Health insurance is a type of insurance that provides financial protection against medical expenses arising from illness, injuries and accidents. It covers costs of hospitalization, surgeries, daycare procedures, modern treatments, and other eligible healthcare services in exchange for a regular premium. It also allows you to receive cashless treatment at network hospitals, reducing your out-of-pocket expenses during a medical crisis.
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Do you remember the time when you received a phone call about a family member being sick and admitted to a hospital? It not only disturbs your peace of mind, but also your savings.
At this moment, all you care about is for the family member to get well at the earliest. You do not have time to calculate the treatment cost or think about the money the hospital would charge. Even if you have saved money, it can fall short in a medical emergency.
This is exactly why you need health insurance. Not because illness or injury may happen any time, but to ensure that when they do, you do not have to worry about arranging money and can focus on the treatment.
Health insurance gives you the confidence to fight the fears that accompany a medical crisis. Let us look at how buying health insurance can be beneficial:
Health insurance lets you focus on what truly matters — your family's care, not treatment costs.

When Your Parents Require a Surgery
Be beside them and not at the billing counter
Treatment Without Delays

When Your Spouse Needs You
Spend your time comforting them, not arranging money
Be There. Stress Less

When Your Child is Hospitalized
Focus on your child's health and not the hospital bill
Peace of Mind for You
At the time of a medical emergency, you can rush to any top network hospital without worrying whether it is in your budget since medical costs will be covered by health insurance.
Health insurance allows you to get quality medical treatment at top hospitals. You do not have to worry about whether you can afford treatment, you just have to think about where to get the best treatment from.
A knee replacement surgery in 2026 can cost you anywhere between ₹1.5 lakh and ₹6 lakh. Without health insurance, you will have to pay the entire amount from your own pockets and can lose your hard-earned savings at the time of a health crisis.
An average health insurance claim settled for bone-related problems in the last five years is approximately ₹2.3 lakh*. This means you could save nearly ₹2 lakh for a knee replacement surgery with health insurance.
A health insurance policy provides financial protection against unpredictable medical expenses. It doesn’t just pay hospital bills, it helps protect your savings meant for your child’s education, your own retirement or other life goals.
Imagine your mother's treatment is delayed because you need to first arrange a large sum of money. Not only is it financially draining, but the feeling of being helpless at such a crucial time also adds to the emotional stress.
You cannot spend much time checking all your investments or running to relatives and banks to collect funds. Through the cashless hospitalization facility, health insurance allows you to get treatment at network hospitals without the need of paying medical bills upfront.
Health insurance ensures peace of mind and lets you focus on the treatment and recovery rather than arranging the funds. Moreover, with 'Cashless Everywhere', cashless hospitalization is not limited to network hospitals in many cases.
Many health conditions do not require a single hospital visit, rather they require long-term care that comes with recurring expenses. Lifestyle diseases, like diabetes, hypertension and thyroid, and critical illnesses, like heart problems, cancer, Alzheimer's, etc., are a few examples.
Health insurance helps to effectively fight lifestyle diseases and manage the treatment costs of long-term health conditions that otherwise would require you to pay concept-of-room-rent-limit-in-health-insurance from your own pockets.
Moreover, most people already suffer from one or more of these conditions if they buy health insurance later in life. But the good news is, you can still get financial protection if you get hospitalized due to an already existing condition, as health insurance covers pre-existing diseases after a specified waiting period (of up to 3 years).
We know that inflation is constantly rising nowadays, but do you know healthcare costs are rising more than the everyday expenses!
Medical inflation in India in 2026 is nearly 12-14%, three times the general inflation rate (about 5%). At this rate, a medical treatment costing ₹5 lakh today shall cost nearly ₹9 lakh (almost double) in just 5 years.
So, even if you can manage healthcare expenses today, future medical costs can be significantly higher. Health insurance helps you fight medical inflation and stay prepared despite the rising costs.
If you choose for the old tax regime, you can claim tax deductions on the premium paid for health insurance under Section 80D of the Income Tax Act.
*Source: Policybazaar’s actual data for claims settled by its partnered insurers.
6,50,00,000 Families have Trusted Policybazaar India No. of Claims Settled 8 Lakh Claim Amount Settled 4,007 Crore Check claims in your city Data Source: Policybazaar’s actual data of claims settled by its partnered insurers between 2018 and 2026.
When you buy from Policybazaar, you are ensuring your well-being is prioritized during the time of need. Our dedicated 50-member claims team exclusively deals with health insurance claims, offering support to individuals, families, and even the elderly living alone.
We also offer on-ground claims support across more than 120 Indian cities, helping with every claim-related phase, including paperwork and coordinating with the insurer and the hospital.
Our 'Claims Samadhan Diwas', a customer-centric initiative, helps customers settle under process or rejected claims with their insurance company. You can be confident that you are getting more than just an insurance policy – you are getting a partner who will be with you at every step of the way.
Read moreGetting health insurance is one thing; getting health insurance that is enough is another. Unfortunately, most people realize this only when they are standing at the hospital’s billing counter.
Imagine you bought a policy of ₹5 lakh for your father.
Your father gets hospitalized for a bypass surgery.
You think you have health insurance, so everything is covered.
But the hospital tells you the treatment would require ₹7.5 lakh.
Now, you will have to arrange an additional ₹2.5 lakh from your savings or investments or you may even need to borrow money while your father is still in the ICU.
At this moment, you would regret not buying enough health insurance coverage.
This is why deciding the ideal coverage amount is as important as buying health insurance.
The right health insurance coverage differs for each person and should be tailored to your individual medical needs. To decide the ideal sum insured for your health insurance plan, you must consider the following four factors:
Your healthcare needs at 25 are entirely different from what they look like at 50. This is because, as you age, health risks and healthcare needs change significantly.
Health insurance coverage is often decided by the stage of life you are in.
For instance, the coverage required by a married couple planning to start a family is entirely different from that of a senior citizen suffering from multiple illnesses.
A treatment that costs ₹3 lakh in a smaller city can cost ₹6-8 lakh in a metro city. This directly affects the amount of health insurance coverage you need.
Location is an important factor to decide health insurance coverage, else you may end up opting for a higher or lower sum insured than required.
Usually, people residing in a tier-1 city (like Delhi, Mumbai, Kolkata), where living costs are high, need a higher coverage than those in a tier-2 city (like Surat, Nashik, Meerut). Tier-3 cities (like Udaipur, Alwar, Jhansi, Ujjain) usually require the lowest sum insured.
| Types of Plans | Ideal Health Insurance Sum Insured | ||
| Tier-1 City | Tier-2 City | Tier-3 City | |
| Individual Health Insurance Plan | ₹15 lakh & above | ₹5-10 lakh | ₹5 lakh |
| Family Floater Health Insurance Plan | ₹30 lakh & above | ₹20 lakh & above | ₹10 lakh & above |
| Senior Citizen Health Insurance Plan | ₹20 lakh & above | ₹15 lakh & above | ₹10 lakh & above |
*Disclaimer: The above sum insured is suggestive and may vary as per the age and medical needs of the people.
Choosing the ideal health insurance coverage can be challenging and confusing. If you still feel unsure or underconfident about what coverage amount to choose, here are the other ways through which you can upgrade your coverage:
Unlimited Sum Insured – Alternative to Choosing a Fixed Amount
If you find it difficult to estimate the ideal coverage amount or feel that even a ₹20-30 lakh sum insured may not be enough, you have the option to choose a health insurance plan with unlimited sum insured. These plans provide unlimited coverage for eligible medical expenses, relieving you of the worry that your coverage is not enough.
Top-up Plans – Alternative Way to Get Higher Coverage
A more affordable option to get higher coverage is to combine a base policy with a lower sum insured and a top-up health insurance plan that provides additional coverage above the previous amount at a lower premium.
For instance, you buy a base policy of ₹10 lakh sum insured.
You add a top-up (or super top-up plan) of ₹40 lakh.
Now, you get a total financial protection of ₹50 lakh.
This way, you get a higher coverage at a lower premium than what a single policy of ₹50 lakh would have cost.
Avg. claim ₹3 L
₹467 Cr
11 K Claims
Avg. claim ₹72 K
₹442 Cr
60 K Claims
Avg. claim ₹1 L
₹437 Cr
22 K Claims
Avg. claim ₹1 L
₹389 Cr
27 K Claims
Avg. claim ₹1 L
₹319 Cr
31 K Claims
Avg. claim ₹1 L
₹295 Cr
28 K Claims
Avg. claim ₹76 K
₹252 Cr
33 K Claims
Avg. claim ₹2 L
₹227 Cr
10 K Claims
Avg. claim ₹62 K
₹154 Cr
24 K Claims
Avg. claim ₹54 K
₹68 Cr
12 K Claims
Avg. claim ₹1 L
₹66 Cr
5 K Claims
Avg. claim ₹38 K
₹885 Cr
2 L Claims
Data Source: Policybazaar’s actual data of claims settled by its partnered insurers between 2018 and 2026.
The right health insurance plan depends on your age, medical history, location, family size and budget. Comparing factors like sum insured, network hospitals and policy benefits along with insurer's financial stability and claim experience can help you choose the policy that best suits your needs.
Check out the list of health insurance plans in India offered by various insurance companies below:
| Insurance Company | Popular Health Insurance Plan | Sum Insured (₹) | Insurer's Claim Settlement Ratio (CSR) for 2025-26 |
| Aditya Birla Health Insurance Company Limited | Activ One Plan | 2 lakh to 6 crore | 97% |
| Bajaj Allianz General Insurance Company Limited | My Health Care Plan | 3 lakh to 5 crore | 93.4% |
| Care Health Insurance Limited | Ultimate Care Plan | 5 lakh to 1 crore | 97% |
| Cholamandalam MS General Insurance Company Limited | Flexi Health Insurance Plan | 50,000 to 25 lakh | N/A |
| Galaxy Health Insurance Company Limited | Marvel Plan | 5 lakh to 2 crore | 90.2% |
| Generali Central India Insurance Company Limited | Health Total Mediclaim Policy | 3 lakh to 1 crore | N/A |
| Go Digit General Insurance Limited | Bharat X Health Insurance Plan | 5 lakh to 3 crore | 92.9% |
| HDFC ERGO General Insurance Company Limited | Optima Select Plan | 5 lakh to 25 lakh | 94.2% |
| ICICI Lombard General Insurance Company Limited | Elevate Plan | 5 lakh and above | 92% |
| IFFCO Tokio General Insurance Company Limited | Family Health Protector Plan | 1.5 lakh to 30 lakh | N/A |
| IndusInd Insurance Company Limited | Health Gain Plan | 3 lakh to 1 crore | N/A |
| Liberty General Insurance Limited | Secure Health Connect Policy | 2 lakh to 15 lakh | N/A |
| Magma HDI General Insurance Company Limited | OneHealth Insurance Plan | 2 lakh to 1 crore | 88.4% |
| ManipalCigna Health Insurance Company Limited | Sarvah Uttam Plan | 5 lakh to 3 crore | N/A |
| National Insurance Company Limited | Mediclaim Policy | 1 lakh to 10 lakh | N/A |
| New India Assurance Company Limited | Yuva Bharat Health Policy | 5 lakh to 1 crore | 97.2% |
| Niva Bupa Health Insurance Company Limited | ReAssure Plan | 5 lakh to No Limit | 94.4% |
| Raheja QBE General Insurance Company Limited | Health QuBE Insurance Plan | 1 lakh to 50 lakh | N/A |
| Royal Sundaram General Insurance Company Limited | NeXT Gen Health Insurance Plan | 5 lakh to 1.5 crore | 89.2% |
| SBI General Insurance Company Limited | Arogya Supreme Plan | 1 lakh to 5 crore | N/A |
| Star Health & Allied Insurance Company Limited | Super Star Plan | 5 lakh and above | 91% |
| Tata AIG General Insurance Company Limited | Medicare Select Plan | 5 lakh to 1 crore | 100% |
| The Oriental Insurance Company Limited | Youth Eco Care Policy | 3 lakh to 1 crore | 89.3% |
| United India Insurance Company Limited | Family Medicare Policy | 3 lakh to 25 lakh | N/A |
| Universal Sompo Health Insurance | A Plus Health Insurance Plan | 1 lakh to 1 crore | N/A |
| Zuno General Insurance Company Limited | HealthPlus Policy | 1 lakh to 5 crore | N/A |
| Zurich Kotak General Insurance Company (India) Limited | LiveWise Plan | 5 lakh to 1 crore | 97.1% |
*Disclaimer: The list mentioned is in alphabetical order of the insurance companies. Policybazaar does not endorse, rate or recommend any particular insurer or insurance product. This list of plans comprises insurance products offered by all the insurance partners of Policybazaar. For a complete list of insurers in India, refer to the Insurance Regulatory and Development Authority of India website www.irdai.gov.in.
Let’s understand how health insurance works with a real-life example.
Step 1: Karan, a 26-year-old from Lucknow, has no pre-existing diseases. But he wants protection against future medical expenses.
Step 2: He purchased a ₹10 lakh health insurance policy for a premium of ₹426 per month.
Step 3: After 3 years, Karan was diagnosed with dengue and was hospitalized for a week, generating a bill of ₹5 lakh.
Step 4: Since Karan had opted for cashless hospitalization, his insurance company paid his hospital bill.
Step 5: Karan still has ₹5 lakh left in his sum insured limit and can raise another claim up to this amount before renewals.
Hence, as seen in the example above, health insurance in India works by providing financial protection to the insured against medical crises in exchange for a small premium. It is a great way to keep yourself and your family covered against the rising cost of medical expenses.
With the rising healthcare costs and increasing lifestyle diseases at an early age, the only way to afford quality medical treatment during a health emergency is by buying a health insurance policy. Take a look at some of the top reasons to buy a health insurance plan.

Increasing medical costs make healthcare treatments expensive. The cost can rise more than you estimate, creating a financial burden at the time of a health crisis. A health insurance policy can help you easily pay your medical bills, despite the rising medical costs.
If you get hospitalized for a critical illness or lifestyle disease, you may end up losing all your savings in one go. A mediclaim policy helps you to protect your hard-earned savings by covering your medical expenses so you can stay financially protected.
A health insurance policy allows you to obtain a cashless hospitalization. This means you can focus on obtaining medical treatment rather than arranging the finances.
It helps you to afford the best quality medical treatment and care at top network hospitals, which could be costlier without a health insurance plan.
It allows you to manage expenses for the long-term treatment of diseases like cancer, heart ailments, etc., that have been on the rise with the changing lifestyles.
You can save tax on the health insurance premium that you have paid under section 80D of the Income Tax Act for better financial planning.
It allows you to obtain medical treatment with peace of mind and focus on recovery rather than worrying about paying hefty hospital bills.
Kokilaben Hospital ₹30 Cr KIMS Hospitals ₹21 Cr Dr B L Kapur Memorial Hospital ₹20 Cr Yashoda hospital ₹17 Cr Deenanath Mangeshkar Hospital ₹15 Cr Apollo Spectra Hospitals ₹14 Cr Data Source: Policybazaar’s actual data of claims settled by its partnered insurers between 2018 and 2026.
Buying a health insurance policy online comes with several benefits. Take a look at them below:
You can now obtain 100% cashless treatment at any hospital of your choice with the ‘Cashless Everywhere’ facility. With this facility, you do not have to look for a network hospital of your insurer to avail cashless treatment. Instead, you can get admitted to any nearby hospital and enjoy 100% cashless treatment if you have health insurance. Be it an emergency or a planned treatment, you can avail cashless treatment at all hospitals without worrying about paying the bills and waiting for claim refunds.
Most health insurance plans in India cover the following medical expenses:
The following medical expenses and situations are usually not covered in a health insurance plan:
Note: It is recommended to check your policy wordings to get a detailed list of exclusions.
Family health insurance offers insurance coverage to entire family against a single premium. Under this health plan, a defined sum insured is divided among the members equally, which can be claimed by one or more family members during the policy term.
Senior Citizen health insurance plans offer insurance coverage to the age group of 60 years and above. The health insurance plan covers hospitalization expenses like in-patient, pre and post-hospitalization expenses, OPD expenses, Daycare procedures with tax-saving benefits.
Critical illness health insurance plans offer a lump sum amount in case the insured is diagnosed with a critical illness such as kidney failure, paralysis, cancer, heart attack, etc. Usually brought as a standalone policy or as a rider, the sum insured is pre-defined
Health insurance for aging parents refers to the senior citizen health plans that are designed for elderly people above the age of 60 years. It is essential for aging parents as they are more vulnerable to health risks like heart ailments, kidney ailments, and other critical illnesses.
Post COVID-19 outbreak, the IRDAI has also launched two Coronavirus specific health insurance plans i.e. Corona Kavach health plan and Corona Rakshak health insurance plan. Corona kavach is a family floater plan while Corona Rakshak is an individual coverage based plan.
Health insurance for diabetes covers hospitalization expenses for diabetic patients, who otherwise find it hard to get insurance cover. The policy can cover both Type 1 and Type 2 diabetes and related medical complications. Tax benefits on the premium can also be availed.
Personal accident insurance is a health policy that reimburses the medical costs incurred on hospitalization due to death or disability caused by an accident. The insurance company pays a certain amount as per the nature of the disability.
There are a few factors that you should consider to make the right decision while buying a health insurance plan:
Riders in health insurance are the additional coverage that you can purchase to avail extra benefits and make your health policy more comprehensive. The cost of the health insurance rider depends on your age, sum insured, type of coverage, etc. Take a look at the five most common riders that you can consider buying with your health insurance policy:
Lifestyle diseases, like hypertension, diabetes, cancer, etc., are growing at an alarming rate in India. This surge is largely driven by poor lifestyle choices, environmental factors, stress and genetics. Moreover, these diseases, which were previously seen mostly among people in their 50s and 60s, are now affecting young adults above 30 years!.
Here are some of the reasons why you should buy health insurance at an early age:
0-25 Yrs
Total Claims: ₹55 Cr
Avg Claim: ₹55 K
26-35 Yrs
Total Claims: ₹722 Cr
Avg Claim: ₹57 K
36-45 Yrs
Total Claims: ₹1,023 Cr
Avg Claim: ₹75 K
46-60 Yrs
Total Claims: ₹1,154 Cr
Avg Claim: ₹1 L
61 & above
Total Claims: ₹1,051 Cr
Avg Claim: ₹1 L
Data Source: Policybazaar’s actual data of claims settled by its partnered insurers between 2018 and 2026.
The eligibility criteria to buy a health insurance plan depend on several factors, such as your age, pre-existing diseases, etc. In most health insurance plans, the following eligibility criteria should be met:
| Criteria | Specifications |
| Entry Age for Adults | 18 years onwards |
| Entry Age for Dependent Children | 90 days to 25 years |
| Pre-medical Screening | Required above the age of 45/55/60 years (depending on the plan) |
All pre-existing diseases must be disclosed during policy purchase. Keeping it a secret may cause problems at the time of claim settlement and can even lead to rejection of your claims. Even if you are a smoker or an alcoholic, you must disclose it to the insurance company.
Based on these criteria, the health insurance company decides to offer you medical coverage.
Comparing health insurance quotes online helps you in choosing the right health plan to suit your healthcare needs. Sometimes, it can also get confusing to select a good health insurance plan as so many insurers offer different health insurance products with impressive features.
Thankfully, Policybazaar.com understands the confusion of the customers and offers a platform where you can compare different health insurance plans’ features, sum insured and quotes online. Here are some of the major advantages of comparing and buying a health insurance plan online:
Before buying a health insurance policy, you must be aware of how it works. Mentioned below are some popular myths that most people believe about health insurance:
Despite being healthy and taking good care of your health, there are numerous unforeseen circumstances, like seasonal illnesses, dengue, malaria, or an accident, that can hit anyone anytime. Nowadays, hospitalization expenses are not easy to pay off. Even 2 days of hospitalization in a tier 1 city would cost you somewhere between ₹60,000 to ₹1 lakh and even more (depending on the type of illness and hospital). With medical insurance, you can get financial assistance to pay for expensive hospitalization costs.
As per the IRDAI regulations, all health insurance plans come with a set of exclusions/limitations. It is advised to check all the policy details and the coverage offered by your insurer. This is because your insurer will only compensate for the expenses that are covered in the policy and up to the sum insured limit.
It is essential to declare all your pre-existing diseases clearly in the proposal form while buying a health insurance policy. Inadequate information or non-disclosure of pre-existing diseases can lead to rejection of the claim and can lead to policy cancellation.
Most smokers believe that they cannot get a health policy. But there are health insurance companies that offer medical insurance coverage to them as well. Considering the risks, alcohol consumers and smokers would need to undergo a stringent pre-medical examination and pay a higher premium to get health insurance coverage.
Though most health insurance plans cover medical expenses for hospitalization of more than 24 hours, there are plans that do not have a cap on the duration of hospitalization. All insurers these days cover day care procedures, where hospitalization of at least 24 hours is not required. It includes cataract surgery, varicose veins surgery and similar medical procedures. Moreover, several health plans now cover OPD treatments that do not require hospitalization at all.
Most people rely on the health insurance plan provided by their employer. It is important to know that a group health insurance policy comes with a set of limitations. It will not offer coverage to all your family members in most cases, the sum insured will not be sufficient, or it will not cover critical illnesses. The coverage will cease to exist as soon as you quit your job. Getting health insurance coverage after retirement or quitting your job can be a difficult and expensive affair.
In order to keep a mediclaim policy in force, regular payment of a fixed premium amount is essential. The average health insurance cost ranges from ₹304 per month to ₹2146 per month, depending on your age, gender, city, medical history, sum insured, coverage, etc. These factors vary from one person to another, thereby affecting the health insurance premiums payable by different people.
Naturally, you might want to calculate your health insurance price to figure out how much you would have to pay for a policy. Well! You can do that through a health insurance premium calculator. A premium calculator is an online tool that calculates the premium to be paid as per the information you provide, such as the preferred sum insured, the age of the insured, the city of residence, etc. At Policybazaar.com, you can calculate your health insurance premium online easily and free of cost.
With the advancement in medical facilities, healthcare costs have also increased. The main benefit of health insurance is that it offers financial security to you and your family in the event of an unanticipated serious illness or accidental injury that could drain all your savings. Here is how the cost of your health insurance policy is determined:
Health insurance plans offer two types of claims – cashless and reimbursement. Cashless health insurance claims allow the insured to get a treatment without any need to pay the medical bill upfront. However, in a reimbursement claim, the insured must initially pay the medical expenses themselves and later get the expenses reimbursed from the insurer.
Traditionally, cashless claims at network hospitals of the insurance provider. However, with the 'Cashless Everywhere' feature, you can file a cashless claim at non-network hospitals up to the sum insured limit of your health insurance policy.
Under a cashless claim, the insurance company settles the bill directly with the hospital, eliminating the need for you to pay from your own pocket. Here is how the cashless health insurance process works:
✅ Inform the Insurer: You must first inform the insurer or Policybazaar.com about your hospitalization at a network hospital.
✅ Get Pre-authorized Approval: Submit the pre-authorization claim form along with the required documents to the insurer or Policybazaar.com (if you have purchased from us). Once approved, you can obtain the medical treatment.
✅ Hospital Discharge: With a cashless claim, you do not have to pay the main medical bill out of your own pocket. At the time of discharge, you need to only:
✅ Claim Settlement: The hospital will send the medical bill for the approved amount directly to the insurance provider. The insurer will directly settle the payment with the hospital.
You can file a reimbursement claim for the treatment done at non-network hospitals. Here is how to file a reimbursement health insurance claim:
✅ Notify the Insurer: Notify the insurer about your hospitalization at a non-network hospital and obtain the required medical treatment.
✅ Pay the Hospital Bill: At the time of discharge, you must pay the medical bills upfront. Maintain a record of all the medical documents and receipts.
✅ File a Claim: Raise the claim with the insurer or initiate at Policybazaar.com if you have purchased from us and submit the required documents.
✅ Claim Decision: After reviewing the documents, the insurer will transfer the approved claim amount to your bank account.
Here are some of the common reasons due to which health insurance claims can get rejected:
| Reason for Rejection | What does it mean? | What to do instead? |
| Documentation | ||
| Incomplete claim form | Submitting claim forms with incorrect details | Before submitting the claim form, ensure you have filled all the fields accurately |
| Mismatch in patient or policy details | Spelling mistakes or incorrect details in the claim form, hospital documents or identity proof documents | Important details like the patient's name, date of birth, policy number, etc. should be exactly same across all documents |
| Incomplete documentation | Missing original discharge summary or bills and submitting photocopies instead of original documents | Always submit original bills and medical documents. Double-check the list of documents provided by the insurer so that you submit all documents in one go |
| Fraudulent claims | Submitting forged documents or inflated medical bills | Always stay honest. Do not engage in illegal activities to claim a higher amount |
| Eligibility | ||
| Waiting period limit | Treatments taken for a disease or medical condition that is still under the waiting period | Check if your medical condition or treatment has a waiting period and its status when you are raising a claim |
| Excluded treatments | Medical procedures that the insurer explicitly excludes under the policy | Always review your policy's inclusions and exclusions thoroughly |
| Inactive policy | Claims made with a lapsed policy, i.e., when the policy was not functional | Check your policy renewal dates carefully. Before raising a claim, ensure the policy is active |
| Time limit exceeded | If the claim intimation is not done within the time limit | Inform your insurer within the specified time limits applicable to both cashless and reimbursement claims |
| Medical Reasons | ||
| Non-disclosure of medical history | Hiding or giving incomplete information about pre-existing conditions or previous surgeries | Honestly declare medical history and pre-existing conditions at policy inception |
| Treatment not deemed medically necessary | Hospitalisation or medical procedures not considered medically critical by the insurer | Your treatment or hospitalisation must be recommended or approved by a doctor |
| Experimental or unproven treatment | Treatments which are not medically documented or proved | Check if the medical procedure you are opting is approved by authorised regulatory authority in India |
| Self-inflicted injury | Injuries or illnesses arising from intentional self-harm | Most policies exclude claims for intentional self-injuries |
| Coverage Limits | ||
| Sum insured exhausted | If you have exhausted the available sum insured, you will have to pay the amount beyond it yourself | If you feel your treatment can require additional sum insured, consider buying a top-up plan |
| Sub-limit exceeded | If the claim amount is above the preset limit for specific expenses, such as room rent, ambulance charges and certain medical treatments | Always check if your policy has a capping on the coverage amount for different medical expenses |
| Deductible or co-payment required | If you have not paid your share of co-payment or a part of deductible amount remains to be paid | You must pay the entire deductible amount or your co-payment proportion when making a claim |
Take a look at the list of KYC documents required to buy or renew health insurance in India:
✅ Identity Proof: Aadhaar Card, Voter ID, Passport, PAN Card, Driving License
✅ Age Proof: Birth Certificate, 10th Marksheet, Aadhaar Card, Voter ID, Passport, PAN Card, Driving License
✅ Address Proof: Aadhaar Card, Passport, Ration Card, Telephone Bill, Electricity Bill, Voter ID, Driving License
✅ Medical Reports
✅ Passport-size Photographs
Here are the documents required for filing a health insurance reimbursement claim:
✅Duly filled and signed claim form
✅Doctor’s prescriptions for hospitalization, medicines and diagnostic tests
✅Original hospital documents, including final and detailed hospital bill, discharge summary and investigation reports
✅Hospital bill payment receipts
✅Copy of the health insurance policy
✅Valid photo ID proof
✅Valid proof of named bank account, such as cancelled cheque, passbook and bank statement
✅FIR (First Information Report) or MLC (Mefdico-Legal Certificate), in case of accidental cases
✅Any other document(s) asked by the insurer
Buying health insurance can be easy if you approach the right channel. Having said this, Policybazaar.com can be a good platform for choosing the right insurance policy as it has made the process of comparing & buying health insurance policy easier in comparison to earlier days. A person has easy access to complete details of almost all health insurance plans available in the Indian insurance market at a competitive price.
Moreover, the post-sale services are extended to the customers online as well as at the time of a medical insurance claim.
To get insured from the comforts of your home, you can buy health insurance online from Policybazaar Insurance Broker Private Limited. by comparing numerous health insurance plans and making online payments. Here is how you can buy a health insurance plan online from Policybazaar.com:
Step 1- Choose the family members to be insured along with their age.
Step 2- Enter personal details, including city, full name and phone number and pre-existing diseases.
Step 3- Compare different health insurance plans on Policybazaar.com, and choose the one that best suits your requirement.
Step 4- Once the plan is selected, pay the premium or speak to our customer care representative.
Step 5- After you buy the health insurance plan, the policy copy will be emailed to your registered email ID.
Policybazaar offers health insurance for NRIs to cover the medical expenses incurred by Non-resident Indians and their families in India. Policybazaar provides an exclusive NRI Care Program that provides:
Policybazaar provides easy comparison of multiple mediclaim policies for NRIs and their families from different insurers online to find the policy that best fulfils their health requirements. Moreover, it provides premium elderly caregiving to the parents of the NRI in partnership with EMOHA Elder Care and provides OPD and wellness services with their Visit app.
Take a look at some of the most common health insurance terms that you may come across:
AYUSH treatment refers to medical treatments taken through Ayurveda, Yoga & Naturopathy, Unani, Siddha and Homeopathy system of medicines. Several health insurance plans cover AYUSH treatment costs.
Health insurance claim refers to the request made to the insurance company by the policyholder to pay the medical expenses incurred on an illness or hospitalization under the health insurance policy. In the absence of a claim, you will have to pay for the medical expenses on your own.
Co-payment in health insurance refers to a fixed percentage of the claim amount that the policyholder has to pay at the time of claim settlement. Opting for a co-payment can help to reduce your premium amount.
Coverage refers to the extent of benefits available under a health insurance policy. The wider is the coverage, the more will be the benefits offered under the policy.
Cumulative bonus in health insurance refers to an increase in the sum insured amount without a hike in premium as a reward for not raising a claim in the previous policy year.
Day care procedures refer to those medical procedures and surgeries that are performed using advanced medical technology and require hospitalization of less than 24 hours. Almost all basic health insurance plans offer coverage for day care procedures. For example, cataract surgery.
Deductible in health insurance refers to a fixed amount that the policyholder agrees to pay towards the incurred medical expenses before raising a claim with the insurance company. It is a part of the total claim amount. Once the deductible is paid, the insurance company will pay for the remaining medical expenses claimed by the policyholder.
Dependent refers to the family members of the policyholder who can also be covered under the same health insurance policy. It usually includes your legally wedded spouse, children, parents and parents-in-law..
Domiciliary treatment refers to the medical treatment taken at home under the supervision of a medical professional in case hospital admission is not possible. This treatment is covered by health insurance plans under domiciliary hospitalization.
Entry age refers to the age at which a person can buy a health insurance policy. Most health insurance plans come with an entry age of 91 days to 65 years.
Exclusions in health insurance refer to the conditions or circumstances that are not covered under a health insurance policy. Any claim arising out of an excluded medical expense or circumstance is not payable by the insurance company.
Family floater refers to the type of coverage where a single sum insured amount is shared by all the insured family members on a floater basis. A family floater policy is more affordable than buying an individual policy for each family member.
Free look period in health insurance refers to the first 30 days of buying the policy, where the policyholder can change the insurance company or cancel the policy without paying any cancellation fee. If the policy is cancelled during this period, then the premium amount is refunded to the policyholder.
Grace period in health insurance refers to a fixed period that begins after the due date of a health policy. During this period, the policyholder can pay the due premium amount without losing the continuity benefits, such as waiting periods. Grace periods are usually of 15 days or 30 days.
An indemnity health plan is a type of insurance policy where the claim amount is paid based on actual medical expenses incurred. Under this type of plan, the policyholder has to submit the medical bills to the insurance company so that they pay the claim amount equal to the total bill amount.
Insured refers to the person who is eligible to receive medical coverage under a health insurance policy.
Insurer refers to the insurance company that is responsible to pay for the medical expenses of the insured under a health insurance policy.
Network hospitals refer to the empanelled hospitals of the insurance company that offer the cashless hospitalization benefit to the policyholders. All insurance companies in India have a network of cashless hospitals.
No Claim Bonus in health insurance is a renewal premium discount offered by insurance companies to policyholders for not raising a claim in the previous policy year. This discount can be accumulated up to 50% for five consecutive claim-free years.
Health insurance portability refers to the procedure of changing the existing insurance company or health insurance policy without losing any continuity benefits like the waiting period. This facility is beneficial for people who are unhappy with their current insurer or policy.
Pre-existing diseases refer to the diseases or medical conditions that the applicant was diagnosed with up to 4 years before buying the health policy. Most health plans cover pre-existing diseases after 2 to 4 years of waiting period.
Premium refers to the cost of an insurance policy. Health insurance premium is the amount paid by the policyholder at regular intervals to get insurance coverage and enjoy the benefits available under a health insurance policy.
Preventive Health Check-up refers to a series of medical tests that are undertaken to assess the health of a person and take suitable measures to prevent the occurrence of a disease.
Restoration benefit in health insurance refers to the facility of refilling your sum insured amount before the policy renewal date in case the original amount gets exhausted on raising one or more claims.
Health insurance riders or add-on covers refer to the additional covers that the policyholder can buy on payment of an extra premium amount to expand the coverage of a basic health insurance policy. For example, PED waiting period reduction, etc.
Room rent limit refers to the limit up to which the insurance company will pay for the hospital room charges incurred by the policyholder. If the hospital room charges are more than the room rent limit, then the additional amount will have to be borne by the policyholder.
Sub-limits in health insurance refer to the limit set on the coverage amount of a benefit under a health insurance policy. Eg: room rent limit. In case a coverage benefit comes with a sub-limit, the insurance company will only be liable to pay up to that limit, and any additional amount will have to be paid by the policyholder.
Sum insured refers to the maximum coverage amount that the insurance company will pay in a policy year. The sum insured is ascertained at the time of buying or renewing the policy.
Top up plan refers to a type of health insurance plan that offers a higher sum insured and can be bought to enhance the medical coverage of a person. However, a deductible amount needs to be paid under all top up insurance plans, which makes its premium affordable.
Underwriting refers to the process where an insurance company evaluates the application of a person. The underwriting team evaluates the medical history and personal details of a person to determine whether the policy should be issued and how much premium must be charged.
Waiting period in health insurance refers to the time period from the commencement of the policy during which the policyholder is not allowed to make any claims. Any claims raised during this period will be rejected by the insurance company. For example, the PED waiting period, critical illnesses waiting period, etc.
Policybazaar makes your health insurance journey simpler, easier and more convenient. Whether you want to buy a new plan, port your health insurance policy, initiate a claim, or track claim status, we provide constant support at every stage. Our customer-first approach helps you get the required support when you need it most.
Here is how Policybazaar helps you with your health insurance needs:
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Read more*We will respond in the first instance within 30 minutes of the customers contacting us. 30-minute claim support service is for the purpose of giving reasonable assistance to the policyholder in pursuance of the claim. Settlement of claim (including cashless claim) is the responsibility of the insurer as per policy terms and conditions. The 30- minute claim support is subject to our operations not being impacted by a system failure or force majeure event or for reasons beyond our control. For further details, 24x7 Claims Support Helpline can be reached out at 1800-258-5881.
*Product information is authentic and solely based on the information received from the Insurer. Policybazaar is acting only as a facilitator and claims settlement shall be at the sole discretion of the Insurer. Policybazaar does not provide any medical or surgical advice or diagnosis and is not responsible for your interactions / treatment by a medical practitioner/hospital. Please consult a registered medical practitioner for any medical or surgical advice. The Information that you obtain or receive from Policybazaar, and its employees, or otherwise on the Website is for informational purposes only. As per the Insurance guidelines, you are allowed to cancel the policy with-in 30 days from the date of Issuance of policy.This option is available incase of policies with a term of one year or more.
*All the health insurance plans cover hospitalization expenses including COVID-19 treatment cover up to the specified limits. You can also buy specific COVID-19 health insurance policies such as Corona Kavach Policy and Corona Rakshak policy.
**All savings and online discounts are provided by insurers as per IRDAI approved insurance plans. #Tax Benefits are subject to changes in tax laws.
*₹1748/month is the starting price for a 1 crore health insurance for an 18-year-old male, with no pre-existing diseases. Discount on renewal premium is subject to the number of wellness points earned in the health insurance policy. For more details about the plans, please read the sale brochure carefully to get upto 100% discount on renewal premium.
*₹400/month is the starting price for ₹ 5 lakh Health insurance for a 30 year old male & 29 years old female, living in Delhi with no pre-existing diseases
*₹541/month is the starting price for ₹ 10 lakh Health insurance for a 30 year old male & 29 years old female, living in Delhi with no pre-existing diseases
*₹762/month is the starting price for ₹ 1 Crore Health insurance for a 30 year old male & 29 years old female, living in Delhi with no pre-existing diseases
*₹243/month(₹ 8/day) is the starting price for a 5 lakh health insurance for a 20-year-old male, non-smoker, living in Bengaluru with no pre-existing diseases
*₹2020/month is the starting price for ₹ 1 Cr Health insurance for a 50 year old male & 50 years old female, living in Bangalore with no pre-existing diseases rounded off to nearest 10.
*₹390/month (₹13 per day) is starting price for 1 cr. Health insurance for 25 years old male, with pre-existing diseases, residing from tier 1 city rounded off to the nearest 10.
*No medical tests are required unless requested by the insurer’s underwriter. In-case of pre-existing diseases relevant medical proof would be required as per the terms and condition of the policy opted.
*The values taken for effective cost calculation are indicative values and may change as per the selected plan.
*Coverage upto double the amount of Sum Insured is available on certain covers for a minimum plan of Rs. 5 Lakh on the first claim only to an individual of upto 45 years of age with no pre-existing diseases. The benefit is available with or without extra cost depending on the plan chosen.
*Coverage of pre-existing diseases is provided by insurer as per their underwriting policy.
*The scope of coverage may vary from plan to plan.
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##On ground claim assistance is available in 114 cities
Tax Benefits are subject to changes in tax laws. For more details on risk factors, terms and conditions, please read the sales brochure and applicable rules and regulation carefully before concluding a sale.
STANDARD TERMS AND CONDITIONS APPLY. For more details on risk factors, terms and conditions, please read the sales brochure carefully before concluding a sale.
Policybazaar is a registered Composite Broker |Registration No. 742, Valid till 09/06/2027, License category- Composite Broker| Visitors are hereby informed that their information submitted on the website may be shared with insurers.
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Policybazaar Insurance Brokers Private Limited CIN: U74999HR2014PTC053454 Registered Office - Plot No.119, Sector - 44, Gurugram - 122001, Haryana Tel no. : 0124-4218302 Email ID: care@policybazaar.com
Policybazaar is registered as a Composite Broker | Registration No. 742, Registration Code No. IRDA/ DB 797/ 19, Valid till 09/06/2027, License category- Composite Broker
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