Beginner’s Guide to Buy and Claim Health Insurance Policy

In today’s times, marked by a volatile economy and even more volatile inflationary tendencies, getting a comprehensive health insurance policy is a sure-fire way to safeguard against skyrocketing costs of healthcare. However, choosing the best health insurance plan isn’t a mean feat, often involving an extensive comparison of different policy terms and conditions.

Discussed below is a 5-point checklist that can help you zero-in on the best health insurance plan for yourself:

  • Compare different policies and their premiums

Experts believe your focus should necessarily be on buying a health insurance policy that complements your requirements, rather than the cheapest of the lot or the one with a host of benefits. It is not an easy task to tally a policy’s cost of premium and total coverage, considering the plethora of health insurance plans in India. Several insurers now offer a myriad of benefits (such as wellness and vaccination cover, to name a few), some of which you might never end up using. Think about whether it is prudent to invest in a high-end policy and if it will serve your needs.

  • Probe the insurer’s claim settlement history

It is a good idea to scrutinise your insurance provider’s financial strength, experience and track record of service. This is because any insurer with an unimpressive claim settlement ratio may not be favourable for you. Experts vouch for an insurer with a diversified product portfolio. Moreover, the number of years a particular insurer has been in this business will play a decisive role in helping you select a policy among all the health insurance plans in the market.

  • Know the insurer’s hospital network

Find out if your healthcare facility is part of the insurance provider’s network of hospitals. While a few insurers would argue, IRDAI states that when you make a health insurance claim, the average payout is just half of what you’d have got had you gone for a cashless mediclaim policy. One of the advantages of a cashless policy is that it saves you the end-minute hassle of collating all paperwork and submitting to the insurance provider for subsequent disbursement. Reputed insurers generally have tie-ups with the leading hospitals in the country.


  • Know your (and family’s) requirements

The health insurance policy that you need will never be the same as that of your relative. That is because your finances and family’s requirements determine the insurance coverage that will be a custom-fit for you and the dependents. For instance, an insurance policy of Rs.5-10 lakhs could be enough for a young family that’s just starting out. Conversely, a family of senior citizens should ideally be looking for a larger coverage. If your parents are old, it is advisable to get them a parent health insurance and not have them in the same floater option.

  • Know about the ‘sum insured restoration’ feature

Consider a situation wherein the treatment procedures that you had undergone have exhausted the plan’s total sum insured, and you end up in the hospital again. How would you then bear all the expenses? This is where the ‘restoration’ feature can be such a vital cog in the health insurance policy. It restores the sum insured, thereby lending renewed coverage for further medical expenditure.

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