Health insurance simplified

M Ravichandran

Due to the burden of new age diseases, illness and a growing and ageing population, India is witnessing a new wake of health awareness. This is also one of the reasons that the health insurance industry in India is gaining momentum, thereby driving insurance companies to design a variety of products to suit diverse customer needs. In the midst of an increasing medical inflation these innovative insurance products do come as a definite relief. However, today in spite of the customer being relatively aware and conscious of what he wants his health insurance cover to include, he is often wedged between what should be the right coverage that would meet his needs. It is therefore important to understand the various components of these tailor made products that companies offer, to best suit customer’s needs.

Kinds of Policies

• Insurance companies start off by offering Health Insurance products which cover basic expenses under an illness or hospitalization. These common policies, are affordable and include the choice of doctor, hospital, the ICU fee, surgical expenses, ambulance, day care procedures, and more.

• Beyond a basic health insurance cover, insurance companies also provide policies for potential life threatening ailments like heart attacks, cancer, blindness, kidney failure etc. under ‘Critical Illness Plans’. Critical illness is a benefit policy where a lump sum amount is paid to the policy holder on the first diagnosis of any of the critical illness covered in the policy.

• Customers should also consider taking additional cover under ‘Top up plans’ to take care of large claims which would be beyond their financial threshold limit. This should be done after assessing their financial threshold for Medical emergency and also the likely medical cost that one may incur in the event of any major ailments.

• Almost all companies offer two kinds of Health Insurance policies today– Individual policy which is cover for just one person and Family Floater policy which covers additional family members. While a Family Floater policy covers more family members under one policy thus saving on premium cost, customers should take note that it does have some drawback e.g. if there is more than one claim in a family in a year, the other family members are left with little cover or if more than one family member has medical emergency at the same time the amount available may not be sufficient.

• Today insurance companies have also designed specific insurance products for women keeping in mind the various illnesses they contact during their lifetime. These schemes mainly cover critical illnesses, daily hospital cash benefits and treatments and surgeries. Some policies also offer Maternity insurance that covers expenditure such as pre & post hospitalization and pre & post-natal cover as well as new born baby cover. However there is a waiting period involved.

• Another growing concept in the insurance market are ‘Wellness plans’ which cater to the demands of the new-age health conscious people and is usually packaged with exciting discounts on gyms, yoga memberships, diet and nutrition counselling sessions, vaccinations etc. Such comprehensive policies contribute towards a lifestyle transformation.

• Premium and deductible are some of the most important factors to be considered before buying a health insurance policy. So read and understand the fine print in the policy wording document.


• It is also crucial to take note of the waiting period, during which claim is not admitted. The three types of waiting period are initial waiting period (typically 30 days), waiting period for pre-existing conditions and specific waiting period for pre-existing diseases.


• Buy a health insurance policy at an early age and ensure its lifetime renewability. If one buys insurance at a later stage in life, you might end up paying higher premium and face difficulties to get a comprehensive health cover.


• Most of insurance companies give discounts in the form of ‘no-claim bonuses’ on the next year’s premium or increase in sum insured at no additional premium if the policyholder does not submit any claim during the preceding year.

The writer is President, TATA AIG General Insurance