In India, health insurance has become a necessity due to the spiralling costs of healthcare in every major city. In the absence of a health insurance plan, medical expenses can quickly deplete your lifelong savings. Since the insurance sector is flooded with several insurance plans, buying a suitable health insurance policy by spending a reasonable premium can be a daunting task. Therefore, it is crucial to check the following factors before purchasing a policy.
Type of coverage
There are two main categories of health insurance policies. If you are single and do not have dependent parents, you can choose a suitable individual plan. However, in case your parents are dependent on you, or you have a family (spouse and children), then a family floater plan would be more suitable. A family floater plan would cover your whole family under one umbrella and the premium amount would also be lower as compared to the premiums for separate plans for each family member.
The total sum insured is one of the most important considerations which should drive your decision making while purchasing an insurance policy. The sum insured would be the maximum liability which the insurance company would pay in case of a claim. Since the medical costs in India are increasing substantially, the sum insured by your insurance plan should be optimal. Health insurance have a wide range of premium and you should choose the one that is affordable and suffices your needs as well.
Nowadays, cashless claims have become the norm for most hospitals. These claims help you lessen your burden of hospital bills. It is futile to purchase a plan which does not cover hospitals in your locality or lacks the cashless facility feature. Therefore, it is vital to ensure that your insurance plan has a robust network of empanelled hospitals that offer cashless facilities.
Read the policy exclusions carefully
Every health insurance plan has its own set of specifications, limits, sub-limits, and exclusions. There are some diseases and pre-existing medical conditions that are normally excluded from all health insurance plans. Most policies have limits on other coverage features such as ambulance cover, AYUSH treatments, maternity cover, domiciliary hospitalisation, and room rent.There are insurance policies which exclude expenditures incurred due to dental treatment, HIV/AIDS, eye-related healthcare, cosmetic surgery etc. Therefore, it is in your best interest to have a health insurance plan with minimum exclusions.
Claim settlement ratio
The claim settlement ratio is a direct indicator of the efficiency of the insurance company when it comes to settling claims. A higher ratio and faster settlement time usually indicate that the insurance provider is effective with genuine claims. If the claim settlement ratio is low and the company has a history of denying genuine claims, then one should opt out from buying any health insurance plan from that particular company.
The waiting period varies from one policy to another and from one company to another. The waiting period can range from 12 months to 48 months. In case you are suffering from a pre-existing disease, you would not be provided health coverage under a critical health insurance plan for a specific time period. Hence, it is always advisable to purchase policies that have shorter waiting periods.
There are many medical expenditures that extend beyond hospitalisation. Depending upon the complexity of the ailments, expenses can be incurred before and/or after hospitalisation. Such expenses may include medical examinations, follow-up with the doctors, medications after discharge etc. It is highly recommended to purchase plans that include a substantial portion of pre- and post-hospitalisation expenditures.
Picking up the best insurance policy is replete with numerous benefits that can make your life healthier, happier, and safer. Bajaj Finserv has introduced a pocket-friendly solution called Pocket Insurance to offer short-term insurance plans designed to cater to your specific needs. Some of its health-related insurance plans include Monsoon Protection Plan, Sports/Fitness Injury Cover, Hospital Cash Cover, Water Borne Disease Cover, Pregnancy Complications Cover, and more. These insurance policies offer a short-term cover at an affordable one-time premium payment.