Most of the Indians are just one medical bill away from the bankruptcy, which means if you take insurance once and have to go to the hospital then the problem is over.Selecting health insurance in India is crucial due to rising medical costs, which increase by 14–15% annually, outpacing inflation. Many Indians lack emergency funds or insurance, making them vulnerable to financial strain from medical bills.

Key Parameters for Choosing an Insurance Company.

Claim Settlement Ratio:

Claim settlement ratio means how many claims out of 100 have been passed by the insurance company. The higher this figure, the better. Whenever you take health insurance, you do it with the thought that whenever I fall sick or am hospitalized, the company should pay my money. But if the claim settlement ratio is low and most of the claims are not getting passed, then what is the use? You should pay attention to the claim settlement ratio before buying any health insurance.

(last 3 years data is here, India Assurance has the highest with 99%, HDFC with 98%, Digit & SBI with 97%, Aditya Birla with 95%).

Hospital Network:

The more network hospitals an insurance company has, the better because you will be able to make a cashless claim there; otherwise, what will happen is that you will have to first pay the bill from your pocket and later you will get the reimbursement from the insurance company.

(Here is some shorted data.) HDFC Ergo has a network of 11500 plus hospitals; Star Health has a network of 14000 plus hospitals; and Digital has a network of 16400 plus hospitals.

You have to keep in mind that the nearest hospital in your city or town is also in the network of your insurance company.

Product Portfolio:

Everyone has different requirements. Some people get simple health insurance, which is fit, but sometimes there are pre-existing diseases for which you can take disease-specific policies. Select your insurance in which you can cover more facilities.

Company Reputation:

What is its repetition in the market? What do people say about the company? You need to look at all these things. Because it matters a lot.

Service Quality:

Generally, we see that the process of a private company, whether it is onboarding or claim, is better than that of the government. In health insurance also, a private company provides a comprehensive service.

These are the five parameters to select the best health insurance company.

You have selected the company, but the company has several plans. Which plane should you select?

You can easily choose the best plane from the best.

Here are nine parameters for

Choosing the Right Plan

Payment Clauses:

You have to pay a certain percentage of the bill yourself. Generally, this clause is there in your group health insurance or senior citizen plan.

So you have to mix this clause that this clause is not there at all in your policy; if it is there, then consider it as a red flag, if there, is a co-pay of 20 percent then on a bill of five lakhs, you will have to pay one lakh rupees yourself.

Room Rent Restrictions:

You have to ensure that there are no room rent restrictions in your policy or there is an option of a private room with AC at the top. There are many restrictions attached with room rent limit, so it is possible that you may incur a huge loss, so mix and ensure that the limit is not there in your policy; if it is there then consider it a red flag.

Waiting Periods:

Look for minimal waiting periods for pre-existing conditions.

If you have a pre-existing disease, then the insurance company generally does not cover them for some specific time, say two to three years, so you have to make sure that the waiting period in your policy is minimal. If you have to pay a little more money. then reduce this waiting period, so still go for it, pay a little more money, but keep the waiting period to a minimum.

Pre/Post Hospital Benefits:

Check for coverage of tests and consultations.

During some daises treatment, doctor recommended some treatment so you have ensure before selection of the plan that how many days pre- and post- hospitalization offered by the company.

Cashless Options:

Prefer policies with extensive cashless facilities.

An insurance company has the better because you will be able to make a cashless claim there, otherwise what will happen is that you will have to first pay the bill from your pocket, and later you will get the reimbursement from the insurance company.

Alternative Treatments:

Consider plans offering coverage for alternative therapies.

Make sure that the policy gives you the option of cashless, and the more network hospitals it covers, the better it is. Nowadays, many policies also offer you alternative treatments. Like homeopathy and Ayurveda, many policies have started providing this. So if you have this too, then it is better. It’s a good thing to have.

No Claim Bonus:

Look for policies that reward claim-free years.

Sometimes it happens that you buy a policy, and after a few years the cover amount seems to be less. So in this case, you can see that if your policy has the option of no claim bonus, then in any year, if you do not make a claim, then either your premium will not increase or the coverage amount will increase by a specific percentage, like ten-twenty percent.

Restoration Benefits:

Ensure coverage can be restored after claims.

This is a good feature if you are taking a family floater plane. If two members of the family get hospitalized in a year, then after the first hospitalization, your coverage amount is restored, which you can do at the time of the second hospitalization.

Price vs. Benefits:

Don’t choose solely based on cost; evaluate overall value.

Never buy insurance policies by comparing them on price. Most people make a big mistake. They will not look at the above eight things, they will only look at one new thing and that is the price. Different policies have different benefits, so if you buy a cheaper policy, then your loss in future can be more. Do not buy such a policy, many times it is not cheaper, so of course you have to look at the reasonable price, but also look at the benefits, how many benefits are you getting from that price.

Recommended Insurers

Top choices based on data include

HDFC, Aditya Birla, and Care, each offering robust plans like HDFC’s Optimize and Care Supreme

All with strong claim settlement ratios and comprehensive coverage options. This is based on my opinion, choose as per your requirement.

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