#Virukipolicy | T&C*
Health insurance is an insurance policy which protects the policyholder and his/her family against the financial costs during hospitalization arised due to an accident, illness, on diagnosis of any serious disease. Health insurance plan offers cashless treatment in network hospitals or reimbursement facility for the medical costs that might take place at the time of treatment.
Health insurance in India was started in the year 1986, the government of India along with private health insurance companies stepped in the industry and has grown substantially to a large extent primarily due to public awareness and liberalisation of economy. The General Insurance Corporation of India and the Insurance Regulatory and Development Authority of India (IRDAI) has initiated health campaigns to minimize hesitation and make the people aware about the health insurance products.
As per report by India Brand Equity Foundation (IBEF) only 14.1% of the rural population and 18% of the urban population have access to some sort of health insurance policy.
Health insurance comes with numerous benefits and riders offered by the different insurance companies in India that makes it difficult to choose the right policy as per the requirements of an individual.
PolicyX.com have picked up in-details about the best health insurance policies in India, which stand superior on parameters such as eligibility, features, coverage, affordability, limits, and exclusions.
Let us look at the following best plans for you as per our survey:
|Plan Name||Eligibility||Sum Assured||Network Hospitals|
|Apollo Munich Optima Restore||Min - 91 days |
Max - 65 years
(Lifetime - Renewability)
|(Rs. 3 L - Rs. 50 L)||4721|
|Religare NCB Super Premium||Min - 91 days |
Max - No limit
(Lifetime - Renewability)
|(Rs. 3 L - Rs. 75 L)||4987|
|Star Family Health Optima||Min - 16 days |
(Lifetime - Renewability)
|(Rs. 2 L - Rs. 15 L)||8341|
|HDFC ERGO Health Suraksha Gold Regain||Min - No limit |
Max - No limit
(Lifetime - Renewability)
|(Rs. 3 L - Rs. 10 L)||6402|
|Aditya Birla Diamond||Min - 91 days |
Max - No limit
(Lifetime - Renewability)
|(Rs. 3 L - Rs. 50 L)||5734|
*Note: The information provided in the above table is not declared by the IRDA but is solely affirmed by PolicyX.
Apollo Munich offers individual as well as family floater health insurance plan to the customers in such a way so that it provides complete cover against the huge healthcare costs. The family floater plan covers self, spouse, children, parents and parents-in-law.
Religare NCB Super Premium comes with a complete health cover for you and your family members. The plan provides increase in the sum assured amount taking CARE starting from diagnosis of a disease to its treatment together with recovery.
Star Family Health Optima brings you a super saver health insurance policy on a family floater basis in a single sum assured for the whole family, offering multiple benefits to the users for extra protective care.
HDFC ERGO Health Suraksha Gold Regain has been launched by HDFC ERGO offers health cover to individual, families and senior citizens. A complete plan with an increase in the collective bonus from 10% to 100% of the sum assured during renewal for every claim-free year.
Aditya Birla Activ Assure Diamond plan provides health insurance at an affordable cost so as to cover all sorts of health treatment expenditure. It offers a health coverage starting from medical health check-ups to hospitalization.
"An ounce of prevention is worth a pound of cure" and the prevention here is a health insurance policy for you and your family's secure future.
Health emergencies and accidents are uncertain in life. List of hospital bills, medical tests, medicines, extra charges, etc. are a pain for significant diseases and illnesses. A common man finds it difficult to pay such huge costs and make the treatment successful on his own without burning all his savings of life.
Research and studies conducted by the World Health Organization (WHO) it has been shown that people who have health insurance are mentally and physically healthier than people who do not have one. Let us look at the following statistics:
Statistics to be shown here as a pie/bar chart that will provide the information of the people who are covered by health insurance v/s the people who are not covered by health insurance in India.
Insurance companies offers a number of variants and advantages to the policyholders. An effective insurance plan must have the following benefits, let's have a look at the below-mentioned benefits offered by the insurers:
It allows the insured to get the required treatment in network hospitals without paying the charges in cash during hospitalization up to the sum assured limit and not above that amount. The insurance company will pay on your behalf and allows you to have a complete focus on your treatment.
Pre & Post Hospitalization Expenses
The expenses prior to hospitalization and after discharge from the hospital upto a specific period are covered by health insurance policy only if the expenses are associated with the illness subject to terms and conditions of the insurance company.
Daily Hospital Cash
This benefit is very useful during hospitalization as this will provide daily cash to a certain limit to take care of the additional expenses in the hospital like food, travelling, etc. Usually, the benefit amount is upto Rs. 2,000 per day but it may vary in case of accident and ICU and goes upto Rs. 4,000 per day.
Organ Transplant Expenses
The costs for the transplantation of an organ are bearable by the insurance company. Health insurance covers the surgery expenses related to organ donation. However, the costs for complications after surgery, organ donor expenses, medical tests are not covered under the same.
No Claim Bonus (NCB)
It is a discount that you will receive from the insurer for every claimless year. NCB comes as a discount on the payable premium at the time of the renewing policy or whenever you want to increase the Sum Assured amount. At the time of renewal, you must check for No Claim Bonus benefit.
Once the sum assured amount is completely used, the insurance company will restore the amount automatically and you don't have to pay any additional cost for the benefit. The plans with restoration benefits are expensive as compared to normal health insurance policies and applicable as per the clauses of the policy.
Free Health Check-Ups
To motivate the policyholders towards a healthy life, insurance companies offer free medical check-up facility occasionally, i.e., mostly once in every 4 years. Depending on the company and the type of policy, you will be eligible for a master health check-up.
This keeps you insured for the long term in life. Most of us try to follow a healthy lifestyle but illness or accidents could take us by shock. Therefore, having a health insurance policy act as a blessing in hard times.
On buying a health insurance policy, you will be liable to receive tax advantages for the premiums paid under Section 80D of the Income Tax Act, 1961. One can avail tax benefits upto a certain limit depending upon the age of the policyholder and his/her parents, if any.
To choose the best health insurance policy, there are a few factors that should be kept in mind before buying a health insurance plan. The below-mentioned factors will help you in selecting the best plan according to your requirements:
Different insurers provide a variety of facilities and covers to the policyholder, it is vital to check all the facilities and the coverage provided so as to fulfill the requirements for treatment. Compare policies and make a checklist for your needs and choose the best plan accordingly.
Reliability of the Company
The policyholder should go through the insurance company's website and its details before choosing a health insurance plan. The profile and the history of the company should be checked along with the customer reviews to make the right choice.
Option For Cashless Claim
Check whether the insurance company is providing the cashless claim facility as it is an important feature of the policy that will help in times of emergency hospitalization.
List of Network Hospitals
The cashless claim facility mentioned above is only available in the network hospitals of the particular health insurance company so make sure to go through the network hospitals also.
Sum Assured Amount
The principal point to be noticed while buying a health insurance is the amount of Sum Assured offered by the insurer to the insured. If you or your family members are suffering from any specific disease then you might have a fair idea of the amount to be chosen for future health costs. Hence, it is important to choose the sum assured wisely.
Add-On Benefits & Plans
Companies offers numerous riders and additional benefits to the customer that actually boost the coverage, scope and advantage of the policy resulting in a complete health cover protection shield. You may also add a top up plan with the respective coverage by paying an extra premium.
The team of PolicyX.com will instantly share policy documents over email.
(*Note: Medical tests would be done according to the plan features and insurance company's norms and conditions).
With the growing awareness about health insurance, many insurance companies have come up with several and irresistible options of health insurance. The needs of a health insurance plan may vary from person to person, and that's why choosing the best plan as per your requirements is necessary.
But to choose the best out of all is a daunting task. So that's why it is important to compare all available plans before buying the desired one.
PolicyX.com is a one-stop shop for all your insurance related needs. PolicyX is Insurance Regulatory and Development Authority of India (IRDAI) certified web insurance aggregator company having License Number: IRDA/WBA17/14
Compare health insurance plans from top insurance companies with PolicyX and buy the best health insurance plan as per your needs. The team of PolicyX make sure that you are getting the best deal within your budget; away of fake promises and products. We try to provide the easiest buying process. Our systems and teams are well equipped to help you with the whole buying procedure from starting till the end. Let us look at the following special features about PolicyX:
Individual Health Insurance
Family Health Insurance
Critical Illness Insurance
Government Health Insurance
Private Health Insurance
Here's a list of Insurance Regulatory and Development Authority of India (IRDAI) registered health insurance companies that offers numerous options with attractive features to its customers. Let's go through the following:
Aditya Birla Health Insurance Company is a renowned insurance company when it comes to the health insurance industry. The company is founded after the amalgamation of Aditya Birla group and South Africa based MMI Holdings Ltd, which owns a 49% stake. The company is offering a wide range of health insurance products to cater to the different needs of customers at an affordable price. It also promotes a healthy lifestyle and for the same, it provides a digitally integrated, incentivized, wellness program.
Health Insurance Plans by Aditya Birla Health Insurance Company
|Activ Health Enhanced||Activ Health Essential||Activ Assure Diamond|
|Activ Secure Personal Accident||Activ Secure - Critical Illness||Activ Secure - Hospital Cash|
|Activ Secure - Cancer Secure||Group Activ health||Group Activ secure|
Apollo Munich is a well-known insurer of the healthcare industry. It is a collaboration between Apollo Hospitals and Munich Health. The company has already spread its wings across all Indian subcontinent. It is delivering affordable yet effective health insurance plans to deal with the growing needs of customers. The company receives appreciation for its amazing concept through a number of awards for instituting innovative health insurance which can easily go we with customers of different age groups as well.
Health Insurance Plans by Apollo Munich Health Insurance Company
|Apollo Munich Health Wallet||Apollo Munich Optima Restore||Apollo Munich Easy Health|
|Apollo Munich Day2Day Care - Silver||Apollo Munich Optima Super||Apollo Munich Optima Cash|
|Apollo Munich Optima Plus||Apollo Munich Optima Vital||Apollo Munich Energy Plan|
|Apollo Munich Maxima Plan||Apollo Munich iCan Cancer Insurance||Apollo Munich iCan Cancer Insurance for Women|
Bajaj Allianz Health Insurance company refers to be the leading health insurance company of India. It is a joint venture Bajaj Finserv Limited and Allianz SE. The company aims to offer innovative healthcare products and comes out with multiple benefits for the ease of customers. The long list of health insurance products and the claim settlement ratio of the company is enough to attract many customers towards it and becoming a trusted insurance provider.
Health Insurance Plans by Bajaj Allianz Health Insurance Company
|Bajaj Allianz online health Insurance plan for individual policy||Bajaj Allianz Global Personal Guard Policy (individual)||Bajaj Allianz Health Insurance Plan for Family- Health Guard|
|Bajaj Allianz Health Insurance Critical Illness||M-Care Health Insurance Policy||Extra care plus a cover by Bajaj Allianz|
Bharti AXA Health Insurance Company Limited is a joint venture between AXA 26% stakes and Bharti Enterprises. It is the fastest growing insurance company with dual certification of ISO 9001:2008 and ISO 27001:2005. The company carries around 59 branch offices across India that deals in multiple forms of health insurance products. Bharti AXA Health Insurance is great at keeping its promises associated with best customer support to maintain a relationship, easy claim settlement, and much more.
Health Insurance Plans by Bharti Axa Health Insurance Company
|Smart Health Insurance Policy||Bharti AXA Smart Health Critical Illness Insurance Plan||Bharti AXA Smart Personal Accident Insurance Policy|
Cholamandalam MS General Insurance Company is founded by the collaboration between two renowned companies- Murugappa Group and Mitsui Sumitomo Insurance Company Limited, Japan. Chola MS provides a wide range of helpful health insurance products that are customized in a way which can easily meet the different needs of customers. Chola MS follows a philosophy of T3, which reflect Trust, Transparency, and Technology. The company carries around 109 branches and over 9000 agents across the country.
Health Insurance Plans by Cholamandalam Health Insurance Company
|Chola MS Chola Swasth Parivar Insurance||Chola MS Healthline Insurance||Chola Tax Plus Healthline|
|Chola MS Family Healthline Insurance||Chola MS Individual Healthline Insurance Plan||MS Chola Topup Healthline Plan|
|Chola MS Critical Healthline Insurance||Chola MS Hospital Cash Healthline||Chola Classic Health - Individual|
|Chola Classic Health - Family Floater insurance Plan||Chola MS Super Topup Insurance|
ManipalCigna health insurance company which was formerly known as CignaTTK health insurance company is basically a joint venture between Manipal Group and Cigna Corporation. The company has its presence in 30+ countries and serving more than 160 million+ customers around the world. With a focus on improving health, the company offers a full suite of health insurance solutions.
Health Insurance Plans by ManipalCigna Health insurance Company
|MANIPALCIGNA PROHEALTH PROTECT SMALL COVER||MANIPALCIGNA PROHEALTH PLUS MEDIUM COVER||MANIPALCIGNA PROHEALTH ACCUMULATE LARGE COVER|
|MANIPALCIGNA PROHEALTH PREFERRED EXTRA LARGE COVER||MANIPALCIGNA PROHEALTH PREMIER EXTRA EXTRA LARGE COVER||MANIPALCIGNA LIFESTYLE PROTECTION - CRITICAL CARE|
|LIFESTYLE PROTECTION - ACCIDENT CARE||MANIPALCIGNA PROHEALTH CASH||ProHEALTH SELECT|
|GLOBAL HEALTH GROUP POLICY||LIFESTYLE PROTECTION GROUP POLICY||ProHEALTH GROUP INSURANCE|
Future Generali Insurance is founded by a joint collaboration of Future Group of industries, and Indian Company (its flagship chains in the supermarket sector viz. Food Bazaar, Big Bazaar, and several other retail stores) and Generali group, an Italy based Company. The company is serving multiple health insurance to deal with the growing healthcare needs of its customers.
Health Insurance Plans by Future Generali Health Insurance Company
|Future Varishta Bima Health Insurance||Future Vector Care Health Insurance||Health Total Mediclaim Insurance Policy|
|Future Advantage Top Up Health Insurance||Future Health Suraksha Insurance Policy||Future Generali Personal Accident Plan|
|Future Generali Hospital Cash Insurance Plan||Future Generali Critical Illness Insurance Policy||Future Generali Top Up Health Insurance|
|Future Generali Surakshit loan Bima Insurance|
It is a renowned health insurance company which is established by a collaboration between HDFC Ltd., India's premier Housing Finance Institution and ERGO International AG, that is basically a primary insurance entity of Munich Re Group. HDFC ERGO refers to be the 4th largest general insurance company in India. The company is offering a long list of health insurance plans that you can compare and choose as per your age and needs.
Health Insurance Plans by HDFC ERGO Health Insurance Company
|Individual Health Suraksha||HDFC ERGO My Health Medisure Super Top-Up||HDFC ERGO Health Insurance for Family|
|HDFC ERGO Critical Illness Insurance||HDFC ERGO Health My Health Medisure Classic Insurance||HDFC ERGO Health Insurance for Senior Citizens|
|HDFC ERGO Health Insurance for parents|
IFFCO Tokio HEalth Insurance Company is a joint venture between the Indian Farmers Fertilizer Co-operative (IFFCO) and its associates and the Tokio Marine and Nichido Fire Group. The company was established in December 2000 and since then the company is serving to the people of the nation with the helpful health insurance products. The company is also good at settling claims in a short span of time.
Health Insurance Plans by IFFCO Tokio Health Insurance Company
|IFFCO Tokio Family Health Protector Policy||IFFCO Tokio Individual Health Protector Policy||IFFCO Tokio Swasthya Kavach Family Health Insurance Policy|
|IFFCO Tokio Health Protector Plus Policy Coverage||IFFCO Tokio Individual Medishield Policy||IFFCO Tokio Individual Accidental Insurance Policy|
|The IFFCO Tokio Critical Illness Insurance Policy|
Max Bupa Health Insurance Company is a consolidated collaboration between Bupa Finance Plc, and Max India which has specialization in the healthcare industry. The company comes out with great healthcare solutions and serving more than 29 million customers. The company has its presence in 190 countries. The company is offering a range of effective health insurance plans and also assist in getting the best medical consultant and care.
Health Insurance Plans by Max Bupa Health Insurance Company
|Max Bupa GoActive Individual Health Plan||Max Bupa GoActive Family Floater Health Insurance Plan||Max Bupa Health Companion Family Floater Health Insurance Plan|
|Max Bupa Health Companion Individual||Max Bupa Health Companion First||Max Bupa Heartbeat Family Floater Health Insurance Plan|
|Max Bupa Heartbeat Individual Policy||Max Bupa Heartbeat Family First Insurance Policy||Max Bupa Criticare Health Insurance Plan|
|Max Bupa Personal Accident Care Health Insurance Plan||Max Bupa Health Recharge Individual||Max Bupa Health Recharge Family Plan|
|Max Bupa Health plus Individual||Max Bupa Health Plus Family Insurance|
National Health Insurance refers to be the oldest general insurance companies. It was founded in 1906 and got nationalized in the year 1972. The company has its headquarters in Kolkata. It is a fully-government owned insurance company which is catering unique insurance needs of an individual, family, and senior citizen among others. The company designed all plans in the ways that each and every plan looks like a comprehensive one.
Health Insurance Plans by National Health Insurance Company
|National Mediclaim Policy||National Mediclaim Plus Policy ( Individual Plan )||Parivar Mediclaim Policy (floater Policy)|
|National Overseas Mediclaim Business and Holiday Policy||National Parivar Mediclaim Policy||National Parivar Mediclaim Plus|
|National Critical Illness Policy||National Overseas Mediclaim Employment and Studies Plan||National Varistha Mediclaim Policy for Senior Citizen|
|National Individual Personal Accident Policy|
New India Health Insurance is a section of the New India Assurance that carries a presence in international countries as well with its headquarters in India. It is one of the oldest general insurance companies which operates worldwide and offering effective health insurance plans to people of all genders and age groups as well. The company has started its operations in 1920 and right now functioning in more than 28 countries including Japan, Mauritius, Singapore, London, St. Lucia, Dominica, Myanmar, Nigeria, etc.
Health Insurance Plans by New India Health Insurance Company
|New India Premier Mediclaim Policy||New India Mediclaim Policy (Traditional support)||Family Floater Policy (Family cover)|
|New India Floater Mediclaim Policy||New India Asha Kiran Policy (For your Girlchild)||New India Top Up Mediclaim (Super Protection)|
|New India Sixty Plus Mediclaim||Senior Citizen Mediclaim Policy (for Elders)||Janata Mediclaim Policy|
|Universal Health Insurance Scheme||Jan Arogya Bima||Cancer Medical Expn-Individual|
|Family Mediclaim 2012 Policy|
Oriental insurance is a renowned name of the health insurance industry in India. The company was founded in Bombay on 12th September 1947. It is a wholly owned subsidiary of the Oriental Government Security Life Assurance Company Ltd. The company carries a wide range of health insurance products to serve better. Earlier it was a subsidiary of Life Insurance Corporation of India from 1956 to 1973 (till the General Insurance Business was nationalized in the country). In 2003 General Insurance Corporation of India acquired all shares of the company has been transferred to Central Government.
Health Insurance Plans by Oriental Health Insurance Company
|Oriental Super Health Top Up||Mediclaim Policy||Jan Arogya Policy|
|Pravasi Bharatiya Bima Yojana||OBC-Oriental Mediclaim Policy||PNB Oriental Royal Mediclaim|
|Group Mediclaim Policy||Happy Family Floater Policy||Overseas Mediclaim Policy (B&H)|
|Oriental Happy Cash Policy|
Reliance General Insurance Company is a renowned company in India which offers a wide range of healthcare products at an affordable price and best claim settlement service as well. The company is getting popular because of its innovative products and easy to access services. The company has its presence in around 102 cities with 139 offices. The company aims to insure each and every individual with a suitable health insurance plan and thus comes out with multiple products.
Health Insurance Plans by Reliance Health Insurance company
|Reliance HealthGain Insurance Policy||Reliance Health Insurance on EMI Policy||Reliance Personal Accident Insurance Policy|
|Cashless Health Insurance Policy||Reliance Critical Illness Insurance Policy||Senior Citizen Health Insurance Plan|
|Reliance Healthwise Insurance Plan|
Religare Enterprise Private Ltd, Union Bank of India and Corporation Bank joined hands to establish Religare Health Insurance. The company got the IRDA approval in 2012 and it always comes out with helpful health insurance products for the comfort of customers. It serves many other products as well but it carries specialization in health insurance products. The company is offering a wide range of health insurance products ranging from individual health insurance to family to group health insurance as well.
Health Insurance Plans by Religare Health Insurance Company
|Religare Care Health Insurance||Religare Care freedom : Senior Citizen Health Insurance||Religare Care heart health insurance plan|
|Religare Joy Health Insurance Plan||Religare Enhance Health Insurance Plan||Religare Assure Health Insurance Plan|
|Religare Care senior Health Insurance plan||Religare Health Insurance Secure Personal Accident Plan|
Royal Sundaram Health Insurance - a popular name in the health insurance industry which customized products on the basis of customer's safety and convenience. The company also receives ISO 9001 - 2015 for the customer service and have won the 'Celent Model Insurer Asia Award' for the intelligent claims management system. The wide range of health insurance products is helping customers to meet their requirements within budget as well.
Health Insurance Plans by Royal Sundaram Health Insurance Company
|Royal Sundaram Lifeline Classic Health Insurance||Royal Sundaram Lifeline Supreme Health Insurance||Royal Sundaram Lifeline Elite Health Insurance|
|Royal Sundaram Family Good Health Insurance Plan||Royal Sundaram Smart Cash Insurance Plan|
SBI Health Insurance Company aims to serve people with the best solutions against the growing health insurance emergencies. SBI Health insurance was founded with the same motive in 2010 and since then it is helping millions of people on a daily basis. To make its plan accessible. The company is offering the same at really affordable prices. With the same, it becomes easier for the insurer yourself and your families as well. The wide range of health insurance plans is a plus point that you will get with this health insurer.
Health Insurance Plans by SBI Health Insurance Company
|Health Insurance Policy||Arogya Premier Policy||Arogya Plus Policy|
|Arogya Top Up||Hospital Daily Cash Insurance||Group Health Insurance|
|Loan Insurance Policy||Critical Illness Insurance Policy|
Star health insurance refers to be India's first standalone health insurer. The company was established in 2006 and since then it keeps on growing well. The company carries expertise in providing health insurance plans at really affordable prices. It has more than 8000 network hospitals which are helping in availing cashless treatment. The company has more than 340 branches in the country which is ready to serve the people with great plans and features.
Health Insurance Plans by Star Health Insurance Company
|Star Comprehensive Insurance Policy||Family Health Optima Insurance Plan||Medi Classic Insurance Policy (individuals)|
|Senior Citizens Red Carpet Health Insurance Policy||Star Super Surplus (Floater) Insurance Policy||Star Health Gain Insurance Policy|
|Star Care Micro Insurance Policy||Star Family Delite Insurance Policy||Star Criticare Plus Insurance Policy|
|Diabetes Safe Insurance Policy||Star Cardiac Care Insurance Policy||Star Cancer Care Gold|
|Star Special Care||Star Net Plus|
TATA AIG is a renowned health insurance company that caters into multiple domains of health care. It is a joint venture between the famous Tata Group and the American International Group (AIG). The company is in the market from the last 19 years and providing amazing health insurance products to cater to different needs of customers. It keeps on introducing innovative products and services over the years. The company is accredited with iAAA rating by ICRA for highest claims-paying ability.
Health Insurance Plans by TATA AIG Insurance Company
|Tata AIG MediCare Health Insurance||MediCare Premier Health Insurance||TATA AIG Medicare Protect|
|TATA AIG Mediprime||TATA AIG Wellsurance Executive Policy||TATA AIG Wellsurance Family Policy|
|TATA AIG Wellsurance Woman Policy||TATA AIG Critical Illness Plan||TATA AIG MediPlus|
|Medi Senior||Medi Raksha|
United India Health Insurance Company was founded in 1938. This insurance company is great at designing complex covers for renowned customers and big companies such as ONGC Ltd, GMR- Hyderabad International Airport Ltd, Mumbai International Airport Ltd Tirumala-Tirupati Devasthanam, and many more. The company designed the products with the help of experts to make it highly effective and useful for customers. The company is also great at settling the claim on time without any hassles.
Health Insurance Plans by United Insurance Company
|Family Medicare:||Individual Mediclaim:||Family Medicare 2014:|
|Senior citizen:||Super top - up:||Top - Up|
|UNI Criticare||Workmen Medical Policy|
Universal Sompo Health Insurance Company is basically a private-public partnership venture which is growing well in India. The collaboration to established this insurance company took place between two nationalized banks namely Allahabad Bank and Indian Overseas Bank, a private sector bank in Karnataka Bank, Dabur Investment Corp- and Sompo Japan of Tokyo. The company is great at offering innovative products. It offers a wide range of effective health insurance products.
Health Insurance Plans by Universal Insurance Company
|Individual Health Insurance||Group Health Insurance Policy||Individual personal accident policy|
|Janta Personal Accident Policy||Group Personal Accident Policy||Aapat Suraksha Bima Yojana|
|Hospital Cash Insurance||Senior Citizen Health Plan||Complete Health care insurance plan|
Claim Settlement Ratio (CSR) is the ratio of the total number of claims to the total number of death claims received by the insurance company.
It is considered as an important factor because it shows the number of claims that an insurer has settled versus the rejected ones. With this ratio, you will be clear in choosing the right insurance company for your health plan. Always ensure that you are going for a high claim settlement ratio of an insurance company.
|Insurance Companies||Claim Settlement Ratio (2017-2018)|
|Apollo Munich Health Insurance Company||62.47|
|Bajaj Allianz General Insurance Co Ltd||77.61|
|Bharti AXA General Insurance Company||98.50|
|Cholamandalam Health Insurance Company||39.96|
|Manipalcigna Health Insurance Company||46.29|
|Future Generali Insurance Company||87.42|
|HDFC ERGO Health Insurance||52.58|
|Iffco Tokio General Insurance Company||90.69|
|Liberty Videocon General Insurance Company||74.58|
|Magma HDI General Insurance Company||34.93|
|Max Bupa Health Insurance||50.19|
|National Insurance Company||115.55|
|New India Assurance Company||103.19|
|Oriental General Insurance Company||113.86|
|Raheja QBE General Insurance Company||18.19|
|Reliance General Insurance Company||106.54|
|Religare Health Insurance Company||51.97|
|Royal Sundaram General Insurance Company||61.41|
|SBI General Insurance Company||52.93|
|Shriram General Insurance Company||50.83|
|Star Health Insurance Company||61.76|
|TATA AIG General Insurance Company||60.68|
|United India Insurance Company||110.95|
|Universal Sompo General Insurance Company||104.17|
*Source IRDAI (Insurance Regulatory and Development Authority of India)
Choosing the right health insurance company is as important as choosing the best health insurance policy. As we have discussed above about the claim settlement ratio, there are other factors that need to be checked before opting a policy.
Let us discuss the following:
Reputation of the company : The reputation of the company plays an important role. It is advisable to go for a company that carries a good brand image. A sound research will be required that will help you to choose the right health insurance provider.
Financial Stability : You must check the financial stability of the company. You can check the Credit Rating Information Services of India Limited (CRISIL) rating. Go for a company with AAA Rating as it considered to have the highest financial strength to meet its obligations.
Product Portfolio : Don't forget that insurance is a vast industry and keeps on changing by time. It does not remain the same all the time and so your needs. That's why it is important to go for a company that offers a wide range of helpful insurance policies cater to different needs of customers.
Smooth & Quick Claim Settlement Process : It is advisable to search for an insurance company that follows simple and easy claim settlement process. During emergencies it is crucial to settle the claims on time so as to seek proper healthcare facilities.
Customer Support Service : Pay attention to the quality of customer services of an insurance company, for that you need to check for the ratings and reviews of the customers for the services provided. Choose the company that offers online chat, email assistance and phone assistance.
Insurance Advisor : Insurance is tough to understand by a common person. But now many insurance companies appoint insurance advisors who will help you in choosing an appropriate insurance plan according to your needs.
Feedback and Reviews : One of the most important and common aspects are customer ratings and feedback received by an insurance company. You can go through the Insurance Regulatory and Development Authority of India (IRDAI) website to check the number of complaints and resolutions against the insurance company.
Health insurance for senior citizens offers financial assistance to seniors or parents who are above 60 years of age at the time of medical emergencies. It is a much needed insurance plan but as the aged and old people are more prone to diseases the premiums for the health insurance policies designed for senior citizens is much higher as compared to other health insurance policies. The health insurance for senior citizens is provided between 60 and 80 years of age. Also, insurance cover paid to an individual aged 65 years or above can lead to an additional tax relief of up to Rs. 20,000.
|Insurance Company||Plan Name||Benefits||Yearly Premium (in rupees)|
|Religare||Care Senior||Co-Pay - You pay 20% of the claim |
Hospital Room - Single Private Room
No Claim Bonus -Rs. 0.5L per year upto Rs. 2.5L
Restoration - Upto Rs. 5L
|HDFC ERGO||Health Suraksha Gold Regain||Co-Pay -You pay 0% of the claim |
Hospital Room - All categories.
No Claim Bonus - Rs. 0.5L Per Year Upto 5L
Restoration - Yes
|Aditya Birla||Diamond with Unlimited Reload||Co-Pay - You pay 20% of the claim |
Hospital Room - Single Private Room
No Claim Bonus - Rs. 0.5L per year upto Rs. 2.5L
Restoration - Upto Rs. 5L Unlimited times
|Star Health Insurance||Senior Citizen Plan||Co-Pay - Fresh Illness : 30% For any Claims and in case of cover against PED : 50% For any Claims |
Hospital Room - Upto Rs. 6,000
No Claim Bonus - Not Applicable
Restoration - Not Applicable
|ManipalCigna||ManipalCigna ProHealth Plus Policy||Co-Pay - You pay 0% of the claim |
Hospital Room - Covered up to any Room except Suites
No Claim Bonus - Rs. 0.55L per year upto Rs. 11L
Restoration - Unlimited
An ideal health plan will be the one which can provide the needful health cover to you on-time. The cover provided by a health insurance depends upon the sum assured amount, health history, current health conditions, age of the customer, and many other things thus, it is important to go for an ideal plan which suits your needs.
In India, employers offer health insurance plans to their employees to provide them future security against health expenses but that is not enough to cover all your requirements at the time of emergencies.
Example 1:- If we talk about a middle class family, the minimum sum assured of Rs. 5 lakhs is necessary. A person can opt for family health cover, and if he/she is going for a family floater, then the minimum sum assured should be Rs. 7.5 lakhs. Moreover, for an extra cover, a top up plan can be bought, which can be used when your basic health insurance plan's limit is crossed. A decent cover that a family should have in the urban areas is of Rs. 10 lakhs as the sum assured. They might go to Rs. 15 lakhs up to Rs. 20 lakhs as per the requirements.
Example 2:- If we talk about buying health insurance with pre-existing disease, then it is important to understand the seriousness of the disease such as treatment costs.
Like, if a heart surgery costs Rs. 5 lakhs today, then in the next 20 years the price will rise to Rs. 80 lakhs. To deal with such scenarios, a minimum cover of Rs. 20 lakhs is a need. You must go with the policy which keeps on increasing the cover on every claim-free year. Also, go for a top-up cover to enhance your existing health insurance cover. Top-up plans are cheaper as compared to others. Buy a health insurance cover at a young age and don't rely on the health insurance plan provided by the employer.
Usually people forgot to check important factors and skip the list of terms and conditions provided by the insurance plan. Due to the busy schedule people often rush to make a decision. The following are some common mistakes that people usually do and you should avoid are as follows:-
Insufficient Coverage: Don't go for insufficient cover just because of the low premium; it will not be able to provide the desired coverage in the hour of need.
The cost that people pay towards his/her health insurance plays a vital role in deciding which policy you should go for. Hence, just because of saving an amount, people end up in choosing a plan with less coverage.
Avoiding the Fine Print: While many of the individuals are aware of different treatment and expenses and look for the coverage provided by the health insurance plan and skip the exclusion part of the policy document. But one should thoroughly check the fine print and read the exclusion part also.
Don't Rely on a Single Insurer or Plan: Don't go with the first insurer while buying a health insurance plan. It is vital to understand that comparison of several plans will help you in getting the best and most suited plan which can easily go well with your needs.
If you get something better as per your o your needs and budget than your existing health insurance plan, then you should switch the insurer without any hesitation.
Hiding Medical History: This is the most common mistake that people usually do, and this becomes the biggest reason behind the rejection of health insurance claims by the insurer. While looking for a health insurance plan it is very important to be transparent about your medical history, don't hide anything and let your insurer know about all your medical problems in advance.
Not Choosing Co-Pay Wisely: If you do not choose co-pay wisely, then you may end up in the wrong situation at the time of claim. There can be a chance of rejection; you might have to pay a big amount from your pocket, not able to get the required coverage and have to face many other issues.
Buying More Add-Ons: There is no need of buying many additional riders if you don't need it. Purchasing too many extra riders will only lead you towards the stage of over policyholder. Spend a few minutes on understanding your needs first, write it down, make a checklist and then go for a plan that can easily go well with your needs.
Delay in Buying: If you delay in buying health insurance, then you might have to pay a high premium, not liable of wider cover, and much more. Moreover, what will you do if you fall ill with serious health diseases before buying it? Invest in health insurance as soon as you can. The older you get, the less will be the options to explore as not all insurance companies will be ready to entertain you.
Insurance Offered by Employer: Don't rely on the employer's health insurance for a comprehensive cover. It would not be sufficient enough to get the required treatment on-time. You should also keep in mind that once you changed the company you will not be able to get coverage from an employer's health insurance coverage.
I got the best service from CUSTOMER SERVICE and Agent VINOD was very helpful. He gave his best which really called customer service however, I request you if you make any commitment with your client. Please do that on time otherwise client could be irate and might not use you again.
- SAURABH GOSWAMI, Meerut
Kuldeep, Thank you so much for all your support at the time of buying the policy... You have been really helpful and humble during the call... PolicyX is lucky to have such Employee. I wish him a great and bright future ahead in his Career....
- Bikash Nath
The sales agent others were knowledable enough to convince me to buy a policy and help me understand how to get health insurance claims and various formalities .
- Hari, Delhi
Buy Early: It is advisable to purchase health insurance at an early stage of life as it will help you to secure your future with affordable premiums. As you grow up, you will tend to develop more diseases and health issues due to aging and that is why the premium is more when you buy a health insurance policy later in life. Insurance companies consider youth to be more healthy than the old age people thus less chances of getting hospitalized thereby charging less premiums to the young policyholders.
Health Insurance Premium Calculator: It is important to calculate the premium amount as per your affordability for a specific term in order to buy a health insurance policy for and your family. An individual can use the online health insurance premium calculators available in various websites of insurance and insurance web aggregator companies to check the premiums. Premiums depend on the health treatment needs and financial goals, hence comparison of premium amount with the different health plans of different companies is also crucial. The premium calculator asks for your basic details and displays all the information of a particular health plan. A simple and easy method of checking premium can save money.
Use of Top Up Plans: Suppose, If you have an individual health insurance policy of Rs. 5 lakhs and your treatment costs around Rs. 10 lakhs. In that case you will be able to pay the hospital bill of Rs. 5 lakhs but what about the remaining balance? This is where Top Up plan works as a support to your health insurance.
On addition of a Top Up plan of Maximum Coverage Amount Rs. 10 lakhs with a deductible amount of Rs. 5 lakhs, the annual premium amount will be Rs. 909. Whereas the annual premium for Rs. 10 lakhs Sum Assured for an individual health insurance policy is Rs. 13,886 and Rs. 5 lakhs Sum Assured is Rs. 10,783.
This means the Top Up plan of Rs. 10 lakhs is cheaper than the individual health insurance of Rs. 10 lakhs sum assured. In this way, you will be able to save Rs. 2,194 on an annual basis if you will purchase a health insurance Top Up plan and get an extra cover for more affordable care.
Go For Family Floater Plan: Companies offer family floater plans to the customers as an advantage to cover all the members of the family under one and single insurance plan. If you will buy family floater plan then your family is covered in one plan and whenever anyone of the members required medical insurance you will be able to seek the same from the policy. In that case the premium will get lower as there is only one one premium against whole family's security. In this way, you may choose this as an option to save premiums.
Choose Long-Term Plan: If you are choosing a long term policy tenure for a health insurance plan as the premiums for a long term policy is less than the premium for a short term insurance plan in India. Also, to minimize the amount you can avail NCB (No Claim Bonus) during renewal for consecutive claim-free years and not making any claim, the same discount will be applicable on your premium and become less than the actual amount.
Here are some of the important terms that you will come across while subscribing to a health insurance policy.
The Sum Assured amount is the maximum coverage amount you get with your insurance policy. It forms the basis of all your claims. Consider the increasing costs of hospitalization, medicines, and treatment before you decide the sum assured. It is advisable to select a higher sum assured.
Co-pay is a fixed amount paid to the insurer for additional services that may go beyond the expenditure of the policyholder. This prevents hospitals from billing unreasonable room rents to patients. For instance, if a policy has 10% co-pay, then the insurance company will pay 90% of the expenses, and you have to bear the rest.
Besides, some insurers cap the expenses of treatments to reduce the claims of hospitals. This is known as sub-limit. While buying a mediclaim, choose a policy which has fewer sub-limits.
Critical illness refers to life-threatening diseases. There is a specific list of critical illnesses to provide cover by insurance companies such as heart attack, kidney failure, cancer, etc.
The restore benefit refers to a feature of the plan that reinstates the basic sum assured if exhausted as well as the multiplier benefit within the policy year. This benefit is useful in a family floater plan where the full sum assured is exhausted for treating only a single family member and the remaining members will have no cover in case of hospitalization for the rest of the policy year.
No Claim Bonus is the insurance company's reward to the policyholder for not claiming in the preceding years.
NCBs can range from 50% up to 100% of the sum assured. A high NCB gives cover against medical inflation, and you don't need to worry about increasing the coverage year after year.
Pre-existing diseases refers to those diseases that you already have before subscribing to the health insurance policy. Most health insurance companies specify a waiting period for these illnesses. If you have a pre-existing illness, the insurance company is unlikely to give a cover against such illnesses. In most cases, a pre-existing illness is covered after at least 2 years (waiting period) of buying the policy.
It means the diseases that are not covered under the mediclaim or health insurance policy. For instance, if you have diabetes while taking the policy, then kidney ailments are likely to be excluded from the cover because diabetes is an exclusion condition as per the policy norms. Never hide any pre-existing ailments from your insurer while buying a mediclaim policy. It may reduce your hospitalization claims.
Top-up health plans are additional coverage plans to cover various other types of expenses for people who have an existing individual health insurance plan or a mediclaim from the employer. It reduces the cost of deductibles (out-of-pocket expenses).
Health Insurance portability is the feature under which the insured is free to change the insurance company and the existing health insurance plan. Where he/she doesn't have to compromise with the existing benefits, waiting period, and bonus. He/she can carry the same with the new insurance company as well. It seems to be an effective procedure which is helping millions of people daily in getting sufficient health insurance cover, or you can say a more comprehensive cover at affordable premiums.
|Portability allows a person to avail better health insurance plans in terms of coverage, benefits, and much more. He/she can modify the health insurance plans as per their health conditions/requirements.||A person can take advantage of portability at the time of renewal of the policy.|
|On switching to a new one, you become entitled to Sum Assured and cumulative bonus which you are getting in the current one. There will be no compromise regarding the same.||Policies and features vary from insurer to insurer, so you need to opt for the new insurer very carefully.|
|You can be more sure about better claim settlement process from all the companies while you plan to change your insurance company.||The new insurance company can reject the policy portability, keeping in view your medical history and claim.|
The most important part of an insurance policy is the claim settlement process. People often worry about the claim settlements within time. Some insurance companies offer direct claim settlement process, and some take the help of TPAs (Third Party Administrators) for claim settlement. The claim settlement process takes place in two forms which are mentioned below:
You can avail cashless treatment facilities only in the networked hospitals of the insurance company. The TPA must be notified beforehand in case of planned hospitalization, or within a specified timeframe in case of an emergency. The hospital's insurance desk helps with all the paperwork. The TPA has to approve the mediclaim amount, and the hospital will settle it with the insurer. There are likely to be exclusions i.e., expenses that the TPA won't pay. Such expenses must be settled by the patient party directly at the hospital cash counter.
The insurer can avail the reimbursement facility both at networked and non-networked hospitals. Here, you can avail treatment facilities and settle the bill directly with the hospital. You can then claim reimbursement of the expenses from the TPA by submitting relevant bills and receipts of treatment.
Usually, people think that they have to pay huge taxes if they purchase a health insurance policy. But there are tax exemptions in health insurance under Section 80D of the Income Tax Act of India, 1961. According to which the premiums paid by the policyholder are free from tax.
PolicyX helps you to understand the importance of tax benefit in a health insurance policy. Below are a few cases to understand more clearly:
Case I: No One Over 60 Years
In a case where no one in the family is over 60 years, the deduction is up to Rs. 25,000 in a year. For health insurance paid for parents below 60 years, the deduction is up to Rs. 25,000. Hence, total deduction a person can avail is up to Rs. 50,000.
Case II: Either Parent Over 60 Years
In case where one of the parents is over 60 years, the tax benefit of up to Rs. 50,000 is allowed. Also, if a person pays a premium for family, i.e., self, spouse and children, then he/she can enjoy a tax deduction of Rs. 25,000. This means as a sum total; a person can avail tax benefits up to Rs. 75,000 in a year.
Case III: Eldest Member In The Family Over 60 Years
Where a family member (self, spouse, or children) is over 60 years, one can claim up to Rs. 50,000 in tax benefits on medical insurance. Additionally, for parents over 60 years, a person can get up to Rs. 50,000 as a tax benefit. So, the total deduction, in this case, would be around Rs. 1 lakh a year.
For Example: Rohit is a young marketing officer who is working in a reputable company and get Rs. 45,000 monthly salary. He bought a health insurance plan for himself and his parents, who are below 60 years and no one in the family is over 60 years. He shows the same at the time of filing ITR (Income Tax Return). Hence, he managed to save Rs. 50,000 on tax, which is a big relief for him.
The government of India is focusing on increasing healthcare awareness, and thus, it came out with several new plans for the people of the country. They are designed to improve healthcare access for the unorganized sectors and for those who come under the Below Poverty Line (BPL) category. Here is a list of health insurance schemes provided by the government:
One of the most effective National Health Protection Schemes, which is offering the required health cover to almost 10 crore poor and vulnerable families. It is designed in a way that can offer required cover to around 50 crore beneficiaries. A cover of about Rs. 5 lakhs per family per year for secondary and tertiary care hospitalization will be there. This effective health program will subsume the current centrally sponsored schemes - Rashtriya Swasthya Bima Yojana (RSBY) and the Senior Citizen Health Insurance Scheme (SCHIS).
As per Niti Aayog Achievements in the Year 2018-19, it has introduced additional 1352 packages in Ayushman Bharat Yojanasuch as emergency room package, mental care package, etc. encouraging healthcare quality and services in far-reaching districts all over the country via development of Standard Treatment Workflow and costing these packages.
Ayushman Bharat has initiated National Health Protection Scheme in September 2018 that offers a wide health coverage upto a maximum of Rs. 5 lakhs for 100+ million poor families. In India, this scheme has resulted in a boost from 34% to 50% to opt for health insurance cover.
The Ministry of Labour and Employment introduced a new health protection scheme to provide the helpful cover to offer the needful health insurance coverage, especially for BPL families. With this effective healthcare plan, all beneficiaries can avail hospitalization whenever it requires up to Rs. 30,000. To enroll under this effective health insurance plan, there is no specific age limit, and you will be liable to get the cover of pre-existing diseases from day 1 of the policy. It can cover up to 5 members of the family includes spouse, children, and dependents. Beneficiaries have to pay only Rs. 30 as registration fee. The central and state government to the insurance company will take care of the rest unpaid premium.
The universal fact is that accidents are unfortunate incidents that can happen at any place, anytime to anyone. It does not discriminate against people on the basis of rich and poor. In such a scenario, the one who suffers the most is the poor section of the society, who are unable to afford an effective and adequate health insurance policy. To provide the needful assistance to the poor section, the government has come out with this effective health insurance plan called Pradhan Mantri Suraksha Bima Yojana. It offers wider cover at affordable premiums and provides compensation to the family of the deceased or if the policyholder has been disabled partially or permanently following an accident.
It was introduced a long time back ago, and since its inception, it is providing great assistance to Indians. It is now available in Central Government Health Scheme CGHS covered cities like Allahabad, Bhopal, Chandigarh, Ahmedabad, Lucknow, etc. The plan is designed to cover central government employees and pensioners. Under the same, the dependant's member of the government employee would also be able to reap the benefits of this plan. The insurance policy provides coverage against domiciliary care, specialist consultation facilities, laboratory tests, hospitalization, and health education to beneficiaries.
A social security scheme launched in October 2017 intending to provide required healthcare facilities to all the rural and landless households. The head of the household or the earning member of the family will be covered under the scheme. The central and state government will pay a premium of Rs 200 per year is paid by the central and state government. The beneficiary should be between 18 to 59 years of age. With the same beneficiary will receive Rs 30,000 upon the natural death of the policyholder member, Rs 75,000 upon accidental death or permanent disability, and Rs 37,500 for partial permanent disability.
This insurance policy was launched in 2000 on 10th August after replacing the Social Security Group Insurance Scheme (SSGIS) and Rural Group Life Insurance Scheme (RGLIS). This policy is specially designed for those people who come under the BPL category and slightly above the BPL category in 45 occupational groups covered under the scheme. Some of the occupations that would be liable to get the cover are beedi workers, carpenters, power loom workers, cobblers, handicraft artisan, agriculturists, construction workers, etc. Aam Admi Bima Yojana and Janashree Bima Yojana have been merged into one scheme and called Aam Admi Bima Yojana since 2013.
Again a social security scheme that is designed especially to offer socio-economic protection to the working class and their dependents. The policyholder and his family who will receive complete medical care from day one. Under the policy, the beneficiary will receive cash benefits in times of sickness and temporary or permanent disablement that leads to the loss of earning capacity. This policy will also be covered by the policyholder's dependents as if the dependant is disabled on the job, a monthly pension called the dependents' benefit is provided under the ESI scheme. The scheme applies to non-seasonal factories, theatres, shops, restaurants, hotels, road motor transport undertakings, and newspaper establishments employing more than 20 people. Recently, private medical and educational institutions employing more than 20 people in certain states and union territories have also been included under the scheme.
A new health insurance plan that is py-1 font-15 specially designed to provide necessary healthcare services to a wide area of the country and to cover poor section effectively. Under this plan, beneficiaries will receive reimbursement for medical expenses up to Rs 30,000 and accidental death cover up to Rs 25,000. This policy is there for the BPL families only. The insurance premium for this scheme is Rs 200 per person, Rs 300 for a family of 5, and Rs 400 for a family of 7. The four public sector/government health insurance companies in India are The New India Assurance Co. Ltd. United India Insurance Company, National Insurance Co. Ltd. and Oriental Insurance.
Before buying a health insurance plan, we are sure you must be having a lot many questions in your mind. Don't worry PolicyX.com is here to figure out the queries at its best. Let's go through some common queries:
Yes, there's no limit to the number of claims in a single year unless there is a specific cap laid down in the policy. The sum insured, however, is the maximum claimable limit under the mediclaim policy.
According to statistics, Rs 5 lakh family floater policy will cover self, spouse and one child will cost anywhere between Rs 10,000 and Rs 17,000 on an annual basis whereas Rs. 5 lakh individual health plan will cost a 35 year old Rs. 4,000-7,000 a year.
The difference between a mediclaim and health insurance policy is all about the coverage provided. Mediclaim is confined to hospitalization expenses and domiciliary care costs whereas health insurance provides full protection against the treatment, hospitalization, surgery expenses.
Therefore, health insurance is a better decision to secure your and your loved ones' future.
During Emergency Hospitalization you can claim for cashless treatment in the following ways:
A health insurance plan is for the future security and a smart investment financial plan. If you buy it early premiums will be low and can cover the diseases coming up in life. It is an absolute necessary and important but not mandatory plan in India.
As we have discussed above, it is important to buy health insurance at an early stage of life. If you are 25 years of age you should buy a health insurance plan to safeguard your health from future medical expenses.
Yes, it is possible to utilize your health insurance immediately after all the paperwork and documentation is done from the insurance company's end along with the payments. However, most companies offer the facilities after a certain waiting period.
Yes, every insurance company has a network of hospitals in which cashless treatment facilities are available to the policyholders.
It varies from insurer to insurer, most of the companies do not provide cover for pre-existing diseases but on the other hand, many companies cover the same after a waiting period of 4 years.
The policy can be renewed later if you pay your premium on time or within the grace period, which is usually 15 days from the date of expiry of the policy for most insurance companies. However, you will not be entitled to any coverage for the period during which the insurance company did not receive any premium. Also, the policy would lapse if the premium is not paid within the grace period.
Yes, according to a circular issued by the Insurance Regulatory and Development Authority (IRDA), with effect from 1 October, 2011, the insured can transfer a policy from one insurer to another, and also from one plan to another. The insured will lose no renewal credit for pre-existing health conditions which he/she enjoyed in the incumbent policy. But the credit would be limited to the sum insured and the bonus eligible under the present policy. Check with your insurance company for the detailed clauses in this regard.
Some insurance companies reimburse general health checkup expenses usually once every 4 years.
Smoking has an adverse effect on health insurance premiums. This means that if you are a smoker, you end up paying higher premiums as you are subjected to greater medical risks.
In case you forget to pay your health insurance premiums, the provider gives you a grace period that usually varies from one to three months. However, if you fail to pay the premiums during this time as well, your insurance policy lapses and you are no longer entitled to the health insurance benefits of the policy.
Yes, health insurance provides cover to diabetes patients and related complications. However, it may vary from insurer to insurer, most of the companies provide the same after a waiting period of 4 years.
Yes, health insurance covers the medical tests and scans for the inpatient treatment, i.e., during hospitalization for at least 24 hours. For outpatient treatment, out of the hospital cover for the same is not applicable.
A waiting period of 48 months is applicable to avail the maternity insurance benefits and cover. A cover of Rs. 25,000 in caesarean delivery and Rs. 15,000 is provided usually from a maternity health insurance plan.
These days, most insurers have arrangements with various hospitals spread across the country as part of a network. An individual, if policyholder under a policy which offers the cashless facility, can get treated in any hospital of the network without paying hospital bills because the same is paid directly by a third party administrator (TPA), on behalf of the insurer. However, all expenses beyond the sum insured or the ones not covered under the policy, have to be paid by the policyholder directly to the hospital. Cashless facility is not available if the hospital is not included in the network. In such cases, payment by the insurance company to the hospital is usually carried out on a reimbursement basis.
You can claim several tax benefits if you subscribe to a health insurance scheme. Such benefits are extended by section 80D of the Income Tax Act. Presently, subscribers to health insurance, who purchased the policy by a payment mode other than cash, are eligible for Rs 15,000 annual deduction from their taxable income for the payment of health insurance premium for self, dependent children, or spouse. The deduction is higher for senior citizens at Rs 20,000. Also, since the 2008-09 financial year, an additional deduction of Rs 15,000 can be claimed for mediclaim premium paid for parents. It's Rs 20,000 if parents are senior citizens.
Age is the biggest factor which determines the premium payable. The older you are, the higher will be your premium, because you'll be more prone to illness. Your medical history is another factor that will go into determining the premium. If you don't have any medical history, the premium would be naturally lower. You are eligible for a discount on the further premium payable for the years for which there has been no claim of the insurance money. Some insurance companies cover add-on benefits like free medical checkups and/or diagnostic tests in case of no claim.
Read the offer document/prospectus and understand it fully before signing on the dotted lines. What's not included will be clearly written in the prospectus. Any pre-existing illness, usually, is not covered under a policy. But read the offer document to understand what the insurer means by pre-existing illness. Also, the majority of the policies generally exclude certain types of diseases in the first year of coverage. A waiting period is also often imposed on such diseases. Some expenses not covered under most health insurance policies include cost of contact lenses, spectacles and hearing aids, dental surgery (unless it requires hospitalization), general debility, convalescence, venereal disease, congenital external defects, use of drugs and alcohol, intentional self-injury, expenses for diagnosis, AIDS, X-ray and/or laboratory tests not connected with the illness requiring hospitalization, treatment related to pregnancy or childbirth, including C-section, naturopathy treatment and others as deemed exclusive by the insurer.
As already said, there is usually a 30-day waiting period when you buy a new policy, starting from the day you enrolled in the health insurance scheme. During this period, the insurance company won't pay any hospitalization charges. But this is not applicable in case of an emergency hospitalization arising out of an accident. The waiting period is not applicable for renewal of the policy for subsequent years.
It's a medical condition or ailment that existed before you took the health insurance policy. This is a significant point in all policies because insurers don't cover such conditions within 48 months prior to taking the first policy. It means a pre-existing condition may be considered for payment, only after the completion of 48 months of continuous insurance cover.
Once an insurance claim is filed and settled, the coverage gets reduced by the amount paid on settlement. For instance, if you take an Rs5 lakh mediclaim policy in January, and in April, the insurance company pays? 3 lakhs towards your hospitalization and treatment, then you will be eligible for the balance Rs 2 lakhs as coverage for the remaining duration i.e., May to December
In a family floater scheme, a single policy covers the hospitalization expenses of the entire family. Such a policy has only one sum insured which can be utilized by a single or all members collectively in the family. The limit of coverage is capped at the sum assured. Family floater plans are considered better than buying a separate health policy for each member of the family. It takes care of all medical expenses, including surgeries, sudden illness, and accidents.
Women of all walks of life are now progressing and trying to maintain the fine balance between their personal and professional commitments. Hence, it is important that their medical needs are catered to. Various health insurance providers have now come up with unique health insurance plans that specifically cater to female medical conditions such as breast cancer, ovarian cancer, cervical cancer, complications during pregnancy, childbirth or other forms of critical illnesses. Some of the top companies that provide these kinds of health insurance plans are TATA AIG, Bajaj Allianz, etc.
Goods and Services Tax (GST) - implemented in 2017 - is an indirect tax levied on the sale of goods and services in India. It has replaced many indirect taxes imposed on goods and services by State and Central Government. Tax slabs under GST have been fixed at 0%, 5%, 12% and 28%.
Before the new tax regime, the service tax rate applicable on health insurance was 15%. However, with the implementation of GST, the tax rate has been raised by 3%- placing health insurance in the 18% tax bracket.
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Last updated on 22-10-2019