Policy Type
The first and foremost thing to decide is whether to enroll in a family floater plan or an individual policy. Buyers with families have to decide whether to cover all members under individual health policies or a general family floater plan.
Probus Insurance Broker Pvt. Ltd. says, “Keep in mind your family members and their age while buying health insurance. Buying a separate policy for the elderly will save on additional insurance premiums that would otherwise be charged based on their age under the family floater plan. Also, having a separate policy for them will help you accumulate a ‘No Claim Bonus’, which will not happen if you are under the same plan (as aging can lead to more claims).
“Also, family floater plans usually come with a waiting period of two to four years for several diseases like diabetes, hypertension and asthma which are common during old age. Amit Chhabra, Head of Health Insurance, Policybazaar.com said, “The whole purpose of having health insurance is futile when you have to wait to avail coverage for pre-existing diseases.” Hence, experts suggest that ideally one should opt for a different health one. Policy.
insurance coverage
Sum Assured is the maximum payout that your insurer will cover in case of any claim as per the coverage chosen by you.
Chhabra said, “Generally when you buy a health policy with a low sum insured, say: 5 lakh, you get a policy with co-pay and sub-limit. In such a scenario, you should look for a higher sum insured that does not have sub-limits.”
Bhaskar Nerurkar, Head of Health Administration Team, Bajaj Allianz General Insurance said, “When you buy health insurance, you should consider the necessary treatment in case of any medical emergency. Also, check your insurance every 2-3 years. Modify the amount. If not, do so at least every five years so that you can avail the best quality treatment. This will help people, especially those who have a problem with their family health history.”
insurer experience
Many buyers view value as the primary criterion when choosing a health insurer, or the number of cashless hospital tie-ups an insurer may have, but very few buyers look at insurers’ proven track record on paying claims. This is an important element as one must know that insurance is not consumed while buying but is consumed when a claim occurs.
Always check insurers’ claim settlement experience by visiting their websites and social media and reading customer reviews. You should also talk to others to understand their claim settlement experience with a particular insurer.
Experts say that buyers should consider insurance companies that maintain more than 95% of their claim settlement ratio.
serious illness rider
A comprehensive health policy will generally cover all hospitalization expenses. However, considering the substantial medical costs arising from serious illnesses like cancer, heart attack, stroke, etc., a critical illness policy can be taken in addition to your health policy.
Experts say, “Insurers sell critical illness riders along with health insurance. However, it becomes important for you to check whether to buy a critical illness rider or not. For example, if cancer is a genetic problem that runs in your family, you may choose a rider for cancer treatment. Otherwise, a separate critical illness rider is not required. Also, look for the waiting period. If the tenure is short, it may not be necessary to buy the rider in your late 20s, but you can buy it when you cross 35 years of age.”
Further, Nerurkar said, “One thing worth noting in critical illness policies is the ‘state of existence’ period. In order to receive a claim, the insured has to make a claim for a specified number of days after being diagnosed with a listed illness. However, this condition varies from insurer to insurer.
waiting period
When you buy a new health insurance policy, it is important to know that not all diseases are covered from day one. You need to serve a specified waiting period to get certain coverage. Chhabra said, “There are three types of waiting periods. Policies come with an initial waiting period of 30 days, during which only accidental hospitalization is covered. In addition, there is a typical illness waiting period of two years for medical conditions such as hernias, hemorrhoids, cataracts, and even for those who require knee replacement surgery. The third is the waiting period for pre-existing diseases (PED). Some of the most common PEDs include high blood pressure, diabetes, asthma, and CVD (heart disease). On all such PEDs, insurers impose a waiting period of up to four years.”