

A new concept of sunset clause for tax disputes has been introduced. It provides that Adjudication Order shall be issued within 3 years of filing of annual return in normal cases and the time limit is 5 years (from the date of filing of annual return) in fraud/suppression cases. SCN will have to be issued at least 3 months prior to the time limit prescribed for issue of adjudication order in normal cases and at least 6 months prior to the time limit prescribed for issue of adjudication order in cases involving fraud/suppression etc. Penalty is Nil or minimal if the tax short paid / non-paid is deposited along with interest at the stage of audit/investigation.

Alternate Dispute Resolution mechanism – Advance Rulings

Advance ruling mechanism has been continued under the GST law. The salient features are as under:
a. Advance ruling can be sought in respect of more subjects than allowed at present. The subjects are: classification of goods/or services, time and value of supply, rate of tax, admissibility of input tax credit, liability to pay tax, liability to take registration and whether a particular transaction amounts to a supply under GST law.

b. Advance ruling can be sought not only for new activities but also for existing activities. The facility of appeal, which is not there under the Central law, has been provided in the GST Law.

c. The applicants or the Department, if aggrieved by the advance ruling, would henceforth get the opportunity to file an appeal before the Appellate Authority for revision of the ruling. Advance Ruling can be obtained more easily as there will be one Advance Ruling Authority (as also the Appellate Authority) in every State.

Other provisions of GST

The provisions worth mentioning here are:
(i) Valuation of goods shall be done on the basis of transaction value i.e. the invoice price, which is the current practice under the Central Excise and Customs Laws. Taxpayers are allowed to issue supplementary or revised invoice in respect of a supply made earlier.

(ii) New modes of payment of tax are being introduced, viz. through credit and debit cards, National Electronic Fund Transfer (NEFT) and Real Time Gross Settlement (RTGS).

(iii) E-Commerce companies are required to collect tax at source in relation to any supplies made through their online platforms, under fulfillment model, at the rate notified by the Government.

(iv) An anti-profiteering measure has been incorporated in the GST law to ensure that any benefits on account of reduction in tax rates results in commensurate reduction in prices of such goods/services.

IT Preparedness

Putting in place a robust IT network is an absolute must for implementation of GST. A Special Purpose Vehicle called the GSTN has been set up to cater to the needs of GST. The GSTN shall provide a shared IT infrastructure and services to Central and State Governments, taxpayers and other stakeholders for implementation of GST. The functions of the GSTN would, inter alia, include:
(i) Facilitating Registration
(ii) Forwarding the returns to Central and State authorities
(iii) Computation and settlement of IGST
(iv) Matching of tax payment details with banking network
(v) Providing various MIS reports to the Central and the State Governments based on the taxpayer return information
(vi) Providing analysis of taxpayers’ profile
(vii) Running the matching engine for matching, reversal and reclaim of input tax credit. The target date for introduction of GST is 1st July, 2017.

The GSTN will also make available standard software for small traders to keep their accounts in that, so that straight away it can be uploaded as their monthly returns on GSTN website. This will make compliance easier for small traders.

Here are some of the tax advantages that Income Tax laws provide to the housing sector:

• You, as a tax payer, get a deduction towards interest up to Rs. 2 Lacs on loan for a self-occupied property per FY.

• You get to deduct even the principal (up to Rs 1.5 Lac) under Section 80(C) for a self-occupied property.

• If you have a second house and if it is a let-out property, you can deduct the full interest (NO LIMIT!) from your rental income. You also get to claim deduction towards municipal taxes paid during the relevant FY and a flat deduction of 30% of the annual value towards repairs.

• The loss, if any, from the house property after considering the aforesaid deductions can be offset against income in any other head of the current FY. In other business you can deduct interest against income made from that business and not against your salary or income from capital gains. In short-term trading of shares, any losses made can’t be used to offset your salary. But for the loss from house property, such is not the case.

• The loss, if any, which cannot be set off against the current FY’s income can be carried forward to subsequent FYs subject to a maximum of eight FY’s for set off against the income from house property of subsequent FYs.

• Capital gains that you make when selling the house can be exempted from tax by buying another house if they are long term capital gains.

• If you make capital gains by selling other capital assets like shares, government bonds and/or gold, you can buy a residential property with the sale proceeds and need not pay the tax on your capital gains if they are long term capital gains.

• Any property which is given out on rent for a minimum period of 300 days in the previous year is not considered as an asset. Such a property i.e. let out for 300 or more days, is excluded from net wealth and not subject to wealth tax as per the prescribed provisions of the wealth tax law.

We closely associated with the Named Builders which includes Tata Housing, Sobha ,Godrej Properties, Raheja, Chintels etc.
In local Delhi, we into the properties of Rohtak Road, Pitampura and Rohini which comprises of Society flats, plots , and Independent floors as well.

We have good comprises,Team of Professional Interior Designer’s and Vastu Consultant’s which strongly will give their recommendation’s and consultation for the dream’s home with very nominal charges compare to Real Estate market’s scenario.

Lorem ipsum dolor sit amet, consectetur adipiscing elit. Suspendisse dignissim, mi ullamcorper gravida euismod, dui neque congue magna, non tristique velit nibh pellentesque enim. Aenean pellentesque nisl ac mi dapibus mattis. Phasellus facilisis sit amet purus nec tempor. Quisque convallis turpis ut orci euismod, quis imperdiet urna pulvinar. Proin facilisis

vulputate accumsan. Aliquam porttitor vitae tortor at suscipit. Cras dignissim dictum vulputate. Suspendisse potenti. Fusce est sem, suscipit ac nibh a, maximus tempus turpis. In commodo leo et purus tincidunt, a sollicitudin eros feugiat. Ut ac neque ac lorem sollicitudin feugiat. Donec metus turpis, sagittis eu nunc nec, euismod elementum ligula. Duis egestas felis ligula, et mollis libero varius quis. Aenean lorem lacus, molestie vel elit ut, molestie accumsan dolor. Aenean semper vitae dui at finibus.

Importance of Health Insurance

Lorem ipsum dolor sit amet, consectetur adipiscing elit. Suspendisse dignissim, mi ullamcorper gravida euismod, dui neque congue magna, non tristique velit nibh pellentesque enim. Aenean pellentesque nisl ac mi dapibus mattis. Phasellus facilisis sit amet purus nec tempor. Quisque convallis turpis ut orci euismod, quis imperdiet urna pulvinar. Proin facilisis vulputate accumsan. Aliquam porttitor vitae

tortor at suscipit. Cras dignissim dictum vulputate. Suspendisse potenti. Fusce est sem, suscipit ac nibh a, maximus tempus turpis. In commodo leo et purus tincidunt, a sollicitudin eros feugiat. Ut ac neque ac lorem sollicitudin feugiat. Donec metus turpis, sagittis eu nunc nec, euismod elementum ligula. Duis egestas felis ligula, et mollis libero varius quis. Aenean lorem lacus, molestie vel elit ut, molestie accumsan dolor. Aenean semper vitae dui at finibus.

How to check the credibility of any Company

In order to go through the history of the insurance company that you are planning to buy the insurance plan from. Below parameters are needed to select a company.

ICR: Incurred Claim Ratio

ICR = (Amount settled as claims / Amount collected as premium)

Customer Experience: Customers share their experiences. You should always consider the mass suggestions.

Find out the Claim Process: Knowing the claim process saves lots of time.

Types of Health Insurance Policies in India

Each Individual expectations related to insurance differs. These expectations can be gained by choosing the right insurance plan. Below are some popular Health Insurance.

Individual Health Insurance Policy: This type of health insurance provides coverage to an individual against certain illnesses, offering advantages like cashless hospitalization, reimbursement, coverage of pre-hospitalization and post-discharge expenses and various add-ons. The entire sum assured is available for only one individual.

Family Health Plan: With family health plan, you can include your family members under the umbrella of a single health cover. Family floater medi-claim policies offer a fixed sum assured to the family members, which can be availed either by one or all members of a family for one or more claims during the tenure of the policy. Family health plans come are more expensive than an individual health plan

Senior Citizen Health Insurance: Senior Citizen health insurance is designed particularly for anyone aged above 60 years and offers protection from health issues during old age. According to IRDAI, every health insurance firm must include people up to the age of 65 years in its plans.

Surgery & Critical Illness Insurance Plans: This plan is usually brought as a standalone policy or as a rider for the treatment of various critical illnesses, such as kidney failure, paralysis, cancer, heart attack etc. As the medication of such illnesses is expensive, the imbursement related to them is also very high. A critical illness is a serious, possibly terminal, disease and is pre-defined by the provider. Most critical illness policies provide a lump-sum benefit if the insured is diagnosed with one or more of the specified terminal conditions.

Maternity Health Insurance: Medical insurance companies today cover additional costs, including those incurred in both pre and post-natal care, child delivery (normal or caesarean), and sometimes include vaccination of newborn babies in a maternity plan. This insurance covers the newborn baby up to the validity of this policy. It also covers transportation fee for ferrying the mom-to-be to the nearest network hospital of her choice.

Personal Accident Cover: These personal accident plans are frequently offered as riders. They include hospitalisation and bear the medical outlay in the event of an accident. These are issued as fixed benefit policies, where a specified sum is paid on the occurrence of unforeseen events, such as accidents, which can result in death or disability of the person. However, the payout is not related to the sum assured.

Pre-Existing Disease Cover: After 2-4 years of policy inception, various policies begin considering pre-existing diseases, e.g. diabetes, hypertension, kidney failure, cancer etc., for claims. Pre-existing disease cover is offered for the policy-specified illness(es) that the insured had before purchasing the policy.

Preventive Healthcare: Undoubtedly, healthcare is very expensive and nobody wants to fall ill. So, now we have preventive health care that takes care of you before you fall sick. Preventive care, such as regular health check-ups, concession in X-ray fees, consultation fee etc., is offered by this policy. By offering various healthcare provisions, this plan aims at keeping you healthy. Preventive care is a medical care rendered not for a specific complaint but for prevention and early-detection of ailments.

Unit Linked Health Plan: Unit- Linked Health Plan (ULHP) has been introduced recently, which offers a unique combination of health insurance and investment. Apart from giving health protection, ULHPs also contribute in building a corpus that can be used to meet expenditures which are not covered by health insurance policies.

Among the ULHPs available in Indian market, ICICI Pru’s Health Saver, LIC’s Health Protection Plus, Birla Sunlife’s Saral Health and IndiaFirst’s Money Back Health Insurance Plan are a few big names. By opting for this plan, one can save a certain amount which can later be used to pay for the treatment of any pre-existing illnesses that are not covered by a normal health policy during the waiting period.

Select Right health Insurance Policy

Features of Health Insurance Policies in India

The cost of healthcare in the modern days is increasing at a crazy rate while one’s earnings do not seem to match up that level. A patient looking forward to availing frequent health check-ups may no longer be able to bear the expenses associated. A comprehensive health insurance comes packed with features that can assist a person in managing expenses associated with medical emergencies and also with preventive healthcare. Understanding the following features can make purchasing a medical insurance policy easy:

Cashless Treatment: Every medical insurance organization has tie-ups with various nursing homes and hospitals across the country called ’empanelled hospitals’. If you are admitted to one of these, you don’t need to pay anything. You only need to mention your policy number and everything else will be taken care of by the hospital and your insurer. This type of plan is preferred because there is no stress of claim reimbursement and arranging documentation. However, if your expenses go beyond the sub-limits specified by the insurance cover or marked as “not covered” by the provider, then you will have to settle it directly with the hospital. Another important thing to remember is that cashless Mediclaim is not available if one gets treatment at a hospital which is not a part of the hospital network of the insurance provider.

Coverage of Pre and Post-Hospitalization expenses: This feature of a health insurance policy takes care of both pre and post-hospitalization fee. It takes into account the costs incurred during a certain number of days both prior to and post hospitalization for a specified period from the date of discharge as part of the claim, provided the expenditures are related to the disease/sickness.

Ambulance Fee: The person is free from burden of transportation fee as it is borne by the insurer. This is an add-on benefit and you should opt for it while purchasing medical insurance.

No Claim Bonus: NCB (or No Claim Bonus) is a bonus provided to the insured if the no claim has been filed for any treatment in the previous policy year. The reward can be offered either as an increment in the sum assured or as a discount in the premium cost. You can avail this advantage on policy renewal.

Medical Check-Up: A Medical plan entitles the insured to receive regular medical check-ups. A free check-up is provided by few insurers, provided you have a good history of no-claim bonus.

Room Rent in Your Health Insurance Sub-limits: A health insurance policy may have various sub-limits associated with it; room rent is one of those sub-limits. General Insurance Companies provide you with a maximum coverage up to the sum assured. However, they can deliberately trim down their liability by introducing the sub-limit clause in the coverage for hospital room rent.

Co-Payment: According to this feature, you can lower the cost of your health insurance. Medical insurance plans offer co-payment option that pre-defines the voluntary deductibles which have to be borne by the insured. So, in the event of a medical exigency, some amount is paid by the customer and the rest, by the provider. Co-payment is a cost-sharing requirement under a health policy, which states that the organization or the person will bear a certain share (in percentage) of the total admissible cost. However, the co-payment option does not have any effect on the sum assured. It allows you to reduce your premium to a certain extent (subject to the insurer and insurance policy).

Tax Benefits of Health Insurance: Health insurance policies entitle you to receive tax benefits under section 80D of Income Tax Act, 1961. The premium you pay towards insurance plans for yourself or your family members, get you a tax rebate, irrespective of whether they are dependent on you or not. The tax benefit offered, with respect to the premiums, is subject to the age of the person and there is a cap on the maximum benefit that can be availed. You can save a max up to Rs. 25, 000 in taxes a year unless your age is above 60 years. If your age is above 60 years, then this cap of maximum tax benefit increases to Rs. 30, 000.
If you are paying the insurance premiums for your parents as well as your own, then you are eligible for tax exemption up to Rs. 55, 000 a year under section 80D, provided your parents are senior citizens.

Health Insurance by Employer: More than 80% of employers in today’s age provide health coverage to their employees. The health insurance offered by an employer covers hospitalization expenses of the employee and his/her family including spouse, children or parents. It is a wise decision to opt for the mediclaim offered by your company as you need not pay any premium. This comes under a group health insurance policy and the premium is paid by the employer, based on the group size and the opted benefits.
However, it might be that you feel your employer’s mediclaim policy is insufficient to fulfil your medical needs. Also, what if you change your job? You will no longer be a member of this plan once you leave the organisation. Hereby Hence, it is necessary to understand the policy terms thoroughly. You can communicate with the HR department regarding what’s covered and what’s not in your health insurance. Mostly, we have observed that employees are more than satisfied with their company providing health insurance, only to find out later that the plan is not sufficient. So, before it’s too late, make your call!

Third Party Administrators: The TPA concept is the brainchild of Insurance Regulatory and Development Authority of India (IRDA), to assist both the insured and the insurer. While it benefits the insurer by reducing their overheads or administrative costs, fake claims, and claim ratios, the insured, too, enjoy improved and fast insurance services.
TPAs are an important players in the sector of health insurance. They have the capacity to handle all or a portion of the claims related to mediclaim insurance. They have tie-ups with the health insurers or self-insuring companies to manage services such as premium collection, enrollment, claim settlement and other administrative services. Often, hospitals and insurance companies organizations outsource health and insurance-related responsibilities to lower their burden. Similarly, an employer may prefer to provide claim resolution of the group health insurance policy via a TPA to manage various aspects of an employer-funded healthcare policy.

Factors needed to Consider Before Purchasing Best Medical Insurance Plans in India

There are few factors that you should consider closely to make the right decision.

Caps and sub-limits: Caps and sub-limits are the thresholds set on various policy-covered expenses. If a health policy has impositions of co-payments, sub-limits, and other caps, this would mean that there will be a policy-stated coverage offered for various expenses. At times, co-pay clause and caps help in reducing the premium of the plan. These, however, would alter the benefits in the long run. To make the most of your health insurance policy, you must understand these factors before you pay for a plan.

Claim settlement record: This is an important criterion to assess the credentials of an insurer. You should always go with a company with a good claim settlement record. Thus, you can ensure that your claims would not be wrongly withheld. Always ask for the company’s claim settlement ratio before purchasing their health plans and save yourself from unnecessary harassment in future.

Scope of cover: Don’t buy a plan by just comparing health insurance premium. Less cost does not necessarily mean a good plan. On the contrary, such a plan might not consider your needs properly. Closely look at what the plan includes. Buying a comprehensive plan is a better option comes to your rescue when you need it the most.

Renewability: It is important to see how many years the plan proposes to protect you. It makes no sense if you are covered by a plan during your youth only to be left without a safeguard when you need it the most – during your old age. Mediclaim policies are usually annual contracts. Once the policy term ends, in the order to continue the insurance coverage, the insured has to pay a premium. This recurring process is called renewal. The policy should be renewed continuously, because if there is a break, then, the person will lose the benefits of insurance.

Cashless Hospital Network: Check if a hospital around you is included by the company you are considering to buy the plan from. You and your family won’t be required to run around collecting documents and filling reimbursements. The provider or its Third Party Administrator should have a tie-up with a range of hospitals. The insured can get admitted in any of these nursing homes without paying anything from the pocket. However, cashless mediclaim resolution is subject to limits and sub-limits, which, in turn, are subject to the sum assured of the policy.

Premium Loading: Premium Loading refers to the increase in standard premium applicable when the insurer perceives a person to be more at risk (of claiming the insurance) in comparison to others. It is strongly recommended that you check the terms and conditions pertaining to premium loading. This will save you from paying an incremented premium after making a claim. This aspect, though ignored in the beginning, usually becomes a bone of discontentment later. The best practice would be to verify the cost fluctuation data of the plan for the previous 5 years at the very least.

Internal Team: Check for plans from firms who have a dedicated internal team for handling Mediclaim. This expedites the Mediclaim resolution process. Most of the players use a third-party administrator to process the claims and do the paperwork. Even though most of these Administrators provide great services, the fact that they are a third-party slows down the process. There are certain rules and regulations to be followed when an administrator processes a claim before it is handed over to the insurance company. These affect the turnaround time.

Floater (family) Size: Everyone has a different family size, so you should always look for the family size allowed under the plan before purchasing it. If you are a person in your late 20s and your parents are in their 40s, 50s or 60s, then purchasing insurance only for yourself does make sense. Alternatively, if you are married with or without kids and have dependent parents, parents-in-law, siblings etc., then a family health plan is best for you. Checking the cost, family size covered, critical illnesses or other benefit will ensure that you are able to purchase the plan you need.

Health Insurance Portability: It is wise to choose a health insurance company that offers health insurance portability. Earlier, policyholders had to stick to a policy just to retain the advantage. Now, you are allowed to switch from one insurance company to another without losing the waiting period advantages earned in your current policy. Moreover, with insurance landscape changing so regularly, insurance companies regularly come up with better policies and it may make sense to opt for health insurance policy portability. Although health insurance portability is free, some companies may charge you a certain fee if you are to port out of their plans to those of some other players. Therefore, make sure you do not pay any charges for medical insurance portability. Health insurance portability is a good thing to check when you are finding the best health policy or mediclaim.

Restore Benefit: With ‘restore benefit’ facility in your health care plan, you can restore your basic sum assured in case you have already spent the same or the multiplier advantage during your policy tenure. Mostly, the benefit cannot be obtained on the same ailment if you have exhausted the existing sum limit.

Restoration assistance proves to be helpful for a family floater health plan, where if the entire sum assured is used in the treatment of only a single family member, the other members are not left uncovered. In such a case, the other family members can avail policy coverage for the illness other than the one for which the expenses have already been compensated by the insurer.
Well, while finalising your health insurance plan, you should consider other influencing factors such as waiting period, sub-limit, claim settlement procedures etc. You can replace restore benefit with a super top-up plan at an affordable price. Moreover, top-up plans are more comprehensive since they comes with less or no restrictions.

Top up Plans: With the rise of medical inflation, having a large medical cover is prudent. But, not all can afford it due to the high premium. This is where a top-up plan comes into the picture. A top up plan reduces the deductibles cost i.e. the portion of claim you pay willingly for the damages before the insurer compensates the rest or up to the sum assured. With a top up policy, you don’t pay until a hospital breaks its defined limit. A top up plan is considered far cheaper than a standalone medical policy.
For instance, if the medical bill is Rs. 6 lakhs with a deductible of Rs. 2 lakhs, you are required to pay only the latter amount and the remaining 4 lakhs will be paid by the insurer. But, you can utilise your health policy to pay the liable amount. Again, the blending of a top-up plan with a medical cover is helpful as the premium you pay is much more affordable than the single plan. For example, if you pay 6,500 as a premium for Rs. 5 lakh regular cover, a top up coverage of Rs. 15 lakh will entail to an additional premium of 5,000, which is anyhow cheaper than a separate policy of identical cover.

Waiting Period: As per the insurance norms, every insured must serve a defined waiting period for any pre-existing illness. It is usually a 30-day period from the day your health insurance policy is initiated. If any claim falls during the waiting period, the insurer has the right to reject the claim for any hospitalisation, except in the case of an emergency. A hospitalisation that arises out of an accident can be registered as a claim and the insurer will compensate the hospitalisation cost. However, the insured is not required to serve the waiting period for subsequent years

Documents Required for Health Insurance Claim Reimbursement

In the event of hospitalization, the policyholder needs to submit certain documents as mentioned below:

Discharge card issued by the hospital.

In-patient hospitalization bills signed by insured for authenticity.

Doctors’ prescriptions and medical store bills.

Claim-form with insured’s signature on it.

Valid investigation report.

Consumables and disposables prescribed by the doctors with complete details.

Bills of doctors’ consultation.

Copies of the Insurance policy from the previous year and the current year/copy of ID Card of TPA.

Any other document(s) asked by the TPA.

Important Points to Remember while buying Health Insurance

Buying insurance is not child’s play and when it comes to buying a health insurance policy, you need to be pretty sure about certain points. A few of such key points are listed below:

What covers are you offered and who offers the covers?

Are add-on features available for later use?

Are individual and/or family floater options available?

What is the Sum Assured?

What are Sum-limits applicable?

Is/are there any discount(s) offered?

Are there any voluntary/co-payment deductible options?

Are policy exclusions mentioned in the documents?

What is the claim process like? – Reimbursement, cashless benefit, immediate claim settlement?

Is there any medical check-up required before proposal acceptance?

Factors That Affect Your Health Insurance Premium

With advancement in medical facilities, health care costs have also increased. The main benefit of health insurance is that it takes care of the healthcare expenses. It offers financial security to you and your family in the event of an unanticipated serious illness or accidental injuries that could drain all your savings. And here’s how the cost of your insurance premium is determined:

Medical History: Your medical history is one of the major determinants of the health insurance premium.
Almost all the insurance companies in India make pre-medical tests mandatory (after a certain age) before buying a health insurance policy.
While, some insurance companies don’t make medical screening mandatory but do consider your current medical conditions, lifestyle-related health risks and medical background of your family.

That is why medical insurance premium for smokers is higher than other people.

Gender and Age: Age is another important determinant of the medical insurance premium. The premium varies based on the age of the insured person.

That is why it is recommended to buy a policy at a young age because the cost of the premium is low for young applicants.
Elderly people are vulnerable to cardiovascular diseases, and other critical illnesses such as cancer, kidney problems etc. For this reason, senior citizen medical insurance premium is usually on a higher side
Also, the cost of the premium for women health insurance is lower in comparison to the male candidates due to lower risk of stroke, heart attack etc.

Policy Term: The premium for a 2-year health insurance plan will be higher than a 1-year plan. However, almost all the insurance companies offer a discount on long-term medical insurance plans.

Type of Health Insurance Plan: The type of policy you select also affects the cost of the premium. The higher the risks involved the higher will be the premium and vice-versa.
With the help of an online health insurance premium calculator, you can compare the premium for different plans.

No-Claim-Discount: If you have not made any claim during your policy term, then you can earn NCB or No-claim-bonus ranging from 5 to 50 percent. It is also one of the most important factor that is taken into consideration while calculating the cost of the premium.

Lifestyle: If you drink or smoke regularly, chances are high that you will be charged more premium amount. In that case, the insurer can also reject your insurance policy request.

Health Insurance Inclusions

The coverage offered by a health insurance policy is subject to the type of policy and the insurance provider. An ideal policy is customizable and suites your requirements in the best way possible. Following are some common health insurance policy inclusions:

In-patient hospitalization expenses

Donor expenses, in case of organ transplantation

During injuries requiring overnight hospitalization

Pre-existing illnesses or diseases

Pre and post hospitalization

Ambulance charges

Maternity or newborn

Health check-ups

Daycare procedures

Treatment availed at home or domiciliary hospitalization

Health Insurance Exclusions

Coverage offered by health insurance policies varies with the insurer; however, certain points are not covered by health policies, and fall under the category of policy exclusions. Following are common health insurance policy exclusions:

Unless an accidental emergency, no coverage or reimbursement offered with the waiting period of the policy, usually initial 30 days.

Coverage of critical illnesses and pre-existing diseases is subject to a waiting period of 2 to 4 years.

Clear exclusion of expenses incurred for maternity/newborn unless a maternity rider has been added on.

Injuries caused by war/terrorism/ nuclear activity/suicide attempt.

Terminal illnesses, AIDS, and other diseases of similar nature.

Cosmetic/plastic surgery, replacement of hormones, sex change and more.

Dental or eye surgery.

Non-allopathic diseases’ treatment.

Bed rest/hospitalization and rehabilitation, common illnesses etc.

Treatment/diagnostic tests, post-care procedures.

Treatment in abroad or by an under-qualified medical professional.

Note: It is recommended to explore each plan to ensure maximum coverage.

Lorem ipsum dolor sit amet, consectetur adipiscing elit. Suspendisse dignissim, mi ullamcorper gravida euismod, dui neque congue magna, non tristique velit nibh pellentesque enim. Aenean pellentesque nisl ac mi dapibus mattis. Phasellus facilisis sit amet purus nec tempor. Quisque convallis turpis

Lack of knowledge –Lorem ipsum dolor sit amet, consectetur adipiscing elit. Suspendisse dignissim, mi ullamcorper gravida euismod, dui neque congue magna, non tristique velit nibh pellentesque enim. Aenean pellentesque nisl ac mi dapibus mattis. Phasellus facilisis sit amet purus nec tempor. Quisque convallis turpis ut orci euismod, quis imperdiet urna pulvinar. Proin facilisis vulputate accumsan. Aliquam porttitor vitae tortor at suscipit. Cras dignissim dictum vulputate. Suspendisse potenti. Fusce est sem, suscipit ac nibh a, maximus tempus turpis. In commodo leo et purus tincidunt, a

Savings/Investment Options

Lorem ipsum dolor sit amet, consectetur adipiscing elit. Suspendisse dignissim, mi ullamcorper gravida euismod, dui neque congue magna, non tristique velit nibh pellentesque enim. Aenean pellentesque nisl ac mi dapibus mattis. Phasellus facilisis sit amet purus nec tempor. Quisque convallis turpis ut orci euismod, quis