Get affordable health protection plan from top insurers now. Save Tax up to Rs. 75,000 under 80D. Avail of cashless hospitalization, free health check up, and other attractive benefits. Protect yourself and your family members against any unexpected medical emergencies. Get FREE quote now!
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Health Insurance is a product by Insurance Companies to cover the medical and surgical expenses incurred by the insurer. Health is the most unpredictable aspect of one's life. Anybody can encounter a serious health issue at any stage of life. Health problems need not crop up only in old age.
If not any health issue, it could be hospitalisation due to an accident. Meeting medical expenses which appear out-of-the-blue is not in the reach of everyone. At least not at present times, when the cost of medical treatment is soaring high day by day.
The product that covers the expenses that arise out of such emergencies is Health Insurance. Periodical payment of premium as stipulated by the Insurance Company has to be made. The payment of the premium could be either monthly, quarterly, half-yearly or yearly.
The insurance company either pays the medical expenses incurred directly to the hospital or will reimburse the expenses to the insured individual. Flexible coverage for ailments/disease is provided. Some Health Insurance companies offer a cover for as many as 80 and above surgical procedures and as many as 30 and above critical illness.
Health Insurance can be a saviour when such critical emergencies emerge at the eleventh hour. If you have a huge family responsibility with regard to every member of the family, then going in for Health Insurance for the entire family is recommended.
The main features of a Health Insurance policy are:
Cover for expenses incurred prior to hospitalisation and post hospitalisation
The expenses incurred 30 to 60 days prior to hospitalisation and post hospitalisation will be reimbursed upon submission of relevant bills and receipts.
Treatment without payment - Cashless treatment
Under this feature, treatment will be provided in the hospitals listed in the insurance policy without the payment of cash. This relieves you of the burden of arranging for cash to meet the expenses. The hospital authorities will send a pre-authorisation request with the details of treatment and the cost. Pre-authorisation from the company will be as good as paying cash for the treatment. The insurance company will remit the treatment expenses directly to the hospital.
Some of the best insurance policies by top insurance companies in India are:
Best Health Insurance Policy by Max Bupa Insurance Company
The above plan is designed to cover an individual or provide cover for the entire family.
The features of the policy are:
Lifeline Health Insurance Plan
The Lifeline Health Insurance Plan has three categories depending on the sum insured.
The features of the Lifeline Plan are as follows:
Myself for Individuals
My family for families
My Parents for Senior Citizens
New India Premier Mediclaim Policy
The following medical insurances are best for the family:
The following are the differences between Mediclaim and Health Insurance:
|Health Insurance covers pre and post hospitalisation expenses including the hospitalisation cover.||Mediclaim covers only the hospitalisation expenses.|
|Expenses incurred for ambulance services and lost income cover is provided by some of the insurance companies.||It takes care of only hospitalisation cover|
|Cover for critical illness for over 30 plus ailments like cancer, kidney failure, paralytic stroke, heart-related problems etc. is available.||Critical illness not covered|
|The maximum sum assured is Rs. 6 Crores||The maximum sum assured is Rs. 5 Lakhs|
|Only one single claim can be made in respect of Health Insurance with a critical illness or accidental disability cover.||Multiple claims can be made until the amount is exhausted.|
Here are a few tips to choose the best Health Insurance policy:
Making a decision while taking Health Insurance is crucial and following the above tips will help you choose the best policy.
With the soaring prices for medical treatments, it is very vital to have Health Insurance plans to provide for medical expenses that crop up out of the blue.
The reason to have Health Insurance is:
The claim ratio is nothing but the claims settled versus the premium collected. If the claim settled is 95% then the Company would have settled claims up to 95% of the premium collected and 5% would be the profit for the Company. The higher the claim ratio the lesser will be the profit earned by the Company. If the claim ratio crosses 100%, it means that the Company may be providing funds for claim settlement out of their reserves which is not good for the Company. The higher claim ratio is good for the customers since it indicates that the company is successfully meeting the claims made.
Claim settlement ratio is nothing but the number of claims received by Insurance Company and the number of claims settled. While choosing the best deal for a Health Insurance plan, the claim settlement ratio should also be a part of your checklist. Go for an insurance company that has the highest claim settlement ratio to ensure that your claim will not be rejected without a valid reason.
Given below is the statistics of the claim ratio of different Health Insurance companies.
|Name of the Health Insurance Company||Claim ratio|
|Bharathi Axa General Insurance||96.85%|
|Cholamandalam MS General Insurance||72.91%|
|Bajaj Allianz General Insurance||76.88%|
|Apollo Munich Health Insurance||54.99%|
|Future General Health Insurance||77.31%|
|Cigna TTK Health Insurance||48.14%|
|Royal Sundaram General Insurance||78.13%|
|ICICI Lombard General Insurance||80.38%|
|Max Bupa Health Insurance||51.96%|
|Star Health and Allied Insurance||60.51%|
When treatment is taken in a hospital which is not included in the cashless treatment hospital list, the claim settlement will by reimbursement only. You will have to initially bear the medical expenses and then claim for reimbursement from the insurance company.
You should ascertain before availing the policy if there are any geographical limitations stated in the policy. Some of the policies offer cover for treatment abroad. So, you should be looking for a policy which is PAN India and also which provides for cover for treatment abroad if required.
To avail cashless treatment, you should take treatment in the hospital that is in the network list of the policy for cashless treatment. If so, then a pre-authorisation 48 hours before admission to the hospital for a certain treatment has to be obtained from the insurance company or if it is an emergency then, at least 24 hours after admission the pre-authorisation has to be obtained. Thereafter, the expenses will be directly dealt with by the Insurance Company.
Yes. Pre-existing illness is covered by Health Insurance policies but there is a certain waiting period from the effective date of the policy. Normally the waiting period is 2 to 4 years. However, there are insurance companies that stipulate lesser waiting period. If you are looking compulsorily for the inclusion of pre-existing illness, then it is better to go for a policy that has a lesser waiting period.
Before signing in for the Health Insurance policies make enquiries about the emergency hospitalisation policy and whom to contact at such a situation to get help with respect to documentation, etc. There will be an exclusive representative or a customer service desk handling these issues. Be aware of the contact persons who will guide you through such situations.
The documents required are identification documents of the member insured, hospital bills, health card, claim form, etc. at the time of the claim. In the case of cashless treatment, a pre-authorisation from the insurance company has to be submitted to the TPA.
Before availing the Health Insurance, ascertain the claim settlement process and the time taken for such processing. Find out if the insurance company is offering cashless treatment wherein you need not bear the burden of the medical bills. There are insurance companies who offer claim settlement only by reimbursement. Avoid such policies and go for a policy which has cashless settlement process.