If you are considering a purchase of a Health Insurance policy for yourself or your family, Well Done, you are making a wise decision.
Why Health Insurance:
Life expectancy has moved up continuously over the last few decades. This means that we may need to manage multiple diseases or medical conditions in our lifetime. Luckily, Medical Technology has made rapid strides in fighting most diseases including big killers like cancer, heart disease, diabetes etc. The only thing that we need is Money. And that is where Health Insurance steps in. Pay a small amount of money every month and almost all your hospital bills will be taken care of by the Insurance company.
Health Insurance Companies:
Till 10 years back, most health insurance plans were from PSU companies like New India, Oriental, United India, National or new age private general insurers like ICICI Lombard, TATA AIG, HDFC Ergo etc.
However, IRDA (the Insurance Regulatory & Development Authority) permitted focussed health insurance companies that would only sell health insurance and nothing else. This article will focus on the main products of the Health only Insurance companies. We believe that the health focus gives them the expertise not only in product design and claim processing but also wellness management, hospital network, analytics. The main Health Insurance companies in India are Star Insurance, Apollo Munich, Religare, Max Bupa, Cigna and Aditya Birla Health.
Individual or Family Floater:
The first decision that you need to make is whether to take an individual policy or a family floater policy that will cover your entire family. We recommend a family floater. By paying some amount extra, you get the assurance that your entire family is covered.
Amount of Cover:
Even if you are covered by your employer, we recommend that you buy a personal family floater plan of at least 3 Lakh that will continue even while you may change jobs. If not, we recommend a cover of 10 Lakh or more. At the very least, a 5 Lakh cover is required to cover even medium intensity surgical procedures in good hospitals. The good part is that a 10 Lakh cover will not cost you double of a 5 Lakh cover. The cost dramatically comes down per Lakh as the Amount of Cover is increased.
We have mentioned the key factors for each company-product combination for you to consider.
The numbers mentioned pertain to a Family Floater Cover of 5 Lakh.
|Company||Birla Health Activ Assure Diamond with Super NCB||Religare NBC Super Premium||Cigna ProHealth Plus||Star Comprehensive||Apollo Munich Optima Restore||Max Bupa Go Active|
|Waiting Period for Existing Illnesses in Years||4||4||3||4||3||3|
|Increase in Cover due to non-claims in Lakh||3||3||0.50||2.5||2.5||1|
|Maximum Cover in Lakh||7.5||7.5||5||5||5||5|
|Complimentary Health Checkup||Annual||Annual||Every 3 Years for Adults||Upto 5K every 3 Years||Upto 2.5K every 2 Years||Annual except 1st Year|
|Hospital Room||Single Private Room||Single Private Room||Single Private Room||Single Private Room||No Sublimits||All excluding Suite upwards|
|Claims Ratio FY16||Started Later||87%||94%||79%||89%||86%|
This is the amount of time after purchasing the policy for existing illnesses to get covered by the policy.
In case you have an existing illness and would like to cover it as soon as possible, you may want to consider the products with a lower waiting period.
Claim Settlement Ratio:
Companies with a higher claim settlement ratio can be favoured while taking a decision.
Some of us may have an affinity for certain brands and that may play a role in the selection. That said, IRDA has put in stringent norms to ensure that all companies provide a decent service level and do not cheat their customers.
The price is an important aspect to consider but should not be seen as the only or the most important factor.The pricing of most companies is comparable. Please consider the different benefits of the shortlisted products in a comprehensive manner before taking a decision..