*All savings are provided by the insurer as per the IRDAI approved insurance plan. Standard T&C Apply
Health Insurance is a type of insurance, which offers coverage for different medical expenses to the policyholder. Based on the chosen health insurance plan, the policyholder can avail coverage for hospital expenses incurred due to an accident or illness, critical illness expenses, surgical expenses, etc.
It is basically a cover provided by health insurance companies against any kind of expense incurred on medical treatment by the policyholder. The health insurance cover, for an individual or family, becomes active by paying an annual premium, which can be renewed yearly.
Most Insurance companies have a tie-up with a large number of hospitals to ensure cashless treatment and speedy recovery of the patient.
Sedentary lifestyle has reduced physical activities to the minimum. Health injuries, ailments, critical illness, and accidents are on the rise. In such a scenario Health Insurance Plans serve as a savior for people by providing coverage against the exorbitant hospital bills.
Top Health Insurance Plans in India 2020
The below-mentioned health insurance providers are ranked basis their Incurred Claim Ratio (ICR). ICR stands for the ratio between the total premiums earned in a year and the total number of claims paid against it by the insurer. ICR ascertains the performance of the insurers. The higher the ICR, the better the record of claim settlement.
Here’s a rundown on some of the top health insurance plans from the best health insurance companies:
|Insurer||Plan Name||Network Hospitals||Incurred Claim Ratio (ICR) (In %)||Sum Insured (In Rs.)|
|Aditya Birla Health Insurance||Activ Assure Diamond Plan||5850+||59||10-30 Lakh|
|Bajaj Allianz Health Insurance||Health-Guard Insurance Plan||6500+||85||1.5-50 Lakh|
|Bharti AXA Health Insurance||Smart Super Health Insurance Policy||4300+||89||5 Lakh-1 Crore|
|Care Health Insurance (formerly known as Religare Health Insurance)||Care Health Care Plan||4987+||55||4 Lakh – 6 Crore|
|Cholamandalam Health Insurance||Chola MS Individual Healthline Insurance Policy||6500+||35||2-15 Lakh|
|Digit Health Insurance||Digit Health Insurance Plan||5900+||11||2-25 Lakh|
|Edelweiss Health Insurance||Edelweiss Health Insurance Plan||2578+||115||5 Lakh-1 Crore|
|Future Generali Health Insurance||Future Health Suraksha Individual Plan||5000+||73||5-10 Lakh|
|IFFCO Tokio Health Insurance||Family Health Protector Policy||5000+||102||1.5-30 Lakh|
|Kotak Mahindra Health Insurance||Kotak Health Premier||4800+||47||-|
|Liberty Health Insurance||Health Connect Supra Top-up||3000+||82||Up to 1 Crore|
|Max Bupa Health Insurance||Health Companion Individual Plan||4115+||54||3 Lakh – 1 Crore|
|ManipalCigna Health Insurance||Prohealth Plus Insurance Plan||4000+||62||2.5-50 Lakh|
|National Health Insurance||Overseas Mediclaim Business and Holiday Plan||6000+||107.64||USD 50,000-USD 5 Lakh|
|New India Assurance Health Insurance||New India Assurance Mediclaim Policy||3000+||103.74||1-15 Lakh|
|Oriental Health Insurance||Individual Mediclaim Plan||4300+||108.8||1-10 Lakh|
|Raheja QBE Health Insurance||Health QBE||2000+||33||1-2 Lakh & 3-50 Lakh|
|Royal Sundaram Health Insurance||LifeLine Supreme Plan||5000+||61||5/10/15/20/50 Lakh|
|Reliance Health Insurance||Reliance Critical Illness Plan||4000+||14||5, 7 and 10 Lakh|
|Star Health Insurance||Family Health Optima Plan||9800+||63||1-25 Lakh|
|SBI Health Insurance||Arogya Premier Policy||6000+||52||10-30 Lakh|
|TATA AIG Health Insurance||MediPrime Health Insurance||4000+||78||2-10 Lakh|
|United India Health Insurance||Family Medicare Plan||7000+||110.95||1-10 Lakh|
|Loan Secure Insurance Plan||5000+||92||Up to 10 Lakh|
Source: IRDAI Annual Report 2018-19
Disclaimer: *Paisawiki does not endorse, rate or recommend any particular insurer or insurance product offered by an insurer.
With the outbreak of coronavirus in the country, people have inquired about the COVID-19 coverage under health insurance policies. Reports say that there has been a 40% rise in queries on health insurance.
Here’s a rundown to health insurance cover for Covid-19:
Coronavirus health insurance cover is available right from the day of diagnosis. As coronavirus is a news disease, it does not fall under the pre-existing illness category.
Listed below are covered under Coronavirus Health Insurance Policy:
Listed below are not covered under the Coronavirus Health Insurance Plan:
The types of medical insurance plans offering health coverage are listed below.
These plans provide health insurance for individual policyholders. The policy premium of individual Health Insurance plans is relatively low and decided on the basis of several factors such as age, previous medical condition, location, etc.
These are plans that offer coverage for the entire family under one medical insurance policy. Most family floater health insurance plans offer coverage for up to 4 members of the family. These include parents and children (up to 2). Some plans extend coverage to up to 15 members of a family under a single Family Floater Health Insurance plan. The sum assured in these plans is applicable to the entire family. The policy comparison of buying a family floater health insurance policy with individual health insurance policies for the family prove family floater to be cheaper.
These plans are specially designed for people who are over the age of 60 years. Most of the Senior Citizen Health Insurance plans offer discounts on the policy premium. The insurers offering senior citizen health insurance plans are limited and may conduct a health check-up before selling the policy. The plans are relatively expensive when compared with health insurance plans for younger people owing to the vulnerability of the senior citizens to fall ill.
This plan is specially designed to provide cover against critical illnesses such as heart attack, kidney failure, cancer, organ transplant, etc. Critical illness plans are useful for people with any medical history of critical illness in the family.
These insurance plans cover expenses related to pregnancy. This includes expenses during prenatal, postnatal, and delivery stages. Both the newborn child and mother are covered under the Maternity Health Insurance plan. These plans are available as riders that can be bought with an existing health policy. However, some of the health insurance providers have started aternity cover as in-built feature in their plans.
These plans are designed for employers or companies to offer health insurance to their employees. The premium of a Group Health Insurance plan is low as they involve less risk, and benefits of the plan remain valid only until the individual is an employee of that company.
These plans offer coverage for expenses borne during the treatment of any disease, illness, or cancer. Screening tests or annual check-ups are some of the services covered under this medical insurance
This plan covers all medical insurance claims that arise through unforeseen and unexpected accidents. Personal accident Insurance offers compensation for death, disablement, impairment, or injury caused by rail, road, air, or water accidents.
Introduced recently, this policy comes with the dual benefits of insurance and investment, where a portion of the premium amount is invested in the market and the other is to provide health coverage. This policy comes in handy in covering those expenses that are not covered by a regular health insurance policy.
Different plans have different features to suit varied requirements. Even though most health plans can be tailor-made as per the needs of the individual. Some common inclusions found in health plans are listed below.
There are certain treatments, injuries, cases that are not covered under the coverage of a health insurance policy. These Exclusions are as follows.
Buying a health policy in India comes with several benefits. These benefits are listed below.
The premium of health policy is eligible for Tax benefit under Section 80D of the Income Tax Act 1961. This deduction is applicable in two ways:
For taxpayers below 60 years of age, who have purchased a medical insurance policy for self and senior citizen parent, can claim tax benefit up to Rs 75,000 under Section 80D of the Income Tax Act 1961
Taxpayers above 60 years of age who have purchased a health insurance policy for self and parents are eligible to claim tax benefits up to Rs 100000 under Section 80D of the Income Tax Act 1961
The unreasonably high costs involved in medical treatments make it indispensable to own a health plan. Comparing the policy options and buying a health plan for the various expenses involved with medical treatment is the best way to keep the family’s health and finances secured. In the event of not having a health plan can lead to depletion of family savings.
This is applicable if the policyholder does not take any policy claim in a given year. In such a scenario, the policyholder gets a no claim bonus which is in the form of a discount in the premium or an increased sum assured in the health policy.
Most insurance companies have a tie-up with hospitals and nursing homes. When an insured takes treatment from such a hospital that is a part of the network, also known as impaneled or network hospitals, the expense of the treatment is borne by the insurer directly, with the insured only mentioning his policy number. The insured is free from the hassle of documentation submission and reimbursement.
The ambulance fee involves getting the insured to the hospital is also covered under the Health Insurance policy.
Cover for Pre and Post Hospitalization Expense
Since the expenses incurred both prior and after hospitalization is part of the treatment, they are included in the list of coverage. The number of days included in the pre and post hospitalization varies with the policy option.
A large number of health insurance providers offer annual medical check-up free of cost. This feature is subject to a particular claim-free year, where the insured is eligible to earn NCB benefit.
Some health insurance plans offer insurance cover for availing medical treatment through alternative treatment methods. These may include Yoga, Homeopathic, or Ayurveda. This feature allows the policyholder the freedom to try alternative treatment methods without worrying about the costs.
Most Health Insurance policies offer cover for the room rent which is another huge cost in the medical expenses.
Once the policy has run for a few years, the insurer offers the insured cover for pre-existing illness. This simply means that the policy will provide cover for pre-existing illnesses that the insured had prior to purchasing the policy.
This benefit is either a rider or an in-built, depending on the provider. Under this feature, the overhead expense that occurs during hospitalization, like travel, food, etc. are covered under this.
These include procedures such as radiotherapy, dialysis, angiography, colonoscopy, appendectomy, chemotherapy, eye surgeries, hydrocele, and lithotripsy among others. Some select medical plans offer coverage for these daycare procedures, which take
Though employers offer health insurance, at times it might not suffice the insurance requirements of a person, considering the rising cost of health care services. Hence, an additional health insurance plan comes at one’s rescue, if the hospital expenses go above the limit.
With innumerable insurance companies existing in the market, each company has its own pool of medical insurance plans, selecting the health plan that suits one individual or family perfectly becomes a taxing task.
In order to simplify the task, a list of the top insurance plans of the country is compiled below.
This plan is popular owing to the numerous benefits it offers to its policyholders. The plan covers people in the age group of 91 days and 65 years and a sum assured ranging between Rs 3lakhs – 50 lakhs. The benefits offered by this plan include a cover for air ambulance, domiciliary treatment, post, and pre-hospitalization, etc. The unique benefit of this plan is the Stay Active Benefit. Under this, the policyholder becomes eligible for certain discounts on the policy premium by staying active and fit.
Policy benefits under Apollo Munich Optima Restore are:
The policy doesn’t cover the expenses incurred for the following:
Counted among the best health insurance plans in the country, Bajaj Allianz Health Guard Plan offers coverage against expenses incurred on major health ailments. The plan is an all-inclusive plan covering individuals, families, and pregnancy (along with the newborn baby).
Policy benefits can be categorized into the following:
Some of the policy exclusions are mentioned below:
The health insurance plan covers all kinds of emergency hospitalization and medical expenses.
Coverage offered under this policy usually include:
The policy doesn’t cover the expenses incurred for the following:
This is a comprehensive single health insurance plan that offers coverage for both Ayurvedic and Allopathic treatments. The coverage under this plan includes spouses and children in the same plan.
The list of benefits under this policy include:
The policy doesn’t cover the expenses incurred for the following:
This health plan offers budget-friendly premium plans offering wide and unique coverage. The plan is available in silver, gold, and platinum variants for the policyholder to select as per the requirements.
The list of benefits under this policy include:
The policy remains null and void in situations such as
This plan offers coverage for 12 critical diseases that are mentioned in the policy document. On diagnosis of any of these ailments, the insurer pays the insured a lump-sum payment of the sum assured. The sum assured for this plan ranges between Rs 1lakhs and Rs 50lakhs.
Policy benefits are to be availed for:
The policy doesn’t cover the expenses incurred for the following:
The plan is a unique health insurance plan offering many benefits to the policyholder. From allowing entry to the policy from the age of 91 days, the policy provides a sum assured ranging between Rs 2lakhs and Rs 1 crore. Offering a health cover for up to 19 relations, the plan is available at budget-friendly prices.
Policy benefits under Max Bupa Health Comapnion plan are as mentioned below:
Some of the policy exclusions are mentioned below:
The plan is ideal for nuclear families and individuals looking for a budget-friendly comprehensive health plan.
The policy provides insurance coverage for:
The list of exclusions includes the following benefits
The plan offers a sum assured as huge as Rs 50lakhs and covers the entire family including children, self, spouse, parents in law, and parents.
The below coverage are offered under this plan:
The policy doesn’t cover the expenses incurred for the following:
The policy offers several benefits to policyholders. The main policy inclusions and exclusions are mentioned below.
This health insurance plan covers individuals between the age group of 18 -65 years extendable up to 70 years.
The list of inclusions covers the following:
The insurer doesn’t entertain a claim during the following conditions:
The plan is available in several variants and offers coverage to people within the age group of 90 days to 65 years.
Some of the policy inclusions include:
The list of exclusion includes:
The plan offers wholesome coverage for both families and individuals.
The policy coverage is offered for below expenses:
The plan offers coverage for some critical illnesses for which the treatment costs are extremely high. Some of the illnesses covered under this plan are Cancer, Third-degree burns, Coma, Organ Transplant, Multiple Sclerosis, Total Blindness, Heart valve Replacement, and renal Diseases.
Some of the benefts of this policy are mentioned below:
Claims arising out of the following will not be entertained:
It is a health plan that offers all-round benefit to the policyholder. Star Family Health Optima Plan offers covers to the complete family at a budget-friendly premium. The policyholder can include spouse, self, and dependent children (of the age group 16 days to 25 years) with this plan. The sum assured offered in this plan ranges from Rs 3lakhs to Rs 25lakhs. Anyone between the age group of 18 -65 years can purchase the plan. This policy scheme has the benefit of lifetime renewability and automatic restoration (3 times during the plan) on complete exhaustion of the sum assured.
Some of the policy benefits offered under Star Family plan are:
The policy doesn’t cover the expenses incurred for the following:
Another comprehensive health insurance plan that offers coverage against medical expenses arising from hospitalization.
To mention a few of the policy benefits are:
The policy doesn’t include the expenses incurred for following:
Government Health Insurance Plans are backed by the Government of India. These schemes are intended to make medical insurance available to all the people who are economically deprived. Here’s a list of health insurance plans owned by the Indian Government:
A Government of India Health Insurance scheme, Aam Aadmi Bima Yojna was started in the year 2007 for the rural landless people of the country. The scheme provides health coverage to the primary earning member of the family. Some benefits of this scheme are
The health scheme initiated by the Government aims to cover poor families across the country. Ayushman Bharat Yojna offers a health coverage of Rs 5 lakhs to each family covered under the scheme per year. This amount includes the expense of tertiary care and hospitalization expense. The Government also aims to open wellness centers and health centers for people for easy access to health facilities.
This health insurance policy started by the Government of India offers medical coverage for the employees of the Central Government and their dependent family members. The scheme benefits are extended to pensioners too. To be eligible to avail the benefit of the Central Government Health Scheme, the individuals must be residing in a city that is covered through this scheme. The scheme provides coverage for treatments provided through allopathy, Ayurveda, Siddha, Unani, homeopathy, and Yoga.
The scheme was started for factories having more than 10 employees. The Employee State Insurance Scheme offers health coverage to the employees and their dependent family members. The benefits of this policy include Vocational and physical rehabilitation. Some other benefits of the ESIS are
This Government-run health Insurance plan provides coverage against death or disabilities caused due to accidents. The scheme is a one-year plan and needs to be renewed every year. People within the age group of 18 -70 years can benefit from this policy, subject to having AADHAR (main KYC requirement of the scheme) and savings account in any of the banks participating in this scheme.
This Health Insurance Policy was started, in the year 2008, by The Ministry of Labour and Employment of the Government of India. From April 1, 2015, the operations of the scheme were handed over to the Ministry of Health and Family Welfare. The purpose of this scheme was to provide health coverage to people who fell in the BPL category. The insured under this scheme was given cover for the medical expense of up to Rs 30,000.00. This service was made available through the network of impaneled hospitals. This plan covers up to a maximum of 5 members of a family which includes up to three dependent children and parents. The greatest advantage of the Rashtriya Swasthiya Bima Yojna plan is the facility of cashless hospitalization offered through its network of hospitals.
Under this policy, the government aims to provide health insurance to the people under below poverty line. 4 companies from the Public sector have come together to offer this scheme to the citizens of India. As per the Universal Health Insurance Scheme, the insured individual or his family can claim health cover for up to Rs 30,000 in case of hospitalization. However, if the breadwinner of the family dies in an accident, the family is given a compensation of Rs 25,000. Additionally, the family will be given Rs 50 per day, for 15 days from the date of death of the breadwinner of the family. The scheme targets poor families who are below the Poverty Line.
There are numerous insurance providers in India offering varied Health insurance plans. When purchasing a policy, it becomes vital to compare health insurance companies and select the one that offers an apt health plan. Some factors that help in comparison to health insurance companies are as follows.
Company Reputation: The goodwill and reputation of a company is a crucial factor in deciding the ideal health insurance policy. A company with an established repute and brand in the market is known for its good services, products, etc. An individual looking to buy a policy should consider the company’s reputation in the market.
Stability: The financial stability of the insurer is another factor to be checked when buying an insurance policy. The Credit Rating Information Services of India Private Limited CRISIL recommended AAA-rated companies are a safe bet as AAA rating implies robust financial stability of the company.
Claims Settlement Ratio: When applying for a health insurance policy claim, a speedy, smooth, and hassle-free claim settlement and minimal rejection lead to a high probability of buying the policy. A high claim settlement ratio of a company is an indicator of the favorable performance of the insurer in settling health claims.
Portfolio of Products: As the number of insurance companies existing in the market keeps increasing, and each company launching new insurance products. It becomes vital to select a company that offers a varied range of health insurance products keeping in mind the needs of the customer and whose products keep updating with the changes in the demand.
Customer Service: Customer service plays a crucial role in the insurance sector. A well informed, helpful, and knowledgeable customer support is of prime importance. The insurance companies providing efficient, quick, and reliable solutions to the customer queries woo more customers. Customer support may be through call/ SMS/ email.
Insurance Advisor: The network of insurance advisors ensures a wider reach. They provide a personal service to the customers and advise products as per the needs of the family. The insurer having a wide network of reliable insurance advisors makes the work of policyholder easy and keeps them attached to the company.
Customer Feedback: Positive feedback posted by people who have bought a specific insurance provider’s policy and experienced their service offers a better and true picture of the company’s performance. Checking the complaint resolution mechanism of the insurer through the IRDAI (Insurance Regulatory and Development Authority of India) can further help in deciding about an insurer.
Here are the factors affecting health insurance premium:
The health insurance premium calculator is a convenient tool available online that helps people find the appropriate premium amount based on the information provided by them.
It is essential that the individual using the tool provides correct information to get actual amounts.
The premium amount of a Health Plan varies from one plan to another and from person to person. There are several factors that affect the policy premium of a health plan. These are
Both of these factors influence the premium amount. The premium amount for a plan increases with rising age. As many diseases are related to old age, the premium of health insurance plans is higher with increased age. Secondly, in the case of females, the policy premium is relatively low owing to their less susceptibility to a heart attack or stroke.
Most insurers conduct a medical test after a certain age when issuing a health policy. Some critical factors in this include the medical condition of the individual, family history of diseases, etc. For this reason, the policy premium of smokers is higher than non-smokers.
As general consideration policies taken for a longer tenure are at a discounted rate than a shorter one. For instance, a 2-year policy is cheaper than a 1-year policy with the same features.
An individual's lifestyle which includes alcohol, smoking, sedentary lifestyle, etc are considered and leads to a higher premium.
If an individual does not make any policy claim during a given year, the next year's premium becomes eligible for a no claim bonus discount that may range from 5-50 %.
The claim process for any insurance policy is a crucial factor to consider when it comes to buying a health plan. A smooth claim process ensures the insured, a smooth and carefree treatment in case of an emergency. The claim process in a Health Insurance Policy can be categorized as follows.
For a cashless claim process, the insured must be treated in any of the impaneled hospitals. The insured can avail the cashless treatment and hospitalization by displaying his health insurance policy, or the card provided by the insurer as proof of the health insurance facility. The illness must, however, be covered in the health plan. Under a cashless claim facility, the medical bills of the insured’s treatment are sent to the insurer by the impaneled Hospital. The insurer on receiving the expense bill settles the bill after careful examination and evaluation of the medical expense bill.
In a cashless claim process, the treatments are either Unplanned or Planned. Unplanned claims are usually for Emergency Treatments.
In order to file a claim for a planned treatment taken at an impaneled hospital, the insured must intimate the insurer about the treatment to be availed. It is usually recommended to inform the insurer a minimum of 72 hours before getting the medical treatment. Along with the intimation, the insured must submit a cashless claim form at the office of the insurer by Post, email, or fax. Once the claim form is received, the insurer would inform the insured and the hospital about the eligibility and cover provided by the policy. Once the treatment is completed, the medical bills are paid by the insurer to the hospital directly.
In the case of a medical emergency, the insured can visit the nearest impaneled hospital to receive medical treatment. The policy card with the insured helps in availing the cashless hospitalization facility at the office of the. Here the hospital fills the cashless claim request form and submits it at the insurer’s office. The insurer sends an authorization letter to the Hospital confirming the policy coverage and paying the bills later on receipt of the medical bills from the hospital.
This claim is applicable when the insured visits a non-impaneled hospital for treatment. Here cashless claim facility does not apply and the insured has to pay all the medical bills, costs, and other expenses involved in the treatment and claim reimbursement after that. For the reimbursement claim, the insured has to submit all relevant documents and original medical bills to the Insurer. The insurance company evaluates all the medical bills and reimburses the insured as per the scope of the policy the
The following documents are generally required when applying for a claim.
It is essential to renew the medical plans every year to keep one's family and self, protected from unexpected and sudden medical expenses. The health insurance companies now-a-days provide simple, smooth, and online means to renew the medical policy on their websites. The insurer needs to access the policy details by entering the policy number, etc. and make the payment using any of the online payment modes available-net banking, credit card, debit card, etc.
The renewed policy details are sent at the registered email id of the policyholder.
Below are some factors worth considering at the time of policy renewal.
Modifying the Members Getting Benefit from the Policy
The policyholder can make changes in the members covered under the policy. The policyholder can add new members. If unfortunately, a member has expired, that member can be removed/deleted from the policy coverage.
Raise the Amount of Sum Insured
The policyholder can utilize the renewal to increase the amount of sum assured. The insurer, in this case, may ask for a medical test and a no claim history. Also, any increment in the sum assured will lead to a new waiting period that would be applicable to the raised amount.
Add Some Top-Up Plan
In the event of the sum insured of an insured being equal to the maximum limit possible under that scheme, the insured cannot raise the sum insured. However, at the time of policy renewal, the insured can look for additional top-up plans with the existing insurer or a different one.
Share Details About Some New Medical Condition
At the time of policy renewal, the health insurance policy is renewed for another year on the same terms and conditions. If however, there have been any changes in the health of the insured in the past year that may impact the policy claim later due to non-disclosure, it is recommended to mention any changes in health conditions to the insurer at the time of health plan renewal.
Read all the Terms and Conditions
The policy providers can make amendments in their policy features, terms, and conditions from time to time. As per IRDA, the insurer has to take the approval of the policyholder for any changes in the terms and conditions. If the insured does not accept any of the modifications made, the policyholder can port the policy to another insurer or migrate to a new plan with the same insurer.
Safely Preserve the Receipt
The renewal receipt of the health insurance policy is a critical policy document and must be kept safely. The details of the policy receipt must be shared with the other family/policy members to be handy at the time of need.
Making Some Other Member as the Policyholder
It is possible to change the policyholder at the time of renewal. An individual can make his parents the policyholder and avail tax benefit for paying premiums under section 80D of the Income-tax Act 1961.
Renewal Time Period
To enjoy the benefits of a policy renewal it is essential that the renewal is done before the policy expiry. The grace period in most policies is usually between 15-30 days. Once the policy lapse the medical cover will no longer be valid. Other benefits such as no claim bonus, critical illness cover, and tax exemptions will no longer be valid.
Let us discuss some of the health insurance companies in detail:
Aditya Birla health insurance plans customizable and are designed to meet the various insurance needs of the people. The insurer offers a range of comprehensive plans with a sum assured limit up to Rs. 2 Crores. Health insurance plans from Aditya Birla can be availed as individual, family, critical illness, and group health insurance plans. With its presence in 650 cities across the country, the insurer has more than 17,000 advisors to carry forward its business.
Bajaj Allianz General Insurance Company has been providing quality insurance solutions in the general insurance segment since its inception. The provider is a joint collaboration between Bajaj Finserv Limited, a comprehensive financial services company based out of India and Allianz SE, the global financial services majorly based out of Munich, Germany. The provider received iAAA rating by ICRA for the 10th year continuously. As of now the provider claims to have a profit rate of Rs 780 crore and revenue of Rs 11,097 crore with a 17% growth rate.
This is an all-inclusive plan that offers cover for medical expenses incurred on any illness, injury, or accident. The policyholder has the option to select the sum insured between Rs 4lakhs - Rs 6crore. Several add on benefits are available with this policy by paying the extra amount with the premium. These include everyday daycare, no claims bonus super, personal accident cover, unlimited automatic recharge, smart select, air ambulance, international second opinion, and global coverage. Care Health Insurance (formerly known as Religare Health Insurance) is available in 5 different variants which are Care 3 (Super Saver), Care 4 (Elite), Care 5 (Elite Plus), Care 6 (Global), and Care 7 (Global Plus).
Inclusions in the policy are:
Exclusions in the policy are:
Cholamandalam MS General Insurance Company Limited, established in 2001, was a joined venture of Murugappa Group, a multi-business conglomerate, and the Japan-based Mitsui Sumitomo Insurance Group to address the general insurance market in India. With 105 branches in the country, the insurer provides individual and corporate insurance solutions with 9000+ agents.
Known as digital-friendly health insurer in the Indian insurance market, Digit health insurance is one of the sought-after insurance products. The polices are designed to cater to the various insurance needs including individual, family, senior citizen, where the insured can avail cashless benefit at over 5900 network hospitals.
Edelweiss medical insurance plans offer coverage to Individuals, Families, and Groups. Available in 3 variants- Silver, Gold, and Platinum, one can avail coverage up to a maximum of Rs 1 cr. Edelweiss health insurance offers coverage for critical illness under Gild and Platinum plan option.
With a PAN India presence of 137 branches, Future Generali Insurance Company is a joint collaboration of Indian Conglomerate Future Group, and the Generali Group. The insurer takes pride of providing customized insurance solutions catering the different individual needs.
When it comes to offering health insurance solutions, IFFCO Tokio Health Insurance can be a true choice. The insurer has been serving the industry since 2000, with maximum customer satisfaction with transparency. IFFCO Tokio offers a hassle-free claim settlement with a CSR of 92% and promises to offer cashless treatment over 5000 network hospitals across India.
Famous as a subsidiary of one of the leading India private banks Kotak Mahindra, Kotak Mahindra General Insurance offers health insurance at an affordable rate of insurance. Apart from the basic coverage, the insured can opt for various add-ons. The insurer also offers discounts on various products, which can be availed online easily. With 4000 network hospitals within the country, health insurance from Kotak Mahindra offers benefits such as cashless hospitalisation, day care procedure, in-patient treatment cover, domiciliary cover etc.
The insurance company was established in the year 2013 and since then has been offering diversified insurance products to cater to the various needs of the people. Health insurance provided by the insurer can be availed an individual and family floater, where the insured can avail cashless facilities at over 5000 network hospitals. For its excellent services, the insurer is awarded with Employer of Choice by the Excellence Awards.
Max Bupa Health Insurance has its global presence in more than 190 countries. The claims are settled directly without an intervene of a Third-party Administrator. To ensure ease of insurance claim for its customers, the insurer offers cashless claim pre-authorization in 30-minutes.
Founded in the year 1919 and having its head-office in Mumbai, New India Assurance General Insurance Company has a reputation in the market. In addition to other insurance products offered by the insurer, health insurance can be a good pick for one looking for securing the finances in times of an eventuality. New India health insurance doesn’t require a medical test to avail the policy, while a comprehensive coverage can be expected at an affordable premium. Currently, the insurer has its presence in 28 different countries globally.
With its global presence in, Nepal, Kuwait and Dubai, Oriental Insurance Company is well-famous for its insurance products. Health insurance from Oriental offers comprehensive coverage for mitigating those additional expenses arising out of a health emergency. The insurance provider also offers insurance products for petrochemical and chemical industries.
With around 139 branch offices across India, Reliance is a renowned health insurer in India. The insurer is more accessible through its digital platform to make the insurance process convenient for its customers. Health insurance from Reliance has its presence in India and abroad with a vast customer database. Reliance health insurance can be availed as individual and family floater.
QBE Insurance belongs to the Rajan Raheja Group. Health insurance from Raheja offers extensive and exclusive coverage in times of need. The insure provides cashless facility, hassle-free claim settlement, online renewal of policy along with the other policy benefits.
Royal Sundaram GI Co. offers cashless hospitalization facilities in nearly 5000 network hospitals in India itself. Some of the alluring features of Royal Sundaram health insurance are lifelong renewability option, option to double the sum insured in 5 claim-free years and 100% reload of sum insured.
Star Health and Allied Insurance Co Ltd. is the first standalone health insurer founded in the year 2006. At its initial stage, the insurer focused on health insurance, personal accident plan and overseas mediclaim policy, and expanded its wings slowly and steadily thereafter. Today the insurer is counted among the most sought-after insurance providers in India. The company is known for its vast network list of 9800+hospitals PAN India. It was awarded by Economic Times with the best BFSI Brand Award in 2019.
Founded as a joint venture between State Bank of India (SBI) and Insurance Australia Group, SBI Health Insurance offers suitable insurance solutions of every genre. Health insurance from SBI General Insurance can be availed for both individuals and groups. Over these years, the company has proved its potential by sharing a vast customer base. Health insurance offered by the insurer provides huge sum insured at an affordable rate, ranging from Rs 50,000 to Rs. 5,00,000.
Tata AIG General Insurance is collaboration between TATA Group and the American International, which celebrates its 18-yers of service in 2019. With more than 4000 network hospitals across India, the insurer facilitates its customers with cashless benefit. Moreover, TATA AIG is quite popular for its seamless claim settlement process.
Founded in the year 2007, Universal Sompo General Insurance Company is a joint collaboration between Dabur Investment Corporation, Indian Overseas Bank, Karnataka Bank, Allahabad, and Sompo Japan. Health insurance plans offered by Universal Sompo are affordable and customizable in the manner to meet the insurance needs of the people. Moreover, cashless treatment is available in more than 5000 network hospitals across India. The policies can be availed for individual, family, senior citizens, groups, NGOs and likewise.
Buying a health plan is possible through both offline and online modes.
In the offline mode of purchasing a health plan, the buyer must visit the insurer’s branch office, refer to the various plans available, select the plan that meets their requirement, provide all relevant documentation and fill the form, and make payment to purchase the policy.
In the online mode, the prospective buyer can make policy comparisons online and select the appropriate plan to be purchased. This involves a simple process of visiting the website of the insurer whose policy is to be purchased, filling all the mandatory details, attaching any documents that are required and making the necessary payments
The documents required to purchase a Health Insurance policy are as follows
The policyholder needs to submit certain documents that serve as age proof of self and dependent family members who are covered in the plan. These include
The following documents are considered valid to be submitted as proof of Identity.
A document as a proof of residence is another mandatory document to be submitted while purchasing a policy. Some documents that are valid to be submitted as address proof are mentioned below:
In some cases, the insurers might ask for some additional documents too while selling the policy.
The basic eligibility criteria to buy a health policy in India are the same for all insurance providers with a slight variation in some cases.
In order to ensure the right health cover, one should consider the below factors:
It is vital to analyze the health insurance needs of one’s family before buying a health policy. This ensures that the health plan that is bought meets the needs of the family.
The amount of cover can be decided keeping the health conditions of the family members in mind. The ideal thing to do when buying a health insurance policy is to select a plan that provides maximum coverage, especially if the family members are susceptible to illness.
It is advisable to select a policy that offers coverage against critical illnesses. The Health policy that offers coverage for a maximum number of critical illnesses must be selected over others. Since the expense incurred for the treatment of any critical illness is huge, this factor must be carefully analyzed.
With skyrocketing costs of medical treatment, doctor consultation, and other hospitalization, it is essential to compare health insurance plans and buy a health plan that offers the highest sum assured. A higher sum assured would mean that that individual and his/her family is covered for a large amount.
The real benefit of health insurance plans begins with advancing age when health starts falling. It is therefore recommended to select a policy plan with a high renewal age limit. Plans that have a renewal age limit of 70 or 75 years must be preferred over others.
Insurers that have a high claim settlement ratio must be selected over others as the preferred choice. A high Claim Settlement Ratio refers to the higher probability of the claims getting approved and settled in case of an unfortunate incident.
All insurance companies have a tie-up with a network of hospitals. The insurer that has an extensive list of hospitals must be considered while buying a health plan.
The co-pay amount in the selected health insurance policy, especially in case of senior citizen plans, must be nil or minimum. Co-pay refers to the amount that has to be borne by the policyholder at the time of a claim settlement. Most companies have a co-pay percentage in the range of of 10-30%.
It is always recommended to select a health plan that covers a wide range of services. Getting mislead by a lower premium must be avoided as it might lead to low benefits at the time of policy claim.
Health insurance Portability allows the policyholder to switch the health plan from one company to another. This way the policyholder can switch to a new plan within the same company or to a new company with a new plan that offers benefits without compromising on the accrued benefits with the existing plan such as NCB, waiting period etc.
It refers to the facility provided by the insurer wherein the sum assured in a health plan is restored during the policy term after getting exhausted for medical treatment. This facility is especially useful in a family floater when the sum assured gets used in the reimbursement of a single member's medical treatment expenses. The restored sum assured can however not be used for the reimbursement of the same illness by any family member.
It refers to the period after the insurance plan is initiated, which the policyholder must serve to get the policy coverage. In most cases, this period is 30 days. Any claim that is presented during this period can be rejected by the Insurer. Apart from the initial waiting period, there are pre-existing illness waiting period, maternity waiting period, waiting period for specific illnesses etc.
If the insurance provider, at any time, feels the policyholder is likely to have a higher probability of claiming insurance, it can raise the standard premium applicable. This process of Premium Loading must be carefully checked while buying an insurance policy to avoid paying any extra premium.
When selecting a health insurance policy, there are several factors that must be considered. Similarly, there are some points that must be completely avoided when buying a health insurance policy.
Buying a policy with Inadequate Cover
It is commonly found that while buying a health insurance policy, people prefer buying a policy that has a lower premium rate and hence low coverage. Though buying a policy within the budget is essential, it is critical to not be too cautious in buying a health cover and rather buy a plan with the appropriate coverage.
It is mandatory and crucial to read the fine print and terms and conditions of the policy carefully before selecting the policy plan. It is the finely written details that mention the policy exclusions which prove critical at the time of policy claim.
When buying a health plan it is mandatory to analyze and examine all the plans of an insurer and the plans offered by other insurers. It is recommended to buy a policy that meets all the requirements and needs rather than buying a policy in haste.
The most crucial factor when buying a health insurance policy is to mention the true and actual medical health at that time. The lure of a lower premium rate lures people to lie about their health and in some cases existing medical conditions which in most cases leads to claim rejection at a later stage.
In many cases, individuals buying a health plan miss checking the cashless facility offered by insurers. The cashless facility offered by an insurer is the most beneficial facility that proves useful to the individual in the time of any health claim.
Although riders prove beneficial when buying a health plan, selecting a rider just for the sake of buying a rider without checking its benefits must be avoided. As rider comes with an additional premium, it should be the one that is necessary and supports the basic insurance cover.
It is of utmost importance that one does compare health insurance plans online to get the best out of the rest. With a plethora of health insurance policies offered by various insurance companies, it gets confusing to land on the right plan. Here comes health insurance comparison into the picture to help someone bring out of this situation. With the online comparison of health insurance plans, one can compare the policies based on their offerings, features, premium and avail the right option. Moreover, online comparison helps in getting the accurate information on the insurer and plans, saves time and money, checking the reputation of the insurer and getting the right health insurance plan at the most affordable rate.
It is no wonder that sometimes, a policy seeker may end up paying for a health cover that is insufficient or has contradictory clauses. That’s why a comparison of plans is necessary. Here’re some of the factors to keep in mind while comparing health insurance plans:
One should compare the plans keeping the sum insured amount and rate of inflation in mind. Also, it is best to go for the maximum sum insured amount at the best possible premium rate.
While comparing, also keep the determining factors of health insurance in mind such as life history, smoking habit, lifestyle, medical history etc.
The comparison tool provides insurance quotes based on the information provided by the individual. So it should be accurate in order to get the right information.
It is one of the most important aspects while comparing and buying a health insurance policy. Having said that, insurers’ claim settlement ratio is the most important aspect to look for. The higher the claim settlement ratio, the better it is for the insurance buyers.
It is recommended to Compare online the health plans existing in the market before zeroing in on the one that suits one's needs and requirements. Comparing plans brings out the features of the plans and makes it convenient to select the ideal plan to avoid any inconvenience at the time of policy claim.
Some benefits of comparing online the Health plans are:
Comparing health plans online provides complete and accurate details about the plans, its features, benefits, etc. An online comparison leaves no scope of getting mislead by an insurance agent who is likely to provide unreliable and distorted information.
Online comparison saves time and people can directly purchase the selected policy plan without spending time visiting offices, meeting agents, or comparing plans. Individuals planning to buy the policy can simply visit the company website and purchase the plan.
Access to all relevant and reliable information at the click of a mouse makes it simple and convenient to select the plan that meets their budget and family requirements. In addition, purchasing a policy online proves quite cheap and budget-friendly as the agent fee or brokerage charges are not levied.
The online comparison provides all critical information about the insurer also such as its claim settlement ratio, etc.
A Health Insurance policy provides a wider area of coverage than a Mediclaim policy. While Mediclaim covers only the expense incurred on hospitalization, health insurance covers both pre and post hospitalization expenses, ambulance fees, pharmacy bills, etc.
Health Insurance Plan
Health insurance plans offer a comprehensive cover against medical expenses incurred by the life insured due to an illness or accidental injury
The reimbursement provided under Mediclaim is for the expense incurred on the hospitalization expense
Critical illness cover, personal accident cover, and accidental disability cover are some of the add-ons or riders that can be attached to the base health insurance policy, wherein the life insured is paid a lump sum amount as a benefit
Mediclaim works on the indemnity principle, wherein the life insured is reimbursed for his or her hospitalization expenses
Once the claim is made and the sum insured is paid, no further claims can be made under a health insurance plan.
Any number of claims can be made under a mediclaim policy until the sum insured is exhausted or paid in full.
The payout in a health insurance plan can be enormous, usually up to Rs.60 lakh.
The insurance cover under a Mediclaim policy is limited up to Rs 5 lakhs.
CRITICAL ILLNESS INSURANCE
Health insurance is a base policy that provides insurance coverage against medical expenses incurred by the policyholder during the policy period.
Critical illness insurance is a defined benefit policy where the insurer pays out a lump sum benefit if and when the insured individual is diagnosed with a pre-specified critical ailment.
A health insurance policy remains active even when a claim has been made until the sum insured limit is exhausted.
Once the lump sum benefit is paid, the policy ends
The waiting period in case of illness is 1 month and in case of a pre-existing illness, the waiting period is between 1-3 years. There is generally an initial waiting period of 1 month for illnesses and 1-3 years for pre-existing ailments.
There is generally an initial waiting period of 3 months.
Comparison Between Individual Health Insurance and Family Health Insurance
INDIVIDUAL HEALTH INSURANCE
FAMILY HEALTH INSURANCE
Individual health insurance offers coverage to a single person.
Family health insurance also referred to as family floater policy covers the whole family under a single policy.
The sum insured is availed by the insured person only
The sum insured under a family floater policy is shared by all the covered family members. When one member files a claim, the cover reduces for the others by that much.
Premiums are determined based on the insured age, medical history, sum insured amount etc.
Premiums of a family floater policy are determined by the age of the eldest member insured.
Premiums are comparatively expensive
Premiums are less expensive as compared to an individual plan
A group of hospitals that are associated with a particular insurer are called network hospitals. The best thing about network hospitals is that life insured can avail the cashless facility at a network hospital that isn’t the same as that of the non-network hospital.
Ans: Daycare health insurance offers many advantages to the policyholder.