Health Insurance
What is a Health Insurance Policy?
A health insurance policy or a medical insurance policy is an agreement between a health insurance company and policyholder whereby the insurance company assures payment of a predetermined sum assured towards the medical expenses for treatment of illnesses or accident to the policyholder. The policyholder pays a premium to the health insurance company to get this medical coverage.
Most financial experts believe a medical insurance policy is considered to be an essential part of all financial portfolios, as most often the savings of an individual are drained in the expensive treatments of medical illnesses. People without sufficient savings, compromise on such expensive treatments.
Hence, to be able to fulfil all other financial goals, having medical care insurance is a must.
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How to get a health insurance policy online from us?
EquitySeeds Consultants would collect the neccessary details and share with Insurance companies and brokers to get the best health insurance policy in India for you. You can follow the steps below to buy a health insurance policy online from us:
Best Health Insurance Policy in India
EquitySeeds Consultants offers guidance in getting a health insurance policy from the below list of health insurance companies in India:
Health Insurance Policy:
Below are the top selling health insurance policies at EquitySeeds:
 | Top Selling Individual Health Cover | Aditya Birla Activ Health Platinum Enhanced Plan | ||
 | Top Selling Family Floater | Star Family Health Optima | ||
 | Top Selling Senior Citizen Health Cover | Care Senior Citizen Insurance | ||
 | Top Selling Women Health Cover | HDFC Ergo My: Women Suraksha | ||
| | Top Selling Child Health Plan | Care Youth Health Insurance | ||
 | Top Selling Critical Illness Cover | Bajaj Allianz Criti care policy | ||
 | Top Selling Personal Accident Cover | IFFCO Tokio Personal Accident Insurance | ||
 | Top Selling Top-Up Cover | NivaBupa Health Recharge |
Benefits of Health Insurance in India:
In today’s time, getting medical care insurance for self and family has become more of a necessity than choice. Below are the benefits of buying a health insurance:
Buying a health insurance policy would ensure that you are financially secured for expensive medical treatments even when the medical inflation keeps on rising.
Medical insurance policy makes it affordable to get quality treatment for everyone. Hence, for the ones who do not have sufficient savings and often compromise on their treatments, with a health insurance can get the best treatments.
Lifestyle diseases such as cancer, heart attacks are on the rise. Moreover, the cost of treatments for such diseases is huge. The cost gets bigger when the treatment and post treatment expenses go on for a prolonged time. Several health insurance policies in India provide health covers for these long-term diseases.
A medical insurance policy assures payment for expensive medical treatments which helps in protecting your savings during a medical crises.
Health insurance companies in India have tie-ups of several network hospitals across the country. One can avail cashless hospitalization treatment at these network hospitals using their medical insurance policy.
A policyholder can get all the below medical expenses covered in a health insurance as per their policy terms:
Hospitalization Expenses | These are medical expenses that are incurred on being hospitalized for more than 24 hours. It includes: room rent, doctor’s fee, medicine costs, diagnostics costs, etc |
Pre- and Post- Hospitalization Expenses | These are medical expenses that are incurred before and after the hospitalization. Usually, health insurance companies in India allow claims for these expenses only for a limited number of days which is mentioned in the policy statement. |
ICU and Ambulance cost | ICU charges and ambulance costs to reach the nearest hospital during an emergency. |
Day care treatments | Treatment of illnesses that do not require more than 24 hours hospitalization. |
Medical check-ups | Free medical check ups at regular time intervals are offered by most health insurance companies in India. |
AYUSH treatments | AYUSH treatments include ayurveda, homeopathy, yoga, etc are also covered in a few medical insurance policies. |
PED | Pre-existing diseases are covered but with a waiting period of 2 to 4 years depending on policy terms. |
You can save up to ₹ 55,000 (₹ 25,000 for self and ₹ 30,000 for parents) under Section 80(D) of Income tax act by getting a health insurance policy for yourself and your family.
Benefits of Health Insurance in India:
Types of Medical Insurance Policy:
There are different types of health insurance policies in India today offering benefits to fulfill your different health goals. Thus, it’s important to understand the differences in each of these policies before you get one.
Mediclaim Health Cover:
People usually say ‘Mediclaim Insurance policy’ and ‘Health Insurance policy’ as a synonym of one another. However, Mediclaim is just one type of health insurance. It is the most popular type of health insurance policy in India as it offers a medical cover at a relatively cheap premium. However, the scope of coverage is limited in terms of hospitalization expense or cost of treatments depending on various policy terms. Any additional cost for treatments that are not covered in policy agreements has to be paid by the policyholder themselves.
The benefit of purchasing a Mediclaim Insurance is simply that it is available at lower premiums with limited scope of coverage.
Individual Health Cover:
An individual health cover provides health protection to individuals only. The maximum claims an individual can make is up to the sum insured for the hospitalization expense. In case, you add family members in individual health cover then each member will get health cover up to the sum insured individually. For example – If you get an individual health cover where you include your mother, father or siblings for a sum insured of ₹ 1 lakh then each family member would have the sum insured of 1 lakh individually.
The benefit of purchasing an Individual Health Cover is to provide each individual an extensive health cover that may vary on insurance coverage and premiums. It is most recommended form of Health Insurance policy.
Family Floater:
A family floater provides health protection to your entire family in one single plan. The total sum insured is divided amongst the family members and hence, the premiums for such medical insurance policy are comparatively lower than an individual plan.
The benefit of purchasing a Family Floater policy is to provide coverage to entire family in a single premium this reduces the efforts to renew policy purchased individually. It is also relatively cheaper than Individual Health Cover.
Group Mediclaim:
Group Mediclaim Insurance policy in India is usually taken by businesses and corporations for the financial well-being of their employees and clients.
An individual can get all the benefits of a Mediclaim insurance policy at cheap premiums under a Group Mediclaim insurance policy. However, they should know that the coverage offered under these group policies are valid only until they remain a part of the group.
Critical Illness Plan:
A critical illness plan provides a predetermined lump sum amount to the policy holder in case they get diagnosed with any of the critical illnesses mentioned in their policy document such as cancer, organ transplant, stroke, kidney failure, etc.
The policyholder gets a lump sum payment from the health insurance companies on detection of illness.
Hospital Daily Cash:
This medical insurance policy offers a daily cash allowance up to a predetermined limit to the policyholder on being hospitalized for treatment of illness or accident.
A fixed sum assured is offered for each day the policyholder is hospitalized. These plans help in paying for small expenses that usually are not billed while medical treatments.
Personal Accident Cover:
This medical insurance policy provides a lump sum amount to the policyholder for treatment of accidental inquiries. In case of death or loss of income due to partial or full disability of the policyholder due to an accident, the beneficiaries of the policy would get the total sum assured.
The benefit of purchasing a Personal Accident Plan is that it offers coverage for medical treatments, life, loss of income due to disability due to accidents.
How to Get Best Health Insurance policy in India?
An average individual in India purchases a health insurance policy with limited information like premiums, tenure, sum assured and process to file a claim. Even among these, premiums are the most preferred point of comparison and the insurance company that offers them a health insurance at lowest premiums is usually termed “best health insurance companies in India”
We would recommend you consider the below fundamentals to evaluate the best health insurance companies in India:
Evaluate Best Health Insurance Companies in India:
Following the below checklist should guide you in choosing the best health insurance companies in India:
IRDAI regulates the Health Insurance companies in India. You should always make sure that you buy health insurance policies online only from IRDAI regulated Health Insurance companies.
Claim settlement ratio is one of the most important points of comparison. You can get the CSR figure of every health insurance company in India from the IRDAI annual reports, it denotes the percentage of claims settled by an insurance company against all claims received in a year. While evaluating the best health insurance companies in India make sure you choose those companies having a high claim settlement ratio.
10 Best Health Insurance Companies in India based on Claim settlement ratio:
Sr No. | Insurance Company | Claim Settlement Ratio |
1 | Care Health Insurance Co. | 95% |
2 | Niva Bupa Health Insurance Co. | 96% |
3 | Star Health Insurance Co. | 90% |
4 | Aditya Birla Health Insurance Co. | 94% |
5 | DIGIT Health Insurance Co. | 96% |
6 | Reliance Health Insurance Co. | 100% |
7 | Royal Sundaram Health Insurance Co. | 89% |
8 | Oriental Health Insurance Co. | 89% |
9 | Liberty Health Insurance Co. | 94% |
10 | Future Generali Health Insurance Co. | 92% |
ICR indicates the financial ability of the health insurance companies to pay claims. The ICR value is calculated using the value of claims paid against the total premiums received in a year. While evaluating the best health insurance companies in India make sure you choose those companies having a high incurred claim ratio.
10 Best Health Insurance Companies in India based on ICR:
Sr No. | Insurance Company | ICR |
1 | Edelweiss General Insurance Co. Ltd. | 113.05% |
2 | National Insurance Co. Ltd. | 101.09% |
3 | The Oriental Insurance Co. Ltd. | 112.51% |
4 | United India Insurance Co. Ltd. | 104.24% |
5 | Acko General Insurance Ltd. | 84.64% |
6 | Future Generali India Insurance C. Ltd. | 90.04% |
7 | IFFCO Tokio General Insurance Co. Ltd. | 99.49% |
8 | Raheja QBE General Insurance Co. Ltd. | 97.22% |
9 | Reliance General Insurance Co. Ltd. | 93.96% |
10 | Universal Sompo General Insurance Co. Ltd. | 111.23% |
Solvency ratio indicates the financial stability of an insurance company as it compares all assets and inflows against the liabilities and outflows. While evaluating the best health insurance companies in India make sure you choose those companies having a high solvency ratio.
10 Best Health Insurance Companies in India based on solvency ratio:
Sr No. | Insurance Company | Solvency Ratio |
1 | Bajaj Allianz General Insurance Co. Ltd. | 3.45 |
2 | Raheja QBE General Insurance Co. Ltd. | 3.66 |
3 | Shriram General Insurance Co. Ltd. | 3.63 |
4 | ICICI Lombard General Insurance Co. Ltd. | 2.90 |
5 | Star Health and Allied Insurance Co. Ltd. | 2.22 |
6 | Care Health Insurance Ltd. | 2.45 |
7 | Tata AIG General Insurance Co. Ltd. | 2.22 |
8 | Liberty General Insurance Ltd. | 2.92 |
9 | The New India Assurance Co. Ltd | 2.13 |
10 | Navi General Insurance Ltd. | 2.12 |
Health Insurance companies in India have tie ups with a list of national and international hospitals for providing cashless medical treatments to the policyholder. While evaluating the best health insurance companies in India make sure you choose those companies having a long list of network hospitals.
10 Best Health Insurance Companies in India based on network hospital:
Sr No. | Insurance Company | Network Hospitals |
1 | Star Health and Allied Insurance Co. Ltd. | 12000+ |
2 | Care Health Insurance Ltd. | 19000+ |
3 | Niva Bupa Health Insurance Co. | 8600+ |
4 | Bajaj Allianz Health Insurance Co. | 7,600+ |
5 | HDFC Ergo Health Insurance Co. | 13000+ |
6 | Aditya Birla Health Insurance Ltd. | 10000+ |
7 | Reliance Health Insurance Ltd. | 8000+ |
8 | Royal Sundaram Health Insurance Co. | 11000+ |
9 | Tata AIG Health Insurance Co. | 7000+ |
10 | ICICI Lombard Health Insurance Co. | 6500+ |
Disclaimer: The below-mentioned claim settlement ratio (CSR) and Solvency ratio has been sourced from IRDA Annual Reports and company websites. EquitySeeds Consultants does not endorse, rate or recommend any particular insurance company or insurance plan.
Evaluating best Health Insurance Policy in India:
Since every individual has different insurance needs, it’s incorrect if we pick any one health insurance policy and term it as the best health insurance policy in India.
To evaluate the best health insurance in India, an individual should first start with identifying their insurance needs and the type of health insurance policy which matches this need.
Once the insurance need is understood and the type of health insurance policies that match these insurance needs is selected. You can compare health insurance policies offered by different health insurance companies in India to identify the best one for you based on below parameters:
Sum assured is the maximum amount that the insurance provider will cover you for treatment of predetermined illnesses. Premiums are the cost of coverage that policyholders pay to the insurance provider to get the health insurance.
- The sum assured should be decided by taking into account the rising medical inflation.
- Since the sum assured and premiums are directly related, one gets a lower sum assured for lower premiums and vice versa.
- People tend to save cost by opting for lower sum assured and remain under-insured or pay premiums that are more than their insurance needs.
- As a general thumb rule, paying up to 10% of your monthly income towards insurance premiums and having a sum assured equal to 50% of your annual pay is ideal. However, depending on your insurance needs you can decide how much you should pay for a certain sum assured.
You can evaluate the best health insurance policy in India by comparing the premiums offered by the insurance provider for a certain sum assured and then select the health insurance policy which offers a certain sum assured at lowest premium.
It is very essential to check the scope of coverage of the health insurance policy you buy as it contains details related to specific inclusions and exclusions within the policy like pre- and post-hospitalization coverage, COVID-19 coverage, day-care treatment, etc.
You can evaluate the best health insurance policy in India by comparing their scope of coverage and select the health insurance policy which offers limited exclusions or specific exclusions that you want an insurance provider to cover in a policy you buy.
Example, few health insurance policies have exclusions for maternity and pregnancy which a newly married couple may not want to be excluded from their policies.
The health insurance policy might have sub-limits on certain treatments. A sub-limit means the insurance provider will provide partial coverage for treatment of a predetermined illness, even though your sum assured is higher than the total cost of treatment.
For example, if a policy has a 50% sub-limit on cataract treatments, then irrespective of your claim amount being under the total sum assured limit, the settlement amount will be for 50% of the cost of treatment.
You can evaluate the best health insurance policy in India by comparing the predetermined medical treatments they cover under a sub-limit clause and select the health insurance policy which has no sub-limit for specific diseases you want a full medical coverage.
Health Insurance policies don’t cover you against all illnesses from day one. For a few predetermined diseases, you need to wait a particular period (days/months/years) to be eligible to raise a claim for treatment.
For example, a health insurance policy may have 2 years of waiting period for any treatment of cancers, so if the person insured is diagnosed with cancer a few months after buying a policy, the cost of treatment shall not get covered.
You can evaluate the best health insurance policy in India by comparing the predetermined medical treatments they cover under the waiting period clause and select the health insurance policy which has no waiting period for it.
Health Insurance companies in India have tie ups with a list of national and international hospitals for providing cashless medical treatments to the policyholder.
You can evaluate the best health insurance policy in India by comparing the network hospitals that have tie ups with the Health Insurer and select the policy having a long list of network hospitals, including prominent medical facilities. Also, make sure that you have hospitals in your vicinity in the network hospital list.
The room rent limit is the maximum amount an insurance provider would cover on the hospital room booked during the medical treatment. It is mentioned either as an amount or as a percentage of the sum insured on the policy documents. It’s important to note that these limits have a direct effect on the premium charged, coverage offered, and the claim settlement amount.
You can evaluate the best health insurance policy in India by comparing the room rent limits of different insurance providers for the premiums they charge and select the health insurance policy which offers the highest limit at lowest possible premium.
Additional riders help in enhancing the scope of coverage of a health insurance policy. However, you should buy these add-ons only after reviewing the main policy documents as most often new buyers purchase add-ons which are already covered in their health insurance policy.
You can evaluate the best health insurance policy in India by comparing the add-ons and its cost offered by different insurance providers and select the health insurance policy which offers more relevant add-ons as per your insurance needs.
It’s difficult to evaluate the quality of customer service before you have purchased a health insurance policy. You may view the ratings and read reviews of the customer service experience on the internet for any Insurance company, however that does not guarantee a good customer service.
Hence, it’s recommended that you buy a health insurance policy from an insurance agent or advisor who can be your point of contact for most of your customer service requirements and also guide you in choosing the best health insurance policy in India.
Conclusion:
After knowing how to evaluate the best health insurance policy in India as per your insurance needs, you should be able to select a health insurance that matches your needs. However, if you need more assistance you can count on our expert advisory.
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