• The motive is to
    lower costs
    , and to
    reward you
    for maintaining a healthy lifestyle
  • No additional cost
    to enrolling for these

Under IRDAI’s Health Regulations:

  • No discount
    on third-party services or merchandise is allowed
  • Discounts in
    premium, consultation services, and medicines
    are okay

Many Indians believe in

‘natural’ systems of medicine
that are normally excluded under a basic policy

This is beneficial to people:

  • Suffering from chronic and lifestyle-related diseases
  • Allergic to allopathic drugs
  • Applicable for
    specified illnesses
    and
    surgical procedures
  • Opinion must be sought from a
    doctor empanelled with the insurance company

It can also be useful for people with:

  • Hereditary conditions
  • A history or tendency to certain illnesses

Useful for:

  • Medical emergencies
    faced overseas
  • Treatment isn’t available
    in the country you’re visiting
  • The cover is usually
    available worldwide,
    but
  • Often
    excludes USA and Canada
  • Expenses are payable only when the
    main claim for hospitalisation is payable
  • Insurance companies are
    not allowed to terminate
    a policy midway due to recurring claims
  • The reinstatement feature
    refills the sum assured
    if it is exhausted
  • The insured
    continues to get the financial support
    during hospitalisation

But

  • Industry numbers show that health claims are hardly ever fully exhausted
  • You’re better off purchasing a ’top-up’ plan to enhance your cover
  • It may be comparatively more costly, but it provides better coverage
  • This is a reward of an increased sum insured given to a policyholder
    for every claim-free year
  • When a claim is made,
    the bonus is reduced
  • The bonus should not be seen as a
    cost-saving tool,
    but as additional cover
  • This refers to handing out a lump sum to the insured,
    post hospitalisation
  • It’s given to the insured for
    household expenses till they cover
  • This is given to the
    patient’s caregiver
    in the hospital, for food and refreshments
  • It’s
    restricted
    to the number of days the patient is in hospital
  • What if a patient can’t get a hospital room? Or is
    too ill
    to be transferred to a hospital?
  • The doctor can approve
    medical treatment in the home