Does Preventive Care Claim Affect No Claim Bonus?
✅ No! Preventive care claims do not affect your No Claim Bonus (NCB) under IRDAI guidelines.
Key Reasons Why:
✔ Wellness vs Medical Claims – NCB applies only to illness/hospitalization claims
✔ IRDAI Regulation 14 – Mandates exclusion of preventive care from NCB calculations
✔ Insurer Policies – All major insurers follow this rule
How NCB and Preventive Care Work Together
https://www.profitableratecpm.com/pzkz9amhcf?key=bd67ff1a98f58b66cfe7746f4f24bff4
| Claim Type | Affects NCB? | Examples |
|---|---|---|
| Preventive Care | ❌ No | Health check-ups, vaccinations |
| Hospitalization | ✅ Yes | Surgery, illness treatment |
| OPD Medications | ✅ Yes | Prescription drugs for sickness |
| Wellness Programs | ❌ No | Gym memberships, diet counseling |
3 Ways to Protect & Maximize Your NCB
1. Use Preventive Care Benefits Fully
- Claim annual check-ups, vaccines, screenings without NCB worries
- Typical coverage: ₹3,000-₹10,000/year
2. Separate Wellness from Medical Claims
- Always file preventive care under “wellness benefits”
- Avoid mixing with illness-related OPD claims
3. Track NCB Accrual Annually
- Most insurers provide NCB status in:
- Policy renewal documents
- Customer portal
- Mobile apps
Top Insurers’ NCB Policies on Preventive Care
| Insurer | NCB Increase/Year | Preventive Care NCB Impact |
|---|---|---|
| Star Health | 5% (max 50%) | Zero effect |
| HDFC Ergo | 10% (max 100%) | No reduction |
| ICICI Lombard | 5-20% (sliding scale) | Excluded |
| Max Bupa | 10% (max 100%) | Never counted |
FAQs About NCB and Preventive Care
1. Can I lose NCB if I only claim check-ups?
✅ No – Your bonus remains intact with only preventive claims.
2. Do dental cleanings affect NCB?
Depends on classification:
- Preventive cleaning: ❌ No
- Cavity treatment: ✅ Yes
3. Will health screenings reset my NCB?
✅ No – Blood tests, ECGs etc. are always NCB-safe.
4. How do insurers track this?
Through claim category codes:
- WXX = Wellness (no NCB impact)
- MXX = Medical (affects NCB)
5. Can I dispute if NCB is wrongly reduced?
✅ Yes – Provide claim documents showing “preventive care” classification.
Expert Tips to Safeguard Your NCB
- Always Mention “Preventive” – When filing check-up claims
- Keep Records – Save approval emails/letters
- Renew On Time – NCB resets if policy lapses
- Verify Before Claiming – Ask insurer: “Will this affect my NCB?”