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Everyone around us talks about health insurance. However, not many know that choosing the right health insurance plan can go a long way in looking after their medical needs or taking care of the hospitalization expenses. Depending on one’s needs, policyholders can either opt for cashless benefits option or choose to get the treatment expenses reimbursed. While most people consider buying health insurance only for tax benefits, it is important to realize how the health insurance coverage in lieu of nominal premiums ensures that policyholders do not have to dig deep into their savings for paying hospital bills.
As an increasing number of people are now including health insurance as an essential financial tool, more insurance companies are now selling health insurance policies modified and suited to their customers’ needs.
Table of Contents
As the name suggests, Health Insurance is a kind of cover that secures against the rising costs of hospitalization and medical treatment. It is, in fact, an agreement between an insurance company and the policyholder in which the former promises to compensate for medical expenses in the event of the latter falling ill or seeking treatment for injuries suffered in an accident.
Advances in science and technology continue to promise better treatment options though they do not have a diminishing impact on medical and surgical expenses. Having a health insurance plan(s) in place ensures that you enjoy the benefits of cashless treatment or reimbursement of medical expenses, if and when you fall ill. Based on the kind of health insurance coverage you have opted for, your insurance company may consider the idea to make payment to your health care provider directly or recompense you for the amount spent on medical treatment incurred.
In addition, health insurance in India comes with its own set of tax benefits. Under Section 80D of the Income Tax Act 1961, the amount of premium you pay towards availing health insurance for yourself, spouse, parents and dependent children qualifies for tax deduction up to Rs. 25,000. Also, if any family member covered under the health insurance policy is a senior citizen, the amount of deduction goes up to Rs. 50,000.
You do not realize the importance of buying a health insurance policy early in life. In fact, many Indian households continue to rely on their income and savings to fund their hospitalization expenses, thus, reflecting on the true state of health insurance in India. According to numbers shared by the National Sample Survey Office (NSSO) in 2016, nearly 86 percent of the population belonging to rural areas and 82 percent of the urban population continues to pay for their treatment themselves.
Financial security stems from prolonged savings. However, the same may be stalled as recurring medical expenses eat into our savings, thus, creating a dent in it. Buying a health insurance policy implies that your insurance company is liable to bear the costs of treatment that otherwise would have been spent from your savings. One realizes the significance of buying health insurance coverage, be it individual medical insurance or group health insurance options during emergency medical situations. Moreover, you can claim a tax deduction on the premiums that you pay towards health insurance under Section 80D of the Income Tax Act 1961.
Not many people in India are aware of the need to undergo regular and recurring health checkups. This is because these involve expenses that most people prefer to avoid. Serious health problems are on the rise with an increasing number of the country’s population reeling under critical illnesses owing to changing lifestyle habits coupled with shifts in climatic patterns and a rise in pollution levels. Having health insurance, especially, family medical insurance, allows you the benefits of health checkups that many insurance companies allow free of cost. These checkups not only keep you informed about disorders that you are prone to but also keep you protected against possible medical conditions that may deteriorate if not treated timely.
The rising costs of healthcare is a matter of concern, especially, in countries like India where income levels have not risen in the same proportion as medical expenses in the past few years. Inflation has had an augmenting effect on the costs of medical treatment, thus, prompting the need to buy healthcare insurance. Many health insurance companies have come up with affordable health insurance policies that secure the cover against increasing medical costs and ensure financial security in the long run. Also, one enjoys the benefit of buying a customized health insurance policy in sync with specific healthcare needs, which means protection guaranteed at lower costs.
The concept of buying health insurance is gaining increasing attention as an increasing number of people are getting hospitalized to seek treatment for chronic disorders. In a world where presence on the web has made it possible to contrast similar looking products and their features, one must compare health insurance policies based on their parameters including premium charges, health coverage, types of illnesses covered and tenure among others.
You might wonder at the idea behind comparing the health insurance policies before choosing the one that suits your needs and budgetary requirements. Insurance is, in fact, a financial product. It is an agreement that promises to keep you and your loved ones covered in the event of unforeseen circumstances without hampering your financial stability. Insurance is not a one-size-fits-all product. Many people remain unaware of the nuances and importance of buying health insurance and continue to opt for cheap medical insurance only. Before choosing to buy a health insurance plan(s), you must take into consideration the following necessary factors:-
Insurance policyholders prefer a smooth and fast claim settlement process. Hassle-free claim settlement is the hallmark of a reliable insurance company. Look at the track record of the insurance company whose health insurance policy you wish to buy. Avoid insurers with lower claim settlement ratio. If possible, consider every insurer’s solvency margins, i.e., the ability to pay out claims. Also, find out the growth in the number of customers of every insurer every year. This can be evaluated by looking at the premium growth registered by the insurers on their websites. How long the insurance company has been into this business also counts as the insurer’s expertise mirrors the experience it has gained over the past few years. In addition, you must find out about the customer support efficiency of the insurer you wish to choose. An effective customer care department ensures timely solutions to the grievances of its customers.
Many insurance companies mandate a two to the three-year waiting period for pre-existing disorders. The mandate period may be more in some of them. Check out the waiting period of the insurer while opting for its health plan. It is advisable to buy health cover when you are young. This is because there are lesser chances of falling ill, thus, making it relatively easier to clear the waiting period without considering the need to file any claims. Choose the health insurance plan with a lower waiting period.
Buying health insurance plans for family necessitates the need to consider their lingering health problems, the frequency at which they are hospitalized and their medical history. Also, keep in mind the pre-existing disorders your family members may be suffering from and if they are covered within the medical insurance policy.
Know the insurer’s hospital network and if it includes the hospital or health care provider you prefer to get treated from. Learn about each insurance company’s cashless network of hospitals. This is to enable the insured to avail cashless treatment option during medical emergencies as the health care provider settles the bill directly with the insurer. Buy health insurance from that insurance company with the most number of hospitals in its network.
Skyrocketing medical expenses have resulted in increased costs of maternity care too. It helps to buy a health insurance plan with maternity benefits and takes care of the pregnancy costs of women. However, one must look at the waiting period and sub-limits too as the same would be applicable for claiming maternity benefits. Outpatient expenses must also be covered under the medical insurance plan while exclusions must be carefully looked at.
Be it pre-hospitalisation or post-hospitalization, costs of medical treatment are rising each year. Many insurance companies cover hospitalization expenses only. Opt to buy health insurance that takes care of pre-hospitalisation expenditure including visits to the doctor, buying medicines and undergoing necessary tests. The post-hospitalization expenses including charges on following up with the doctor and buying medicines during the entire course of treatment must also be a part of the healthcare insurance plan that you buy. Also, if you have elderly parents living with you who require frequent health check-ups, then find out if your health insurance plan covers for OPD services and ambulance charges too.
Buying health insurance does not mean that you would be making claims each year. To encourage policyholders into claiming only when it is most necessary, many health insurance companies offer cumulative bonus benefits if they had not made any claim on the policy during the previous year. In the case of no claims made, the amount of bonus gets accumulated every year. The collected bonus amount may benefit the insured either in the form of the increased sum insured or discount on premiums payable in the future or both.
No one buys health insurance only for a year, which means that it is preferable to buy policies that offer the option of lifetime renewability. Renewing health insurance policies from the same company ensures that you avail all the benefits of being a loyal customer of that insurance company. Also, since you are most likely to get ill with increasing age, paying for health insurance plans that offer lifetime renewability helps in the long run.
Many people are not aware of the free medical check-up facilities that some insurance companies provide. Though this does not affect the premium charges during policy renewal, having this option informs early about any probable disease incidence.
However, many health insurance companies make way for premium variants for added services including doctors’ second opinion, vaccination cover, wellness benefits among others. Avoid falling into the trap of paying higher premium charges in lieu of services that you might not need or would not avail in the long run. Buying a high-end health cover just to avail tax benefits. Instead of spending on costly health insurance plans, buy health insurance that offers more benefits at nominal premium charges. Invest the rest of the amount in other tax-saving schemes that allow you to create wealth too.
Why buy health insurance online? This is a common question by customers who realize the value of buying products online but are clueless about the benefits of availing insurance services through the web. Indians are currently riding the wave of shopping online, especially, as digital payments have made online transactions easy, transparent and convenient.
The need to buy health insurance has undergone a change similar to the way people now choose and pay for it. There are no advisors or middlemen who decide and choose a health insurance policy on your behalf. The web has now made it easy for prospective policyholders to view online health insurance plans shared by insurers on their sites. Insurance web aggregators also offer multiple health insurance products on their sites, thus, making it easy for customers to compare their attributes, features, and benefits before opting to pay for any of them.
Online health insurance quotes not only ensure that customers are able to buy their choice of health insurance plans but also do away any scope of mis-selling or other snags associated with a traditional insurance purchase. In addition to convenience, online health insurance is cheap. This is because there are no agents’ commissions payable in online insurance purchase as opposed to the offline selling/buying mode.
The benefits of buying online health insurance plans far surpass traditional methods. Some of them include:-
Browsing through the list of health insurance plans lends a brief idea of the insurance policies being currently sold in the market. In addition, customers also learn about the benefits promised in each plan coupled with the terms and conditions of all the health insurance companies in India. Premium calculators shared online help to find and buy the right healthcare insurance in sync with our needs and budgetary requirements. Apart, other factors including claim settlement records, solvency margins, quality of customer care service and reputation of the company can also be looked into. Buying insurance online surely helps!
It does not make sense to pay more for some health care plan when another plan with similar benefits is already available in the market. As an increasing number of companies are getting into the insurance business, it is not difficult to look for affordable health insurance plans. Buying an online health insurance policy ensures that one has to pay lower premium charges, thus, rendering it inexpensive. This is because the web allows customers to buy insurance directly from the insurers, thus, relieving them of the burden of commissions paid to distributors in addition to overhead costs and operational expenses.
Also, the insurance premium needs to be paid regularly either monthly or annually. Health insurance plans with lower premium charges mean that the customers continue to avail the benefits of buying cheap health insurance plans throughout the policy period.
With a multitude of health insurance products being sold by multiple insurance companies, customers often inquire about how to buy health insurance online. Just like you compare products across various sites before buying the one that fits your needs and budget, you may purchase health insurance similarly. Easy to compare and contrast, the web has made buying health insurance so simple.
Online insurance purchase is synonymous with comparatively easy documentation procedures and lesser paperwork. This applies when you buy health insurance online too. Every step of the insurance buying process is managed digitally, which means that the hassle of submitting xerox copies of your documents gets replaced with emailing the insurer the electronic version (scanned copies of the documents). Just choose the medical insurance policy you wish to buy, log on to the site, upload your Know Your Customer (KYC) documents and pay using your card or mobile wallet.
Those who are not internet-savvy can call on the helpline numbers of the respective customer care departments who then guide customers through the insurance buying process. Insurance companies usually have a chat facility (also called chatbots) on their websites where the customers may inquire about the company’s products or seek clarification regarding its services. Calling on the toll-free numbers on the website ensures that you are connected to a representative who would lend adequate support regarding the product or service or arrange a face-to-face meeting with the company executive for better understanding.
Insurance in India is a misunderstood product, thanks to the agents who deceived their customers into buying those policies that fetched them more commission than others. Most agents regardless of what their customers required or need in the long run sold them policies that only proved to be futile and expensive. Online insurance has done away with the need for agents as customers browsed for product details from the website before making their choice. With no intermediaries or distributors to meddle in between, online insurance has put an end to mis-selling of any kind of insurance products.
Companies today are more concerned about how their products are reviewed by their customers. While positive reviews propel sales, negative customer reviews about any product or service may result in sales decline and a bad reputation. The same applies to insurance companies selling insurance policies too. Customers looking to buy online insurance can view and compare the reviews and experiences shared by existing policyholders, thus, helping them to make an informed choice about the credibility of affordable insurance plans being sold before buying them.
As opposed to agents who limit themselves only to selling insurance products, online insurance involves more than just the sale of insurance policies. In addition to availing various kinds of insurance policies, buying insurance from the web facilitates customers with added benefits including automated reminder systems concerning dates of renewal of the policy bought. This keeps policyholders informed about the next premium payment due till the last date of the policy period.
The growing presence of the internet across major cities, towns, and villages in India has led to an increasing number of the country’s population gradually gearing towards making online transactions. Health is a crucial factor has led to more people being inclined towards comparing online health insurance policies and buying them. Buying online health insurance has become easy, thanks to some of the top health insurance companies using advanced technological methods to garner the attention of customers and retain them in the long run.
The web has brought to focus all that can be sold and bought. These include health insurance policies too. Also understood as medical coverage plans, these can be bought online either from your choice of the insurance company or from the sites of online insurance aggregator portals that list details of some major health insurance companies along with details of the health plans they sell.
With nearly 30 insurance companies selling more than 200 health insurance plans in the Indian market, comparing the benefits availed by each health plan and buying the right healthcare product is not easy. Listed followed are essential tips and tricks that ease the process of health insurance buying from the web. Some of them include:-Choosing the right sum assured the amount
Healthcare expenses are increasing each year. Inflationary rates also have had an augmenting effect on the prices of medical treatment. The amount spent on hospitalization and treatment of critical illnesses can burn a hole in your pocket. Hence, it is important to choose the amount of sum assured that would be adequate to pay towards the cost of treatment. Be it an indemnity plan or defined benefit plan, choose the health insurance policy that promises a higher amount of sum assured at nominal premium charges.
Many people tend to misle insurance companies by submitting fake details regarding their age or health conditions to avail health coverage that otherwise would not have been available. Any kind of insurance policy is based on the principle of Utmost Good Faith, which means that in the absence of accurate disclosure, the insurer has the right to stall or deny the claim altogether. Submitting incorrect information or mismatch of details provided by the insured will result in claim rejection, thus, necessitating the customers to provide complete and correct details.
Not all health insurance policies cost the same. This means that the premium charges towards different health plans vary. There are myriad factors that affect premium charges including policyholder’s age, medical history, lifestyle, smoking and drinking habits, region, etc. Opting for cheap health insurance plans may prove to be disadvantageous in the long run. Also, not all costly plans providing health care coverage are unique. Take into account the premium determinants before zeroing on an affordable insurance plan for you and your family. It is important to remember that premium pricing is one of the vital factors for choosing a health plan, but definitely not the only factor. Contrast the premium prices with the benefits and features pursuant to each plan and buy your health insurance product accordingly.
Though family healthcare policies cost less than the medical insurance plans for individuals, it may not be always wise to choose health insurance policies based on premium prices or for the added services they promise. Not all add-on covers may be useful, so choose wisely. If your family members are already covered under a certain plan, it makes no sense to opt for family healthcare product options. Understand the extent of your needs before selecting the kind of plan you need.
While making health insurance claims, policyholders have to bear the claim amount in the ratio of the predetermined ratio or percentage. Many health insurance companies selling health plans mandate their customers to conform to the co-pay clause, thus, mandating them to make payments towards the definite amount of claim amount on each and every claim amount made during the policy tenure. Health insurance companies requiring their customers to bear a major portion of the co-payment clause will charge lower premium amounts while those offering low or zero co-payment clause will have higher premium charges as the onus of risk is greater on the insurer.
This is actually a kind of restriction barring the insured from claiming too high from their health insurers. This limitation on the claim expenses is determined by the insurance company to put a cap or sub-limit on certain charges to do away any scope of raising the charges. The health insurance company may apply sub-limits on room rent charges, the amount paid as consultation fees to doctors, ambulance fees, admission charges to the Intensive Care Unit (ICU) of any hospital. The charges may be restricted to roughly one or two percent of the total amount of sum assured. However, there are some health insurance policies that include sub-limits on surgeries so that the claim amount on surgeries does not exceed 50 percent of the total sum assured.
Policyholders suffering from pre-existing disorders will have to go through a waiting period. The waiting period is essentially a prohibitionary phase wherein the insured are not allowed to make any claims on the health insurance policies they have bought nor are the insurers to accept the claim made towards the treatment of the pre-existing health problems. The waiting period varies across different health insurance companies. Hence, opt for health plans with minimal waiting periods.
Many health insurance policies in India come with the No Claim Bonus provision. The benefit of this bonus is evident if the insured does not make any claim in any particular year. As per the provision, the insured benefits from the bonus in the form of increased sum assured or reduced premium rates at the time of policy renewal. The amount of NCB varies among health insurers. While reading the terms and conditions of the various health insurance companies, make sure that you read the maximum extent of NCB given by each of them.
Some of the best health insurance companies in India offer cashless hospitalization facilities to the insured getting admitted to any of the hospitals listed in its network. Before opting for any health insurance policy, it is important that you look at the list of hospitals included in its network and check if the preferred hospital near your place is included in the list of the intended insurer. This may prove fruitful in the event of emergencies where you might require to rush your loved ones to the nearest hospital providing the best facilities and avail the cashless treatment facility available.
You are more prone to illnesses and debilitating ailments with advancing age. This implies that one must opt for health insurance companies that allow policy renewal to many more years in the future as opposed to some that limit the plan renewability only to a certain period. Discard plans with limited renewability option as the need to purchase health insurance from an altogether different insurance company refrains you from buying a plan of your choice coupled with higher premium charges owing to buying the plan at a later stage. Also, if you wish to include your aged parents under the health plan, then it is preferable to opt for lifetime renewable health insurance cover.
The credibility of your insurance company matters. First, check the list of health insurance companies selling the kind of plans you are looking for. Find out how long your health insurance company has been in business and its increasing consumer strength. Keep the following parameters in mind before choosing your insurer:-
Incurred Claim Ratio (ICR)
This is one of the most determinants while comparing health insurance companies in India. The ICR may be evaluated as under:-
ICR = Total amount settled in claims / Total premium amount collected
Compare the ICR of all companies and prefer to choose with the highest ICR value.
Like all other products or services, check the reviews about your insurer too. Many customers share their experiences over the web, thus, making it easy for prospective policyholders to gauge the quality of the various insurance companies and their health plans. An increasing number of unhappy customers reflects the insurance company’s attitude towards its existing customers in addition to the quality of its customer care department and after-sales service.
Ease of the claim settlement process is essential to the credibility and reputation of any insurer. The aim of buying any kind of health insurance policy is an easy to claim settlement. Find out the claim settlement ratio (CSR) of each insurer. Opt for the one with a higher CSR value as it reflects the efficiency of the insurer’s claim processing department.
Having a health insurance policy is important as without it one would incur heavy financial expenses towards medical treatment. Before buying any health plan, understand the factors that label it good or unsuitable. What suits your friend may not be in sync with your need or the requirements of your loved ones. Understand how you would want your health insurance policy to benefit you and your family in case of sudden need. Read the fine print of each insurer’s plan details before deciding to pay for the one in tune with your medical needs and budgetary limits.
The age-old adage “Health is Wealth” is now being considered in all seriousness by most Indians. This is evident as an increasing number of the country’s population is queuing up to buy health insurance policies, both online and offline. There are others, however, still unaware of the nuances of health insurance and the types of health insurance policies sold in India.
Health insurance companies in India are many. These insurance companies offer a range of health insurance plans suited to every kind of need and budget. Health insurance in India is broadly divided into two categories, each of which is again divided into certain subcategories or specific kinds of health insurance policies that one may buy depending on need and fiscal convenience.
The two broad categories of health cover plans are:-
Health insurers selling these kinds of health plans are liable to make good for the expenses or compensate for the amount spent on treatment and medical assistance. The idea behind buying insurance is to seek cover or protection in lieu of regular premium payment. These kinds of health insurance policies are bought to ensure that the policyholders find themselves on the same financially secure footing similar to what had been before the loss. Indemnity health cover plans reimburse the amount that the policyholder or the insured may have spent on paying hospitalisation bills subject to the amount of the sum assured determined while buying the policy.
The common kinds of indemnity plans include:-
This is the simplest kind of health insurance that covers a single insured person from the brunt of the amount expended on hospitalization and consequently medical treatment. Multiple benefits including that of cashless hospitalization, reimbursement of the amount spent on treatment and medical bills, pre and post hospitalization expenses, in addition, to addon covers. However, the amount of cover is subject to the sum assured limit determined while buying the health insurance coverage.
As the name suggests, this kind of health cover is bought to secure the lives of all family members covered under the health insurance policy. Many insurance companies sell them as Family Floater Plans, thus, allowing all the members in the family to get health coverage. However, the amount of cover, as in all other health insurance plans, is limited to the sum assured amount determined while buying the healthcare insurance plan. As opposed to the individual health insurance plans, the premium charges towards family health insurance are much lower.
This is also called the Senior Citizen Health Insurance and is bought to secure the lives of those aged above 60 years. These kinds of health plans aim to secure the protective cover to senior citizens against nagging old-age health issues. As per the provisions of the Insurance Regulatory Development Authority of India (IRDAI), health insurance companies must include people until the age of 65 years while selling their plans.
Many health insurance companies in India also cover additional costs inclusive of the amount spent on prenatal care, delivery of the child, postnatal care in addition to vaccination of the newborn babies as mentioned in the terms and conditions of the maternity insurance plan. Some health insurance plans with maternity coverage also include ambulance fees spent on transporting the mother to the hospital for delivery and cover the expenses on health check-up and treatment of the newborn baby throughout the entire period of the policy.
This is unlike other healthcare that involves treatment only on the diagnosis of any illness. As the name suggests, this kind of health plan is aimed at providing preventive check-ups and necessary medical procedures to prevent falling ill or falling prone to serious ailments. The insurer indemnifies the costs of availing regular healthcare including the amount spent on X-Rays, blood tests or consultation fees of the medical practitioners. This plan is created to generate awareness among customers the significance of going through regular checkups in order to remain healthy while aiding in the prevention and early detection of serious health problems.
Unlike indemnity plans, these plans do not compensate for the extent spent on hospitalisation but pay off the amount predetermined while buying the health insurance policy. The amount of claim paid by the insurer, according to the provisions of this kind of plan, is unbiased of the actual amount spent on hospitalisation and medical treatment and does not exceed the amount of sum assured promised at the time of buying the health plan.Some common defined benefits plans are as under:-
These health insurance policies are different from others in the sense that they are bought to secure against the amount spent on treatment of various critical disorders. Customers may buy this policy either as standalone plans or add-on riders as an effective cover against certain specified chronic diseases including kidney failure, sudden paralysis, cardiac arrest, etc. The list of critical illnesses varies among plans sold by different companies covering health insurance in India. On diagnosis of any of the critical illness specified in the list published, the insurer is liable to pay the amount of sum assured in a lump sum to the policyholder irrespective of the costs borne during treatment of the illness.
Also called personal accident cover, these kinds of plans are bought as riders, i.e., in addition to the plain and vanilla medical insurance plans and include hospitalization costs in the event of unforeseen and unfortunate events including accidents. These are issued as defined benefit or fixed benefit plans as the amount decided while opting for the rider is paid to the insured in case of death or permanent disability resulting from the accident.
Also called as Hospital Daily Cash plans, this kind of health plan promises a fixed sum of money towards hospitalisation. This health insurance policy ensures that the insured is paid for each day hospitalised. The amount of money paid by the insurer is determined while buying the policy and is irrespective of the amount spent as hospitalization expenses.
These are actually investment cum insurance plans that also act to cover against the health problems of the insured. Offered by only a few insurance companies, this product combines the benefits of both investment and health cover. Continuous and regular payments of premiums towards these kinds of plans not only allow the creation of a corpus amount subject to the market conditions while also ensuring a cover towards the treatment of pre-existing disorders not covered under any other health insurance policy during the waiting period. Some common ULHPs being sold in the Indian market include ICICI Pru’s Health Saver, LIC’s Health Protection Plus, Birla Sunlife’s Saral Health, and IndiaFirst’s Money Back Health Insurance Plan.
Health is a matter of concern in India, especially, as changing the landscape and rising pollution levels among myriad other factors have resulted in growing pervasiveness of critical disorders. Expenses on hospitalization and medical treatment are higher than ever before, thus, prompting people to buy health insurance plans in a bid to secure cover for themselves and their loved ones.
You may consider buying either a basic health insurance plan for yourself or a comprehensive health insurance cover to cover all your medical needs in addition to securing your family members against possible health problems. Buying a comprehensive health insurance plan ensures that policyholders are better able to manage their expenses in the event of an unforeseen medical emergency while also opting for preventive healthcare options. There are multiple benefits of buying health insurance policies. Some of them include:-
Most people associate the idea of buying health insurance with the freedom from the stress of paying off bills incurred on hospitalization and medical treatment. However, opting for a health insurance plan and deciding to pay for one involves greater benefits than merely saving on hospitalization expenses in the long run. Some common benefits that health insurance policyholders enjoy include:-
Paying nominal premiums regularly is definitely a much easier option than having to pay hospital bills in a lump sum. This explains why people with a health insurance policy in place are more at peace post-discharge from the hospital as the onus of meeting the expenses lies with the insurance company.
With insurance companies tying up with thousands of hospitals across the country, policyholders do not find it difficult to get treated at their own choice of a hospital within the network of the insurance company. As opposed to paying bills on the spot or going through the hassle of collecting the bills and getting them reimbursed, policyholders are now able to avail the cashless facility, thus, redeeming them from the pain of rising medical expenses.
Sudden expenses can mar the plan of enjoying a financially secure future. Having health coverage lessens the possibility of people dipping into their savings to pay off their medical bills.
Some people are apprehensive of taking necessary steps much needed for treatment. This may include getting tests done or consulting with a specialist or getting operated in a hospital using advanced treatment methods and having all essential amenities. Since a health insurance plan covers both pre- and post-hospitalization expenses, complete treatment is possible for the policyholders sans the fear of having to spend extra money.
The number of insurance companies selling health insurance plans in India is gradually rising. There is an increasing competition among the insurers to attract more customers by promising the best possible benefits at nominal premium charges. This explains companies selling health insurance plans for individuals and family floater insurance policies in India. Insurance companies promising health coverage in lieu of premiums promise an amount of sum assured for both individuals and family members as per the terms and conditions of the insurance proposal agreement.
What if we were promised an increased sum assured by paying only the same premium amount? Most health insurance plans today contain an inbuilt clause allowing policyholders the added benefit of Cumulative Bonus pursuant to each claim-free year. According to this, the sum assured is increased by a certain percentage during the time of renewal. However, the amount of Cumulative Bonus must not exceed 50 percent of the total amount of Sum Assured.
Just like we exercise caution in buying necessary products or making important financial decisions, one must be similarly careful while buying health insurance plans. This is because health insurance policies serve to pay for rising medical costs, be it planned or emergency hospitalization of the policyholders and their loved ones.
Taking into consideration the increasing number of insurance web aggregators that promise their customers the best in terms of insurance products and customer services, it is easy to find out how Wishpolicy stands out from its peers and competitors.
Buying health insurance is not enough until you have bought the right plan that is in sync with your needs and budget. Most people in India are not aware of the nuances of insurance, thus, resulting in buying health insurance policies with either very low coverage than what is necessitated or paying for excess cover. Our team at Wishpolicy ensures that you buy the right kind of health insurance after taking into account the policyholder’s age, medical history, number and age of dependents, the extent of dependence and budget concerning premium charges. This means that you not only get to choose between the various health insurance plans listed on our site but are able to buy it after making an informed decision with our expert help.
We prefer an easy and workable approach. This explains why our customers love to scroll through the details on our website and buy the health insurance plans using our online support system. Instead of giving you a list of all the policies at one place, we present details of each plan one by one, thus, enabling customers to make their choice based on premium charges and the corresponding health insurance coverage. This means that customers can look at how their coverage changes as their premium rates change or how premium amounts get affected while vacillating between different coverage amounts.
Gone are the days when people filled in insurance forms and submitted the physical documents of their details while applying for their choice of health insurance plan. Our online platform allows insurance buying and the claim settlement processes much easier. Built keeping in mind the drawbacks of offline insurance purchase, Wishpolicy aims to lend its viewers the same ease at which they engage in daily online shopping.
Any change in the premium rates or insurance purchase guidelines is reflected on our site promptly, thus, ensuring our viewers and customers the exact details of each policy along with their benefits.
The attitude towards securing necessary medical treatment has undergone a wide change in the past few years. Thanks to the increasing importance of health insurance as an essential financial planning tool, more people are now able to access necessary medical care to live healthy lives. This is because buying health insurance policies early in life helps defray the rising cost of medical care in the long run. But, the benefits of having a health insurance plan in place come at the cost of paying health insurance premiums. Premium is nothing but the amount customers have to pay each month to buy health insurance coverage.
Different insurance companies in India charge varying rates of health insurance premiums depending on the nature and extent of health insurance coverage promised. While choosing among the different options available, customers tend to focus on the premium charges involved as opposed to the medical cover sought. However, it is important that interested customers pay attention to not only the premium amounts that are to be paid but the benefits that they would gain after buying some particular health insurance plan.
Health insurance premiums are not chosen randomly. In fact, there are myriad factors that can affect the premium rates and come into play while calculating them. Some of them include:-
This is one of the primary factors that insurance companies take into account while calculating the amount they wish to charge as health insurance premiums from their customers. Buying health insurance plans early or when young necessitates lower premium charges while the premium charges are more for those buying at a later stage. This is because young people are less likely to fall ill or suffer from serious disorders. As opposed to them, older customers are more vulnerable to be afflicted with grievous illnesses, thus, raising the risk of being hospitalized and making health insurance claims.
Health insurance policies sold to women cost lower than those bought by men. This is because women are less prone to suffer from grievous disorders including heart disorders, kidney ailments, cancer, etc. The risk of women getting hospitalized and treated for prolonged periods is relatively low, thus, implying lesser liability on the part of the companies to pay for their medical treatment.
The current health condition has a determining effect on health insurance premiums too. Customers suffering from obesity or pre-existing disorders like diabetes are at a greater risk of falling ill and seeking treatment for their health problems, thus, raising the risk of insurance companies selling them health insurance to cover their medical expenses in future.
People diagnosed with some serious health problem before buying health insurance cannot avail its benefits immediately after buying the policy. In fact, most insurance companies will cover the medical expenses arising from their treatment only after the completion of a specific waiting period ranging from three months to two years. In addition, complications stemming from pre-existing disorders may not be covered. Insurance companies selling health insurance plans to customers detected with any serious medical problem before buying the policy will always charge them premium rates higher than others.
Paying premiums for a one-year health insurance plan is different from paying for prolonged health insurance policies extending to two or more years. Depending on the guidelines laid down by different insurers, policyholders may have to pay more or less amount of premium charges.
The place of living has an effect on one’s lifestyle and consequently health conditions. This explains why policyholders living in metropolitan cities pay higher health insurance premium charges than those residing in rural areas. In addition, the amount expended on treatment in cities is more than villages, which explains the greater premium amount.
Smoking, drinking or staying out for late-night parties can affect one’s health conditions adversely. Since these habits increase the risk of suffering from diseases or susceptibility to various unforeseen disorders or critical illnesses, the chances of buying comprehensive health insurance coverage at lower premiums are considerably reduced, thus, explaining high premium charges to be paid every month.
The principle of NCB comes into effect when customers are applying for renewal of their health insurance policies. The amount of NCB that the insurance company allows may range between five and 50 per cent, which means that existing policyholders can enjoy discounts on premiums depending on the NCB value.
Buying health insurance is no more just a matter of choice, but an essential financial tool to offset the effect of rising medical expenses and increasing costs of hospitalization. However, not all can buy health insurance plans as the guidelines shared by different insurance companies in India require fulfilment of certain essential conditions. These include:-
The policyholder needs to be of minimum 18 years of age to apply for health insurance irrespective of any insurance company. Most insurance companies, however, warrant against covering people who have crossed 65 years of age. However, increasing competition has now resulted in many insurance companies allowing their customers to be covered until they reach 70 years of age.
Family floater health insurance policies are bought by policyholders to keep their loved ones covered. This includes providing the necessary cover to their children aged between 90 days to 18 years.
Buying health insurance from an insurance company is futile if the latter does not allow scope for renewing the health insurance plans each year. However, the same is subject to certain guidelines issued by the IRDAI and your insurance company.
Buying the right health insurance plan requires a considerable evaluation of the benefits offered by the plan and whether they are in sync with your needs and the medical requirements of your loved ones. While making your choice of health insurance, it is important to keep in mind certain basic parameters that making the buying process easier and much more informed. These include:-
Not all insurance companies in India charge the same amount of premium for providing similar kinds of services. While some companies charge low premiums, there are others who justify their high costs by providing additional services. However, while choosing health insurance, it is important to take into account the nature and extent of services one essentially needs. Opting for frivolous services and paying unnecessary higher premium amounts may result in excess expenditure compared with the nature and quality of benefits availed.
Though premium charges are not the ultimate deciding factor while opting for health insurance plans, they must not be ignored completely. Health insurance policies providing necessary benefits in lieu of nominal premium charges must be preferred.
There are times when the insurance company perceives some customers to be at a greater risk of suffering from grievous disorders or vulnerable to illnesses than others. Most customers do not check the terms and conditions regarding premium loading while buying health insurance. Moreover, many customers remain unaware of any such concept because of which they have to pay higher premium charges after making the claim on their health insurance plans. Terms and conditions associated with this concept may result in inconvenience on the part of the customers who end up paying more premium than intended while opting for the policy. Seek information about the health insurance policy before choosing to buy it.
Not all families have the same number of members. Every health insurance plan caters to different family size, and hence, it is important to check if the policy you are opting for fits the bill and meets your loved ones’ medical requirements in the long run. Depending on the number of members in your family and the extent of their dependence on you, prospective customers must choose between individual health coverage and family coverage health insurance.
Some insurance companies require their customers to co-pay the bills of hospitalization and medical treatment. In the event of hospitalization and treatment of any illness, policyholders or their loved ones are required to bear a part of the medical expenses from their pockets. As per the co-pay clause, policyholders would be required to pay 10-20 per cent of the total hospitalization expenses.
Many customers require their customers to co-pay the bill if they opt to seek treatment at a hospital external to their network. There are others who have an age-linked co-pay policy or determine the extent of the co-payment required to be paid based on the zone they belong to.
Companies with a higher co-pay ratio always charge a lower amount of premiums while those with a lower or zero co-pay clause charge increased premium amounts. Customers opting for low-premium health insurance plans must refrain from opting for unnecessary expensive procedures to ensure lower medical bills and, thus, a lower rate of co-payment on the bills.
Does the insurance company offer its policyholders the benefits of availing NCB? Not all policyholders make claims on their policies during the first or second year. Some insurance companies in order to encourage their customers to stress on healthy living and refrain from spending on unnecessary treatment processes award them by allowing the benefit of NCB. However, not all insurance companies do not allow the same NCB value. Greater the value of the NCB, better is the health insurance policy considered. Insurance companies may introduce NCB as reduced premium rates or increase in the basic insurance coverage.
As per the guidelines set forth by the IRDAI, policyholders have to go through a predetermined waiting period before they can seek a claim for treatment of any pre-existing illnesses. This is true of all health insurance plans irrespective of which insurance company one may choose. The minimum waiting period is 30 days and may go up depending upon the terms and conditions of each health insurance provider. Prefer to buy health insurance from a company with the least waiting period so that one does not have to wait before seeking treatment for any disorder that may be existing before buying the plan.
The ICR is the ratio the net claims paid by the insurance company to the net premiums earned. A higher value of ICR implies increased chances of the insurance company’s likelihood to settle your claims in future.
ICR = Amount Settled As Claims/Amount Collected As Premium
A longer policy period ensures maximum protection for prolonged periods. Prefer to buy health insurance plans that cover policyholders for a maximum period.
This factor is important considering that customers buy health insurance policies to meet sudden hospitalization expenses and costs of medical treatment. While opting for your choice of health insurance plan, find out if the hospital or treatment facility near your place is included in the list of network hospitals of the insurance company. This saves your loved ones from the hassle of filling in necessary documents and reimbursing your medical expenses with their hard-earned money. Remember that your insurer or a third-party administrator (TPA) should have a tie-up with your choice of hospitals.
Some health insurance plans ensure scope for additional benefits including critical illness riders by paying a nominal additional amount. Find out which health insurance policies ensure the most benefits to the policyholders without charging too much for the same.
Plan renewability is important. The significance of having a health insurance plan in place is greater when one is old as growing age increases the vulnerability to many kinds of disorders. Most health insurance plans can be bought for a year, thus, prompting policyholders to renew the policy next year. However, some insurance companies allow the policies to be renewed only for a limited number of years. This leaves the policyholders without a proper health insurance plan to cover expenses of treatment, if and when necessary.
Prefer to opt for a company that offers health insurance portability. As opposed to earlier times when policyholders were forced to continue with the policy they had bought initially to avail the benefits of the waiting period clause, the option of health insurance portability has brought respite to many existing policyholders who wish to avail benefits of a new insurance company. Though health insurance portability does not involve any added expenses, many insurance companies charge a certain amount as fees when customers opt-out of their plans to buy another.
Rising medical expenses have mandated the need for a higher health insurance cover. However, opting for a comprehensive health insurance plan or opting for an increased insurance cover may result in greater expenses on premium payments. This is where opting for a top-up plan helps. Buying a top-up plan reduces the amount policyholders would be required to pay on deductibles, thus, making it more affordable than buying a standalone health insurance policy. Opt for insurance companies that allow their customers to buy health insurance top-up plans.
Many people buy health insurance plans from insurance companies in India without taking into account the efficacy and ease with which the companies settle their customers’ claims. Though there is nothing complex about the claim settlement process, a lot depends on whether the policyholders had opted for cashless claims or reimbursement of the expenses on hospitalization and consequent treatment.
To understand the process, it is important to understand the types of health insurance claim available in the country. There are two ways that policyholders may adopt to claim a health insurance policy. These include:-
As per this type of health insurance claim, the insurance company settles the hospitalization bills with the hospital directly. However, to avail this benefit it is important that the amount of bill must not exceed the total sum assured amount and that the policyholder must be hospitalized only at a network hospital.
This is a different kind of settlement process in which the policyholder pays for the hospitalization expenses and then seeks reimbursement from the insurance company post-discharge from the hospital. The reimbursement facility is available at both the network hospitals and those outside the network.
If treated at one of the network hospitals, policyholders need not make any upfront payments for the treatment they had sought. The insured will not be required to bear the burden of the medical bills as the insurance proposal agreement contains details of acknowledgement by both the health insurance provider and the hospital in which the policyholder is being treated. In addition, the cashless benefit is pursuant to the approval of the third-party administrator (TPA).
All that the policyholder has to do is to show the health card issued by the health insurance company at the particular hospital for treatment as a proof of having bought the relevant health insurance plan along with a valid government ID.
One of the benefits of buying health insurance is that the policyholder can get the expenses on treatment reimbursed. The reimbursement is made as per the terms and conditions of the insurance agreement signed between the insurance company and the policyholder. The total amount of expenses minus the exclusions are credited to the bank account of the insured after the insurance company is satisfied with the validity of the invoice raised by the policyholder post-discharge.
Before we proceed to explain the claim settlement process, let us look at the following conditions necessary to avail the health insurance claim. They are:-
While most policyholders are aware of the insurance buying process, not many people realize the need to pay similar attention to the health insurance policy claim settlement or reimbursement process. While claiming for the necessary health insurance cover, policyholders would be required to submit the following documents. These include:-
Before you proceed to buy health insurance, it is important to know some of the best insurance companies in India known for their affordable health insurance plans, multiple benefits, incurred claim ratios declared each year and, last but not the least, their financial standing in the Indian insurance market. Listed below are some of the foremost insurance companies reputed for their transparent dealings, premium charges and myriad benefits overlooked by their competitors. These include:-
One of the foremost names in providing health insurance services, Bharti AXA General Insurance Company Limited is the result of a joint venture between Bharti Enterprises and AXA. Bharti Enterprises enjoys its reputation as a trusted business group, AXA is known for its myriad services including financial protection and wealth management. Started in August 2008, Bharti AXA is the only general insurance company that had received the dual certification of ISO 9001:2008 and ISO 27001:2005 during the same year. Currently, the company provides the following health insurance products to its customers that include:-
One of the foremost among the health insurance companies in India, this health insurance company was formed as two of the biggest business organizations came together to avail some of the best health insurance facilities seeking a cover against the burgeoning medical expenses in the long run.
HDFC Limited, a renowned housing finance institution and ERGO International AG, the primary insurance arm of Munich Re Group has more than 100 branches throughout the country, thus, enabling interested customers to seek necessary information regarding insurance purchase or claim settlement. Awarded the “iAAA” rating by the Investment Information and Credit Rating Agency (ICRA), this insurance company sells two types of health insurance policies including:-
This health insurance company was formed as a result of coming together of Religare Enterprise Limited, Corporation Bank and Union Bank of India. Customers buying this policy can avail the benefits of getting treated at any of the 4,100 hospitals in its network. Religare Health Insurance company offers insurance plans including:-
A standalone company by Aditya Birla as opposed to its peers and competitors stemming from collaborations and amalgamations, the company was established with the support of MMI Holdings Ltd, a South Africa based organization. Keeping in mind the diversity of the Indian population and their equally diverse and unique needs, the following kinds of health insurance plans are sold. These include:-
Manipal Cigna Health Insurance Company formerly known as Cigna TTK Health Insurance Company is a forefront player in providing top-notch health insurance plans to its customers. Let us understand more about the company and its health insurance products
What happens when a premier group of private hospitals company joins hands with one of the top international medical insurance organization? The answer is Apollo Munich Health Insurance company that combines the expertise of Apollo Hospitals Group and Munich Health, the medical insurance company run by Munich Re, a major German insurance company. Currently, the company sells health insurance products including:-
This is India’s first standalone health insurance company that focused on overseas medical plans in addition to health insurance plans and personal accident policies. Found by Star Health and Allied Insurance Co Ltd in 2006, customers can avail health insurance benefits by getting treated in any of the 8,400 hospitals within its network across the country. With more than 300 branches across the country, policyholders find it easy to get in touch with the company’s officials for easy claim settlement, thus, explaining its inordinately high claim settlement ratio (CSR). Currently, this health insurance company is selling the Following plans including:-
Policyholders planning to buy health insurance plans from this company can modify the conditions of the plans, policy term and sum assured according to their needs and budgetary limits. With an asset base of over Rs. 60,000 crores, this New India Assurance health insurance company currently sells the following plans including:-
This is a question that most customers ask the health insurance company to ensure hassle-free hospitalisation in times of emergencies. Though having health insurance means that you can get yourself treated at any place in India, it is important that you seek information regarding the same to avail seamless and timely treatment. Also, companies selling health insurance in India may have added conditions owing to geographical limitations. In addition, there are many health insurance policies that offer international coverage too.
Firstly, it is important to inform about any illnesses that the policyholders may be afflicted with before buying health insurance. It is important to note that any and every company offering health insurance in India does not cover pre-existing illnesses for a certain period, also called the waiting period, at the beginning of the best health insurance plan. This means that the policyholders can seek a claim for treatment of the pre-existing illnesses post the completion of the waiting period. Ask your health insurer if your pre-existing illness is not covered temporarily or is completely excluded from the amount of health covered determined while buying the policy.
Sudden hospitalization can take a turn for the worse, especially, if the families of policyholders are unaware of the claim settlement process. Before buying the health insurance plan, find out if the policy facilities cashless settlement of the claims made by their customers. Seek information about the documentation process and the customer care number with whom one has to contact during emergency hospitalization. Some of the best health insurance companies ensure that they have active customer care in place or a representative in place who would guide about the claim making the process.
During sudden emergencies, it is possible that your loved ones may get you admitted to a nearby hospital that may not be included in the health insurer’s network. Knowing the claim settlement process in such a scenario is imperative. Policyholders admitted to a non-network hospital would be reimbursed the amount expended on treatment and payment of medical bills. The policyholders while opting for any health insurance policy must first find out about the reimbursement process, necessary documents to be submitted and the deadline for informing the best health insurance Company about the hospitalization and consequent treatment.
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