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Buying health insurance? 4 smart tips for you

By Naval Goel
February 04, 2016 10:11 IST
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Companies selling health insurance are not in the business of giving away money. Let us face the fact that more they deny the claims, more they will earn. So, it is better for you to think and check out on all the details of a perfect health plan before signing the agreement.

By spending a little time in understanding health insurance cover/s which you plan to buy, you can save the financial cost if you ever require health care at some point of time.

Medical insurance or health insurance in India is now greatly advertised and numerous individuals and families are purchasing plans that would help them in case of an emergency medical treatment.

However, health insurers do not provide complete coverage as there are many medical expenses which your health plan will not cover in India, unlike overseas countries where even a single consultation with the doctor is to some extent insured and the insurance company pays for it.

Things to consider while buying health insurance plan in India...

It is common practice in India that people select the health insurance plan by checking the coverage amount only. In India, usually, health insurance starts from Rs 1 lakh and ends at Rs 10 lakh.

Don't think that if you have a health insurance plan of Rs 5 lakh then the insurer will pay out all the expenses up to Rs 5 lakh. It does not work like that, companies have their own rules and regulations regarding health insurance plan. Insurers have also set limits to the maximum sum they will pay for health treatments and for hospitalisation process also. For example, your plan may have some limitations over the hospitalisation process.

Suppose you have a health insurance plan for Rs 1 lakh. Normally in India most of the insurers have put some limits in their contracts for hospitalisation procedure, some companies limit the room rent billed to just one per cent of the sum insured. So, according to it the charge that your insurer pays for room rent will be Rs 1000/day in a Rs 1 lakh insurance plan.

If you are seeking good medical facilities in metropolitan cities such as Mumbai, Delhi etc, the hospital room charges varies from Rs 6000 to Rs 8000 per day. In the case you are hospitalised for three days, then your insurer will pay you only Rs 3000 under this head and the rest of the amount will have to be borne by you.

Useful tips:

  • Don't believe in the verbal promises by insurance agents or brokers. Ask for everything in writing; if the insurer is not providing everything in writing, then there is high chance that your expenses won't be covered by the insurer.
  • It is advisable for you to not buy a health insurance plan with the mentality that you will change the insurer if you are not satisfied with the current insurer. If you are thinking on these lines, then you may face issues while switching plans as the new health plan will not provide coverage for pre-existing disease for at least 4 years.
  • Many medical measures, such as surgeries for cataract would not be covered for first two years and payments may also be limited to a definite amount set by the health insurer. Check the plan carefully to know what and how much will get covered for an emergency medical treatment.
  • As said earlier, don't rely on the words of the insurance brokers or agents, unless they provide everything in writing. It is advisable to do an online comparison of the health insurance plans by different insurance companies but don't just take premium as the most important factor, check other features too.

Yes, it is a fact that the internet is full of complaints from dissatisfied customers who had to suffer because their claims were delayed or denied but that does not mean that you should stop your search for a policy.

Check out the master policy before purchasing any insurance plan and do check what is covered under it. You must pay attention and do your homework before purchasing the best health plan for yourself and your family.

Illustration: Dominic Xavier/

Naval Goel is CEO and Founder, PolicyX

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Naval Goel