Top 10 Health Insurance Checklist

Choosing the right health insurance is important as the investment is going to matter all your life & not just to you but your family members as well. Important parameters you should look into for health insurance as a customer are:

  1. How much cover is enough?
    Ideal sum insured (SI) should be 50% of your annual income. However, you can cover yourself as per affordability & your lifestyle.
  2. Individual vs Family floater: e.g. SI is 5 lacs
    • Individual SI means each member having 5 lacs cover separately
    • Floater SI means total cover of 5 lacs between all family members
    • Although floater SI is economical, in case of all the family members getting hospitalized at the same time, the chances of it getting exhausted is higher compared to Individual SI.
  3.  Hospital cashless network:
    Cashless means you do not have to pay when you are admitted in network hospital & so quality large network is vital.
  4. Room rent & ICU limits –
    • Room rent limit is total of bed, nursing & doctor visit charges. Normal limits are 1% of SI for room rent & 2% of SI for ICU. However, presently many insurers have removed these limits beyond a certain SI.
    • Also need to check whether your policy allows for Standard Single Private AC Room, Deluxe, Super deluxe & Suite room or not.
  5. Co-Pay: In co-pay part of the claim is borne by the customer.
    • Premium is charged as per zone. However, during claim if treatment is taken in higher zone, then co-pay is applied by some insurers.
    • Check if there is any co-pay imposed after a certain age by insurer or not
  6. No Claim Bonus:
    Your SI increases every claim free year & so higher the NCB is better for the customer.
  7. Pre & Post hospitalization period:
    Normal is 30 days pre & 60 days post hospitalization which is now offered to 90 / 180 level also. In event of long recovery period, this Pre / Post feature becomes very helpful.
  8.  Free Health Check Up:
    This is offered by many insurers on every 1/2/4 claim free years up to 1% of the SI limit.
  9. Pre-existing diseases waiting period:
    Normally this is 4 years but now insurers have reduced this to even 2 or 3 years.
  10. Restoration of SI:
    Due to single large claim or multiple claims in a year if entire SI is exhausted, then this feature restores your SI and it can be used for any future claim but not for the same disease & same person.

Stay insured. Stay safe.

Birju Shah – Founder, Customer First Marketing Services
We provide tailor-made solutions in Health, Life, Motor & SME insurance.
You can reach me on & Mobile No. 859-1314-007

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