A Health insurance policy is a contract between the insurance company and the policyholder, wherein the insurer pays for the medical expenses incurred by the life insured. The insurer will either provide a reimbursement for your medical expenses or ensure you are eligible for cashless treatment for injuries or illnesses covered under the policy at one of the network hospitals. You can also get tax deductions on the premiums paid towards health insurance under Section 80D of the Income Tax Act, 1961.
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Listed below are some of the top insurance companies offering health insurance policies. The insurance companies have been ranked based on the Incurred Claims Ratio of every insurer. This is the ratio between the premium earned and the total claims incurred by the insurer.
This is the ratio that is generally used to determine how an insurance company is performing. A higher incurred claims ratio means the insurance company has a better track record of settling the claims they receive. It is always good to opt for an insurance company with a high Incurred Claims Ratio.
| Health Insurance Companies | Incurred Claims Ratio (ICR) |
|---|---|
| IFFCO Tokio General Insurance | 99.49% |
| Bajaj Allianz General Insurance | 77.31% |
| Care Health Insurance | 55.15% |
| Navi General Insurance | 26.78% |
| Bharti AXA General Insurance | 65.37% |
| Acko General Insurance | 84.64% |
| Cholamandalam MS General Insurance | 77.35% |
| Edelweiss General Insurance | 111.57% |
| Kotak Mahindra General Insurance | 55.17% |
| Royal Sundaram General Insurance | 67.88% |
| Insurance Provider | Claim Settlement Ratio | Key Features |
| IFFCO Tokio General Insurance | 99.71% |
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| Bajaj Allianz General Insurance | 98.48% |
|
| Care Health Insurance | 96.2% |
|
| Navi General Insurance | 97% |
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| Bharti AXA General Insurance | 99.05% |
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Mentioned below are the different types of health insurance plans you can choose to meet your specific requirements:
The following are the documents you will require to purchase health insurance in India:
Age proof:
Proof of identity: The following documents can be submitted as ID proof when applying for a health insurance plan:
Proof of residence: A permanent address proof must also be submitted when applying for health insurance. The following documents can be used for this purpose:
Passport-sized photographs
Certain health insurance companies will require applicants to undergo medical examinations in order to qualify for coverage. Also, insurers can also request other documents apart from the ones mentioned above.
The following are some of the best health insurance policies offered by the Government of India:
The common eligibility criteria for Health Insurance in India are as follows:
Minimum Entry Age: The minimum age to avail of the benefits of health insurance for your child under a child plan is usually 16 days to 18 years. The entry age of a policy for adults ranges from 18 up to 65 years. It can also be 70 years and above based on the plan and insurer.
Pre-Existing Medical Conditions: If you are purchasing health insurance after the age of 45, you may have to go through various medical tests before getting health coverage. If the policyholder is not asked for the medical tests, then he/she has to submit a declaration disclosing his/her pre-existing conditions. These preconditions or revelations by medical tests determine whether a policy is accessible to a policyholder.
In order to keep the policy in force, regular payment of a fixed premium is essential. Did you ever think about how this premium is calculated? There are certain factors that affect health insurance premiums such as the medical background of your family, sum insured, cumulative bonus, your personal medical history and so on.
Based on that, you might want to calculate your premium to figure out how much you would have to pay for the policy. It can be done through a health insurance premium calculator. A premium calculator is an online tool that calculates the premium to be paid as per the information provided by you, such as the preferred sum insured, age of the insured, etc. At Policybazaar.com, you can calculate your health insurance premium online easily.
Based on a combination of various factors, your health insurance premium is defined by the following:
Age - While health conditions are on a rise for both people young and old, younger people are still a lot healthier due to stronger immune systems. Additionally, the younger you are, the more time you have to complete your waiting period for specific illnesses and covers. Therefore, the younger you are, the lesser is your premium!
Lifestyle - More than 61% of deaths in India are due to issues stemming from lifestyle diseases, including pollution levels! Therefore, your lifestyle habits such as if you’re a smoker or not will have an influence on your health insurance premium.
Pre-existing diseases or conditions - If you’ve already been facing symptoms of some kind, or have a family history of a particular illness, then your health insurance premium will probably be higher due to the higher risk involved.
Location - Your premium will be affected by the city you live in because every city is different, in terms of risks and medical costs. For example, people living in North India are a lot more prone to lung diseases, due to the high percentage of pollution.
Additional Covers - One can customize their health insurance plan based on their personal requirements and health conditions. Therefore, when you opt for additional covers like a Maternity Benefit or AYUSH benefit, your premium too increases by a small margin.
The following are the main benefits of being covered by a health insurance policy:
Cashless Treatment:
When you are covered under a health insurance policy, you can avail cashless treatments which essentially means that you can receive medical treatments without having to pay the hospital from your own pockets.
Cover for Pre- as well as Post-Hospitalisation Expenses:
Effective insurance policies offer coverage for pre- as well as post-hospitalisation expenses for a period of 60 days before and after an insured individual is hospitalised.
Transportation Expenses:
In case you hold a health insurance policy and get hospitalised the plan will cover the costs incurred on using an ambulance to transport you from your home to the hospital or vice-versa.
Medical Check-ups:
Most health insurance policies offer free health check-ups. However, most insurance companies only offer these check-ups for free depending on your No Claim Bonus.
No Claim Bonus:
If you hold a health insurance policy and do not make any claims over the course of an entire policy year, you will be rewarded in the form of a No Claim Bonus.
Room Rent:
In case you are hospitalised, you will have to incur costs on room rent. Having a health insurance policy will ensure that these costs are covered to a significant extent.
Tax Benefits:
Having a health insurance policy can offer tax benefits as well. The premium payments you make towards your health insurance plan qualify for tax deductions under Section 80D of the Income Tax Act.
Online Purchasing Facility:
Thanks to the advancements in technology, you no longer need to visit a branch of the health insurance company in order to purchase a plan. You can do so from the comfort of your own home or office.
Renewal:
The renewal of your health insurance policy can also be done online. There is also a lot of flexibility when it comes to renewing your insurance plan. You can alter the terms of coverage based on what you think will work best for you.
Cover for OPD Expenses:
Most of the traditional health insurance plans require the insured individual to be hospitalised for a minimum of 24 hours if they are to be eligible for reimbursements.
Choosing the right insurance plan can be a difficult task, but thanks to advancements in technology, the internet can now grant you access to a large number of options .This can be assessed and compared before you pick the plan that best suits your needs. People tend to make common errors when purchasing health insurance, and avoiding these mistakes can help you make the most of your health insurance policy. The following are the common mistakes you must avoid when purchasing health insurance:
The amount for which you are covered plays a crucial role in determining which policy will best suit your needs. Most people tend to choose plans with lower coverage as it helps them save some money. Lower coverage will help reduce the amount you pay as premium for your insurance policy. While it is important to save money, it is also crucial to ensure that you don’t be too stingy when it comes to buying health insurance as it could prove to be a hassle later.
Many people tend to go with the first insurance company they find. When purchasing a health insurance plan, it is crucial to compare as many plans as possible as it will help you identify which one best suits your needs.
People tend to lie about their medical history when purchasing health insurance as it tends to lower their premiums. When you purchase a health insurance plan, it is essential to be truthful about your past medical health and situations. When you lie about your medical history, there is a chance that your claims could be rejected if the insurer finds out about the same.Ensure that you submit the correct records so that you do not have to encounter a problem later.
The cashless facility is one of the most important things to look for when purchasing a health insurance plan. However, many people tend to even consider this facility when looking for policies. By finding an insurance provider that offers the cashless facility, you can rest assured that you will receive immediate treatment in case of emergencies and the insurer will cover the costs.
When you purchase a health insurance policy, the insurer will provide with an option of co-pay. If you choose this option, you will have to contribute a certain pre-determined amount at the time of making a claim, and the remainder will be paid by the insurance company. The sum assured will not be affected by the co-pay amount.
‘No-Claim Bonus’ is a benefit offered to the policyholder for every claim-free year. It is awarded upon renewal and comes in the form of discounts on premiums or enhancements in the chosen sum assured. Discounts/enhancement range between 5% - 50%.
If a policyholder is not satisfied with the policy he/she has taken or the provider of the policy, he/she can cancel and return the policy within 15 days of receiving it. Premiums already paid will be refunded, subject to adjustments.
Anyone who depends on the primary member for their livelihood, commonly the proposer’s spouse, children and parents, are considered dependents. Children are often considered dependents beyond 18 years up to the age of 25 years if they are still students (sons) or unmarried (daughters) or mentally challenged. Dependent children are often covered only if a parent is concurrently covered under the same plan.
Under some plans, the insurer and the insured are jointly liable to meet expenses. The policyholder will pay a certain percentage towards expenses incurred. If policyholders exercise this option, they are often given reductions in premiums.
If, during a particular year, a claim was made, the sum assured is reduced by that amount. The amount remaining as sum assured may not be sufficient to cover any future claims. In this case, some companies offer their clients the benefit of restoring the sum assured to the original amount so as to meet a subsequent claim. This is offered once during a policy period as an added benefit to enhance coverage.
Although used interchangeably, mediclaim is technically not the same as health insurance. Broadly, the difference between the two types of health covers lies in the quantum and breadth of coverage offered. Even though it is considered a form of health insurance, mediclaim plans are more specific in their coverage i.e. it is usually only for hospitalisation expenses, particular illnesses and hospitalisation/treatment in case of accidents. Health insurance plans on the other hand can be customised to cover expenses pertaining to pre/ post-hospitalisation, ambulance charges, critical illnesses etc.
Day care procedures ate those medical treatments that do not require the patient to be hospitalised for a minimum of 24 hours. Day care treatments can be done in few hours so it is done as an outpatient procedure. There are many insurers who offer health insurance coverage specially designed for day care treatments.
Domiciliary hospitalisation means that the policyholder is being treated for a certain ailment within the confinement of his/her home and not in a hospital or a nursing set up. Usually, domiciliary hospitalisation is allowed when they aren’t able to move the patient from home to the hospital or when the patient cannot be taken to the hospital due to lack of accommodation. In other words, domiciliary hospitalisation refers to the treatment given to a patient for a certain disease or injury for more than 3 continuous days due to non-availability of accommodation in the hospitals or because the patient cannot be moved to the hospital.
Most of the health insurance plans do not cover dental treatments. Dental treatments are one of the common exclusions in India. Please check with your insurance provider if they do.
Generally, not all health insurance plans cover homeopathy treatments. You will have to check with your insurer if homeopathy is covered under the plan. However, if you are looking for insurers who offer health insurance plans that cover AYUSH (Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homeopathy) treatments, visit - Medical insurance for AYUSH.
Some of the parameters that an insurer considers while calculating the premium for your health insurance plan are:
For a comprehensive list of factors that are considered while calculating premium, please visit this page.
A health card is like an identity card given by the insurer to the policyholder. It contains information like the policyholder’s insurance account number, the name of the insured, the age of the insured, gender, policy expiry date, and other such vital information. It is mandatory for an insured person to show the health card at the hospital in case of hospitalisation.
GST rate of 18% applicable for all financial services effective July 1, 2017.
Disclaimer: Premiums may vary depending upon factors like age, location and prevailing taxes/GST.
Reliance General Insurance Firm Ltd. (RGICL), a prominent private general insurance company, has announced the launch of Reliance Health Gain, a flexible and personalised health insurance policy. Customers can customise their health insurance policy by selecting features that meet their needs and paying just for what they want. RGICL has introduced three alternative plans – Plus, Power, and Prime – as well as a variety of features to make policy customization easier for customers.
02 June 2022
Now, in India, newborn babies and even young children will be issued Ayushman Bharat Health Account (ABHA) numbers. These will be their health IDs. With this, parents will be allowed to track their children’s health records.
25 May 2022
A unified and fully stacked AI platform known as ALFRED has been launched by Artivatic.AI. The main reasons to launch this platform is to simplify fraud management, risk, and tariff. According to the company, the introduction of the platform will provide access to health financing and bring about end-to-end self-operating. The platform will reduce the burden on health insurance purchasers as well as the insurance industry.
18 February 2022
According to a poll of the top cities, Indian consumers want the government to increase healthcare funding and implement better policies that will minimise their total medical expenditures. A survey by Kantar, an insights and consulting company stated 66% of Indian consumers expect an increase in healthcare budget allocations while 72% want the government to cut down the petrol rates.
Kantar conducted a survey for 1,419 consumers, including males and females in the age of 21-55 years in SEC A and B in 12 Indian cities. Coming to the tax deductions, investments under 80C, which offer a variety of investment alternatives, came out on top, with 60% of respondents requesting an increase in deductions from the same. The surveyed consumers are expecting better benefits related to house purchases, with 39% requesting the tax deductions on their home loan EMIs to be increased.
27 January 2022
According to the IRDAI, Omicron treatment costs will be covered under health insurance policies that cover COVID treatment. A directive has been issued by the IRDAI to health and general insurers after seeing an increase in the number of Omicron cases. The IRDAI has also requested insurers to ensure that an effective mechanism is in place so that cashless facilities are available for all policyholders.
4 January 2022
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