After the removal of lockdown, the sales of health insurance policies have come down due to the reduction of fear among the people. It is important to consider many factors while selecting health insurance because it is not possible to shift from one insurance company to the other easily unlike motor or property insurance. The insurance company which you wish to port your health insurance policy may or may not accept your proposal, if accepted the new health insurance policy may not satisfy all your existing requirements and the premium may or may not be at par with what you are paying now. So taking all the factors into consideration it is important to decide on the Best health insurance policy.
How to choose the Best Health Insurance Company in India
Things to keep in mind before deciding “Best Health Insurance Company” in India
Product Features & Coverage:
Almost all the health insurance policies from different insurance companies would contain the same features such as in-patient hospitalization, Daycare treatment, domiciliary hospitalization, Ayush benefits, etc. Apart from the basic features, few health insurance products contain extra coverage such as Ambulance Cost, Restoration Benefit, No Claim Bonus, Preventive Health checkups, etc. These extra benefits are provided in the health insurance policy without payment of any additional premium to the insurance company.
Health insurance products can be designed to include or delete any coverage, so an insurance company may have more than one health insurance product to offer to its customers. Most of the insurance companies design health insurance products by keeping different factors in mind such as:
- Senior citizen health insurance in which the health insurance product is specifically designed to cover the needs of elderly people. In general most of the health insurance plans in the market have the maximum entry age of 60 years above which the customer cannot take that particular health insurance policy. For instance, a person aged 59 years can take these policies and renew them throughout life but a person aged 61 would not be eligible to take that policy. To prevent these issues, insurance companies have designed senior citizen health insurance policies which would cover the health insurance requirements of elderly people, these policies are usually designed with the inclusion of a Co-pay option where the customer has to pay a pre-agreed percentage of the claim amount.
- Disease-specific health insurance policies cover certain diseases with/without having a waiting period. For instance, there are Diabetes health insurance policies in the Indian market that are intended to cover the healthcare costs of diabetes patients with minimal waiting periods. Such policies do not cover the other medical costs associated with which can arise due to any other illness or disease. The premium for these kinds of policies would be less compared to the other health insurance policies which cover all types of illness and diseases.
Co-pay or Co-payment is a term used to refer to the part of the claim which has to be borne by the insured customer for every claim made. In general, the co-pay under the health insurance policies would range from 5% to 20% depending on the type of health insurance product. The concept of co-pay is to make the customer respond in the claim payment process where a part of the claim amount has to be borne by the insured customer. When comparing the health insurance policies it is important to check if the health insurance policy has any co-pay clause included. Opting for co-pay can reduce the premium to be paid by the insured customer.
For instance, if your health insurance policy has a co-pay of 10% and the claim amount has accounted to Rs.1 Lac then 10% of the total claim amount i.e. Rs.10k has to be borne by the insured and the remaining amount would be settled by the insurance company. Senior citizen health insurance policies and other cheap health insurance policies would generally have a co-pay clause imbibed in them. The main intention of installing this clause is to discourage people from making petty claims which not only affects the claim ratio of the insurance company but also increase the health insurance premium at the time of renewal. One more reason is to prevent people from undergoing unnecessary treatments inexpensive hospitals, also having an insurance policy increases the confidence of an individual to take treatment in an expensive hospital as the bill will be paid by the insurance company.
It is important to check if your health insurance policy has a co-pay clause, there would be many health insurance policies in the market which charge less premium. People need to make an apple comparison and check for a co-pay clause in the proposed policy. Best Health Insurance Company does not include a co-pay clause in its health insurance policy.
Exclusions are the list of diseases or illnesses which are not covered under your health insurance policy and the list is mentioned in the brochure of the health insurance policy and the policy copy. Many agents or intermediaries refrain from explaining the exclusions in the health insurance policy to the customer as it may hamper their sale process. Most of the customers unknowingly take health insurance policies without reading the exclusions mentioned under the health insurance policy. This leads to rejection of claims in most of the cases where the customer was not aware of what is covered and what is excluded in a health insurance policy.
The first and foremost thing a customer should do is to get the list of exclusions under the proposed health insurance policy copy from the agent of the insurance company and go through them thoroughly before paying the premium. Few health insurance policies have certain exclusions such as Robotic treatments, Treatment under Ayush, etc. which might have been covered under a different health insurance policy. There are two types of exclusions which can be in any health insurance policy, they are:-
- Permanent exclusions in health insurance such as HIV/AIDS, WAR, NUCLEAR, etc. would not be covered under any circumstances. Any diseases or illnesses arising out of these permanent exclusions would not be payable. Other exclusions such as Cosmetic Surgeries and accidents due to participation in Hazardous activities are outside the scope of a health insurance policy. These permanent exclusions are common for all the health insurance policies available in India as per the directive of the IRDA.
- Specific Exclusions in health insurance such as the Hypertension, Diabetes, Chemotherapy, treatment for mental illness, etc. are excluded in certain health insurance policies for a definite period of time by the insurance companies.
It is in the interest of customers to check for the diseases or illnesses that are specifically excluded by the insurance company apart from the permanent or compulsory exclusions. It is advisable to select the health insurance policy if it doesn’t have any specific exclusion.
Claim Settlement Time – Cashless & Reimbursement, In house or TPA:
Insurance is a service industry where the time taken to settle a claim creates an impression on the customer rather than the appearance of the product. Insurance as a product has only a policy document which is a promise for the future in case of any claim, if the insurance company can satisfy the customer with the service then it is rated high based on the service provided. Claim settlement time is the time taken by the insurance company to settle the health insurance claim of the customer. As per the IRDA, the claim settlement time would be within 30 days after the submission of all the relevant documents by the insured customer.
Claim settlement can be done in two ways: Cashless Claim settlement and Reimbursement Claim settlement depending on the option chosen by the customer.
- Cashless claim settlement involves the customer getting admitted to the hospital and taking approval from the insurance company for claim settlement directly to the hospital. This process is more popular among the customers the reason being that the customers need not pay the amount from their pocket. Cashless claims are authorized by the insurance company within a few hours of getting admitted to the hospital. Few companies take 4 hours to authorize while few companies take 2 hours to authorize. The cashless option is available only in the network hospitals where the insurance companies have a tie-up; insurance companies have an agreement with the hospitals and decide on the rate to be charged for each type of operation as a package. The time to authorize a claim is considered important in the cashless claim settlement process. It is advisable to talk to your agent and know the cashless approval time before purchasing the health insurance policy.
- Reimbursement Claims are those which are reimbursed to the insured customer after submitting all the claim-related documents. The reimbursement process involves the customer paying the claim amount and then getting it reimbursed from the insurance company. If the insured decides to get treated in a hospital other than the network or tie-up hospital then the customer needs to pay the claim amount first and get it reimbursed from the insurance company later. For reimbursement of the claim amount all the relevant and required documents are to be submitted to the insurance company within the stipulated time and the reimbursement would be done within 7-15 days after the receipt of all the required documents.
- Most insurance companies have Third Party Administrators (TPAs) to settle the claims of their customers. These TPAs act as the intermediaries in providing the service to the customers of the insurance companies. The insurance companies provide a percentage of the premium to the TPAs to serve their customers. There are advantages and disadvantages with the TPAs, as the time taken to approve a claim may be longer with the involvement of a third party.
- Few insurance companies have An house Claim Settlement Team which settles all the health insurance claims of their customers. This team provides approvals for cashless and settles the claim on a reimbursement basis as well. The time taken for claim settlement with the In House team depends on the number of staff the insurance company has for claim settlement.
It is advisable to check the list of network or tie-up hospitals in your area or locality before deciding on the health insurance policy. The more the number of network hospitals in your area the better it would be to go for cashless treatment. The difference between TPA and “In house “would be different for different insurance companies and it cannot be compared, this depends on the commission paid to the TPAs by the insurance companies. Best Health Insurance Company settles the claims of its customers within the least possible time.
The waiting period is the time the insured customer has to wait before making any claim under his health insurance policy. Any claim during the waiting period would not be covered by the insurance company and all the insurance companies have waiting periods. Insured needs to satisfy the waiting period requirements before making any claim. There are three types of waiting periods in every health insurance policy, they are:-
- Initial Waiting Period/ 30-day Waiting period: An initial waiting period or 30 days waiting period in health insurance refers to the amount of time one has to wait before making any claim. The only exemption to the initial waiting period is any accident-related injury claims under your health insurance policy. The 30 day waiting period is applicable to prevent people from buying a health insurance policy only at the eleventh hour. As an industry-standard, all health insurance companies have an initial waiting period of 30 days under their health insurance policies.
- Specific Waiting Period: Specific diseases such as Cataracts, Gastric ulcers, Hernia, etc. have a waiting period of at least 2 years before the claim is settled under the health insurance policy. The reason to include this clause is that these specific diseases can be treated later and are not considered as an emergency. Any claim related to these diseases will not be settled by the insurance companies before the waiting period is satisfied. On average, the specific waiting period is 2-4 years depending on the insurance company.
- Pre Existing Waiting Period: Pre-existing diseases or PED refers to any condition, ailment, injury or disease which has been diagnosed up to 48 months prior to the purchase of the health insurance policy. This means any disease which exists before purchasing the health insurance policy would be treated as a pre-existing disease and a waiting period of 48 months needs to be satisfied before claiming for any PED. Few companies have a pre-existing waiting period of 24 months while few companies have a pre-existing period of 48 months. Any disease or illness contracted after purchasing a health insurance policy would not be treated as a pre-existing disease by the insurance companies.
- Maternity Waiting Period: Maternity is the state or quality of being a mother. Maternity claims are usually settled by insurance companies after a certain waiting period, for instance, insurance companies have 9 months to 4 years waiting period for maternity-related claims. The waiting period also includes the pregnancy period which is an added advantage to the insured customer.
It is advisable to select the insurance company and the health insurance plan which has the least waiting period requirements. In the best interests of the customer, one should take a health insurance policy at a young age to satisfy all the waiting period requirements. Best Health Insurance Company has the least waiting period which helps people with pre existing diseases or illnesses.
Premium is the amount of money paid by the insured customer to the insurance company in return for the health insurance coverage offered by the insurance company. The premium to be paid in a health insurance policy depends on the below factors:-
- Age of the insured: The age of the insured decides the premium to be paid. The higher the age, the higher would be the premium to be paid. This is due to the chance of diseases of illness happening increases with the age. Nowadays due to lifestyle changes, many people are suffering from other diseases such as Diabetes, Blood pressure, Thyroid, etc. Insurance companies classify customers as per the age bands and charge premiums depending on the age of the customer.
- Sum Insured: The sum insured selected by you decides your health insurance premium. The higher the sum insured, the higher would be the premium. Sum insured is the maximum liability of the best health insurance company in case of a claim. It is important to carefully select the sum insured which suits your requirements, too high a sum insured results in paying a high premium, and too less sum insured results in paying a part of the claim amount.
Customers are advised to check the premium offered by the insurance company for their health insurance policy and compare it with the other health insurance products in the market before deciding on the best health insurance policy and the best health insurance company. The premium of different health insurance policies can be checked online using the link https://www.policybachat.com/health-insurance.
Health insurance policies also contain few extra benefits apart from the basic coverage; these extra benefits are offered without paying any extra premium to the insurance company. Extra benefits which can be offered by the insurance companies include:
- Yearly Health Check-up: In case of a claim-free year health insurance companies provide free health check-up options to their customers for free of cost at any of the tie-up hospitals or diagnostic centers. The health check-up is offered to all the Adults mentioned in the policy copy. The types of checkups to be done depending on the type of policy opted. Basic tests include Blood tests, Urine tests, etc.
- Second Opinion: If you are diagnosed with any of the illnesses mentioned in the policy copy, you can opt for a second opinion from a different doctor and the charge for the same would be borne by the insurance companies. There could be some cases where the insured is diagnosed with cancer and the family doctor advises a particular treatment, if you are not satisfied with the advice you can take a “second opinion” from any other doctor and the charges for the same would be settled by the insurance company. It can happen in the case of an Organ transplant and any other major Critical illnesses mentioned in your health insurance policy.
The best health insurance company is the one that provides the best health insurance product which has the extra benefits apart from the basic coverage such as Second opinion, free health check-up, etc. Usually, these extra benefits cost some amount to the customer if taken separately.
Which is the best health insurance company in India?
There are so many health insurance companies are available in India. The best health insurance company in India provides maximum coverage with a reasonable premium when compared with the other health insurance companies in the market and with no hidden sections in the policy. There are various factors that make a health insurance company the best among all health insurance providers in India. The main factor which decides the best health insurance company in India is the claim settlement ratio. IFFCO Tokio General Insurance featured the highest Claim Settlement Ratio of 96.57% in FY 2020.
Best Health Insurance Companies in India based on Claim Settlement Ratio
Below is the list of top health insurance companies in India along with their claim settlement ratio
|Health Insurance Company
||Claim Settlement Ratio
| Iffco Tokio General Insurance
| Care Health Insurance
| Magma HDI General Insurance
| Oriental Insurance Company
| The New India Assurance
| Bajaj Allianz General Insurance
| Niva Bupa Health Insurance
| Navi General Insurance
| HDFC Ergo General Insurance
| Manipal Cigna Health Insurance
How to Get Best Health Insurance Policy Online in India from PolicyBachat
You can get Instant Quotes for Health Insurance Policy from the best health insurance company at Policybachat
- Visit the Policybachat Website and Select the ‘Health’ tab.
- Select your ‘Gender’.
- Select ‘Who do you want to insure’ and their ‘Age’.
- Enter your ‘Pin code’.
- Enter your ‘Name’.
- Enter your ‘Email Address.
- Then click on ‘Start Saving Money’.
- Premium Quotes of top health insurance plans will be displayed as per data entered by you and which are suits your requirement.
- You can edit policy details, sum insured value, policy term and you can choose your preferred brand
- Purchase best health insurance policy using online payment
- If any queries are raised call: 1800-123-4003.