Can I Increase the sum insured in my existing health insurance?

Most health insurance companies have a fixed sum insured in their plans. So, you have to do proper research before choosing any health insurance that fulfills your requirements. You can also get in touch with your insurance provider for more info.

Why is the sum insured important?

It is important because the sum insured is the amount that the insurance company pays to the insurer in case of any unpredictable event.

Can I change my sum insured at the time of renewal?

Yes, you can change your sum insured at the time of renewal, while the cost of the premium may vary depending upon requirements.

Written by varun saxena

Published: 12 Aug 2024

Updated: 18 Jun 2026

4 min read

Expert Verified

IRDAI Licensed

Importance of Sum Insured in Health Insurance

In today’s fast-paced world, having health insurance is more important than ever. With the rising cost of healthcare and the unpredictability of illness and accidents, it’s crucial to have a safety net in place to protect you and your family financially. Health insurance ensures you have access to the medical care you need when you need it, without breaking the bank.

This article will explain the term 'Sum Insured' in health insurance.

What is the Sum Insured?

The Sum Insured is the maximum amount of money the insurance company will pay out to the policyholder in the event of loss or damage. This important term is particularly relevant in the insurance industry, especially for products like term insurance and health insurance. Simply put, it defines the maximum financial assistance an insurance provider is responsible for, indicating the scope of coverage.

What is the Sum Insured in Health Insurance?

The Sum Insured in health insurance is the maximum amount the insurance company will pay for medical expenses covered under your policy. It represents the highest financial limit the insurer will cover for an approved claim under your chosen health plan.

Benefits of Choosing the Right Sum Insured

Choosing the right Sum Insured offers the following benefits:

Maximum Financial Coverage: Insufficient coverage can lead to significant out-of-pocket expenses. By choosing an adequate Sum Insured, you can avoid financial stress related to health issues, as the insurance company will cover treatment costs and other specified expenses.
Avoid Multiple Claims: While IRDAI allows filing multiple claims to cover the maximum cost of medical events, this process can be time-consuming and delay financial assistance during urgent situations. A sufficient Sum Insured can help you avoid this hassle.
Sustained Coverage Throughout Policy Term: A lower Sum Insured can quickly deplete, leaving you financially vulnerable for subsequent claims. Opting for an appropriate Sum Insured ensures sustained coverage throughout the policy duration.

Let us take an example

Consider this example: Simran, 20, is covered by her father’s family floater health insurance plan with a Sum Insured of ₹5 lakhs. She was hospitalized for several weeks after a serious road accident, incurring a hospital bill of ₹4.5 lakhs, including surgery costs. The insurance company covered most of her hospital bills, except for the deductible as per policy terms. One year later, Simran’s sister Priya was diagnosed with Dengue and hospitalized, with a bill amounting to ₹50,000.

Here's how the Sum Insured financially supported Simran's father in both instances:

Parameters	Case 1: Simran’s Accident	Case 2: Priya’s Hospitalization
Hospital Bills	4,50,000	50,000
Claim amount	4,50,000	50,000
Pocket Expenses (Deductible)	45,000	5,000
Remaining Sum Insured	50,000	0

Factors Affecting the Sum Insured in Health Insurance

Type of Health Insurance Plan: The market offers various health insurance plans, including individual, family floater, employer-provided, and critical illness plans. The Sum Insured you need will depend on the type of plan you choose.
Number of Family Members Covered: Plans like family floater or employer's group health insurance cover multiple individuals, unlike individual or senior citizen policies. When determining the Sum Insured, consider the total number of people requiring coverage.
Health History and Age of the Insured: If family members have pre-existing conditions like asthma or diabetes, requiring regular check-ups, a higher Sum Insured is advisable. Age is also a crucial factor; older adults generally benefit from higher coverage due to increased health risks.
Quality of Medical Facilities in Your Area: Medical treatments in metro cities (e.g., Delhi, Mumbai, Ahmedabad, Pune) are often more advanced and expensive than in other parts of India. Factor this into your decision when selecting the Sum Insured, as it may necessitate higher coverage.
Existing Health Insurance Coverage: Before buying a new policy, assess the remaining coverage of any existing health insurance. Be aware that employer-provided plans often have limitations and typically cease upon termination of employment.

Kindly Note:

Having multiple health insurance policies can be beneficial. As per IRDAI guidelines, an individual can claim against more than one policy to cover the full cost of a medical event.

Conclusion:

Understanding critical health insurance terms like 'Sum Insured' is vital for making informed decisions about personal and family coverage. While a higher Sum Insured may result in higher premiums, it acts as a crucial financial shield against escalating medical expenses.