A Brief Overview of Health Insurance Plans in India


You will see everyone around you running to sort their lives. Due to your busy work schedule, you might miss out on keeping a check on your health. With the developments in technology, its cost of availability is also rising. The case is similar in the healthcare section. In fact, it has turned out to be India’s largest segment when it comes to revenue and employment.

It is essential to remain fit. But if one falls sick and needs hospitalization, the treatment expenses can cost you all your savings. Hence, there are a few measures you can take to ensure you do not spend a lot of your hard-earned money.

Deal with all roadblocks

Once you’ve purchased a health insurance policy after conducting due research and paying the premium, you must assume that you will receive the benefits upon raising a claim. But circumstances might arise wherein the treatment will cost you more than what you are insured for and situations like these happen frequently.

If you face a similar difficulty, i.e. the treatment costs are greater than the sum insured, then you can upgrade your plan. Top-up plans offer extra coverage to make sure that you don’t have to face financial burden. Usually these plans act as alternatives. You can also convert this plan to a basic plan.

Common features of health insurance plans

Health insurance policies can also cover the following expenses:

  1. Managing chronic diseases
  2. Rehabilitation services
  3. Medical care of children, infants, and adolescents
  4. Outpatient treatment
  5. Maternal care
  6. Consulting medicines
  7. Emergency Service

Apart from these features, additional benefits are also provided such as daycare service, ambulance cover, etc. You can purchase critical illness insurance to cover life-threatening illnesses that might have a severe impact on your finances.

Claim settlement procedure

With their busy and hectic schedules today, people don’t have the time and patience to go through complicated claim processes. Therefore, it is wise to research the claim process of different insurance companies. Don’t buy the policy if customers have complained regarding the claim process.

To raise a claim, you are required to submit a request with your insurer. There are two ways of making claims:

  1. Cashless Treatment

This is one way of raising a claim, i.e. direct settlement. The insurance company has a list of network hospitals mentioned in the policy document. To avail this benefit, you will have to be hospitalized at one of these network hospitals. Your medical bills are directly settled between the insurer and the hospital and you need not pay anything from your pocket.

  1. Reimbursement

If you are unable to take the patient to a network hospital, you can go somewhere else as well. However, this means that you must pay the medical bills from your pocket. Later, you can avail a reimbursement from the insurance provider. You just need to submit the necessary documents, including original bills, to the insurer. There is a medical team that approves or rejects your claim request after they’re done with all the verification.

If you haven’t disclosed your medical history, you provide incorrect details to your insurer, file a false claim, etc., then your claim will get rejected. Therefore, always make sure that you provide the insurance company with accurate details for a smooth claim settlement process. Compare from the host of policies such as family floater health insurance, senior citizen plans, policies for individuals and more to choose the best plan for you.