Health Insurance FAQ's

While "best" depends on individual needs, the top-rated insurers in 2025 based on Claim Settlement Ratio (CSR), network hospitals, and customer service include HDFC ERGO, Care Health, Aditya Birla, and Star Health. Experts recommend looking for a CSR above 95% and a large network of hospitals in your specific city. 

Most standard policies cover:

• Hospitalization: In-patient treatment (minimum 24 hours). 

• Pre & Post Hospitalization: Medical expenses incurred 30-60 days before and 60-180 days after hospital stay.

• Daycare Procedures: Treatments like dialysis or cataract surgery that take less than 24 hours.

• Ambulance Charges: Emergency transport to the hospital.

This is the duration you must wait before you can claim for specific conditions.

• Initial Waiting Period: Usually 30 days (except for accidents).

• Specific Illnesses: 2 years (for surgeries like hernia or stones).

• Pre-Existing Diseases (PED): Typically 2 to 4 years.

• Note: Many modern plans now offer "PED Waivers" to reduce this to Day 1 or 1 year. often called PED 

Yes. you as the proposer can have your children, spouse, parents and or parents In-Law in your policy. Generally only 6 people are allowed under one policy . Combinations could 6A, 5A+1C, 4A+2C, s so on and so forth. this depends of policy's elegibility criteria

Yes. There are specialized Senior Citizen Health Insurance plans for those above 60. Note that these often come with a "Co-payment" clause (where you pay a part of the bill) and might require a pre-policy medical check-up. 

Cashless: The insurer pays the hospital directly. This only works at Network Hospitals.

Reimbursement: You pay the bill first and then submit all documents (bills, discharge summary) to the insurer to get your money back. This is used at non-network hospitals.

 Family Floater: One sum insured covers the whole family. If the sum insured is ₹10 Lakh, any family member can use it until the ₹10 Lakh is exhausted. It is more cost-effective.

• Individual: Each person has their own separate sum insured (e.g., ₹5 Lakh each).

A sub-limit is a cap on how much the insurer will pay for a specific expense. For example, many older policies cap room rent at 1% of the Sum Insured. If you exceed this, the insurer applies a Proportionate Deduction, which can significantly reduce your total claim payout.

• Pro-tip: Always look for a policy with "No Room Rent Capping."

If you don't make a claim during a policy year, the insurer rewards you by increasing your Sum Insured for the next year at no extra cost. This increase can sometimes go up to 100% or 200% over a few years. 

Yes, under Section 80D of the Income Tax Act. You can claim a deduction of up to ₹25,000 for yourself/family and an additional ₹25,000 to ₹50,000 for your parents' insurance premiums. 

Yes, this is called Portability. Ideally need to be done within 60-45 Days from renewal. But you can switch your insurer at the time of renewal your new company will internally send a port request to you old company. The best part is that you don't lose the "Waiting Period" credit you have already earned with your old insurer.