6 Things you didn’t know about Health Insurances 

There are a few things in life that you just buy once and forget about it & wish you never have to use it. Insurance of any kind is one of them. It gives you peace of mind to stay financially equipped for those unfortunate medical emergencies without drowning you in the paralysing worry about your investment.


I like to imagine them as harnesses and support while you are rock climbing. They just ensure that you don’t fall off & hurt yourself. At the same time, they let you focus on the real experience & the primary task at hand. But can you go rock climbing with a poor harness, weak rope etc? That’s what you plan for once.  It’s exactly what Insurance does for you. It provides you a logical backstop in case things don’t go as planned.

So it is worth going into the details to uncover the important nuances to discover the best health insurance for yourself.

Now, here is the deal- you get coverage up to 10 lakh INR for a yearly commitment amount of 10,000 INR. It is a skewed relation that works because of risk pooling. Hence, Insurance companies have introduced several measures to make it a profitable venture for themselves.


But knowing some of the below lesser-known features can help you maneuver the treacherous world of insurance with confidence:


  1. Savings through 2 pay & 3 pay options: Most Insurance companies offer you a discount of 5-10% for the 2 pay & 3 pay option, which means you can pay for your insurance premium for the next 2 or 3 years in one go at a slightly discounted rate.
  2. Room rent limit impacts overall claim amount: Most people think that the room rent limit will only impact their hospital bills related to room charges. But this is where it gets complicated. Say, you exceed the room rent/day limit by 50% (due to availability issues), then you will be looking at – paying 50% of the entire hospital bill. This pro-rata-based or proportionate payment structure is a scary financial move. In some cases, this could cost you a few lakh Rs despite holding insurance of much higher coverage.
  3. Premium changes with location: Premiums change based on your PIN code location as healthcare charges depend on the kind of hospitals in your area and also their average cost of treating you. But it does not mean that you should apply from a location where the premium may be low as while claiming you may have to shell out more money because of something called a forced copay. It is always advisable to be truthful to your insurance provider.
  4. Forced co-pay: Delhi is known for its hospitals and its ability to treat even the most difficult health ailments. Someone living in Mathura may have to visit Delhi to treat some diseases to get better care. Your insurance plan is applicable throughout India but the treatment cost will be very high in this case (considering that Delhi is a Tier 1 city & Mathura is a Tier 2 city). While this spiked expenditure will be financially covered by your total sum insured, more so if you have a restoration benefit in your policy, your insurer will face the brunt of the situation. The payout for the claim raised by you will be a financial punch to their faces since you will exceed their anticipated claim amount for you. So they may introduce a co-pay option for your case. It may not be applicable to all cases.
  5. No Claim bonus rolls back: No Claim bonus is a great feature in the insurance plan. It boosts your insurance plan by 2X in some cases. But always remember that NCB is just additional coverage that rolls back in case of a claim year.
  6. Perks of being healthy: Generally Insurance companies treat the very healthy, moderately healthy, and someone on the verge of some ailments in the same manner i.e. premiums of all three categories will be the same. But there are many plans that give you discounts on renewal for being active e.g. running a marathon, walking a certain number of steps in a month, etc.



Frequently Asked Questions


Can I buy a policy for a duration of 5 or 10 years?

Currently, there are options to buy a policy for up to 3 years. Beyond this, there are no options.


Can an Insurance company deny my renewal if I develop some ailment later on?

No. An Insurance company cannot deny the renewal of a policy in such a scenario. These are the risks that they had undertaken while issuing you the policy.


Can an Insurance company deny a claim if it is discovered that I did not disclose some ailment while issuing of policy?

Yes, this will be flagged as fraud and the insurance contract stands null & void. Therefore it is important to truthfully disclose everything.


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