Smart Health Insurance Choice: A few overlooked yet significant factors to consider

The recent COVID-19 pandemic has exposed the horrors of multiple hospitalisations within the same family. As countless earning members lost their employment and associated health benefits, many families were pushed into poverty while trying to tackle the tough situation. Yet, sadly, nearly 30% of the Indian population still do not have health insurance coverage, according to a NITI Aayog report in October, 2021 .

The fact is, accidents and medical complications can happen to anyone and at any time leading to substantial medical bills. Therefore, having adequate and comprehensive health insurance coverage is absolutely necessary these days. It provides you with essential financial support during medical emergencies and prevents the depletion of your hard-earned savings and investment returns.

Read along to find out how to make a smart choice in picking a health insurance policy.

Choosing a health policy with an ideal sum insured

Choosing a health insurance policy whose sum insured is in complete alignment with your medical requirements is very important. While doing so, you should carefully consider the number of individuals you wish to cover in your plan, the age and medical condition of all the covered members in addition to your location among other critical factors (medical costs in metropolitan cities could be significantly higher than smaller towns).

Besides the sum insured, the two most important factors at the heart of a smart health insurance choice are the claim settlement experience and policy features and benefits.

You might want to purchase a health plan that offers adequate coverage for pre and post hospitalisation expenses, domiciliary treatment, road ambulance charges, etc. while imposing minimum restrictions on critical things like room rents, pre-existing conditions, etc.

The claim settlement experience is also a crucial factor determining your choice, as you will want a quick and hassle-free resolution during medical emergencies.

Other Critical Factors to Consider While Choosing a Health Insurance Plan

Here are some other critical factors involved in choosing a health insurance plan.

1. Network hospitals

All medical insurance companies have tie-ups with many hospitals across the country under their network, where the insured members can get cashless treatment. As such, before choosing a health plan, make sure to check whether the insurer has a wide range of network hospitals, including those near to your place of residence. You will also want to check their pan India network to ensure that you can get cashless treatment anywhere in India.

2. Auto restoration of the sum insured

 Auto-restoration is usually an extremely helpful benefit provided by some insurers where they restore the base sum insured after its exhaustion during the policy year, i,e, before the policy renewal date. There are two types of auto-restoration benefits- I) Complete exhaustion 2) Partial exhaustion.

For example, let us assume that Mr Singh has a health policy with a sum insured of Rs. 5 lakh and makes a claim of Rs. 4.8 lakh for hospitalisation. The complete restoration benefit will only take effect if his subsequent claim within the policy year exceeds Rs. 20,000. With partial restoration, however, the insurer will restore the sum insured fully up to the base sum insured after the first claim.

Many insurers offer the former benefit, where the entire sum insured needs to be exhausted to trigger an auto refill. But some companies also offer the flexibility to utilise the restoration benefit on partial exhaustion of the restoration benefit. This is very helpful if one has multiple family members covered by the same policy as it keeps up the coverage after one member gets hospitalised.

3. Claim settlement ratio

 The claim settlement ratio of an insurance company is the total number of claims they have settled in a year over the total claims received. This is a reliable measurement to assess the credibility of an insurer in honouring filed claims. An insurer with a high claim settlement ratio will very likely accept your claim unless they have a valid reason not to.

4. Daycare cover

 It’s a fact many health insurance plans do not offer coverage for daycare procedures. This refers to medical treatments and procedures that require less than 24 hours of hospitalisation, like cataract surgery, tonsillectomy, nasal sinus aspiration, etc.

But some insurers do cover daycare procedures subject to terms and conditions. As such, you’ll be well-advised to see if your insurer offers adequate coverage for daycare procedures, as you could incur significant expenses for these treatments if required.

Why Choose Navi for Health Insurance?

 If you are looking for an insurance policy that offers comprehensive benefits for an affordable premium, take a look at Navi’s health insurance policies. Here are some of the benefits you can get by opting for Navi Health Insurance.

● 100% paperless process: Navi Health Insurance plans with sum insured of up to Rs.1 crore can be purchased seamlessly on the app in just a few minutes with monthly premiums starting at only Rs. 241.

● 10,000+ network hospitals: Navi Health Insurance has tie-ups with over 10,000 network hospitals across 400 locations in India. You can get your cashless claims approved in just 20 minutes with the help of a dedicated claims relationship manager.

● Unlimited auto restoration: Navi Health Insurance also offers unlimited 100% restoration of the base sum insured subject to specific terms and conditions. You can utilise the sum insured for all subsequent claims in a policy year, even for the same illness. Moreover, the auto restoration can get triggered even if you partially exhaust your policy’s sum insured.

● 97% claim settlement ratio: You can have complete peace of mind knowing that Navi Health Insurance settles all legitimate claims.

● Daycare coverage: Navi Health Insurance also provides wide coverage for a number of daycare procedures.

Navi Health Insurance plans could provide you and your family members comprehensive coverage, including pre and post hospitalisation expenses, road ambulance costs, maternity expenses, vector-borne diseases, etc as per the policy’s terms and conditions. So, make a smart choice by picking Navi as your health insurance provider. Simply download the Navi app from Google Play Store to insure yourself and your family. Some due diligence and informed decision-making in choosing a health insurance plan that best meets your requirements will go a long way to secure your family’s financial future.

 Download the Navi app now to know more about the policy features and purchase a plan within a few minutes!