Health Insurance Checklist for First-Time Buyers in India

Choose Plan Type

First, you need to decide what type of insurance plan you want. You could go for an individual plan, which will cover your health expenses, or opt for a family floater plan, which provides health coverage to your spouse, parents, and children in one premium.

Pick Sum Insured

Sum Insured is the maximum amount your insurer will pay at the time of an insurance claim. Decide on your sum insured that will cover all your medical expenses based on your unique health needs and requirements.

Select Basic or Comprehensive Coverage

You can select either basic health coverage or comprehensive coverage. It is recommended to go for an extensive coverage as it covers not only your hospitalization expenses but also other health-related expenses.

Avoid Co-Payment Insurance Plans

In a co-payment insurance, you are liable to pay a certain fixed percentage of the claim amount each time you raise a claim. Though your premium expenses go down, your financial burden increases, so it's better to avoid taking an insurance policy with the co-payment clause.

Go for a shorter waiting period.

The waiting period is the timeframe between the time your insurance is accepted and the time when your risk protection starts. You cannot raise a claim for health-related expenses incurred during the waiting period. So opt for a shorter waiting period.

Avoid the room rent limit in the policy plan.

Most health insurance doesn’t cover the total hospital room rent charges, nor do you have a say in the type of room you want. If your hospital room rent exceeds a certain amount, you are liable for paying the balance. So it's better to invest in an insurance policy with no room rent limit.

Opt for Free Annual Health Check-ups

Most insurance companies compensate for preventive health check-ups, so make sure your preferred medical insurance policy offers free annual health check-ups.

Avoid sublimits on diseases.

Certain insurers may levy sub-limits on specific diseases. The insurer will pay a maximum amount as per the sublimit mentioned in the policy, and the balance amount has to be borne by you. Hence, make sure your insurance plan doesn’t have sublimits on diseases.

Check Policy Exclusions & Riders

Riders are additional benefits along with the existing coverage you get. Read your policy and check the exclusions and riders mentioned. You may have to add a premium for riders.

Check Insurer’s Claim Settlement Ratio

Before investing in a health insurance plan, check the insurer's Claim Settlement Ratio (CSR) and Incurred Claim Ratio (ICR). CSR helps you estimate the chances of your claim being settled, while ICR shows the claim-paying ability of the insurer.

Insurers with 95% or more CSR and 80% to 90% ICR are considered favorable.