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How well do you know your Health Insurance Policy?

  By : , Delhi, India       8.2.2017         Phone:-          Mail Now


Most health insurance policyholders simply assume that only hospitalization expenses are covered under their plan. Either they do not read their document carefully, or their insurance advisor does not inform them. Irrespective; we need to know that there is much more to your health insurance. It is important to understand your specific health insurance benefits before buying the policy and select the right cover.

Letís have a look at the case of Chatur who has bought a medical insurance plan for his family:

Mr. Chatur is a 45-year-old salaried employee who bought an insurance plan (after his colleague purchased one). He was happy to learn that his health insurance policy will take care of hospitalization expenses. Chatur was also delighted to learn that he is entitled to additional tax benefits on the premium paid. He bought an insurance policy that reduces his tax liability, and it is all that he cares for as of now.

When Chatur, unfortunately, required treatment for heart failure, he knew that the hospitalization was covered under the health insurance policy. What he did not know was that his policy can also cover associated expenses (point 2). Chatur was also not aware of the critical illness rider that he could have bought with the health policy and which couldíve provided an additional lump sum amount for the treatment and rehabilitation saving him approximately Rs. 7 lakh and covering for his income loss of Rs. 1,50,000 while he remained under treatment.

10 Things You May Easily Ignore About Your Health Insurance Plan

There are many other things you would want to take care of while buying the health insurance plan for your family so that in the hour of need, the burden on your pocket is minimum:

Life-Long Renewal: Whether you hold an individual policy or a family floater, you are entitled to renew your health policy throughout your life; i.e. there is no maximum age for the cover to cease. It means you can avail health expense cover post-retirement. You can renew your policy, with add-on benefits. However, entry age in most plans is limited to 65 years.

Daily Hospital Cash Allowance: You already know about the hospitalization expenses and treatment expenses covered by the plan, but what about your daily expenses on food and commute of your family members to look after you in the hospital. Your health plan offers you a daily cash allowance to take care of such expenses. This amount is payable daily through the tenure of hospitalization of the person (limits vary from policy to policy).

Good Health Bonus: You are aware of a reward for not claiming from your health policy in the year. But, medical insurance companies like Apollo Munich award their customers for maintaining good health as well, which is great motivation for staying active and healthy. The reward is given to you in the form of a discount on renewal premium. Check with your insurer for more details.

Example of Different Types of No-Claim Bonuses offered by Medical Insurance Companies


No claim benefit


Atul has a sum insured of Rs. 200,000. During the year, he does not make a claim. The policy offers no claim bonus of 10% of the original sum insured:

His new insurance coverage is Rs. 220,000

He pays same premium amount

He continues to get 10% increase if no claim is made in future years

He is not entitled to more than 50% value of Rs. 200,000 as a no claim bonus(at any time)

Self + family

After a specified number of claim-free years, policyholder and insured people, are entitled to free or discounted medical tests.

Free-Health Checkup Benefit: Some insurance companies provide the benefit of free or discounted medical examinations, even if you have made a claim. It is subject to limits, and the policyholder should have been continuously renewing the policy for a specified number of years.

Recovery expense: If your hospital stay is extended by say 5 to 10 days, then your insurance company may bear that expense too depending on the policy conditions. Usually, policies have the option for post hospitalization expenses for some time. This is also known as recovery or convalescence expense.

Preventive Health Checkups: Your insurance policy is not limited to only hospitalisation expenses of the insured. You might also be entitled to preventive health tests. Your diagnostic tests, consultation costs, and other health checkup are likely to be included. You can also claim a tax deduction of up to Rs. 5,000 spent on preventive health tests.

Covering Parents: While you may be aware that your parents can be covered under your family floater policy, you may not be aware that even your parents in law can be covered under your family floater policy. This condition is subject to the maximum number of persons allowed to be covered by the policy.

Maternity Cover: Medical expense incurred pre-and post-natal care may be covered under your health insurance policy. It includes the cost of delivery (normal or C-section both).

Treatment at Home: If a patient under extreme conditions cannot be moved to a hospital, then the treatment cost at home is borne by the insurance company. Other conditions like non-availability of hospital beds are also covered. However, the exact scope depends on your insurance provider.

Alternative Treatment: Some insurance companies cover the cost of AYUSH (Ayurveda, Yoga, Unani, Siddha, and Homeopathy) treatments. The amount of cover is usually a percentage of the total sum insured available.

Stay updated about the benefits of your health plan, it might come in handy in more circumstances than you may assume initially. Many of these features are mentioned in the policy documents, spending some time reading it will certainly boost your confidence about your purchase.

TAGS: Health Insurance,   Insurance,   Finance,  

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