5 important things to consider before buying a health insurance policy

February 26, 2021 11:23 AM

Before choosing the right insurance policy and covers, there are a few important things that need to be kept in mind.

When it comes to buying a health insurance policy for your family, it’s important that you look at all the options.

Everyone in the world today is reeling under the after-effects of the Coronavirus pandemic. Given the severe impact of this pandemic on the lives and livelihood, no one would want an unwanted financial liability. And there can’t be a better time to invest in a health insurance policy than now. After all, the entire concept of insurance is to protect yourself from unforeseen financial liabilities, in case things go south.

However, before choosing the right insurance policy and covers, there are a few important things that need to be kept in mind. Before you pick a policy, it’s important to do some research and find a policy that fits your needs.

The Amount of Cover You need to get in Insurance Policy

As medical expenses are on the rise, it has become imperative that we think about the kind of cover we need from our health insurance policy. While Rs 5 lakh may seem like a lot of cover today, it may end up being inadequate 10 years from now. It’s a good idea to factor in medical inflation before deciding on how much cover would be enough to help you and your family through a tough time.

Protection for the entire family

When it comes to buying a health insurance policy for your family, it’s important that you look at all the options. You can choose to cover everybody under a single-family floater policy, or, you could choose to get individual health insurance plans for each family member. If you opt for a family floater, your sum assured will be divided amongst all the family members under the policy.

Limits on Treatments and Co-Payment

Depending on the kind of policy you choose, the cover you will receive for certain treatments, such as a cataract operation, could have a cap. For example, the limit on a cataract operation may be Rs 40,000. If you choose to go to a doctor who charges Rs 45,000, the extra Rs 5,000 will be an out-of-pocket expense for you. There are also co-payment clauses in insurance policies, which require the insured party to cover up to 20% of the claim settlement amount. Depending on the kind of treatment you’re claiming for, you could end up spending quite a lot of money.

Cashless Claim Facility

You should check the insurance provider’s list of network hospitals to see if you can avail the cashless claims at your preferred hospital. Most providers have a well-connected network of hospitals where insured individuals can get treatment done without having to pay anything upfront. Now that you know what to look out for, you can easily decide what kind of health plan would be ideal for you and your family members. Remember, insurance is a necessity, not a luxury.

Credentials of the Company

And finally, beyond all the product comparisons and technical aspects, choosing a brand or company with the right credentials is extremely important. My advice will be to look at the following aspects of the company, while zeroing on the policy.

a) Brand reputation & lineage – Choose a brand that is trustworthy and has a strong lineage of serving its customers.

b) Claim settlement figures – Claims settlement percentage is a ratio of total claims settled by the brand, compared to the total claims received. Make sure to check the claim settlement ratios which are available in public domain like the company website.

c) Customer service – You don’t want to be stuck with a brand that doesn’t serve its customers well, or has complex processes. While no brand will be complaints free, a good measure of this can be the number of complaints reported over the total number of policies sold. This information can be found on the IRDAI website.

d) Financials of the brand – While it is a technical area, financials of a company tell you about its financial health and stability. Go for it, if you have the appetite to understand and delve slightly deep. This information, again, can be found on the company’s website, in the public disclosures.

As I said earlier, it is extremely important to have a comprehensive health insurance policy, more so during these unprecedented times. Understand these aspects, be well informed, and choose an insurance plan which is best suited based on your needs and usage.

Stay healthy, Stay safe.

(By Eswaranatarajan N, COO, Kotak Mahindra General Insurance Company)

Disclaimer: Views are personal and do not reflect the views of Kotak Mahindra General Insurance Company.

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