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10 Things to Know Before Purchasing Health Insurance in India

Even though the sum insured is one of the integral parameters one should carefully consider while purchasing a health insurance policy, there are multiple other elements that must be taken into consideration as well. These have been mentioned below: 

Claims Procedure Efficiency

While purchasing a health insurance policy, the policyholder must always take into consideration the claim settlement ratio and claim settlement time taken by the insurance company. A high claim settlement ratio indicates that the insurer settles more claims and a lower claim settlement time indicates that the insurer typically is highly efficient while settling individual claims. 

Co-payment clause

Most group health insurance policies (plans offered by organizations) have the co-payment clause wherein the policyholder will have to bear a certain portion of the claim amount. The rest of the claim amount will be borne by the insurance company. While a certain health insurance policy may seem cheap to you, the co-payment clause might make it expensive as you have to bear part of the cost. 

Network hospitals

It is important to purchase a health insurance policy that has an extensive list of network hospitals. The policyholder must check if the list is inclusive of the facilities that he/she visits. Network hospitals are also important if you are moving to a different city. Your health insurance policy should go with you. Moreover, if you want to avail cashless hospitalization, you have to get the treatment from a network hospital. In case of a non-network hospital, the claim amount is typically reimbursed by the insurance company. 

Day-care procedures

Sometimes, surgeries and medical procedures do not take more than a day. Since day-care procedures are not covered in most health insurance policies, it is important to opt for the one that does cover maximum day-care procedures.  

Pre/Post hospitalization

The medical expenses that a policyholder incurs before being hospitalized and after hospitalization are known as pre/post-hospitalization. After you are discharged from a hospital, your treatment might continue beyond that point. During such cases, you will need a policy that covers post hospitalization expenses. Under the category of post-hospitalization, elements such as consultation, follow-up visits with the doctor, etc. are typically included. 

No-Claim bonus

If a policyholder has not made any claims during a particular financial year, the insurance company will provide him with a special discount known as the No-Claim Bonus. During such a scenario, either the sum insured amount goes up or the amount of premium payable goes down. 

Maternity benefits

Pregnancy-related costs are skyrocketing immensely these days. This is the reason why it is important to have health coverage that offers maternity benefits as well. Maternity coverage typically commences after a certain period of time, which means they usually come with a waiting period. Hence, while purchasing a health plan with maternity benefits, you must ascertain the following elements: 

  • First and foremost, look at the waiting period that comes with the health insurance policy 
  • Second, take into consideration the sub-limit of the health insurance policy 
  • Third, consider whether the health insurance policy covers outpatient maternity expenses 
  • Lastly, it is important that you carefully take into consideration the exclusions that come with your health insurance policy

Lifetime renewal

If the insured individual wants to provide coverage for his/her elderly parents, it is important that he/she gets a policy that has lifetime renewal. Such health plans can be renewed lifelong, which means that they do not have an age limit associated with them. It is a very important factor to take into consideration if you want to secure the health of your elderly parents. 

Free of cost medical checkup

When you are purchasing a health insurance policy, ensure that you go with the one that offers a free of cost medical checkup. This is one of the integral parameters to consider as outpatient expenses are typically higher than hospitalization costs. The medical tests or checkup have no effect on the premium amount when the policy goes up for renewal. 

Tax benefits of health insurance policy

A great benefit of purchasing a health insurance policy is that you can save up a lot on taxes. A policyholder can save up to Rs.25,000 on the premiums that he is paying for himself, his spouse, and children during a particular financial year according to rules established under Section 80D of the Income Tax Act, 1961. Additionally, if the policyholder is paying the premiums for his/her parents’ health plan, he/she will receive an additional tax benefit of Rs.25,000 or Rs.30,000, depending on his/her parents’ age. 


In case you do not raise any claims, the insurance company will make sure that you are rewarded for staying hale and hearty. 

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