Most health insurance firms in our country do not provide any coverage for dental procedures as these companies believe they fall under the cosmetic treatment division. Nevertheless, treatment stemming from accidental injuries is covered by most insurance companies in India.
If you are considering buying health insurance, you need to be aware that while there are a lot of comprehensive insurance policies that offer coverage for an array of medical conditions, very few provide dental insurance. Most insurance packages offered in India do not often cover dental procedures for private and group insurance policies.
What is Dental Insurance?
It refers to the insurance rendered for dental procedures, excluding treatments falling under cosmetic dentistry's umbrella. Treatments are generally classified under either preventive or diagnostic. A few of the procedures covered under dental insurance include filling caries, tooth extractions, dentures, root canal procedures, etc.
Why insurance companies in India do not cater dental treatment?
While there is no consensus on the exclusion of dental cover from traditional health coverage, many believe that dental treatment does not come under the umbrella of health services classified by insurers.
Another plausible deduction could be that policyholders could file claims for procedures that purely come under the umbrella of cosmetic dentistry. Adding to this loophole, they could also opt for complex & expensive dental procedures, resulting in a loss or cut in the markup for these Insurance companies having to pay out large amounts toward insurance claim settlement.
Dental Insurance Coverage scenario in India
In India, very few insurance companies cover dental procedures, with none of the major insurance firms offering dental insurance as an exclusive cover. More often than not, dental treatments are covered in the case of an accident and would be narrowed to repairing the injury caused by such events.
On the other hand, insurers cover dental treatment through outpatient department (OPD) treatments. Insurance companies covering dental insurance for dental treatments hold a maximum cap limit usually specified in the policy documents, irrespective of the dental procedure opted for. Further terms govern such coverage, besides limiting their scope like claims pay-outs for dental procedures after the second policy year only.
In the case of OPD procedure policies, policyholders will have to pay an additional premium, which is oftentimes relatively high. Thus, while some inroads are being made in providing dental insurance, comprehensive dental coverage is still not a reality in India.
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