Planning to buy a health insurance policy? 5 things to check before buying one

By: |
Updated: December 31, 2018 12:35:18 PM

Depending on the individual or family’s needs, one must decide on the type of policy to buy. Find out the key factors to consider prior to purchasing a health insurance policy

 health insurance, health insurance plans, health insurance plans in India, assess health insurance cover, claim rejection, claim rejection ratio of insurance company, claim insurance, claim settlement ratio, claim settlement ratio of health insurance companies, Sum Insured, Restore option, No sub-limits, Undergo pre-policy tests, minimum co-pays, lower waiting periods, room rent capping, comprehensive cover, maternity, treatment abroad, OPD benefit, coverage to new born child, good network of hospitals, Cashless facility, Mental illness, Psychiatric illness, HIV, AIDS, genetic disorders, buy a health insurance policy, things to check before buying a health insurance policyKey factors to consider prior to purchasing a health insurance policy

In recent times healthcare costs are skyrocketing, and having health insurance has become imperative in one’s financial portfolio. Health insurance policies not only provide protection against unforeseen expenses arising out of medical emergencies, but they also ensure that you don’t need to dip into your savings to pay for these medical expenses.

Experts, however, suggest while choosing the health insurance policy, one should not only look at the premium of the product. Other factors included such as OPD benefits, sub-limits, no or minimum co-pays, lower waiting periods, no room rent capping, and treatment abroad, should also be looked at.

Find out the key factors to consider prior to purchasing a health insurance policy:

Sum Insured: The sum insured should be selected, keeping today’s costs in mind. Experts suggest if you live in a small city, then the sum insured should range between Rs 3 to Rs 5 lakh, and between Rs 5 to 10 lakhs in case you reside in a larger metro. However, a floater sum insured plan is ideal for young married couples with kids.

Don’t want your health insurance claim to be rejected? Know the disclosures you need to make

Restore option: One should also look at policies which give Restore option. In case the sum insured is fully utilized the Restore or Regain option acts as a buffer to cover additional health-related emergencies. This kicks in only after the sum insured are exhausted. This means, that the insured will be paid for the claim amount over and above the total sum insured if they have opted for the restore add-on.

No sub-limits: Plans with no or minimal sub-limit should always be considered for a health insurance policy. Sub-limits are where the insurer specifies a limit for an expense, beyond which the policyholder must pay for the rest expenses from their own pocket. Says Anurag Rastogi, Member of Executive Management, HDFC ERGO General Insurance: “One can also opt for a super top-up insurance policy, as a contingency or standby, which works alongside your current health insurance policy and enhances it to provide a larger coverage at a much lower premium.”

Undergo pre-policy tests: Ensure that you undergo pre-policy tests as required. It is important to undergo these tests as per policy requirement. Industry experts say this helps the insurer to make the right decisions with respect to policy acceptance and ensures a more seamless experience in event of a claim. Additionally, many insurers also pay for the pre-policy test charges.

A trusted brand: One should always check for the claims settlement ratios, claims paying ability, claims and cashless facilities of health insurers. A claim is a moment of truth for any health insurer and having systems and processes in place helps them rise to the occasion.


Other top mentions that one should look at before buying a health insurance policy are products that offer coverage with no sub-limit for any ailments or procedures, no or minimum co-pays, lower waiting periods, and no room rent capping. Adds, Shreeraj Deshpande, Principal Officer, Future Generali India Insurance: “A policy with comprehensive cover should provide coverage towards maternity, coverage to treatment taken abroad, OPD benefit, coverage to a newborn child from day one, with a good network of hospitals on the panel to offer Cashless facility.” One can also look at recent products offered in the market that provides coverage towards Mental or Psychiatric illness, HIV/AIDS and even genetic disorders.

Experts also believe, one should opt for insurers who underwrite the risk at the time of buying the policy. Insurers underwrite risk either at time of policy buying or at the time of claim. Individuals should ideally choose an insurer who underwrites the risks at the policy inception.

Get live Stock Prices from BSE and NSE and latest NAV, portfolio of Mutual Funds, calculate your tax by Income Tax Calculator, know market’s Top Gainers, Top Losers & Best Equity Funds. Like us on Facebook and follow us on Twitter.

Financial Express is now on Telegram. Click here to join our channel and stay updated with the latest Biz news and updates.

Next Stories
1PMCARES Fund to allocate Rs 2,000 crore for purchasing ventilators, Rs 1,000 crore for migrants