How to buy Health insurance in India: 13 point checklist

How to buy Health Insurance in IndiaHow to you buy health insurance…?

India is a big market.

Competition here is so fierce that it is very easy for a customer to be misled. Though, internet has come out as a great help, but too much information is only making things worse.


The Same is true for the insurance sector.


Choosing a policy is a herculean task. Because very rarely you will find everything that you need in a single policy. Thus you would need to make sure that whatever you choose makes the best out of your investment.

Inorder to find what to look at before buying a health insurance policy, you would need to go through the below given checklist.

Though as already said that you cannot find everything in one policy, but even if you manage to get a plan with majority of factors covered then you will find worth for your money.


Let’s check out how to buy health insurance plan in India…

Questions you should ask…

1. What is there Claim settlement ratio…?

What is there Claim Rate

When buying a policy it is very-very important that you check the claim settlement history of the company.

This history itself is enough to let you know how the company has entertained their clients over the years. Just by looking at the record you will know that if in future you file for the claim then with how much probability you will be dealt.


Let’s say the company you want to buy a plan from has a claim settlement history of 95%. Now if you buy a policy with them then rest assured you will have 95% probability that your claim will be met.

Claim settlement record is the first and foremost thing you should look at as this will help you find not only the best plan but also the best company among the lot.

2. Will you get cashless facility…?

Cashless facility will be your biggest benefit

What’s the point of buying a policy when you cannot get the real benefit out of it…?

Health insurance can come as a great boon if cashless benefit is added to the plan.

Consider this…

Would you want your family running back and forth to the bank while you being treated in the hospital…?

I am sure your answer would be NO…!

That’s why it is really important that whatever company you are buying from should provide you with cashless service. Availing such a facility will give you biggest relief and your life will be lot easier than you think.

3. How much big is their network…?

How much big is there network


Cashless service alone won’t be of any importance if you can’t avail it in the nearest hospital.


It would be very important to find whether the company you are buying from has networked your closest branch or not.


Unless that is done you won’t be able to find any worth and your policy will expire worthless.

When the emergency arises then people often forget to carry cash. And if unfortunately you are limited by cash then it only brings delays. When time is the life line then every second counts and I am pretty sure you would not wont to lose it.

That’s why it is always said that it’s of key importance to have a good network.

4. Who will pay for the ambulance…?

Who will pay for the ambulance

When it comes to money then everything counts. Your every single penny spent will add up to your cost and can potentially disturb your budget.

Thus, before buying a policy make sure who will spend on what. One such thing you would need to find beforehand is cost of transporting a patient to the hospital. Since you won’t know what happens the next hour, thus make sure who will pay for the ambulance.

Though the expenses won’t be much, but if the patient needs that little extra care then the cost can be a lot high.

5. Will I be paid for my medicines…?

Who will pay for the medecines

With the advancement in technology and development in the field of science there is hardly any disease left which is left uncured.


We have possibly cured every single problem that affects mankind.


This advancement and development has greatly affected our pockets. Today we can find everything provided we should have the corresponding cash for it.

Though we have the treatment but only few have the money. Thus, ask your company whether they will pay for the medicinal costs 100%. Most probably they will, but some companies maintain a policy of Co-pay.  Thus make sure to clear the cloud of doubt.

6. Will I be asked to contribute…?

Will you have to contribute

There are many companies in the health insurance sector which will ask you to contribute some portion of the expense. When they do, that means that they have a policy of co-pay in practice.

If you don’t know about this beforehand then it might give you a shock when you would be asked pay rest of the bill.

There are companies that ask for 10% co-pay but in some cases you can also be asked to pay upto 20%.

Now think for a minute, had your cost of treatment been Rs.2 lac. then with 20% cop-pay you would shell out Rs.40,000/-. For some this might not be a big deal but for others it is like asking for their lifetime savings.

7. For how long will I have to wait…?

What is their waiting period

Insurance policy is not like, that you can start taking advantage the very next day. Instead you will be asked to wait for a set period. In more general terms this period is also called the waiting period.

This is the period for which you will have to wait before your policy can be activated.

Most likely this waiting period ranges from 30 to 90 days.

Max Bupa for e.g. has an initial waiting period of 30 days written in their policy documents.

The time you have to wait to start using your policy

In general if this period is too long, let’s say 90 days then you will have to wait for 90 days before your policy will come into use. This simply means that if anything happens to the insured within these 90 days then he will get no claim.


If possible then always go with the plan that offers minimum waiting period.

8. Will my policy be with me, always…?

Will you always be with me...?

Well, it may or it may not…!

If you have chosen a policy with lifelong renewability then rest assured your policy will be with you.


If the case is otherwise then there will be a big problem, your insurance may leave you when you need it the most.

Generally, it is only when you grow old; you suffer from more health problems. And when your policy is not there to protect you then what’s the point of buying it in the first place.

You may find hard time choosing a policy with lifelong renewability option thus here is the list of companies offering the same.

  2. Royal Sundaram,
  3. Star Health,
  4. Religare Health insurance,
  5. HDFC Ergo,
  6. L&T insurance,
  7. Apollo Munich,
  8. Bajaj Alliance,
  9. TATA AIG,
  10. Bharti AXA,
  11. Reliance general Insurance etc.

9. Does Insurance Policy cover for the room rent…?

Who will pay your Room rent...?

Sometimes, YES…

It depends on company to company.  Some companies pay less and others contribute more.

For e.g.

IFFCO TOKIO contributes 1% of the sum assured as Room Rent but Royal Sundaram reserves 2% for it.

The same varies for the ICU ward as well. If God forbid an insured is kept in the ICU then IFFCO TOKIO pays 2% of the sum assured while Royal Sundaram contributes 4%.


Make sure the company you choose works in your favor.

10. Will I be heard…?

Will I be heard...?

Keep in mind that you are not the only one buying insurance. India is a populous country having more than 1.2 billion people. And as per IRDA more than 50 crore people are insured which are only growing in number. Thanks to the initiative taken by our Prime Minister who launched Pradhan Mantri Suraksha Bima Yojna.

When the population is such big and is served by handful of companies then it really becomes difficult to handle every query.

Thus find, whether the company you are buying from has even invested in customer care centers…!

If yes,

Then do they even provide personal relationship managers to handle customer queries.

Knowing all this beforehand will provide with lot of comfort in later years of your life.

11. Will I able to enhance my policy…?

Will you add-on...!

This one is really important…!

Unless you get what you need, you may not find the real worth…

Companies usually offer standardized plans but what set them apart is their ability to offer customization.

Though universal plans include almost everything but they may not work for everyone.

Seeing this many insurance companies have started offering add-ons with their plans.

Now if you would want something more than your usual policy then buy an add-on and you will be good to go.

12. Any loyalty Bonus…!

No-Claim Bonus

Though we buy insurance for our personal self, but we always pray of not using it. We don’t want to harm ourselves just to see big money (claim amount)…


Do WE…!

We don’t even want to keep on paying with no benefits either…!

As this will then be such a burden.

Is there any middle road, where you can travel with benefits…?

And the answer is…

Yes, there is…

When you don’t make any claim in a given year then the company rewards you with No-Claim Bonus.

An Insured usually gets this bonus either in the form of discount in premium or higher sum assured by a certain percent.


Before buying your health insurance in India always check, will your company provide you with any such bonus/benefits…?

13. Will I save on Tax…?

Tax Relief

Though it is pretty much obvious, but it totally makes sense to enquire about tax relief.

As per current guidelines, if you have insurance policy in hand then you will be exempted from tax under Income tax act 1961.

You are exempted for a maximum sum of:

  • 25000/- if you are under 18 to 50 years of age and
  • 30000/- if you have crossed 50.


You can greatly save a lot of money if you take a knowledgeable approach.

Thus, consider the above given factors and you will never ask… How to buy health insurance in India…?