Act of God in health insurance

Act of God in a health insurance plan is an event that happens outside of human control. It includes natural disasters such as earthquakes or floods, in which more than one person is affected simultaneously. While health insurance companies generally only cover natural events in the Act of God like floods and earthquakes, the insurance plans may differ from company to company.

The Act of God is not related to any religion or caste in the health insurance sector. Health insurance companies cover only unforeseen events that humans cannot control with the help of this. For example, if an insured is physically hurt due to a flood, earthquake or storm, then the incident falls under the Act of God. Whether coverage is given for adverse health effects due to these reasons or not depends on your insurance company and policy.

(Read more: What happens to the health policy after the death of the insured)

As its name suggests, the Act of God usually includes natural disasters that are not within the control of humans to prevent or bring about. Below is a list of some of the events that are included in the Act of God:

• Flood
• Earthquake
• Storm
• Lightning strike
• Tsunami
• Forest fire

In the context of health insurance companies, the Act of God is a section of the documents of the insurance policy, according to which the company decides whether the claim amount can be paid to the insured or not. In simple words, if a policyholder is physically affected by any natural disaster, then the insurance company puts him under the category of Act of God.

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All health insurance companies have different plans and procedures for the Act of God. However, the companies that provide Act of God coverage in their health insurance plans also have conditions for the event the patient has been hit by. Below are some of the incidents as well as how health insurance companies cover them.

For example, there is a flood in an area and some people have come under its grip. If the flood-affected people have a health insurance plan, then the company provides coverage on the medical expenses incurred on any injuries or harm to their health caused by the flood. Similarly, in other natural disasters, the cost of the care provided to the insured who are in its grip is borne by the insurance company

There are a lot of insurance companies in India that have many different health insurance plans. Insurer companies provide health insurance plans to a person by examining their health, lifestyle and many other things. What is and isn’t included in a health insurance plan depends on the policy and company you choose as well your priorities. The rules of the Act of God should be clearly explained in the policy so that the insured does not face any unforeseen troubles later.

It may also be possible that the company may not provide coverage for a particular physical problem and you may not get coverage if you’re experiencing the same problem under the Act of God. For example, an insurance company provides coverage for Act of God but not for daycare treatment. In such a situation, if you suffer a simple injury due to a natural disaster that is treated within a day, then it is kept in the category of daycare and you cannot get a claim on it.

(Read more: What to do if the health insurance company does not pay the claim)

As you may know, negligence can result in a loss. If you are planning to buy a health insurance plan, then it requires a lot of thinking and understanding so that you can buy a suitable plan for yourself and your family and do not end up wasting your money. It is important to carefully read about many things before buying health insurance, including the Act of God. If you do proper research, you will know for yourself whether a medical emergency can be covered under your health insurance plan or not.

You can also understand the consequences of not researching the Act of God from the 2012 Bollywood film "Oh My God". In this film, when Kanji's (Paresh Rawal) shop collapses due to an earthquake, he goes to an insurance company for a claim. There he learns that an earthquake is an Act of God, which the company does not cover in their policy. The movie addresses the nuances of an insurance policy and the importance of reading the policy document carefully before signing it. Though the insurance issue in the movie was related to the shop i.e. property, you should keep in mind that your biggest asset is your health.

(Read more: What is Family Health Insurance)

According to some experts, if your health insurance company provides coverage for damages under the Act of God, the claim process is relatively easy. This is because, under some natural disasters, you are given special exemption on documents, meaning you do not need to show all the papers while requesting the claim. However, this may vary depending on the norms of the company.

The policyholder is required to report the health damage caused to the insurance company, after which the company starts the claim process expeditiously. Also, as the Act of God sometimes affects more than one insured, insurance companies tend to employ more than one officer in order to get information about the loss at the earliest and expedite the claim process.

(Read more: Can you claim health cover from two insurance companies?)