Health Insurance 421 views January 4, 2022

Buying a health insurance plan means securing your hospital’s bills and costs related to the treatment or surgeries of the illness/injury. There are basically two types of health insurance plans available in the market – Indemnity and Fixed. Under an Indemnity Plan, you’ll get coverage for the medical expenses up to the sum insured. Whereas, in the case of fixed health insurance, you’ll get a fixed amount for the treatment as shown in your policy schedule. The fixed amount is irrespective of the actual expenses incurred during hospitalization. In case the fixed payout falls short of meeting the hospitalization expenses, you’ll need to bear the extra cost. Read this page further to know the difference between indemnity vs fixed health insurance and see which one meets your requirements better.

Health Insurance

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What to Expect from Indemnity vs Fixed Health Insurance Plans?

While buying a policy, you need to consider various factors. So, based on that, we’ll compare Indemnity vs Fixed Health Insurance in the below table –

Insurance AspectsFixed Health Insurance PlanIndemnity Health Insurance Plan
Coverage Limited coverage for specified illness or injury onlyCoverage for a wide range of illnesses
Premium Premium can be lower Premium can be higher considering its extensive coverage
Sum InsuredBased on the type of illness/injuryUp to INR 1 - 5 Crore
Waiting PeriodA 90-day initial waiting period is applicable A 30-day initial waiting period, up to 48 months for a pre-existing illness
Survival PeriodA 30-day survival period applies after the treatment of the illness/injuryNo survival period is applicable here. You will get coverage for all the expenses
No claim BonusNo bonus is available After every claim-free year, the insurer will provide a bonus that increases the sum insured. And this is subject to 100% of the base sum insured.
Top-upNo top-up allowedYou can add top-up plans to increase protection against medical expenses.

Based on the comparison, it can be said that indemnity plans offer higher coverage than fixed plans. Indemnity plans can command a higher premium, but that should not make you conclude. Check your overall requirements and see which one meets the same the best way. Flexibility such as the addition of a no claim bonus in case of a claim-free year only makes your experience better with indemnity plans. To help you decide better, we’ve elaborated various fixed and indemnity plans individually. Check all these plans below.

Fixed Health Insurance Policy & its Benefits

Under this type of health insurance, the insurance company will cover the treatment expenses up to a limit. And it may vary based on the type of treatment you receive or the illness you’re diagnosed with. Below are some of the top fixed health insurance plans and their benefits –

HDFC ERGO my-health Critical Suraksha Plus

Under HDFC ERGO my-health Critical Suraksha Plus, you will get coverage against the following –

Cancer Suraksha – The company will pay 25% of the sum insured, subject to INR 1 Lakh for early-stage cancer and carcinoma in situ. And for Malignant Cancer of specified Sites, 100% of the sum insured will be payable which include –

  • Breast
  • Cervix
  • Uterus
  • Fallopian Tube
  • Ovary, Vagina/Vulva (for female)
  • Head and Neck
  • Lung
  • Stomach, Colorectal
  • Prostate (for male)

Cardiac Suraksha – Only 25% of the sum insured, subject to INR 10 Lakh will be payable for Balloon Valvotomy or Valvuloplasty and Insertion of Pacemaker. And 100% of the sum insured is payable for the following –

  • Open Chest CABG
  • Myocardial Infarction (First Heart Attack of specified severity)
  • Open Heart Replacement or Repair of Heart Valves
  • Major Organ Transplant – Heart
  • Surgery of Aorta
  • Primary (Idiopathic) Pulmonary Hypertension
  • Other serious coronary artery diseases
  • Dissecting Aortic Aneurysm
  • Cardiomyopathy
  • Eisenmenger’s Syndrome
  • Infective Endocarditis
  • Angioplasty

A wide range of variants are available under this plan, so choose your cover as per your need.

Chola MS Critical Healthline Insurance Plan

Chola MS Critical Healthline Insurance Plan provides you coverage for the following –

  • Cancer of Specified Severity
  • Stroke Resulting in Permanent Symptoms
  • First Heart Attack of Specified Severity
  • Open Chest CABG
  • Kidney Failure Requiring Regular Dialysis
  • Multiple Sclerosis with Persisting Symptoms
  • Major Organ / Bone Marrow Transplant
  • Permanent Paralysis of Limbs
  • Surgery to Aorta
  • Primary Pulmonary Hypertension
  • Parkinson’s Disease
  • Motor Neuron Disease with Permanent Symptoms

And it comes in two variants, Standard and Advanced. If you choose Standard, you will get cover for 10 critical illnesses mentioned in the above order. Whereas, under the Advanced variant, the cover is available for all the mentioned critical illnesses.

The following sum insured options are available under the Chola MS Critical Healthline Insurance Plan –

  • INR 3 Lakh
  • INR 5 Lakh
  • INR 10 Lakh

Bajaj Allianz Critical Illness Health Insurance

Bajaj Allianz General Insurance covers the following critical illnesses –

  • First Heart Attack (Myocardial Infarction)
  • Open Chest CABG (Coronary Artery Disease Requiring Surgery)
  • Stroke Resulting in Permanent Symptoms
  • Cancer of Specified Severity
  • Kidney Failure Requiring Regular Dialysis
  • Major Organ Transplantation
  • Multiple Sclerosis with Persisting Symptoms
  • Surgery of Aorta
  • Primary Pulmonary Arterial Hypertension
  • Permanent Paralysis of Limbs

And under this fixed health insurance plan, you can cover yourself, your spouse, children, grandchildren, parents, sister, brother, parents in law, aunt, uncle. The adults should be aged between 18 to 65 years, and children are covered from the age of 6 to 21 years.

Indemnity Based Health Insurance Plans & their Benefits

Get coverage for treatment of the illness/injury up to the sum insured with no sub-limit unless the same is mentioned in your policy documents. Let’s take a glance at the popular indemnity-based health insurance plans below –

Star Comprehensive Health Insurance Plan

Under Star Comprehensive Health Insurance Plan, if you get hospitalized, the insurer will cover the following expenses –

  • Room rent (which would be a private single A/C room), boarding and nursing expenses
  • Anesthesia, blood, oxygen, operation theater charges, ICU charges, surgical appliances, medicines/drugs, diagnostic materials, x-ray, diagnostic imaging modalities, dialysis, chemotherapy, radiotherapy, pacemaker if used during the hospitalization period in treatment or surgery.
  • Surgeon, anesthetist, medical practitioner, consultants or specialist fees

The insurer provides the following sum insured options under this indemnity-based health insurance plan –

  • INR 5 Lakh
  • INR 7.5 Lakh
  • INR 10 Lakh
  • INR 15 Lakh
  • INR 20 Lakh
  • INR 25 Lakh
  • INR 50 Lakh
  • INR 75 Lakh
  • INR 1 Crore

Niva Bupa Health Companion

You will get the following benefits under Niva Bupa Health Companion Plan

  • 12 different sum insured options and three plan variants
  • Get coverage for in-patient hospitalization expenses
  • No room rent capping other than suites
  • Pre and post-hospitalization cover up to 30 and 60 days, respectively
  • Coverage for daycare treatments
  • Ambulance cover of INR 3,000 for emergency hospitalization
  • Restoration benefit
  • Alternate treatment cover
  • No Claim Bonus of 20% of the Basic Sum Assured, subject to 100% after every claim-free year
  • Health Check-up for you and your family once every 2 years for variant 1 or yearly for variant 2 and 3.
  • Use the top-up facility for extra protection
  • Get a discount of 12.5% on the 2nd year for a 2-year plan
  • Coverage for organ transplantation expenses
  • Domiciliary Treatment
  • Vaccination for an animal bite, subject to INR 2,500 for variant 1 and up to INR 5,000 for variant 2 and INR 7,500 for variant 3
  • You will get INR 1,000 daily cash for variant 1, INR 2,000 for variant 2 and INR 4,000 for variant 3 should the hospitalization sustain for a minimum of 48 hours

Indemnity Plans Stand Out Further through Individual Plan Explanations

After reading the page entirely, choosing an indemnity-based health insurance plan becomes an automatic choice for you with coverage for actual expenses, subject to the sum insured limit. Else if you choose a fixed health insurance plan and the expenses increase, you will end up paying from your pocket which you may not like.

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