IRDA Incurred Claim Ratio-How to choose the best health Insurance?

When it comes to purchasing health insurance either for you or to family, then you will come across many more doubts, like how much insurance is suffice for you, whether you can afford it or not, which one to buy and much more. The answer to this is a simple tool developed by POLICYADVISOR. Let us look how it works and help you.

Before proceeding further, let us look at recent annual report of IRDA Annual Report 2013-14. This will also give you some inputs about whom to believe and how they are doing business.

What is the Incurred Claims Ratio?

It is the ratio of claim incurred by the insurance company to actual premium collected for that period. You may also say it as a net claim settlement cost incurred to the net premium collected for a given accounting period. Formula for calculating is as below.

Incurred Claim Ratio=Net claims incurred/Net earned premium.

For example, let us say an insurance company’s incurred claim ratio is 90%. Then what it indicates is, for every Rs.100 earned as premium, Rs.90 spent on the claims settled by the insurer. Therefore, Rs.10 is the profit to the company. If this incurred claim ratio is over and above 100%, then it indicates that they suffered a loss in their business.

What this ratio indicates?

This indicates how much you can believe in insurance companies, when it comes to claim. Usually higher the incurred claim ratio then it is good for you. This is how the health insurance company’s performance is gauged. However, when it comes to insurance company point of view, then if higher the incurred claim ratio means the company is in loss. That is the reason usually insurance companies load your premium when they incur a higher loss in particular age group segment (even though you do not have any claims in previous years).

What this ratio doesn’t indicate?

When company A and company B have a same incurred claim ratio then it is hard for you to judge who settled claims quickly. So even though it may give a clear picture about an insurance company, but still hard to find who is efficient in claim settlement.

What is the difference between incurred claim ratios to claim settlement ratio?

You can confuse yourself between incurred claim ratios to claim settlement ratio. The claim settlement ratio is the ratio of settled claims to the total claims filed in a given accounting period. Therefore, if claim settlement ratio indicates 90%, then it means that out of 100 claims filed 90 claims are settled. Remaining 10% claims are either rejected or pending with the insurance company.

Below is the latest IRDA Annual Report for 2013-14 for individual Health Insurance Companies Incurred Claim Ratio for 2013-14.

Claim Incurred Ratio 2013-14

As I said above, this CIR will give you an indication of believing on these insurance companies. You may notice that none of the private health insurance companies (including standalone health insurance companies) has CIR of more than their collected premium.

Now let us move to the next step of selecting the health insurance product by using the tool of POLICYADVISOR. Here in the first place you need to enter your date of birth and city you currently live. The name of the city is important to identify the cost of health in these cities. They did some research on this to arrive at the final figures on this.

Next, you need to enter your marital status, your monthly income, whether you want to add family members or not. If yes, then add the number of members you want to cover in this policy.

Last step is to specify whether you have any existing health insurance or not. This is required to arrive at the required Sum Insurance. Along with that, you need to enter information about any health issues. Finally share the information, whether you have any major hospital expenses in last 1 year or so.

That is all what you need to do. The result will show you whether you require any health insurance or not (based on your current health insurance), ideal cover required for you (based on current requirement, the city you stay, family members you want to cover and your health status.) and the required cover which excludes the existing insurance coverage.

Health Insurance Calculator

If you need quotes for this insurance, then you can fill up your personal data like name, email id and mobile number. This will give you the list of products.

Few assumptions that were made to arrive at required quote are as below.

  • You are the eldest member of the family.
  • You have an annual surplus of 3% to 4% to pay towards your health insurance premium.
  • You have not exhausted the Sec.80D limit.
  • Your premium affordability may vary to actual calculation. However, it is considered based on industry average.
  • This is not a final recommendation. Before buying a product, consult insurance adviser or financial planner.

I know that buying health insurance involves too many data like apart from said information you may require information like co-payment clause, pre-existing diseases or many more. But by going through IRDA ICR and using the POLICYADVISOR tool at least you may come to nearer of your selection.

560 Comments

  1. I need your suggestion for MEDICAL AGENT sir.

    Reply
  2. GM Basu sir,
    I have passed IRDA exam to be an agent for Life Insurance and can also be a medical insurance agent. So need your suggestion before opting for a particular Company.

    Reply
    • Dear Jyoti,
      You can go with LIC and in case of general insurance go for Public Sector Companies.

      Reply
  3. hello sir

    i have been denied insurance policy recently by a big vendor as i mentioned of ocd and 3 months medication to doctor i had around 15 years back.

    Now can i apply to other insurance and is the data of rejections shared across and if i don’t mention still will i be rejected again with new one?

    Please advice. I am really worried as this ocd no more exists for me and wonder how can this be taken as a reason to reject. Also, these days everybody talks so casually about ocd.. but still its a taboo and can be a reason..

    thank you very much..

    Reply
    • Amit-You can apply with new insurers. But NONE can guarantee you that whether they accept or not.

      Reply
      • thanks.. does this affect term insurance too, because I already have one and there I was not asked such thing so didn’t provide any information on this as I was not aware that this matters. Should I do anything related to that now…

        Also, is the rejection data all pooled into one at IRDA?

        Thanks again..

        Reply
        • Amit-If such diseases cause in death, then it really affects. Hence, you have to disclose (if the disease was there during policy issuing time). Otherwise you can ignore it. There is no such system to pool data from IRDA.

          Reply
          • Thanks Sir

            Reply
  4. hello sir

    i have question in my mind

    you have a mediclaim if yes so which company ???

    please give answer

    Thank you sir

    Reply
    • Pradeep-If I disclose MINE, then will that be your’s also? See, I am not saying the product I bought must also be purchased by all blog readers. Each individuals requirement differs. Hence, I don’t think it is necessary for me to disclose. Thanks for your interest in me ๐Ÿ™‚

      Reply
      • hello Basavaraj sir

        i respect your opinion

        Thank you

        Reply
  5. hello Sir,

    I have decided to take a health insurance upto Sa of 5 Lakhs. Thinking of Religare. But uinversal sopmo offers almost same benefits with 3 thousand lesser premium.
    1. Is religare worth paying 3 K more.
    2. Which one you would recommend as an individual.

    Reply
    • hello sir Basavaraj

      iam totall aggree with ASHISH SINGH iam also buy uinversal sopmo mediclaim its nice no room rent capping and cliam settelment ratio also good enven nice network hospital
      main thing is comapre to other than mediclaim is cheap price (iam port bajaj to uinversal sopmo )

      Thank you

      Reply
      • Pradeep-I am not at all against any particular company nor I have any personal interest to the particular company. I respect your decision.

        Reply
        • hello sir
          i know but i reach that point because of you & your research

          Thank you

          Reply
  6. Hi Basu ,

    Thank you for the prompt replies.
    What is your opinion about Canara Bank ( in tie up withUnited India) Mediclaim ?
    I couldn’t find the figures for that in your website.
    I read an article insurances through banks cannot be trusted as their agreements might break down in the future. Is this true ?

    Thanks,
    Raj

    Reply
  7. Hi Basu,

    I would like you to answer another question if possible.
    I went through some plans and saw that most private plans provide health insurance only for upto 5 and 10 lakhs.
    Am interested in getting an insurance fro worst case scenarios like cancer etc and these plans seem to grossly inadequate.
    From your comments to other answers , I know you don’t specifically suggest any policies , but could you make an exception please and give some direction.
    I saw that new india assurance provides 20 lakh and 30 lakh plans. Are their plans good, and do they settle plans quickly? Am afraid they will be slow and inefficient since they are a government company.

    Many Thanks ,
    Raj

    Reply
    • Raj-I don’t think there is a cap in sum insured with private players. However, you can rely in public sector companies also. If you feel the cover not enough, then you can opt for super top up plans than buying higher base plan.

      Reply
  8. Hi Basu,

    Thank you for your informed posts. Could you please make it more clear about what constitutes a pre-existing condition claim? Suppose I have a disease I am not aware of, and it is diagnosed after I take a policy, will it be considered preexisting ?

    Thank you,
    Raj

    Reply
  9. Hello Sir,
    I want to purchase a individual health insurance. My basic criteria is
    1. No Room rent Cap
    2. No Sub Limit & Co-Pay
    3. Least permanent exclusion and maximum disease type coverage.
    4. Lowest waiting period
    5. Good and reliable and hassle free claim settlement service
    6. No or lower loading and hassle free renewal.
    Can you please suggest or name 3 insurer according to your preference which fulfills these criteria?
    Thanks.

    Reply
      • Sir,
        Still, which plan will be the nearest option?

        Reply
  10. Hi Basu,
    Is claim settlement ratio the only measure available to consumers to help them make a decision ? I feel more data is required by customers. Especially what percentage of โ€œnumber of claimsโ€ received by the company has been settled ? Example: Company A got 10 customers who pay a premium of 10,000 INR each and this policy lets say allows them to claim upto 5 lakh INR each per year. Lets assume that 5 of these customers made claim worth 1 lakh each during the year. Lets also assume that company A approved only 1 claim and denied 4 claims for flimsy reasons.

    Now here is the math: In this example, company A earned total premium of 1 lakh INR for the year (10,000 * 10 customers) and paid out 1 lakh to customers. So Incurred Claim Ratio = 100 percent BUT actual claims settled = only 1 out of 5 = 20 percent . If customer looks at Incurred ratio it looks great โ€ฆwow 100 percent..BUT the real deal is how much number of claims they settled..ie only 20 percent (1 of 5 claims) in this example. The measure โ€œincurred claim ratioโ€ we are discussing in your article suits the company not the individual. Your opinion please ?

    Reply
    • Mathew-I understood your views. That is the reason, initially I pointed what IRDA publishes is just raw data. We can’t rely on this sole data while selecting a product.

      Reply
  11. Hi basu
    I have national familyfloater parivar mediclaim policy of 5 lac. My age 43 wife 36 kids 9 and 6 yr. I need to increse cover which my plan does not allow and other policy of national is quite expensive more than Apollo munikh. I plan to port it. I have shortlisted 2 policy
    Apollo munikh optima restore I plan to have 2 plans for 1 adult + 1 child for 10 lac for me and wife
    Star family health optima ..same 2 plans for 1 adult plus 1 child
    Both offer almost similar features. Premium of Apollo munikh is high by 25 %. Is star worthwhile or better to stick to Apollo considering its services, brand etc
    What is your advise
    Thnx

    Reply
      • Dear basu. Regarding top up can I continue with this approach i.e national policy plus top up for life long. Will it be problematic as age advances. Pls advise

        Reply
  12. is there any copayment in max bupa health companion plan ?

    Reply
  13. Sir,

    Please help me out with the best policy for me , my age is 24 yrs, i want a cashless policy of 4 to 5 lac claim , which health insurance company will suits me ?

    Reply
  14. Hi,

    I am 33 years old and my wife is 26. I am looking for a Health Insurance policy. But i am a bit confused between National Insurance and Star Insurance. My confusion is NIC , apparently , provides treatment for Infertility but has Co- Pay for non cashless hospital whereas Star has full reimbursement for non cashless but does not cover Infertility treatment . Also i have heard National Health insurance are safer than the private ones.Could you guide me which one is better.

    Reply
    • Mahesh-Whether you checked the co-payment clause for both National and Star? Star in my view have more co-payment. Hence, it is cheaper.

      Reply
      • i guess star has no co payment whereas NIC has 10 % co-payment on non cashless

        Reply
  15. Dear Vasu,
    I am looking for health insurance of 5 lacs for me( Age-28Yrs), Wife (30Yrs) and mother (55Yrs). My current employer also provides medical facilities upto Rs. 2Lacs. Presently I am working in Pantnagar (Uttrakhand).
    But Few things I am not able to understand, requesting you to pls help-
    1. I searched all PSU health insurers but for cashless facility they dont have their network hospital in pantnagar, In this case, I have to pay the complete amount and then I will claim?
    2. How many times in a year I can claim reimbursement or cashless facility.
    3. Annual premium that I pay will be same for lifelong or it will increase? If increase, what is the avg rate in the industry (Just a rough Idea).
    4. My mother has been treated with 2 medical surgeries, should I choose a family floater or I should chose Individual health insurance for mother.
    5. I was reading super top in your blog, How it works. Pls elaborate.
    6. Is sub limits on room rent in different policies can effect my total reimbursement (Surgical or other charges being paid by insurers on the basis of that)?
    7. Suppose I avail cashless treatment in network hospital, Some charges are crossing my policy limits (For example Nursing/Doctor charges), how It will be processed? I have to pay the extra amount at the hospital or policy will pay & charge me extra.
    8. In case of policy, do the hospitals charged blindly because I am having policy. I might not object?

    Pls treat me as novice in this field & help me to make my decision. These things will also helpful for other peoples.

    Reply
    • Abhishek-1) Yes.
      2) There is no such limit.
      3) It will increase based on age slab.
      4) Better individual.
      5) Refer the same post.
      6) Yes.
      7) You have to pay the additional bill amount.
      8) YES, it is rampant.

      Reply
      • Dear Basav,
        Thanks for your kind response, It is very valuable to me.

        Requesting you to pls share your insights also on-
        1. Which is better
        – buying insurance through health planners/Brokers or buying online. What are the advantage in case of having expert by your side ( health planners/Brokers), Do they support you lifelong or will be limited to just buying policy.
        2. Some Private insurers are increasing your policy cover each year by some percentage in case of no claim. These things to be considered during taking policy ?
        3. Kindly suggest some policies for me and my wife (age-28 & 30Yrs), which also cover addition of new member in our family. (Maternity cover need not a compulsion)
        Wife is also having history of surgery for cyst- 1 time.
        4. Kindly suggest some policies for My mother-
        Age 55, Previous history of surgery for cyst – 2 times, currently having blood pressure issue.
        Please also suggest avg medical cover required in both cases.

        Reply
      • sir are you agent of star insurance company…

        Reply
  16. Hi have a policy with cignat ttk of 5 lakhs but want to swith bcoz of high premium, my age is 37 years.thinking to buy royal mediclaim policy a joint venture of pnb and oriental.kindly advise if i can take it or rethink the decision.

    Reply
  17. hello sir,

    My name is Maulik. I am planning to take health insurance of Rs. 10 Lakhs for myself (28) wife (25) & daughter (6months). i want no co-payment, no caps at all.
    I’m confused btw Star Health Comprehensive Plan & Apollo Munich Easy Health Exclusive.
    I need your suggestion regarding from above both the policies which company is to go for when it comes to good after sale services?
    and please advise me if any other good policy is there to go for.

    Reply
    • Maulik-Whether both plans of Star and Apollo offers you “no co-payment, no caps at all”?

      Reply
      • Yes. as far as interaction with the executives of both the companies concern they told me that there would be no caps & no co pays at all.

        and also the website of both the company with this particular plans also states the same thing that’s why.

        So, now its up to your advise that which way to go for me? and even suggest me if any other plan from any different company would be there.

        Reply
        • Maulik-Can share the link of the product which claim ZERO co-payment clause or there will not be any caps?

          Reply
          • sir could you please suggest me which one to go for regarding after sales service provided by these two?

            Reply
            • Star is worst
              Go for govt.insurance company

              Reply
              • Sashikant-May I know what prompted you to tag this negative image towards STAR? I am not representing any company. But asking this to share your experience with all as it may be helpful for readers and ME.

                Reply
  18. Hi Basavaraj,,

    i would like to Thank You first for this post and the forum replies. I really appreciate your work.

    I have family of 5 members Myself (29 Yrs) , Mother (54 Yrs) , Father (59 Yrs) , Spouse (27 Yrs) , 1 Child (2 Yrs) .

    I work for private organization which gives me mandatory health insurance which covers 4 people including me .
    The premium is 12000 for 1.5 LAC SA , 16500 for 2.5 Lac and so on till 8 Lacks. I have taken 16500 SA 2.5 Lacks .
    The ultimate insurer is New India assurance company LTD
    I have included my Myself (29 Yrs) , Mother (54 Yrs) , Father (59 Yrs) , Spouse (27 Yrs) in my employer’s health policy.

    Now My Child (2 years) old is not covered with any policy . I wanted to cover him along with me.

    Questions

    1.0 Should I take new policy for Myself (29 Yrs) Child and Spouse (27) or just me and Child ?
    2.0 I have chosen New india Assurance and Oriental Health among Gov sec Please suggest which one is good
    3.0 Among Private sector I can see ICICI Lombard top ranking in Mint rating don’t know how and suggest me
    good insurer among ICICI Lombard , Religare , Star health ?

    Reply
    • Shridhar-1) It is for you, child and spouse.
      2) To me both.
      3) I am not aware about their ranking strategy.

      Reply
      • Thank-you Basavaraj !!
        Irrespective of mint ratings can you please suggest good among ICICI Lombard , Religare , Star health ?

        Reply
  19. Sir,
    Nice reading your post.
    I havejust taken Max Bupa health Companion policy.I was about thinking doing between Religare care and Max Bupa but after call from some policy X site personnel.But after reading ur post with checking the ICNR data i am contemplating Religare one.Please advice.

    Reply
    • Biswajeet-If you already purchased it, then better continue the same.

      Reply
  20. Hi
    I m 32 unmarried. Earning 50k/month.
    I wanna go for cashless medical insurance.
    I have diabetes n currently taking physiotherapy for disc buldge.
    I wanna know which policy will help me.

    Reply
  21. dear how can i discus my quries with u.

    Reply
  22. Dear Sir,
    I have taken STAR health family health optima policy since last 3 years. Also I have not taken any claim. The SA is 2 Lakhs bonus 30 K. I have received call from broker company to change above policy with Apollo munich because STAT health will change his conditions in future. but Apollo premium is increasing by Rs 6 K per year.

    Should I port my policy with Apollo ?
    Is STAR health is not good ?
    What is claim settlement ration of both company ?

    Reply
    • Rajesh-How come the so-called broker came to know that Star will change it’s conditions in FUTURE?

      Reply
  23. i am 25 years old looking for a individual cashless mediclaim policy. I have pre existing eye disease for which i have gone through multiple surgeries.
    i want a policy to basically cover my expenses related to eye treatment.
    Please help me in choosing a good policy.
    I have two companies in mind Bharti AXA and Cigna TTK.
    Please suggest any other policy if you feel so.

    Reply
      • yes …cigna is covering it after 3 years and bharti axa is covering it after 4 years.
        which one to choose?
        My primary question is which insurance company has the best claim settlement record?

        Reply
        • Aakash-Both are good and bad. No one can assure that this company will settle 100% claim or that company reject your claim. It is your features, premium affordability, and comfort with insurer that matters.

          Reply
  24. Hello Basavaraj,

    I am planning to take health insurance policy for my parents (age father 59 ,mother 56) with no major problems till now with SA of 5 lakhs.

    I have shortlisted 2 policies

    1) Max Bupa Health Companion โ€“ premium starts with 26k and reaches to 34k by 5th year , with SA increasing by 1 lakh each year till it reaches to 10 lakh

    2) Apollo Munich Optima Restore โ€“ premium starts with 28k for first 2 years and then jumps to 38k from 3rd year but here the SA insured also becomes 10 lakh from 3rd year onwards.

    Can you tell which of these should I take. Also will it be more beneficial to get a higher SA assured with a top up with Max Bupa rather than pay extra premium for 10 Lakh for Apollo Munich.

    Please let me know.

    Many thanks in advance

    Himanshu

    Reply
      • Hi Basavraj,

        I also have similar query. I found MaxBupa HC V2 better in policies then Apollo Optima. Besides Apollo cost increases exponentially with ae bracket and MaxBupa cost is increase on yearly basis say 3%.. which infact turn out economical. But MAXBPUA CSR/ICR are all much lower. Should I worry about these CSR and ICR as Apollo claime 90%++?

        Thanks

        Reply
        • Reema-ICR data is raw. You can’t rely on this data and decide the company. It is just an indicator but not a major factor to decide.

          Reply
  25. HI,

    I want family floater policies

    1. Myself (34) and my Wife (32)
    2. Father (65) and Mother (63)

    Please advise on below
    a)I believe taking 2 separate policies is better. Please advise
    b) I don’t want CAP on room rent.. Which company to go for Religare or Star.
    c) Can Co-pay be avoided in either of these policies ?

    None of the 4 members have any medical problem till date by gods grace… Please advise

    Reply
  26. Kindly help me Mr basu .sir my name is Mr Vishal and I have taken family policy from star health and they are bypassing the rules and regulations in claims passing .what should I do if insurance company is violating terms and conditions.if have marked a mail to irda and grievance of company but nothing has happened.kindly tell what to do?

    Reply
  27. Sir

    I am looking for health insurance for my parents . Father 57 and mother 47. i have wife,kid for whom i have taken seperate base policy and top up. ALso, i have health cover of 3 lacs from my employer which i can use for my parents , if needed.
    Now my doubt is , should i buy a base plan and then top up for my parents.

    If yes, pl suggest a decent base plan with reasonable premium charges.

    As far as super top up is concerned , all are in range of > 20 k per annum premium except L&T . Is L&T good to buy ?

    pl ssuggest

    Reply
    • RAvi-I suggest to increase your parents health insurance coverage for around Rs.5 lakh. You can check with Star, Apollo or Maxbupa.

      Reply
      • thanks sir . you mean sperate pbase plan of 5 Lacs , right ?

        2). what about super top up of L&T ?

        pls advise

        Reply
        • Ravi-1) Yes. 2) First buy base plan for parents, then look for top up.

          Reply
  28. Hello

    I am 31 years, wife 25 years and daughter 2 years. Please suggest me best health insurance plan.
    1. Religare care
    2. Apollo Munich Optima Restore

    I want to go with hasle free company which don’t delay during claiming and increase the premium when claiming is done for a year.

    Reply
    • Vamsee-Both are best companies. You can chose the one which comforts you.

      Reply
  29. Sir

    I am Sai Krishna 30 years age, wife 25 and Son below 2 year age group.

    We stay with our parents , Father 56 ( Diabetic ) and mother 47 with no issues.

    My employer covers all of us with 3 lacs coverage per annum.

    Since this amount is very meager, i want to go for personal health insurance policy . Can you pl suggest some best options available.

    1. Should i go for total family flaoter
    2. or should i take one for me,wife and kid and another for my parents.
    3. Also, pls suggest which company is good to go for w.r.t hassle free claim process and good claim ratio.

    Thanks in advance

    Reply
    • Sai-1) Better you separate your family with parents.
      3) There are many. I can’t specifically mention.

      Reply
      • Ok many thanks.

        1. should i take basic policy and then go for top up cover ?

        2. Amongst Religare, Cigna TTK and Apollo Munich which company offer good features ?

        Thanks

        Reply
  30. hello sir,
    my name is hitesh, living in mumbai.
    I had purchased star health optima plan last year. i hadn’t claim in this period.
    now it’s time for renewal of my policy. but i think the premium is little bit high.
    so i got help from Policy X website. they suggested Religare over star health .
    they told me that religare has more facilities with approx Rs 1000 less in premium as compared to Star Health.
    can you suggest me which is the best company to select from the above.

    Reply
  31. Dear sir

    I am 55 years old and have Rs 3.5 lac family health insurance paying premium around Rs 16000 p.year(myself my wife with my 22 years son) with star health from last seven years and not taken any claim till last month , this April 7th we admitted my son in global hospital pearl Mumbai for the treatment of ACUTE VIRAL HEPATITIS

    when the time of admission we told the hospital that he consumed alcohol on 3rd April Sunday and he omitted on Sunday with blood and some black tar like substance and even other days also from Monday to Wednesday without consuming alcohol he was omitting regularity
    then we taken a blood test on Wednesday and the result showing that SGPT & SGOT is more than 2500 so we admitted in GLOBAL HOSPITAL
    ACUTE VIRAL HEPATITIS normally getting from the food and water from outside and it no where related with alcohol still star TPA Rejected our claim

    please help me in this issue ,

    Reply
    • Babu-If you have concern, then raise the issue with company then with IRDA.

      Reply
      • After star rejecting the claim almost 2 times and giving me lot of mental stress I gone to star grievances cell where I received the claim , I will never ever go to star health insurance again ,Thank you sir.

        Reply
        • Babu-Thanks for sharing your bad experience. But each claim is different. We can’t generalize and blame the insurer.

          Reply
  32. Dear Basavraj,
    I am 44 years old, Wife is 35 & daughter is 10 years Old. I would like to opt for a decent Family Floater health Insurance around 5 lakhs. I don’t want any Co pay option. Can you please suggest me any public sector, Private sector or Stand alone Insurance company

    Reply
  33. Hi,
    I am currently 42 with okay health. I have a son of 8 with no medical issues. My wife is 34 having Limb Girdle Muscular Dystrophy (LGMD) and father (69) with asthama, prostate (to be operated), gallbladder stone issue (to be operated). Mother is 67 no medical history except age related like little joint pain, cataract (one eye operated).

    My employer covers all of us under group medical insurance. Till now this group policy was not attractive (SI-1 Lac, balance are sometimes paid from common pool) but next month onward they are trying to improve it.

    1. Shall I consider of having a parllel mediclaim policy for my family.
    2. If yes, one policy for all for in 2 or 3 policies (one for me and son, one for wife and thirs one for parents.
    3. the purpose of my taking a policy now is to taken advantage of continuity benefits on retirement. There are so many companies in the market. What if the insuring company runs away/ gets closed. Since this planning is for next 40-50 years, there are many possibilities/ risks. Shall I prefer Indian company in such a case rather foreign.

    Reply
    • Sanjeev-1) YES. 2) One for your family and another for your parents. 3) They can’t run away in middle. Don’t worry.

      Reply
  34. Hello Basavaraj,

    Which is the best International Travel Health Insurance policy for my mother aged 57 years old, for travel to Canada for 183 days?

    Is there any cashless policy which also covers pre-existing ailments?

    Which company has the best Claim Ratio for International Travel Health?

    I look forward to your prompt response.

    Thanks & Regards,
    Suhail.

    Reply
  35. Hi,
    I am planning to buy health policy for my father (65) & mother (61). I have sorted out 2-3 options.
    Request you to advice on it. My father is having B.P problem & mother is having Diabetes. Following are the health plans –

    1) L&T health insurance.
    2) Max bhupa
    3) national insurance varistha (Senior citizen)

    Reply
  36. Hi,

    I want to take Health insurance for My Mother ( 59 years old)
    I contacted Easypolicy for that purpose and finally filtered out Religare Care plan.

    Now my concern is — Should I buy this through Easy Policy or should I look for an agent Religare to buy policy

    Which of these 2 options will help me in availing claim settlement process.

    My friends are saying to prefer insurance agent instead of easypolicy.

    Please suggest regarding this.

    Regards,

    Vikash

    Reply
    • Vikas-Go with agent only if he is next to your home and you are confident of his service.

      Reply
  37. hello

    i m planning for health insurance

    in the terms of service and claim settlement ration which company is better

    1. Religare
    2. Max Bupa
    3. Cigna TTK

    Reply
    • Mahebub-All are best. But first look at plan features than company.

      Reply
  38. Basavaraj,

    Which is better: single private room or no room limit?

    Thank you.

    Reply
  39. hello basavaraj,

    I like to take a health insurance policy for my mother(61). we are located in kerala. i need No room rent cap and no co-pay. Pls give your comments

    1. Is it worth to opt on health insurance.
    2. what should be the avg sum insured for senior citizen.
    3. which insurance is trouble free claim settlement.(not to run behind them)
    4. which have more or good features.
    5. is it good to have critical illness plan.
    6. how do you rate hdfc ergo health suraksha/sbi/star.

    Reply
    • Rinu-You can chose senior citizen plans offered by insurance companies.
      1) Yes, but not depend fully on insurance.
      2) There is no such yardstick.
      3) All are equally good and bad.
      4) Generic question. Hard to specify particular.
      5) Buy it only if you have such family history.
      6) I rate in the same order like you mentioned them.

      Reply
  40. Hi Basavaraj ,

    I am looking for mediclaim policy for my mother, She is 62 years of age.
    I am confused between two policy for Senior Citizen.

    Oriental HOPE & United Insurance Senior Citizen policy, Which one is better & why?
    Another question is why public sector companies provide less coverage for senior citizen? & what should I do to get more coverage?

    Another question is why people prefer mediclaim policy from private insurance companies inspite of they are more costly & thet have high complain ratio compare to government policy?

    Thanks,
    Tausif Shaikh

    Reply
    • Tausif-You can go with United. They are providing less coverage, may be they feel risk is more. If you need higher coverage, then go for private sector. Check your facts, public sector companies are bit costly than private insurers.

      Reply
      • Thanks Basvaraj for quick response.

        I need more suggestion from you.

        I am citi bank credit card holder, and citibank is offering one health insurance in association with Royal Sundaram. Plan name is HEALTH FOREVER. Here is the link for the same:

        https://www.online.citibank.co.in/products-services/insurance/health-accident/health-forever.htm

        They are offering cover of 3 lacs in premium of 11k apx for 62 yrs of age adult

        As you know i am looking it for my mother.

        And main doubtful thing is that they are asking to submit 3 test report of my mother.
        1. Blood report.
        2. Urine report.
        3. ECG report.
        And they will issue insurance policy on basis of this report.

        Q.1 Is this reliable policy????

        Q.2 Is it advisable to buy this insurance?

        I would really appericiate your help in this.

        Thanks,
        Tausif

        Reply
        • Tausif-It is a group mediclaim. But not found a detailed features. You check for the same with bank officials. Provide the test reports.

          Reply
  41. Hello Basavaraj,

    Appreciate all your suggestions you have been providing to public.

    I have few queries:

    1. Do all companies allow portability for health plan. what if i want to change my health plan after 2-3 years from one private company to another. Do I have to pay hefty amount due to increase age or it will remain same as previous company.
    2. I heard Max bupa do not increase yearly premium as per age bracket but around 1% increase per year. is this correct
    3. I have a family cover for 2.5 lac from my employer with a co-pay of 20%, which I dont like. Do I need to declare this while taking my own family floater.
    4. I am 37, wife 34 son 8 year old, want to take 5 lac cover. confused between icici, maxbupa, religare, apollo. Please suggest which is better in terms of service, customer care, fast approval
    5. Do we get option to declare previous disease while taking policy online?

    Kindly advise…thanks a lot!!

    Reply
    • Deepak-1) Yes, all companies offer portability. Premium changes based on age slab. It depends on company you want to move. You have to check first with that company.
      2) It may be. But both are same at end ๐Ÿ™‚
      3) Yes, you have to declare existing policy details.
      4) All are equally good and bad.
      5) YES.

      Reply
      • thank you Basavaraj..

        one more query pls…what is cheaper of below 2 options

        1. Take a family floater of 10 lac

        or

        2. Take a family floater of 5 lac and then take a top-up of 5 lac.

        kindly suggest…

        Reply
        • Deepak-We can’t say which is cheaper. Because it depends on age and product you chose. But obviously second option is cheaper.

          Reply
  42. Mr basu I spoke to the doctor of star health insurance.what do u mean by pre existing disease. Can u believe the doctor told me that disease diagnosed after the policy inception and which is diagnosed at advanced stage is called pre existing disease .I asked my agent he told me that symptoms occurred after the policy inception is not a pre existing disease.I’ spoke to grievance people in the company about this but they said there are some new doctors which not aware of policy terms and conditions.Mr basu is this u called customer service of blah blah company like star???what should I do when doctors are not aware of policy terms and conditions.

    Reply
    • Gunjan-If it is doctor fault then why you blame me? At the same time, I am not pointing you fingers. Insurance companies have many reasons to reject. We the customers must know what we are doing.

      Reply
  43. Hi, good website. But you have conceptually misunderstood Incurred Claims. As you said at the start it is an accounting number. The KEY to note is that it is only for this period and not lifelong/ cumulative to date. Insurance companies set premiums as per market conditions but the claims they incur are not within their control and depend on other factors. So this ratio can change due to many factors, not just whether “a company is into profit” as you naively put. For example, it can depend on the profile of the customers that bought these policies IN THE PREVIOUS YEARS that might differ from each insurance co to the next.

    So to base your choice of insurance provider based on this is ill-advised.

    The claims settlement ratio on the other hand is a more reliable indicator.

    p.s: I have 10+ years of experience in the sector.

    Reply
  44. Dear Mr.Basavaraj,

    I , Am 50 Years Old , Looking For Medical Insurance For Me , since I have a slight heart condition request you to suggest which Insurance agencies can provide me a Medical Insurance.

    Many Thanks In Advance.

    Vishal.

    Reply
    • Vishal-All will offer with loading. Check with private insurers.

      Reply
  45. Hi Basavaraj,

    I’m looking for insurance policy for my parents who are 66 years old. Please advice on below questions.
    My mother is taking diabilities, blood medication on daily basis whereas my father don’t have any existing diseases so far.
    Please advice which type of insurance company – public/private or both I need to target, for sum assured of 5 lakhs. Do I need to consider joint policy for both or go with individual policy quote. If you can help me with selective insurance companies who offers policy with attractive premium for senior citizen would be great and offcourse claim process should be easy.

    Reply
    • Sachin-Go for family floater to them. But check first with public sector. Then go for standalone companies like Apollo or Star.

      Reply
      • usually you advice to go for two separate policy when one is having an issues and others none. Along with this sum assured 5 lakhs for example would be shared among them or each will have this sum assured. Please give some references of public sector companies and rough estimate of premium if possible.

        Reply
        • Sachin-My logic is not that. But usually in health insurance, premium will be fixed based on the oldest person of family. Hence, the difference between youngest and oldest member of family, then for separate.

          Reply
      • Dear sir
        pl provide star healh insurance co

        Reply
  46. Dear Basavaraj,

    I am 41 and covered by my company however want to take a medical insurance for 4 Lakhs from Max Bupa for myself annual amt appox 7069 while Apollo Munich (Easy Health Ind Exclusive) 4 Lakhs for my husband who had a suspected heart problem when he was 14 yrs old he is 50 yrs appox amt 9438.
    1. Since these companies have CIR of more than their collected premium, please confirm if these heath insurances are good
    2. Is there anything hidden that I need to consider
    3. Will there also be a 10% increase in Medical Insurance premium every year

    Regards,
    Sheena

    Reply
    • Dear Basavaraj,

      Request you to please guide me on my 25 Jan post.

      Many Thanks and Regards,
      Sheena

      Reply
    • Sheena-1) For your information, these companies CIR is less compared to public sector companies. They are into profit. Also, depending too much on CIR is not a right strategy. It is just an indication. But not a sole criteria.
      2) Read my latest post “Best Health Insurance Company in India-Based on IRDA 2014-15 Incurred Ratio“.
      3) Premium will not increase year on year. They set age slab. Once you fall into next age slab, then your premium will increase.

      Reply
  47. Hello Basu,
    I applied for the insurance of my parents, Religare Care 5 Lakhs floater. Insurance is rejected as my dad is having DVT. Now the policy bazar guys are asking me to go with Royal Sundaram. Request you to please suggest what are my options given my dad has DVT?

    Reply
  48. Sir I have taken a health policy from star health insurance .but after 4 months I have symptoms of sudden chest pain and back pain.but the problem of spondolysis is diagnosed.as per policy term and condition symptoms occurred after the policy inception is not a a pre existing disease.but their doctor is saying go anywhere ..even the grievance is also not helping me.what should I do?

    Reply
    • Gunjan-If you are sure that it was not there during policy buying, then you can raise the complaint with grievance cell of insurance company and along with that with IRDA.

      Reply
      • Irda is saying report to grievance cell.when I marked the mail I told them that my symptoms has occurred after the policy inception..they are not replying to me..If I go to court then it will take around 1 to 2 year.I’m asking if a customer gets claim from court.I told them that my symptoms have occurred after the policy inception but they are ready to pay my claim.I’m really disappointed if I get the claim ..what court will put penalty on this company as they are rejecting claims on flimsy reasons.

        Reply
        • Gunjan-Don’t go to civil court. You can go for consumer court, where the process will be bit faster.

          Reply
      • Mr basu I want to ask you if company rejects your claim and the customer gets claim from court..what u will say about technical expertise of those doctors.this is big mark on the insurance industry.I want to know your comments on it.

        Reply
        • Gunjan-Who are those technical expertise doctors? They are hired by insurance companies. They are not independent sometimes. Hence, they may act bias. So don’t trust their claim also.

          Reply
  49. Hi Basvaraj,

    I’m looking for health insurance, to cover my small family. we are three. Me and my wife are 33 years old with son (5 years old). My sleep apnea test was postive and using CPAP for last two years and wife got thyroid three years back.

    When I apply for insurance, believe both disclosures might increase price of insurance. Please advise, do I need to hide or disclose.
    Along with this, applying for one public and two private insurance will be a good idea or not. In India does insurance companies shares medical test results so that I will not be ended up with multiple exam results.

    Reply
    • Timmu-Yes, disclosing is MUST. Otherwise, it creates problem for you. I don’t think splitting is wise. Stick to one insurance. Sharing medical depends on health insurance company. You check the same with them.

      Reply
      • Thanks for your reply. I was looking for an advice to apply for one public sector and two private insurance companies at the same time. Is it a good idea and test results would be shared among them or ended up with separate test?

        How usually insurance companies discover existing diseases especially when one is not taking any prescribed medicine. Please help me to understand better.

        Reply
        • Timmu-I am against the idea of splitting. Rest is left with you. How insurance companies comes to know about existing diseases? They are into this business and know very well how people can hide. There are some diseases which are instant and some from past. So it is not hard to identify them.

          Reply
      • Hi,
        Thanks for your valuable advice.Can you please suggest me Any good private insurance and another in public sector insurance.
        Thanks

        Reply
        • Abhishek-First check your requirement, then select a product or company. I can’t specify any single.

          Reply
  50. Dear Mr.Basavaraj

    My Mother Sr. Citizen, Myself & My wife & Two children

    Reply
    • Karthikeyan-Better to separate your mother with your family.

      Reply
  51. Dear Basavaraj,

    I’m 37 with a wife (36) and kid of 5 yrs. I want to buy a health insurance for my family. I want a minimum of 10 lakhs rupees cover and can pay premium of upto 15-17000 rs. I want a cashless service with wide cover. I also do not want co-pay and want the insurance company to cover the entire expenditure. Please suggest a suitable policy for me.

    Reply
      • Good Afternoon Mr. Basavaraj

        I am 53 year old and my wife is 46 yrs. Both of us smoke and my wife has diabetes. I take Blood Pressure Medicines. Presently my family is covered by the organisation I am working for .

        However I need your able advice to explore a MEDICLAIM policy including me and my wife ( Family Floater is also an option) for the future medical expense post my retirement age of 58.

        Can you advice me on the same.

        Thanx in advance

        Reply
        • Tapas-You can check with public sector companies or privates like Star (offers health insurance for diabetic patients), Apollo or MaxBupa.

          Reply
          • Thanx a ton Mr. Basavaraj

            My trust is on Public sectors. Keeping that can you advise any particular public sector with reasonably good Claim settlement record also any particular scheme.

            Thanx in advance

            Reply
  52. Hi Sir,

    I am planning to buy health insurance for myself (24), my mother(55) and my father (60, suffering for hypertension).

    Can you suggest which policy should I buy ? should I take one policy for all or separate for me and my parent ?

    Also, I am posted in rural area in Bihar. What all policies are good options (claim settlement ratio, easy documentation etc) ?

    Thanks
    Shiv

    Reply
    • Shiv-You separate your insurance from parents. You can check with public sector companies or in private like Star, Apollo or Religare.

      Reply
      • thanks.

        Reply
  53. can u please suggest the health insurance policy which covers 3 adult & 2 child in india

    Reply
    • Karthikeyan-Who are those 3 adults and 2 children and what is the relation among them?

      Reply
  54. Hi Basava Raj,

    I am planning to purchase Health insurance for my Parents(Senior Citizens). Now my father is 64 yrs of age & my mother is 62 yrs of age. Please suggest best health insurance for senor citizens with smooth claim settlement ratio.

    Reply
  55. Want to take a top up health insurance policy for my parents aged 57 and 55, please suggest the best plans/insurers offering the same. The required coverage is Rs. 10,00,000/- , deductible being Rs. 4,00,000/-

    Reply
    • Star Is best plan for your Parents

      Reply
  56. Sir,
    for health insurance which company is better public sector or private sector.
    I have insurance with national and i want insurance plan for my wife , mother and father.
    please guide me.

    Reply
    • Rajendra-There is no such difference. Instead, concentrate on the features and premium of company product.

      Reply
      • Sir ,
        Thank u for reply.
        I am confused between national and apollo .Please help me . Because some features are better in apollo but premium is higher than national.

        Reply
          • Thank u sir.

            Reply
  57. Hello Basavaraj,

    Apollo Seems to be good with regards to your article and the benefits they offer like Restore, No Claim Bonus, No Room Limit, Co-Pay & few other things. However the only thing which is worrying is their ICR which is so low. I mean that is one of the most important points to be considered before we go in for a health insurance policy. Please advice if their ICR have got better for 2014-2015?

    Reply
    • Sharath-ICR is one indicator but not a sole or major indicator.

      Reply
  58. Dear Basavaraj,

    Myself Ashish Gupta aged 24, looking for a health insurance policy. I have my father (aged 52) working as semi-govt. employee , mother (aged 45) housewife ,one elder sister (aged 26) and one younger sister (aged 21). I have few queries mentioned below-

    1. Should I purchase a family floater policy or break it into two or three policies (say one for parents, one for me and elder sister)?
    2. Should I purchase it from Govt. or opt-out a Pvt. companies?
    3. Which one is best from United India, Apollo and Religare?
    4. Is claim settlement ratio decisive factor in policy selection?
    5. What features consist priority among all features?

    I want a good policy having normal amount of premium.

    Thanks in Advance

    Reply
    • Ashish-1) Break. 2) Check features and go ahead than concentrating public sector or private sector. 3) All are BEST. 4) To certain extent but not a major criteria. 5) Sum Insured, comfort with company, what is your requirement and premium affordability.

      Reply
  59. hello sir, i would like to take PNB- oriental royal mediclaim policy as i am a customer of punjab national bank. In this regard,please give your opinion whether to go with it or not

    Reply
    • Abinash-First check the features. If it matches, then go ahead. Otherwise, don’t buy blindly as if you are customer of Bank.

      Reply
  60. Sincere thanks for throwing light on this spectrum.
    i have a query too:-

    my father will complete 64 years in april end 2016 and is perfectly health except a daily b.p. pill to keep b.p. normal. he is currently insured under pru icici by a policy of 4 lacs which has some capping and is now discontinued by the company. as per my recent conversations with icici they dont have any new or rather no health insurance plans anymore. i am looking for a policy in which he will be covered reasonably in terms of number and type of diseases and the exclusion period for specific and pre existing diseases etc. i am looking for atleast 5 lac sa and although a zero co-pay is always better , dats not a deal breaker. my main priority is an insurer with good reputation of claim settlement and smooth processing. also plz advise if portability for pre existing disease and wait period etc can be availed if switching from icici hospital care to the new insurer?
    Also plz suggest a good policy for my mother who will turn 58 in may 2016. she has high bmi and was covered in icici pru which we discontinued as they were asking for more premium. she has an ankle fracture and was treated for same during her icici tenure. then we took cigna for her as none other were insuring her due to rejection in medical tests over bmi. my doubt is whether cigna is good company in terms of claim settlement ration and claim increment ratio as cigna issued her policy even though her bmi is above normal or acceptable limits?
    if yes then is it worth buying cigna for my father too

    ps: my father has not claimed anything in the last 10-11 years ever since he has started with health insurance. my mother has claimed for her ankle fracture surgery through icici and after that we discontonued it due to incleared premium

    Reply
    • Achal-I don’t think ICICI have no health insurance products at all. They are just lying. Anyhow, you can check with public sector companies for your parents.

      Reply
      • thanks for ur reply.
        i went in personally at icici office , they dont have a pure health insurance actually. what they say is a market linked plan which i think is not advisable. Icici lombard however does have a pure health insurance but i got super confused amid mixed opinions about its reliability for claim settlement ratio. What is your opinion on Cigna? would you recommend to go for Cigna ? Public sector insurers are good but i doubt whether their claim settlement process would be hassle free. plz advise. Also what would be the best option in terms of buying a policy and topping it up with a diff company plan?
        Many thanks.

        Reply
        • Achal-Oh..You mean ICICI Pru Life, but I thought ICICI Health. Cigna is the new entrant. So I can’t say anything on that. Topping is cost effective strategy, you can use it.

          Reply
  61. Hello Shri Basavaraj,

    Myself, Dr. Samir More, age 32yrs, am looking for a good health insurance policy for self, my wife of 31 years and my mother of 55 yrs. Myself and my wife and perfectly healthy but my mother is a known case of Diabetes and HTN.

    1) My question to you is whether I should go for a family floater plan or individual plans?

    2) Also, public sector vs private sector….which of the two provide better service and hassle-free claims with the premium not being too much of a limiting factor?

    3) Which is better between Max and Star and Bharti? Or should I go for some other provider?

    Thank you for your valuable time.

    Regards,
    Dr. Samir More

    Reply
    • Samir-1) You and your wife go for family floater. For your mother, better to go for individual plan.
      2) In my view there is no such difference. But before deciding, check the features you are looking for. If it matches with either public sector or private sector, just go ahead. Personally I inclined towards private sectors, when it comes to service.
      3) Star is cheapest. So if your concentration is on budget then star is best. But Max and Bharti are bit costlier than Star. Check the features.

      Reply
  62. Hi Basavraj,
    I am 30 years old & working for a MNC at a CTC of 5.50Lacs, where I am 100% covered. For my wife aged 29 I have a Maxbupa Silverbeat plan with a cover of 2lacs at annual premium of Rs.38oo approx.. The policy is 2years old, with next renewal in Feb2016. Now I am confused as:

    1. My Friend who is also an agent, suggests me to shift the policy to Apollo Munich.

    2. I feel, I need to change it to Family Floater by adding myself ( as who knows when I might Change my job)

    3.Seeing your blog on Best Health Insurance Companies, it clearly shows that Future Generali,Reliance, Religare, National & Universal Sompo are the best options for a Family Floater.

    So please suggest whether I should continue with the same, by adding myself or port my policy. If port, then to which company? And what should be the total cover amount for my wife & myself together.

    Reply
    • Praveen-No need to shift based on your agent friend’s advice. Instead include you in that plan (I didn’t understand what is 100% cover from your employer). If you still feel the plan is not suitable to you, then switch the products which you saw in my recommendations.

      Reply
      • 100% covered means, the company I work for, provides me a cover of any amount that incurs out of hospitalization.

        Secondly what should be the total cover amount for my wife & myself together.

        Thirdly the products you recommend are all from Public Sector & Private Sector where as Maxbupa being Standalone. So which one would be the best of these?

        Lastly Claim Settlement Ratio- How much does this matter in terms of Health Insurance, as you have tabulated everything based on ICR.

        Reply
        • Praveen-It is hard to say how much cover you need. But ideally, I prefer a minimum of Rs.5 lakh. I recommended all, but check which suits your requirement. Claim settlement is just a type of indicator but not a sole criteria to select a product. Don’t think too much on this.

          Reply
  63. Dear Sir,

    I am having a Mediclaim policy named “Health Suraksha ” from HDFC ERGO for last 4 years without any claim for my 3 member family (Myself-40 years, wife-39 and daughter-3).

    My policy has sum insured of Rs 1.5 lacs under critical illness and Rs 3.0 lacs under Hospitalization for which premium is Rs 9403/-.

    There is another policy associated with it named “Sarv Suraksha Advantage” with premium of Rs 890/- mentioning following benefits. (Death+PTD- 1.0 lac, Education Benefit- 5.0 lacs, Personal Accident- 1.0 lac). Total premium paid towards both is Rs 10,293/-. We don’t have any preexisting disease and fit and fine as of now.

    I have also earned cumulative bonus of Rs 60,000 each for myself and my wife and Rs 15000 for my daughter.

    Now i need your advice as my this policy got expired on 18th Nov, 2015 and i am considering to look for porting options.

    1. What is your opinion on cost front and the services of HDFC Ergo?
    2. Should i port out and look for other options? if yes, what do you suggest?

    Thanks
    Vikas

    Reply
    • Vikas-1) You can go ahead with HDFC.
      2) No..instead try to buy separate accidental insurance.

      Reply
  64. Dear Sir,

    I am planning to Medi Clam policy for me 24 and my brother 21, I got quote from MAX Bupa 100000 Per Person and 1500000 Lakh for both ( Total 1700000) . Premimum approx Rs. 10000.

    So request you please suggest the policy And which is best in settlement also.

    Reply
    • Hitesh-Without knowing your requirement, it is hard to guide or name few.

      Reply
    • Plz go with max bupa its really Good ..believe me they really provide great services.their services are excellent.

      Reply
      • Sneha-If your recommendation is as an agent, then stay away from recommending any particular product.

        Reply
  65. Hello sir,
    I am looking for insurance for my mother who is 59 years old. Could you please suggest a best health insurance plan so that my mother can get best in class facility.

    Reply
    • Manish-Check with public sector companies and the private sector companies like Star, Apollo, Max or Religare.

      Reply
  66. Dear sir,
    I have Apollo Munich optima restore family floter for 5 lac sI
    plus no claim bonus 4.5 lac which is up for renewal on 1st Jan
    I have two issues with the policy. One if a claim is made then bonus is reduced by 50%, Second after 80 years of age you can’t renew policy online. plus top ups not available. because of above issues I am thinking to port in Max bhupa health companion. please advice.

    Reply
    • Shalu-Regarding bonus issue, you might have thought about this earlier. Second, I feel 80 years of limit is suffice for our survival. Top up may not be available with Apollo. However, you can buy top up plans some other insurers.

      Reply
  67. Basava,
    I am 53 Yrs,wife 48 Yrs,Son1-24,Son2 18.I work for a multinational & covered through its Health Insurance Plan till 58 Yrs ,my retirement age.However,I had also done a Health Insurance with New India Assurance New MediClaim 2012 way back in 2007 for both me & my wife insured for Rs 250000 each & cumulative No claim bonus of 75000 each as never had to use it.My concern is with growing age & owing to diabetes (both me & my wife) & the impending retirement in next 4 years,should I change over my Policy to a Family Floater in some other Company with higher Premium & coverage of 10 L appx? Point to note is while insuring in New India in 2007,I did not have diabetes or any declared disease.Ease of settlement of claim is also a matter of worry.
    Will be grateful to get your wise opinion on the matter & any suggestive switch over proposal.

    Reply
    • Devashish-Considering your age and health, I suggest you to enhance the cover with the same insurer.

      Reply
  68. Dear sir,
    I am looking for a mediclaim policy for my family. I have short listed national insurance and religare, but confused about the claim settlement, can you suggest which one will be better for me? myself-46 years, wife-40 years and son-13 years and for a cover of 6 lakh. also suggest which will be better option between family floater or individual.

    Reply
    • Anjan-Plan features are best in Religare than National. Hence, better to go with Religare and family floater.

      Reply
      • Sir,
        Thanks for your prompt reply. one thing i would like to know that is there any specific advantages/disadvantages regarding service/claim settlement between public sector, private sector and standalone company, as Religare is a standalone company and National is public sector.

        Reply
        • Anjan-When it comes to service, public sector companies still feel they are in old 1942. So they may act as if they are not for you but you are for them to trouble. Hence, I prefer standalone.

          Reply
  69. Mr basu I want to know that my policy is rejected due to non disclosure of material fact about my previous insurance company.I marked a mail to the company that those policies were cancelled by me in free look up period.I want to know can I get fresh policy from them again.but I have no previous claims or any other active policies

    Reply
    • Vishal-If you don’t have any running policies or you mentioned all existing policies properly, then I don’t think there is a valid reason for rejection. You can apply.

      Reply
  70. Dear Basavaraj,
    I need a health insurance for me(37), my wife(31) and our kid(4). Looking for a sum assured between 5 -7 lacs. My question is can I increase the sum assured over the years. Today 7 lacs may seem sufficient, but 10 years down the line it will not be.
    Why do I need a critical care insurance, is a a good combination ? Which companies have good claim settlement ratio ?

    Regards
    Amartya

    Reply
    • Amartya-Yes, you can increase sun insured during renewal. Buy critical care only in case you have family history of such diseases.

      Reply
    • go with star total family cover in only 16419 including total cover 5lak(critical) and u will get PA cover of 5 lack with 50% no claim bonus….

      Reply
      • PA cover is free with health cover and no claim bonus is 50%.. ; )

        Reply
  71. Dear Basu,
    I recently applied for ‘Apollo Munich Optima Restore’ floater for my parents (Father 59.5 years, Mother 57 years). Their medical tests were carried out and Apollo has regretted to issue the policy to both of them. This is despite of the fact that both of them Do Not have any critical illness, BP, diabetics etc.

    Can you please suggest me another good option of Insurance provider and also where can we meet the medical fitness requirements?

    Reply
    • Girish-What reason they said regarding rejection? You can check with Star, National Insurance, United or New India.

      Reply
      • Hi Basu,
        Thanks for your suggestions.
        About rejection of Insurance, they said that there are problems in medical test results (LFT, High BMI, TMT, Ultrasound abdomen findings etc).

        Will we face the same medical test problems with other Insurance providers also or do their criteria can vary?

        Reply
        • Girish-It depends as what reports the other insurers ask for and how the reports be.

          Reply
          • Ok. Thanks a lot for your response Basu. As always your guidance has been very much helpful.

            Reply
  72. Dear Sir,

    We are four persons in my family Me (age 31), Wife (age 28), My Father (age 59) and My Mother (age 54). Sir i want to start mediclaim coverage for my family. We all are good in health except my father who has the problem of Blood pressure and diabetes.
    Sir, My question is should i go with Family floater policy in my name (and covered all other 3 members in that policy) or should i opt for individual policy for my father (or my parents) or Me and My wife?
    And Sir which companies / sectors (Private and others) product should i select?

    Reply
    • Ravindra-Buy separate plan for parents and one for your family (as a family floater). Go with Star, Apollo, MaxBupa, Religare, National or New India.

      Reply
  73. Hi Mr Basavaraj,
    Genuinely appreciate your service.

    I am a doctor and have been spending lot of time to upgrade my insurance cover. Too many options adding to the chaos.

    My family includes myself (36yrs) and my wife (36yrs) and my parents are 67 and 68 years respectively. Parents are covered under Oriental Insurance as family floater by my brother’s employer for SI of Rs 5lacs.
    My mother has many preexisting illnesses like diabetes, hypertension, thyroid and SLE (lupus). Father has no major illness till date. Me and wife are also healthy and are keen to have a baby very soon..

    I want to increase the SI to 10 lacs.

    1. I have a ULHP of ICICI Prudential for 5lacs (with Moderate Risk Fund) and my wife has same SI under National insurance. Is it wise to use ULHP or should I switch over to pure health insurance as is routinely advised?

    2. I want to increase the SI to Rs 10lacs..Should I go for family floater or do I take super top up for me and wife. (Coverfox exec told me that as mine and wife’s insurance companies have different dates of premium renewal, we cannot go for a floater)

    3. How can I increase the cover for parents? Star Red Carpet seemed a good option as the waiting period for PED is 1 year as opposed to 3/ 4 years for other policies, provided I am willing for copayment. Should I take a common policy for parents then?

    4. I am paying heavy premium of 15K pa for the ICICI plan. So considering to port out to another plan if possible. Also HDFC ergo & ICICI have more than double the premiums as compared to smaller private companies.Wish to know if companies like National Insurance, Apollo Munich or Max Bupa are better in easy claim settlements?

    5. Should I buy an exclusive critical illness cover for me and my wife ?

    I hope I have not made things very complicated for you to reply. Looking forward to hear from you ASAP.

    Regards,
    Dr S Kumar

    Reply
    • Kumar-1) I suggest you to come out of ICICI Product and opt for pure health insurance.
      2) Coverfox is nothing but an agent. They suggest which opt them higher commission. Hence, don’t follow anyone who have conflict of interest. In my view, if it is affordable for you to increase another Rs.5 lakh then go ahead. Otherwise, the best option is to opt for super top up.
      3) Please go ahead with Star.
      4) The companies mentioned by you for cheaper premium are best. You can chose anyone of them.
      5) critical illness insurance is bit complicated in nature (when it comes to claim). Hence, opt for it only in case you have family history of such diseases.

      Reply
    • Hi Mr Basavaraj,
      Genuinely appreciate your service.

      I am a doctor and have been spending lot of time to upgrade my insurance cover. Too many options adding to the chaos.

      My family includes myself (36yrs) and my wife (36yrs) and my parents are 67 and 68 years respectively. Parents are covered under Oriental Insurance as family floater by my brotherโ€™s employer for SI of Rs 5lacs.
      My mother has many preexisting illnesses like diabetes, hypertension, thyroid and SLE (lupus). Father has no major illness till date. Me and wife are also healthy and are keen to have a baby very soon..

      I want to increase the SI to 10 lacs.

      1. I have a ULHP of ICICI Prudential for 5lacs (with Moderate Risk Fund) and my wife has same SI under National insurance. Is it wise to use ULHP or should I switch over to pure health insurance as is routinely advised?

      2. I want to increase the SI to Rs 10lacs..Should I go for family floater or do I take super top up for me and wife. (Coverfox exec told me that as mine and wifeโ€™s insurance companies have different dates of premium renewal, we cannot go for a floater)

      3. How can I increase the cover for parents? Star Red Carpet seemed a good option as the waiting period for PED is 1 year as opposed to 3/ 4 years for other policies, provided I am willing for copayment. Should I take a common policy for parents then?

      4. I am paying heavy premium of 15K pa for the ICICI plan. So considering to port out to another plan if possible. Also HDFC ergo & ICICI have more than double the premiums as compared to smaller private companies.Wish to know if companies like National Insurance, Apollo Munich or Max Bupa are better in easy claim settlements?

      5. Should I buy an exclusive critical illness cover for me and my wife ?

      I hope I have not made things very complicated for you to reply. Looking forward to hear from you ASAP.

      Regards,
      Dr S Kumar

      Reply
      Basavaraj TonagattiBasavaraj Tonagatti says
      November 21, 2015 at 8:14 PM

      Kumar-1) I suggest you to come out of ICICI Product and opt for pure health insurance.
      2) Coverfox is nothing but an agent. They suggest which opt them higher commission. Hence, donโ€™t follow anyone who have conflict of interest. In my view, if it is affordable for you to increase another Rs.5 lakh then go ahead. Otherwise, the best option is to opt for super top up.
      3) Please go ahead with Star.
      4) The companies mentioned by you for cheaper premium are best. You can chose anyone of them.
      5) critical illness insurance is bit complicated in nature (when it comes to claim). Hence, opt for it only in case you have family history of such diseases.

      Dear Mr Basu,
      Thanks for your reply. I couldn’t reply earlier due to some other commitments.
      I am discontinuing my existing ULHP and will opt for pure health insurance very soon. As my wife’s policy renewal date is far away, can I take family floater policy for both of us if I stick to her plan?

      Reply
      • Kumar-If you want to opt some other insurer than the existing insurance (In your wife’s health insurance), then go ahead and buy now itself. However, if you have any plan to continue with same insurer, then you can enhance the limit and can also add members. But suggest you to check whether the insurance company provides such enhancing facility or not.

        Reply
  74. Dear Sir,

    I am 37 and my wife is 26. I am a Govt. of India servant… as being the govt. servant I would get CGHS benefits. I am thinking to buy a health insurance worth 3-5 lakh provided the insurer must provide single private room /icu without limits, Doctor consulation and surgicals/medicine charges upto sum insured. No-Copay , auto restoration facility must be available , am looking for Cigna ttk. kindly suggest me if it is ok..

    Reply
      • Dear Basavaraj,

        I want to hear your expert openion as per my requirement mentioned in my earlier query

        Reply
  75. Sir,

    When I comparison online health insurance plan no website show National Insurance product why?

    Reply
    • Sunil-It may their idea or they may not be receiving any monetary benefits from that company ๐Ÿ™‚

      Reply
  76. Dear Basavaraj,

    Would there be an advantage in buying health insurance through a broker such as Medimanage rather than directly? Would the claim settlement be easier and faster?

    Thanks

    Reply
    • Murthy-First think about online brokers, will they come to your doorstep and help you in processing the claim? They are good only to buy products ONLINE..but claiming and all, they just wash their hands.

      Reply
  77. sir i am 37 yrs old ,my wife 32 yrs and 2 children below 5 yrs
    my salary 85000 per month
    i would like to take health policy for 3 lakhs
    i shortlisted apollo optima restore
    hdfc ergo suraksha regain
    max bupa
    there should not be any co payments and sublimits
    hassle free claim settlement pls suggest

    Reply
    • Vishwanath-Whether you checked the co-payment clause in the shortlisted products?

      Reply
  78. Please let me know the claim settlement ratio of health insurance of Religare and Maxbupa in 2014-2015.

    Thanks in advance.

    Reply
  79. My father age is 66 yrs…

    Reply
  80. Before 3 months my father diagnosed multiple myolema – cancer. Tell me health insurance for my pappa… That will accept cancer a pre existing Dieses.. We are ready to pay extra premium charge also….

    Reply
    • Chetana-It is hard to get considering health status and the age. Check with few public sector companies.

      Reply
  81. Dear Mr. Basavraj

    Thanks for your highly informative blog.

    I am looking for a medical insurance plan for my family having 4 members: me (37), my wife (34) and two daughters (5 and 2 years old). My employer is providing me coverage of Rs 2L from Oriental Insurance (TPA Mediassist) but I am looking for higher SI. My annual income is about 4.5 L per year. My family does not have any significant history of disease. I can go for Annual premium of about 20k. In this case please suggest:

    1. How much SI should I go for – 10L or more?
    2. Royal Sundaram Lifeline premium seems to be providing the coverage with adequate features at lower premium. But I am not aware of its services and its ICR is quite low? Should I look for other options? If yes, what are those options?
    3. Should I take critical illness cover as well?

    Please note that I have a life insurance cover from HDFC SLIC of Rs 6 lac.

    Waiting for your suggestion

    Yours sincerely

    Yogesh

    Reply
    • Yogesh-1) It depends on the facility you look when you admit to hospital and the city where you opt for medical service. Ideally it must be at least equal to your yearly income.
      2) I am not sure about the service of this company.
      3) No..buy it separately (ONLY YOU HAVE FAMILY HISTORY OF SUCH DISEASES).

      Reply
  82. Deasr sir , please guide me best health insurence paln in Public sector and pvt Sector comapany I am 24 year old and my wife age 21 I want purchese a Family Floter Policy 4 Lac please guide me.

    Reply
    • Sanjay-One type of data is already available in above chart. Just check yourself about premium affordibiity, comfort with company and plan features.

      Reply
  83. WE have New India mediclaim of Rs. 125000/- (plus bonus of 31000/-) for each of the four members of our family. Husband, 53, self, 53, two daughters 21 and 20. WE want to port to a family floater of 500,000/-. Please give your opinion on Apollo, Bajaj, Star, Religare. We were looking at Apollo but from your c0mparison table, we understand that the claim ratio is very low. Please guide us.

    Reply
    • Shibani-Why can’t you opted family floater than individual plans? Any specific reasons for this and also why you now want to use portability option?

      Reply
      • Sir, we would like to opt for family floater because in the individual policies , there is a cap of 1% on room rent and therefore all the corresponding charges are also calculated on thatbasis. Also in this particular family floater policy, after one year if no claim is made, then cover / bonus increases by 50% and after two years by 100%. Pls give your opinion

        Reply
        • Shibani-I know that particular product feature. But this time if you go for individual or family floater? If family floater then I don’t have any issues.

          Reply
  84. currently my father (66) and mother (62) are having ICICI-LOMBARD health insurance for the past 7 years but at their age they are charging huge premiums, i want to change their to a low premium company, but seeing the results here it seems that ICICI-LOMBARD has one of the best claim-settlement ratio. so creates doubt in my mind whether to change or not.kindly advise.

    Reply
    • Dev-At your parents age it is costly to have health insurance. Also, other companies may reject the proposal considering the age or health issues (if any). Hence, my suggestion is to stick to ICICI.

      Reply
  85. I would like to open one medical policy for entire family and currently we all are covered from our employer provided medical insurance with complete coverage without any exception.

    But in future we need to get cover when we will return to India and settle down and hopefully not in near future.

    My family details are shown below, so please provide your package with annual premium so I can study the same and confirm.

    SL No. Name Sex Age DOB Remarks
    1. K. R. Satheesan Male 50 02-02-1965
    2. Ambili Satheesan Female 40 04-01-1975
    3. Akhil Satheesh Male 18 28-02-1997
    4. Ashwin Satheesh Male 14 12-09-2000

    Best Regards,

    Reply
  86. I have another question. I think Oriental does not have top-up or super top-up policies. If I go for base policy with oriental, can I go with other company super top-up if required later?

    Will it create any problems while claim settlements?

    Reply
    • Vageesh-Yes, you can buy top up plans from other insurers. But being within same company may be easy for claim processing.

      Reply
  87. Hi,
    Self (36Yrs), Wife (29), Father (62), Mother (57), Daughter (5) and Son (2). All are fit and fine (no existing deceases). We have a cover from my company for 4L (for all of us). Please suggest me I go with Oriental Happy family floater for all of us or should I take separate policy for we 4 and parents. Please suggest how much cover is necessary for us.

    Religair care was one I shortlisted earlier for we 4 but if I go for separating for parents, premium goes very high.

    Thanks,
    Vageesh

    Reply
    • Vageesh-Better you separate your parents. Because premium is fixed based on the eldest member of family. If you already have Rs.4 lakh policy from employer, then try to buy another Rs.5 lakh (assumption but if you feel more then buy it).

      Reply
  88. I want health for 2+1 for 5 lac. I have shortlisted Star and National Ins with Bank of baroda. Premium of BOB is lower than Star but confusion is with post hospitalization room rent. BOB is providing 1% of sum assured and star is providing upto 7500/-
    Please suggest me which one i should choose and also performance of both these two companies.

    Thanks,

    Ranjan

    Reply
    • Kumar-Bank of Baroda act like agent. Hence, don’t feel that it is owned by Bank. I think 1% of room rent is suffice in today’s term. But if it is the major concern for you then switch to Star.

      Reply
      • Can i become an agent of both religare and national

        Reply
  89. Bro
    My age 29
    Wife age 27
    Son age 6
    2nd son age 5 month ( diphgragmatic harniya with birth. 2 good surgery done and still in icu). No health insurance i have. Payed almost case 16 lakh.
    I want a health insurance with 20 to 25 lakh with cashless and great claim sattlement.
    Is my little son covered or i never tell them of his surgery. I mean i will hide.
    If yes then how much time if i buy a policy online in October 2015 then my policy start in how many months?
    Plz chat with detail. Im very sad.
    Some people’s give bad reviews for religare.

    Reply
    • Virender-First of all sorry for going through such horrific incident. I pray for recovery of your kid. Based on above data chose a company then go ahead. BUT NEVER DO A THINGS LIKE HIDING ANYTHING. It may actually turn into big issue or cancellation of policy also. Instead disclose all facts properly.

      Reply
      • Ok bro then plz suggest a best of best company who fulfill my requirement. Is dengue covered in these health policy or i buy a different policy for dengue. Also i want a critical illiness polocy also

        Reply
        • Virender-BEST OF BEST? Let me know first know your BEST ๐Ÿ™‚

          Reply
        • For Critical illness,go for standalone cover.Choose between bharti Axa,Religare assure and Optima Vital.These three are the best.

          Reply
  90. As per irda health insurance companies 2015 report give rank 1,2,3 etc. … From these (2014-2015) companies like Apollo Munich, Cignattk, Maxbupa, Riligare and Star health, please send reply immediately and as per irda give clamratio

    Reply
    • Please send reply immediately Sreenivasulu

      Reply
      • Dear sirvwhich company is better and please give rank 1,2,3,4,5 and select 5 companies please send repply

        Reply
        • Sreenivasulu-Form me all companies are good and equally bad. Chose the one which you feel comfortable.

          Reply
          • I thought you give suggestion here however you are giving more lacture than suggestion

            Reply
            • Sun-I am not an AGENT OR ADVISER to suggest you the product as a and look for the earning from that. I am here to make sure to educate and understand. I will never give readymade suggestion without knowing much of you. Sorry.

              Reply
  91. Hi Basu,
    One of your posts last year “Best Health Insurance Companies in India-Based on IRDA Data” says incurred claim ratio of Oriental for family floater policies is 73.57% and here in this post it shows 115.23%. Will it change every year?? and is it good to go with Oriental?? Pls reply.

    Thanks,
    Harsh

    Reply
    • Harsh-Yes, data changes every year. Oriental is good public sector company. You can go.

      Reply
      • I took a 5 lac cover for 36,000 + 20 lac super top up from L&T seeing claim settlement ratio of 91% for my senior parents

        I hope its okay?

        Reply
          • Hi
            is coverfox.com gud site ? do they really help in claim settlement ?

            Reply
            • Vaibhav-Only GOD knows. Because they are typically a broker. How can they come to your place and help on each individual claim?? Buy at your own risk.

              Reply
              • Sir religare gives a single pvt room eligibility

                is it better or worse than no room limit like L&T ?

                does no room limit mean we can take most expesive room in any hospital, which religre wont allow ?

                Reply
                • Vaibhav-Your understanding is correct. But each facility will be offered you with cost. Nothing is free. Hence, if you feel that is the major concern then go with L&T.

                  Reply
                  • Sir
                    a new thing i came to know. When i bought policy i thought premium will only rise as per premium chart. But now come to know that premium will be hiked in case we make a claim….. is this true that insurance co. can raise rates not following premium charts ?

                    i now thinking of going for “National Parivar Medical Plus Policy” which covers parents and for person of 30 yrs like me has premium of 50k for 30 lacs . Please advise really confused

                    I thought L&T 52k remium for 25 lac cover will be enough. But this remium hike issue giving me tension

                    Reply
                    • Vaibhav-Earlier insurance companies use to load the premium based on the claim. But now it is totally abolished. Hence, no need to worry.

  92. Dear Basu,
    Thanks for increasing awareness about financial planning and solving our query.
    Looking ahead to buy health insurance plan for my father and mother. Father is 64 and mother is 58 years old.
    Father and mother are having mild blood sugar levels .
    Selected max bupa health companion plan due to its no co payment, sub limit clause and life long renewability.
    1. Selected max bupa 5 lakh sa and l&t super top up of 10 lakh.Its good to have basic plan with supertop due to its cost effectiveness? Its coming as 50000pa.
    Other combination is Max bupa health companion with 10 lakh sa coming at 45k but most likely loading will be there.
    Which is better option and policy gets issued likely with no extra loading?
    2. Better to buy it from agent/Broker or through online ?
    Health insurance plan get issued easily and claim settlement is hassle free with proper guidance.
    3. Chances of loading is likely as they are having sugar at 115 level.Shall I declare the same or let it come into report. My experience is that if you declare the same prior… They will charge loading irrespective what comes into report.
    Looking forward for your reply.

    Reply
    • Abhishek-1) Yes, super top up plans saves your money. Go ahead. 2) In my view ONLINE. But if the agent is reliable to you then go ahead with agent. 3) Even if not declare, it will show in report and they load extra premium. Don’t worry ๐Ÿ™‚

      Reply
      • Thanks Basu for your reply.
        I was going throught the MaxBupa Policy Doc.But not able to understand the clause “The maximum risk loading applicable (for individual & family first policies only) for an
        individual shall not exceed 400% per diagnosis / medical condition and an overall risk loading of 400% per person. These loadings are
        applied from the inception of the initial Policy including subsequent Renewal(s) with Us or on the receipt of a request for increase in Sum
        Insured (for which the loading shall be applied on the increased Sum Insured).”
        What does it mean?
        Can you plz help me out to understand the same.

        Reply
  93. Hello Sir,

    I have zero idea about insurance. My take home salary is around Rs 75,000/month after all deductions like TDS, PF etc. My office has a medical insurance policy for me. My requirements are as follows:-

    1. I want to ensure health of my parents. Father(Hypertension patient) 55 years and Mother(Thyroid Patient) 50 years.
    2. I want a policy where everything is covered as much as possible including all types of illness and whatever may arise to the maximum extent.
    3. I want to be protected for any illness that may come after 5 years to them which we are not aware now.
    4. They get full body complete health checkup done in a year or two.
    5. The amount of the premium is not an issue, securing their health is the key issue here.

    Which is the closest policy that comes to my requirements?

    I am not looking for tax benefits or returns. I am just looking to secure health of my parents. Please guide me.

    Reply
    • Rohit-1) Health of parents or health insurance? 2) Sorry there MUST be some exclusions and conditions. 3) That can be possible. 4) It depends on the policy you buy. Check for the same during buying. 5) Check with National, New India, United, Apollo, MaxBupa or Religare.

      Reply
    • Hi Rohit,

      You can take policy for your parents but Apollo Munich , Religare and Max Bupa will not issue policy in case of person already have Hypertension and Thyroid, but I can suggest a policy which can be issue for your parents.

      Reply
  94. Hello,
    my self Anup Mishra 37 year old i am planning for buying health insurance for indiviual i have short listed three company Religare ,Star Health and Oriental Insurance company ,but my concern is regarding day care dieasies like dialysis and other only these private company saying that they are covering dialysis including medicine upto sum insured till policy tenure and also proveding super topup facility but government insurance company not covering dialysis under day care treatment but there preimium is almost same , why government company not proveding dialysis type dieases under day care treatment .Kindly suggest to which one i should buy

    Reply
    • Anup-Why the feature not included or added is purely a decision of insurance company. In my view dialysis is a major concern for you, then go with private.

      Reply
  95. I want to take a individual Mediclaim policy for my mother from National Insurance. My mother age is 50 yrs & 8 months. If i take sum insured of RS 45000 ——–
    1. is it mandatory for health checkup ?
    2. can i increase the sum insure up to 3 lakhs from 2nd year ?

    Reply
    • Rahul-Health check up depends on product rules. Check the same with National Insurance. Check whether increasing sum insured is available in that or not. But from your question I feel that in first year by going through small sum insured you just don’t want any medical check up. Once insurance company issue the policy then next year to increase it to higher sum insured. But insurance companies are smarter than you. Don’t try to fool ๐Ÿ™‚

      Reply
  96. Hi there…..
    i am looking for a health policy for my family of 2+2

    Myself 35
    Wife 33
    Kid 5
    Kid 3 months

    i need

    a minimum cover of 5lakh
    no sublimit
    no co pay
    private room with no minimum rent clause
    least number of excluded diseases
    clearity on NCB
    additional covers that are available
    health check up every year
    portability
    restore option
    claim ratio capability

    i have shortlisted Religare,Apollo,Max Bupa,Royal Sundaram & ICICI please suggest the best policy provider that will suite my requirements

    Reply
    • Ashutosh-Your’s is a dream list ๐Ÿ™‚ Whether the short listed companies offers all these? I doubt.

      Reply
        • Ashutosh-I will not believe on such ratings. Because if they downgrade after some point of time, will you cancel your policy? First look at your requirement, premium affordability and the comfort with company. Their ratings are generic but not specific to YOU.

          Reply
      • Hi
        My parents have 5 lac insurance with oriental. If they buy 5 lac insurance from say New india, will then they will be covered upto 10 lacs in case of hospitalization ? Will the hospital get 5 lacs from both ?
        how does it work ?

        Reply
        • Vaibhav-Yes they be covered under Rs.10 lakh. No, hospital not get Rs.5 lakh from both for a single bill of Rs.5 lakh. Insurance companies share the bill based on the proportion of insruance they issued.

          Reply
    • Frd I’m a insurance broker with clients from all companies .plz never buy your sensitive health insurance from Religare,royal Sundram as they are worst of all.rest all other companies are good.u must see into new entrants in the health sector like SBI, universal sompo , Larsen and turbo and liberty Videocon.choice is yours.but from my point I would suggest u max bupa

      Reply
      • John-Can you elaborate more about your EXPERIENCE about Religare and Royal Sundaram to specifically downgrade them?

        Reply
      • Dear John and Basu,

        I had a policy with religare care with client ID 51289899 for Rs.10,00,000 with super top up options. Last month just before renewal i just enquired through email about their claim settlement ration on individual claims. They didn’t bother to reply, when I escalated the issue to their head office, they replied ‘Go and check in our website” this was the reply from their corporate office towards an existing customer. If anyone of you want I can share the email with you.
        Hope both of u get some idea from this

        Regards
        Ajithchandran CB

        Reply
        • Ajithchandran-Why you have to contact them regarding claim incurred ratio? It is available on their portal or on IRDA.

          Reply
    • Go with max bupa

      Reply
  97. Hi,
    How is the Star health insurance company customer support and claim settlement ? Please suggest , i am planing to take new plan from star health.

    Reply
  98. hi, i want to take polocy for my parents and i am so confused about that , any budy can suggess what feature and benifits i should check in all companies?

    Reply
  99. i have couple of questions regarding the health insurance :

    CASE A: if a person took the health insurance policy and forgot to mention pre existing condition ( ex: thyroid) later he realized he need to declare, how to deal with this situation ?

    1) can he call the insurance company explain the scenario and update pre existing condition ?
    2) since its a thyroid so he can leave as is without any action ?
    3) is thyroid condition need to mention as pre existing condition ?

    Please advice your expertise.

    Reply
    • Ramki-If you missed any such declaration, then I feel you must visit the branch and declare the same in written and get copy of acknowledgement from the concerned. This clears your doubt and get proof.

      Reply
  100. Let me tell how I have differentiated Religare ,royal Sundram and star health .I will give u a live example.if u have any pre policy related queries.they never reply to my customers ..these are real fact .

    Reply
      • Mails response u can try yourself…

        Reply
      • Mails response for policy related queries…Religare ,royal Sundram and star never replies to me and my clients.I’m really pissed off with this behaviour

        Reply
        • John-But I get the immediate response with Religare and Star (earlier I was the customer with it).

          Reply
    • Can any health insurance company terminate agent code due to work or portability his policy to any other company with a different name code .?

      Reply
  101. Frds I’m a insurance broker with all companies.frds plz never go with these 3 companies Religare ,star health and royal Sundram.these are the worst of all .u can take health insurance from any other insurance company.plz read carefully terms terms and conditions carefully before going for any claim.genuine advice to all.

    Reply
    • John-I think you not representing the company which you said WORST COMPANIES. Can you elaborate more or specific to any cases? Shooting at air will not leads to any result ๐Ÿ™‚

      Reply
  102. Hello,

    Really great informative blog.
    Please guide.
    There are public health insurance company like oriental, new India and private insurance company like Apollo, star health. Now if I see average no of people prefer private insurance than public company. Here as per data public company claim settlement ratio is more than pvt. Company’s. Then what is the reason that pvt. Company is preferred over public company.

    As per your view what people should mostly check before going to any health insurance and which sector is more suitable as per giving quality service public or pvt.

    Please guide.

    Reply
    • Satish-What matters to all of us is the service and quick response, which lacks from public sector companies. They still feel that we (customers) are for them to trouble.

      Reply
  103. sir hello
    i am 42 yrs and i want to go for pnb oreintal royal mediclaim family floater policy beacause of its attractive premium 7000 for 5 lacs. please suggest me if i am not doing anyhing wrontg by choosing it.

    Reply
  104. Hello Sir,

    Can i be an agent for all companies.
    Plz guide me.

    Rgds
    Narayan

    Reply
    • Narayan-You can represent one general insurance company and one standalone health insurance company but not more than that.

      Reply
  105. Hello sir,

    Thanx for your valuable blog.
    Please guide me through health insurance plan for my parents (father 59, mother 51) for 2-3 lakh cover. There is no any premedical issue with them. Have checked some company, mainly family floter plan in appolo Munich and bajaj alianz. Please suggest any other company suitable for best claim settlement and service.

    Waiting for reply.

    Reply
    • Sujeet-Check with National, New India, Apollo, Star or ICICI.

      Reply
  106. Hi sir

    I HAVE TAKEN RELIAGRE CARE POLICY OF 5LACK SA WITH NCB AUPER ADD ON BUT GOT TO LNOW ABT UNIVERSAL SOMPO WHO IS OFFERING 5K OF OPD REIMBURSEMENT FOR A PRWMIUM OF 6450 Rs
    Would it be Good option To port to UNIVERSAL SOMPO?

    Also my bro is diognased with hepatitis B, any policy in market covering this illnesses?

    Reply
    • Prahlad-What is your main requirement? Whether it is NCB, OPD treatment reimbursement or something else? First understand your requirement then decide. It is not good to opt for portability only because of one good offerings.

      Reply
    • Frd universal sompo has excellent customer services but Religare is worst.but Mr basu is a authorised agent of Religare.

      Reply
      • John-Is it? If I am an authorized Agent of any health insurance companies and you prove, then I leave this profession !!! Will you prove it? For your information, I am not at all representing any particular company.

        Reply
        • Mr basu I apologise as I called u the agent of Religare.but believe me I have marked a lots of policy related mails to reliagre but they they never replied to my policy queries.so I’m really pissed off with the services of reliagare.I’m getting all communication from Religare through phone only ..if some company never replies to policy queries.what should I expect the customer services of Religare?

          Reply
          • John-It may be your experience, but as far as my own experience, I don’t have any such trouble even during claim.

            Reply
  107. Hi Basavaraj,

    Currently I have a policy offered by my company for me(42) , wife(37) and my 2 kids(11 & 8) . I want to take another health insurance policy for my family.
    My wife had a surgery for breast cancer, now she is fine. Please suggest a suitable health insurance policy.

    Appreciate your response.

    Reply
    • Rajagopal-You can check with National, New India, United, Star, Apollo, Religare or Max.

      Reply
  108. Dear Sir, thanks for your amazing effort on clarifying so many doubts from so many people !!

    My existing policies are as follows :

    1. Four member Family floater ( M-39, F-38, F-9, F-2 ) : 2 Lakh coverage from National Insurance. Four years old policy. Claimed once for wife which was got settled well.
    2. Individual 1 Lakh coverage for my mother ( F-62 ) from National Insurance who is a cancer patient with pre existing rheumatoid arthritis. The policy is just four years old and claim free.
    3. My corporate policy. 3 Lakh for entire family with 20% co payment for parent.

    Now, I feel to increase to enhance the coverage.

    My plan is as follows,

    1. To continuing with the 2 Lakh family floater.

    2. To go for individual fresh coverage of 5 Lakh each for me and wife. ( I have tried for online options but transparency level is remarkably poor. Religare Care + Union Bank offering Life time renewal offline, No sub limits for room , doctor fees etc. Total four years of restricted period etc. Which seems fine for me. I think, the private players are unpredictable in terms of changing policy clauses or premium values etc. While, Sub limiting clauses are more in case of Public players. Whom should I go with ? After four years of locking period, considering my age, I will left with very limited options for switching or go for new policies. Seems, Public players are more predictable in this case. Need your suggestion, What should I opt ? )

    3. To enhance coverage for mother’s policy to three lakhs. ( Should I go with the existing policy top up or go for a new one. Once this was dishonored for Pre Existing diseases ground. )

    Reply
    • Supriyo-I suggest to enhance your cover from existing family floater which you personally own. Regarding mother, it is better retain the Rs.1 lakh policy and at the same time increase your corporate cover. Because in corporate insurance, your mother already included. The existing disease clause usually not there in such group insurance.

      Reply
      • Thanks for your response !! Sir, The Family Floater from National Insurance will disburse only half of the sum assured ( ie 1 Lakh ) in a single hospitalization. They will not reimburse for same disease in a single year for same head. Room rent capping is there ( 1% per day , 25% in total ), Doctor charge also got upper limit.
        Contrary to that, Religare CARE / Apollo Munich claims to have no such capping.
        CITI Bank is promoting New India policy. Union Bank is offering Religare Care policy. Allahabad Bank is offering Universal Sampo. What is your opinion on these types of PPP models ? Are they more predictable and transparent ?

        Reply
        • Supriyo-PPP models is for business purpose. If the offering is not acceptable to you then go ahead and buy another insurance.

          Reply
  109. Hi Basavaraj,

    Thanks for the valuable info you are sharing with all.
    I have a query.
    I am currently having Max Bupa insurance for me and my wife ( 35 , 28 y ) , policy name — FamilyFirst Gold 5 lacs + 30 lacs
    So this has individual 5 laks coverage individually to me and and my wife and then the remaining 20 Lacs as floater.Last year premium was Rs 20,731.00
    Now I got a proposal from CITI corporate Health Insurance from New India Insurance – of 10 Lac each for me and my wife ( 10 L + 10 L individual ) , The premium from them is total for 2 — Rs 18,514 for both.
    So could you suggest whether I need to continue with existing Max Bupa ( the policy is going to expire this month end aug 30) or go with the new policy , the new india insurance also sum insured increases 5% annually if there are no claims annually the same case with max bupa as well.
    So request you to guide whether to continue with Max bupa or go with New India Insurance.
    Thanks and Regards,
    Rajesh.

    Reply
    • Rajesh-Before moving check for co-payment clause, up to what age they renew the policy, room rent charges also the exclusions. Because I feel this looks cheap but something is hidden.

      Reply
  110. Hello,

    My mother is 56yrs and has kidney and heart disease from 1yr .She is not on dialysis now. However, she has to visit doc for regular checkups every month and her medicine costs are too high.My father is 62yrs and is diabetic.We cannot neglect any emergencies and want to be prepared.Please suggest a good insurance company and policy that has best cover and affordable premium.

    Your reply will be much appreciated
    Thanks

    Reply
    • Priya-It is hard to get health cover with such health complications. But try your luck with few public sector companies.

      Reply
  111. Hi,

    I am looking to take insurance for my parents (aged 74 and 70).my brother is an advocate and has included them (for health insurance under bar council-advocates association)for one lakh.I have joined a new job which offers optional parental insurance (by mediassist)the premiums are 1lakh-around 13k 2 lakhs-19 k and 3 lakhs around 23k(inclusive of all surcharges and taxes).I need your help in choosing a right insurance policy for my parents(my mum is diabetic and dad has bp).I am new to this insurance I have gone through your article which has enlightened me with insurance.but to decide there are so many confusing factors.Please help on the following points.

    1.I felt Mediassisst premium(included preexisiting ailments)are on the higher side.what is your opinion.
    2.I am open for an insurance policy from any other provider which covers preexisting ailments and less /no loading and lesser copay.could you please suggest a policy.

    Appreciate your help.

    Thanks a ton.

    Reply
    • Latha-In my view better to buy an insurance with your employer. Because in that case claims will be easy. But at the same time, I suggest to have your own insurance which may protect them in case you switch or leave the existing company. Mediassist is not insurance company but a TPA. I think they are the TPA for your employer insurance. You can go ahead. Along with that buy an separate insurance on your own.

      Reply
      • Thanks for the prompt reply.

        The insurance provider will be united and Mediassist is the TPA.

        Will the insurance premium be less incase I take a policy from United directly?

        Also own insurance (independent of employer’s) can you suggest one please?

        also as mentioned in my previous comment they are covered under my brother’s insurance .

        appreciate your help ,time and efforts.

        Thanks again.

        Reply
        • Latha-If you go directly then the first problem you face is of existing diseases. They will not cover and usually there be some waiting period (usually 4 years). Second problem is, the premium will be higher side. The company provided insurance is group insurance and hence it will be bit cheaper. To own the insurance separately, I suggest to check with National Insurance Varishta Mediclaim (SA is Rs.1,00,000 only), Star, Apollo or Religare also.

          Reply
          • That helps a lot

            I will opt for my company parental insurance.

            Thank you again.,

            Reply
  112. Sir,
    Again thanks for your awesome articles and help. I just came recently to your website and can’t stop myself from reading all your old articles.
    I have one query regarding Health Insurance. I wants to take Health Insurance for two people which are Myself and also for one more person. But this person is not related to me as of now. I am currently engaged. I am planning to get married in next 1-2 year to my fiancee. So can I take Insurance for both of us as while looking in few forms it was mandatory to state Relation. Also is it possible to benefit Maternity claims if available after waiting period if we take Policy now but we will marry later.
    Thanks!

    Reply
    • Anil-You can’t propose on someone who is not relative to you. No before marriage you can’t buy a policy including the girl (with whom you not yet married) for maternity benefit.

      Reply
    • Sir i want public sector health insurance plan …because i can not belive on private insurance ..suggest best health insurance plan near about 15 lakhs for 3 person 32 /25/2. Age

      Reply
  113. Mr basu I am planning to buy max bupa platinum policy but I am having problem in their policy terms and conditions.i escalated the concern to Saurabh tripathi but he said that we can’t change our policy wordings.what should I do now?

    Reply
    • Sneha-Yes, they can’t change wordings based on individual client’s requirement. Either you have to accept or search for different insurer.

      Reply
  114. Dear Basavaraj

    Again thanks for your patience and time. You are doing an excellent service.

    My age is 37. I planned to buy an individual health insurance of 10 lakhs.

    I personally feel that it is risky to deal with private players rather than public players.

    So, to reduce the risk, I wish to go with 2 insurance companies. One with public player say “United or New India” and the other with private player say “Apollo or Religare” with each 5 lakhs. So, totally 10 lakhs. I know that the premium is slightly high if I go with 2 insurance companies.

    Please let me know if my idea is wrong. Also please let me know whether I will have any issue or problem in future.

    Your suggestion will help me.

    Regards,
    Guptha

    Reply
    • Guptha-If you feel insecure then you can split your insurance. I don’t have any issue. After all at the end of day it is your comfort with company that matters more ๐Ÿ™‚

      Reply
      • Dear Basavaraj,

        Thank you for your suggestions. I am thankful for your time and efforts.

        Today I tried to take health insurance from 2 companies (1 private and 1 public) for each 5 lakhs through online.

        But while applying online, it is asking for the existing health insurance policy details. I don’t have any existing health insurance now. Can I declare it as NIL?.

        But after taking the policy if I want to use both the health insurance in an emergency situation, then they should not deny that I have another insurance which is not declared.

        Please help me with your suggestions.

        Regards,
        Guptha

        Reply
        • Guptha-While buying the first one you have to mention as NIL. But while buying second policy, you have to mention the existing one.

          Reply
  115. Dear Mr Basavraj
    Thanx for informative articles. I am looking a policy for my son who is completing his graduation next year and will be 20 year old. I need a separate policy for him as me and my wife are covered by my employer. Pl suggest an optimum policy keeping his age and future requirement in mind. He will start working next year and is single.
    thanx

    Reply
    • Answer-Even if you both husband and wife covered under employer insurance, I suggest you to have your own. Whether your employer provides health insurance during your retirement also? If yes, then go ahead. Otherwise, better to you have your own. But a family floater by including all family members.

      Reply
  116. Could you suggest a good Health Insurance provider for myself ( 32 ) and my Brother ( 26) .Thanks Sir.

    Reply
  117. Dear Sir

    I want to buy health insurance for me & my wife. pl suggest which is best for for me keeping in mind service, Claim settlement ratio, support & premium.

    I want following things to be covered :

    1. Minor operations like herina, cattract eye sight issues etc. ( immediately after 30 to 90 days after i buy policy)
    In most of polices , this benefits they give after 24 months.
    2. Maternity benefits
    3. Critical illness coverage
    4. Pre diseases cover
    5. Reimbursement if i use non-network hospital like Fortis, PGI chandigarh etc.

    i have gone through Max Bhupa (family first plan )- for 15 lakh – premium is 18222/- , it is too high.
    Apollo is also there but i do not know much about their service, performance. CIR etc.

    Pl give me ur valuable advice.

    regards

    Sandeep Singh

    Reply
    • Sandeep-It seems you are going for surgery or hospitalization soon and that is the reason looking for a health insurance. No one can protect you in such situations.

      Reply
  118. Sir,

    I have Max Bupa Gold Heartbeat Gold 10 Lakhs for 2 Adults ( 36 and 32) and one Child 2 Years. My this years premium is 27,500. I have checked our Religare the same is 16359 for Super No Claim Bonus. What would you advice? Max Bupa claims that within my policy they also cover Critical Illness to the SA but I do not see it written anywhere within the policy. Please advice.

    Best Regards

    Gaurav Malik

    Reply
    • Gaurav-Don’t combine critical illness with health insurance. Just buy it separately.

      Reply
      • But do you advice that I discontinue the Max Bupa and go in for the Religare Policy. I feel a premium for 27,000 is unjustified almost for a similar policy.

        Regards

        Reply
        • Gaurav-I am not suggesting either to discontinue or continue. I just said separate the health insurance with critical. If the Religare is matching your features requirement and also within budget then you can go with Religare. You are the right person to judge it.

          Reply
          • Basavaraj,

            Your post is very much helpful in deciding the health insurance. Thank you for your patience and time.

            I have a question. I would like to know why you dont want to combine health insurance with critical illness insurance. Why you are telling to take both separately.

            Regards,
            guptha

            Reply
            • Guptha-Just compare yourself. You notice the when you combine then there are limitations. That is not the case when you buy separately. This limitation either may be sum insured or the plan features.

              Reply
  119. Dear Basu,

    Thank you for this wonderful blog !

    Basu, Just need your advice…

    I am planning to take a family floater with Sum Assured of Rs 10 Lacs where the NCB could go upto 20 Lacs if there is no claim ( 2 Adults + 1 Child )

    I have found Max Bupa Companion and Royal Sundaram Lifeline Supreme quite attractive. However I am not quite sure of their services in the long run and I have also found their premium low compared to others.

    Whats your take on this ? Which one do you suggest or is there any alternative ?

    Regards,
    Srivatsav

    Reply
    • Srivatsav-I am not sure about Royal Sundaram but I feel MaxBupa provides good service.

      Reply
  120. I want to buy Health Insurance for my Parents. Father Age โ€“ 52 & Mother Age โ€“ 49.
    Mother is having joint pain .is this considered in preexisting disease ?

    Please suggest which Insurance Provider is best for SI 4-5 lacks ?

    Shall i go with Religare or ICICI lomard ?

    Reply
    • Malhari-Joint pain is considered as existing disease. For me both are fine. Also, suggest to check for Apollo or some public sectors like National and New India.

      Reply
  121. Mr Basavaraj,

    First, thank you for such informative post.

    I noticed, mostly you’re suggesting buying health insurance from standalone companies e.g. Star, Apollo, Max or Religare even though their CIR is much less than other private sector companies e.g. ICICI, HDFC etc. I undersntad that public insurers can sustain on loss (with high CIR) but what are the advantage you see going with standalone insurers compared to private insurers? I feel ICICI with 93% CIR is very good compared to Apollo’s 65%.

    Reply
    • Nitin-First of all, I am not sticking my recommendations to any particular company. Second thing is, CIR is not a sole criteria to select a company. There are millions of reasons for getting hospitalized. Hence, we can’t generalize and say that based on CIR we must buy an insurance. We have to look for efficiency in claim settlement (adopting fast approach), features we are looking forward, premium affordability and comfort with company.

      Reply
      • No particular to a company but to group of standalone insurers…two of your replies here prove it

        Basavaraj Tonagatti says
        June 29, 2015 at 11:56 AM

        Sujit-You can check with Star, Apollo, Max or Religare.

        Basavaraj TonagattiBasavaraj Tonagatti says
        May 6, 2015 at 10:14 AM

        Sunny-Go with Apollo, Max or Religare (I am not aware about TTK). There is no advantage. But in case of settlement they may be bit generous.

        Reply
        • Nitin-I consider service as a major issue when it comes to health insurance. Hence, I am fan of standalone companies. You may think of I am biased and you are free to interpret it. Because I have any profit from recommending public, private or standalone companies ๐Ÿ™‚

          Reply
      • Yes, you’re not sticking a particular company but to group of standalone insurers. This is evident from your replies below. CIR is not only criteria but most important because delay in claim (public company) is better than denying claim (private standalone company). Will you prefer “efficiency in claim settlement” than increasing probability of claim denial ?

        Reply
        • Nitin-There are million reasons to be sick and at the same time insurance companies have million reasons to reject. Hence, depending solely on CIR is not best. Also, for companies point of view, approving is easy than rejecting. Because rejecting leads to proper answer to client or in some cases either court or IRDA. Hence, they must take into notice of that point. The data which IRDA publishes itself not indicate what are the major reasons for rejection. Then it is wrong to generalize and say that if a company rejection ratio is more than it rejects your claim too. You are saying “PROBABILITY”. Hence, I will not indulge in predictions. For me what matters more is complete disclosure from my end, understand the plan features and exclusions.

          Reply
  122. Hi, Do you have latest updated table of ICR published in current year?
    Thanks

    Reply
  123. Dear Mr. Basavaraj,

    Thank you for the detailed guide on how to choose the best health insurance, which is of great value to all of us.

    I have a question: I have a Religare Care floater policy for Rs.5 lakhs, which is one year old, and a Religare Enhance I floater policy for Rs. 5 lakhs which I have taken on 18 July 2015. Both these policies are for me and my wife. The Enhance I policy has “Deductible: Rs.5 lakhs”.

    Now suppose that I or my wife incurs a medical expense of say Rs.8 lakhs , does “Deductible” mean that I can claim Rs.5 lakhs from the Care policy, and the balance Rs.3 lakhs from the Enhance I policy? This way can I claim the full Rs.8 lakhs from the two policies?

    Secondly, if say the other person in these policies have any medical expenses in the same year, how much will be left to claim for the other person in the same year?

    Your reply shall be highly appreciated. Just want to be clear about how these policies will operate.

    Thanks
    Ravi Kumar

    Reply
    • Ravi-Care policy is treated as separate than the Enhance. Please read the definition provided by Religare about Deductible as “Deductible Plan works on the simple principle of Policy Deductible, which is the pre-defined amount that you will bear, through your own finances or any other source, during a medical event Any amount over and above policy deductible will be borne by us. The pre-specified deductible can be reduced/exhausted using the principle of aggregation. Simply put, if you opt for a 6 lac Sum Insured with deductible of 2 lac, then 2 lac will be borne by you and 6 lac over and above the deductible of 2 lac will be borne by us.”.

      Reply
      • As you said, Care policy is treated as separate from Enhance policy, but suppose that I or my wife incurs a medical expense of say Rs.8 lakhs for hospitalisation, can I can claim Rs.5 lakhs from the Care policy, and the balance Rs.3 lakhs from the Enhance policy? This is the idea of the Enhance policy, is it not, as a top-up policy?

        Ravi

        Reply
        • Ravi-In case the claim amount is less than sum insured then there will not be any problem. You can approach any insurance company (in your case policy) and settle the claim. However, if the claim amount is more than sum insured then insurance companies may raise the “Contribution Clause” will come into picture and insurance companies settle the claim based on the sum insured to % of cliam amount.

          Reply
          • thanks, but in the situation that I have mentioned, the claim of Rs.8 lakhs will exceed the Rs.5 lakhs of our Care policy, so can the balance of Rs.3 lakhs be claimed against the Enhance policy, since Deductible in Enhance policy is Rs.5 lakhs, and this Rs.5 lakhs I will claim against my Care policy.

            This is basically what I would like to know.

            Ravi

            Reply
            • Ravi-Yes, you are right. But I still suggest you to confirm this example with Religare. Because whether Enhance deductible of Rs.5 lakh is treated on whole claim amount of Rs.8 lakh or the left out claim amount (post claim settlement from Care i.e Rs.3 lakh). If they consider on whole claim amount then you can get it from Care and rest Rs.3 lakh from Enhance. However, if enhance policy considered only Rs.3 lakh as claim amount which they need to settle then they may turn up the claim stating that Rs.3 lakh will come under deductable amount.

              Reply
  124. Hello Sir,
    Please suggest me a best Health insurance plan & company for coverage of my entire family??
    Me-27 years
    Spouse-23year
    My Son-8 months
    My father-55 years
    My mother-46 years old,

    Sir pls Can you help me guide on which policy can be benificial?

    Reply
    • Sudhakar-In my view, better to separate your parents from you three. Let them have separate insurance. One more insurance for you, wife and a kid. For this, I suggest to check out with Star, Apollo, Religare, National, New India.

      Reply
  125. Basavaraj jee, I am continuing my mother health insuarance poliicy for last 6 yrs, with star healh red carpet, she is 73 yrs old. Can the policy claim still be rejected saying p.e.d and suppression of material fact?

    Reply
    • Anindya-It hard for me to say that they not reject. But at the same time, if you are with them since 6 years, I feel they not reject (again it depends on case to case).

      Reply
  126. Hi,
    I want to buy a health insurance for my family(me,wife and 1 child). My and my wife’s is age 31 and child is 3 year old.
    I have already a corporate health plan of 3 Lac SA which is provided by Employer. But I want to take a personal one which i want to continue with whole life. I am living in Ghaziabad UP.

    I have lot of confusions for choosing a Health Insurance company

    1. Which Company i need to choose? like Public or Private
    2. If answer is Private comp, which is best one?
    3. What should be sufficient Sum Assured?
    4. If i will take a plan from private comp and after some years comp shutdown their health insurance unit.
    in this case can i continue my plan with other company OR I need to buy a fresh plan.

    Thanks in Advance.

    Reply
    • KP-1) In my view both are same. 2) NA 3) Ideal sum insured in case of health insurance must be around 50% of your yearly income. 4) Yes, you can move to public sector companies using portability option.

      Reply
  127. hello bro,
    Im 37yrs old and my wife 32 yrs we have 2 kids 3months old. pls suggest a best insurance plan for my whole family. I want 2 to 3 lahks cover. with critical illness rider and policy should be renewable to life long or maximum age. thanks. pls reply.

    Reply
    • Siva-Insurance is required on you but not on your wife (is she is not working) and in kids name. Ideal insurance coverage must be around 15-20 times of yearly income. Now think how much you need.

      Reply
  128. Hi basu
    I had national family floater 5 lac for last 5 yrs. I want portability to Apollo munikh optima restore 10 lac as I cannot increase my sum insured with national policy. But 1 yr back I got some ear surgery and my son had some kidney disease 3 yr back which is now cured. These diseases were not there when I had purchased national policy and I got claim for these two.
    My question is that if do portability to Apollo ..these two will be preexisting disease.if I need any claim for these two disease in future..will Apollo give claim..their customer care say Apollo will cover these after portability as I am having previous running policy for 5 yrs..
    Will it be ok or Apollo will look any excuse to cancel claim
    Should I make it portable or keep these 2 policies for 3 years so that I take claim form national for these 2 diseases
    and then leave national ..after 3 yrs Apollo will in any case cover these
    Kindly suggest
    Thanks

    Reply
  129. Hi,
    Please suggest me a best Health insurance plan & company for coverage of my entire family me, my wife and my parents?? Thanks.

    Reply
  130. Hello sir
    I have purchased the heath insurance from religare i.e. Care for a sum insured of 5 lakhs. My age and my spouse age are 25 each. My question is when shall i consider increasing the sum insured ?
    Both health condition are absolutely fine.

    Also whether my decision is right to go with religare?

    Reply
    • Subhasish-You can consider increasing sum insured at the time of next premium payment.

      Reply
      • Actually i am covered under corporate insurance, so i decided to go for a lesser sum insured plan.

        Reply
        • Subhasish-Ideal insurance cover must be around 50% of your yearly income. If both the corporate and Religare combining cover is that much then no need to increase.

          Reply
  131. Hello Basavaraj

    I follow your blogs actively. For health insurance, it is important to also share with the readers that the premium increases over time. This is based on my analysis of the Apollo Munich and the ICICI Lombard proposals. The premium table (as stated by the agent) is fixed when you take it for the first year for the insured amount – and so the consumer has to pay higher premium when they move into the next bracket as they age. This is unlike a term insurance where the premium remains fixed over the period of coverage.

    It is likely that people end up paying an annual premium of Rs. 1 lakh for a coverage of Rs. 5 Lkahs.

    Thanks
    Sri

    Reply
    • Sri-Yes, it is known fact. Because loading will be based on age bracket the proposer or insured fall.

      Reply
  132. Hello,
    I need your help for choosing a good health policy for me and my wife. I am 32 and my wife is 26. We don’t have any critical illness and any hospitalization before. Can you suggest me a good health policy in terms their easy claim settlement and less premium. I need 4 lacs sum assured policy.
    Thank you in advance

    Reply
    • Sujit, for you couple you can try best in terms of maternity claim settlment and ped coverage you cna try national teller made plan

      Reply
  133. Hello,

    I want to buy Health Insurance for my Parents. Father Age – 65 & Mother Age – 60.
    Please suggest which Insurance Provider is best like: Star or Religare or any other option?

    Reply
    • you must go with govt companies i.e oriental, national

      Reply
  134. Great, thanks a lot Basavaraj for speedy reply on my earlier query!

    Could you also suggest for below:

    1. Is critical illness better from Apollo, as it covers more no. of deseases? Or do you suggest some other company?

    2. I have plan to take a total LI term cover of 2 Crores, out of which I have already taken 1 Cr. term cover of Aegon Religare and am planning to take 2 more insurerโ€™s policies of 50 Lacs each to diversify. Could you please suggest which are better ones, considering low premium and better claim settlement ratio?

    3. I have taken a personal health cover of 5 Lacs (Family Floater) from Religare (Care, Super NCB) policy due to its good features, especially Super No Claim Bonus (Super NCB) and recharge feature wherein SI is doubled if base cover exhausted. Hopefully this is good?

    Thanks.

    โ€”
    Br, Ravi

    Reply
    • RAvi-If you feel it covers more illness then go with Apollo. Why not the further insurance from Aegon? I feel no logic in splitting your sum assured. I too have my health insurance with Religare ๐Ÿ™‚

      Reply
  135. Hi Basavaraj,

    Thanks for sharing this valuable information. Could you please suggest which personal accident policy is better out of Apollo and Bajaj. Else, would you like to suggest any other better than these two?

    Is personal accident cover included in the health policies itself for companies (from statistics perspective) as I could not find Personal Accidental policy statistics from IRDA site? Thanks in advance.


    Best Regards,
    Ravi Aswani

    Reply
  136. i want to take health insu. plan for my parents in which OPD should be cover.
    my father is 54 yrs. and mother is 49 yrs old. There is no nay pre-existing condition.
    i want to take 5 lacs cover for both. within 15-20 thousand,but not should be expensive more than 20k.
    Please suggest me from which company i shoud take.

    Thanks

    Reply
    • Raj-No insurer will offer you and cover the pre-existing diseases.

      Reply
    • Dear Raj, there is no any company whcih can wave you off ped waiting periodfo 4yrs and 3yrs .

      but if you talk about opd you can try with icici lombard,star health ,cigna .

      but i would suggest you also try for medhealth opd cards basically of opd only

      Reply
  137. Can you tell me which is the best between RD & FD

    Reply
    • Ashish-Both are meant for different usage. RD can used for monthly or quarterly investment. Whereas, FD for one-time investment. Therefore, it is hard for me to say which suites to you.

      Reply
  138. hi ,

    I am 60 years old , planning to buy health insurance plan for me and spouse from any of nationalized banks health insurance products.

    Can you please suggest is Andhra bank’s AB HEALTH Insurance product good to buy?

    Reply
      • Which is the best health insurance,
        Private Or Public Sector.

        Reply
    • yOU CAN BUY NATIONL TELLER MADE POLICY WHERE PED WHOULD BE COVERED AND PREMIUM WOULD BE VERY LESS IN COPMPARISON OF OTHER HEALTH INSURANCE COMPANIES

      Reply
  139. Hi
    My retired parents have taken OBC mediclaim or 5 lacs in 7k. But i think limit is less ,especially 1% sublimits
    Please advise another policy of 5-10 lacs. We are most worried about claim settlement

    Reply
    • iF WORRIED ABOUT CLAIM SETTLEMENT PLEASE YOU CAN CONSIDER l&t,cIGNA,mAX AND ICICI,AND IN PUBLIC SECTOR NATIONAL AND ORIENTAL

      Reply
      • I want no which company is best in health policy ICICI Lombard or Religar .

        Reply
        • Rajesh-I personally feel Religare offers more features than ICICI.

          Reply
  140. Hello Sir,

    I want to take policy for me and my husband.We both are diabetic and below 30 yrs.

    pls suggest we want to take health cover.We both diagnosed this disease bcoz of some financial problems in family.can u pls suggest best for us.

    Companies cover pre existing disease after 3 yrs thats no problem for us but they need to take medical of us if we mentioned diabetes in this age medical they take ???

    if any company covers after 36 mnths & 48 mnths we are ok with that but the claims we get afterwards if any complications arise…

    As u know diabetes are not having complications in early ages if we hide and we need claim after 10 years then how company willa ble to diagnose etc..

    but we want to be honest but good claim settlement.Pls suggest your approach in our case.

    waiting your valuable feedback.

    Reply
    • Meena-I suggest you to check with first through public sector companies. In private sector, my recommendations are Apollo, Religare or MaxBupa. I personally have insurance with Religare.

      Reply
      • Dear Basavaraj Tonagatti,
        you must check the claim settlement ratio of religare, I am not commenting you, please check it, it have lowest claim settlement ratio. also never recommend apollo munich to any customer its a fraud company, Apollo Munich can increase premium any time according to there policy wording in addition to age group. recently they have increased the premium to 40% and at your age of 50yrs the premium of customer will be rs 2.7lakhs for sum insured of Rs 3Lakhs, Always ask your customer to buy health insurance from public sector insurance companies like oriental, new india, united and national if you are really a good financial planner.

        Reply
        • Pal-How efficient are these PUBLIC SECTOR biggies when it comes to responding to emergencies? I know how they behave. Regarding Apollo, if the feature of plan matching you and the claim is within purview of the insurance contract then even GOD can’t stop. Please note that, claim incurred ratio is not a single criteria to select a product.

          Reply
    • yOU CAN CAN TRY FOR CIGNA AND ROYAL SUNDARAM .IF THEY WILL REJECT THEN LAST OPTION NATIONAL TELLERMADE

      Reply
    • mEENA U CAN TRY WITH CIGNA ,l&t ,rOYAL sUNDRAM,AND NATIONAL TELLER MADE

      Reply
  141. Hi,
    Thanks for nice blog.

    Want to confirm if executive of any company make a false commitment and make us to buy policy. Is he doing the violation of IRDA rules and do we have any chance to challenge the company based on this fact.

    Notable thing is, every time conversation is on Recorded line but that is for company only. consumer don’t have any access to that.

    Reply
    • Gaurav-If you have valid proof then you can go ahead and compalin. But the problem is, in most cases you fail to produce the proof.

      Reply
  142. Dear basu. I have corporate medical insurance of. 5 lac from new india insurance and a family floater policy from national insurance for 5 lac ( one member can use only 2.5 lac ) .i want to add topup to these. I have shortlisted apollo Munich but then all policies will be from different co…will it be problematic at time of claim if I need claim from two co. Will it be more useful to take topup from new india co itself ..
    In top up policy if claim is rejected by first company ( like new india, national ) then the company which is supposed to pay the topup ( like Apollo munikh ) above certain sum will reject rest of sum of topup or will always pay the topup irrespective of first company

    Thanks

    Reply
    • Jai-For comfort and ease better to use the same insurer. However, it is not mandatory to hold both under one insurance company. Because what if you change job and new company not offering the insurance with New India? It is your comfort with a company that matters. Regarding rejection, they may or they may not. Because it is purely a decision based on case to case.

      Reply
    • Dear basu and jai,
      never buy insurance from any private company specially from Appollo Munich, these companies always hide required information from customer, Appollo Munich have increased the premium recently upto 40% by taking permission from IRDA, and according financial planners for a sum assured of Rs 3 lakhs at age of 60yrs the premium will be as below
      according to company after every 3 yrs (may be every years according to policy terms) apollo munich will increase premium to 40 % and let us make calculations for sum assured of 3 lakhs at age of 33 yrs premium is 10000/- approx, if ur aspect-ed age is 80 years
      total number of yrs for premium 80-33= 47 years
      total number of times premium increases 47/3= 16 times
      premium increases 1st time 40%> [email protected]%= 4000/- total premium of next 3 yrs= 4000+10000=14000/-
      and 2nd time increase in premium 14000*40% =5600/- total premium of next 3 yrs= 5600+14000=19600/-
      and soon… upto 16 or 17 times in ur life
      in addition to this regular premium increase according to age group 36 to 45=5000/-
      46 to 50=7000/-
      50 to 55=23000-/-
      56 to 60=32000/-
      61 t0 65=70000/-
      Now gross premium paid by you at age of 36=4000+10000+5000=19000/-
      after 3 year with 40% increase in premium to 39 5600+14000+7000=26600/-
      and so on……….
      at age of 60 years ur gross premium will be= 2.7 lakh for a sum assured of Rs 3lakh and at age of 75yrs premium will be 6 lakhs for sum insured of rs 3 lakhs
      this is how apollo munich optima restore plan lot the Indian people by a other country company
      and also optima restore option will not act effectively at that age and no other company will give u an option to by any other plan.. its premium increases exponentially after age of 45 years

      Reply
      • Pal-Premium will increase based on the age slab (irrespective of companies). Apollo may have some different slab. But fixing the premium is entirely the company decision.

        Reply
    • Dear BAsu What i would suggest you can try Super toup of L&T ,cigna or i.e. royal which is unique in industry.

      And one thing if your base company rejects any claim then also you can not claim from topup also

      Reply
  143. sir
    i want to purchase a health insurance policy for 5-6 lakhs. which company should i prefer public sector or private sector. name some good companies and policies

    Reply
    • Sudhadar-To me all are good companies. Hence, first understand your requirement like apart from sum insured what other features you are looking, premium budget and comfort with a company.

      Reply
    • You can go for ICICI Lombard health smart,max health companion,cigna plus,royal supreme

      Reply
  144. Mr basu I would like To tell you that max bupa company has permanently excluded ulcerative colitis and crohns disease.I’m really shocked that max bupa has permanently excluded ulcers in large intestine. I have read this thing in their policy wordings and they are saying that these are genetic disease.but when I visited mayo clinic website there it is written ulcerative colitis often occurs to those who do not have this disease in their families.max bupa is clearly violating the terms and conditions of irda

    Reply
    • Sakshi-May I know which terms and conditions of IRDA is MaxBupa violating?

      Reply
  145. Hi Basu,

    I am a IT professional and have 3 lakh mediclaim policy from employer.I want to take another super top up policy(family floter 2+2) 3 lakh deductible with more than 7 lakh sum insured.I know how topup and super topup policy works. I choosen United India(SUPER TOP UP MEDICARE POLICY) and L&T (Medisure SuperTopUp policy). L&T offering little less premium than United India.Also offering pre and post hospitalization.But pre and post hospitalization is not covered in United indias case.Even in L&T case, 12 lakh sum insured possible with low premium.

    But as per your chart, United india has better claim and revenue than L&T. Is govt company is better than private? L&T has coomited to give better response at the time of claim settlement.But I doubt about Gove case.

    Could you please review these two policies and guide me which one is better. I am looking for only super top up plan.

    Thanks,
    Pradipta

    Reply
    • Pradipa-When it comes to service, then private players always respond lately. Hence, if that is your core concern, then I suggest to go for L&T.

      Reply
      • Dear Basu,

        I want to share one incident with all the readers.

        Recently I wanted to take super top hearth policy, so I approached many companies and finally decided to take from L&T health insurance for 3 lakh deductible to 12 lakh sum insured. They approached many times.
        When I declared that my wife has preHypertension for last 1 year and no issue as of now, they told to take medical test. After that when I agreed and asked them to schedule the test, I did not get any answer from them, even they didnot replyed my mail. So they want only healthy person to take insurance.

        So in this case what we can do.?So Im thinnking, i will not declare anything now, and declare after 3/4 years of continuous renewal that i am suffering from that disease since last 1 year. As there is no alternative.

        Thanks,
        Pradipta

        Reply
        • Pradipta-Is it right from you to hide only because they avoided the business of risky? Let them not approach you, but you can approach and submit the proposal. If they reject the proposal then let them provide valid reasons for that. If they are doing wrong then why you too doing wrong by hiding the medical conditions? It may cost you in different way. Please don’t do.

          Reply
  146. hi,

    i would like to take a health insurance policy for my family. myself, wife and my baby of 1 year old. i would likr to inform that my baby was born with one kidney and he is fine . will i be able to add him in the health insurance policy, will it be considered PED….kindly clarify

    regards
    Ramreddy

    Reply
    • Ramreddy-This is unique case, I suggest you to discuss the same with insurance company.

      Reply
    • You can try with cigna and Royal

      Reply
  147. A very good article. I was looking precisely for claim settlement ratio but incurred claim ratio is an added bonus. I’m personally looking to migrate from New India Insurance health policy.

    Looking at this , i believe one should take into consideration is incurred claim ratio. It should ideally be between 80-90%, anything more than that and there would be chances of premium being increased in the future years.

    Reply
  148. Hello Sir,
    I am at the age of 36 going to have family floater (2A + 2C )from Max.
    I am having slightly hypothyroidism which is under controlled due to medicine and did not have any issue because of it at present.
    I used to take tobacco 2 years back but quitted since 2012.

    Please suggest me should I disclose Under Active Thyroid and Tobacco consumption to insurer before taking health insurance or this will automatically treated in PED?
    Should I avoid to disclose?
    Does premium will increase if tell them?

    Kindly suggest me

    Reply
    • Rajeev-Better disclose it. However, I am not sure whether they increase the premium or not.

      Reply
      • Thanks for getting back to me.
        Just one clarification sir.If someone hide it and disease occur due to hidden fact but after 5 years, ( after PED waiting time) then also insurer can raise issue?

        Reply
        • Rajeev-In theory no, but in practical insurers look for reasons to reject the claim ๐Ÿ™‚

          Reply
  149. I have medical insurance from New India Assurance. I have a coverage of 2 lakhs. I am 43years now, and want to buy a super top up plan for myself. for 10 – 15 lakhs. Please advice which one I should go for.Thank You.

    Reply
    • Sanchita-New India Assurance offers this plan. You can buy from them.

      Reply
  150. Hello Sir,

    I am 32 , married and i have a kid. I already (since 2009 Mar) have a term policy of tata aia for 20L and a ULIP of 18 lakhs. Also, i have a health insurance policy of 3L from Apollo Munich since 2012 Nov.
    I am diagnosied with Asthama 2 years back. Now, i want to close the existing policies and take fresh policies of term plan to 1 cr and health insurance to 10L. I want to disclose my health condition but i am not sure if insurance companies are going to decline the policy. Please suggest. Thank you very much for your suggestion !

    Thanks,
    Rama

    Reply
  151. Mr basu u r a promoter of religare health insurance company

    Reply
    • Sakshi-Not at all. Because if I promote or not, I will not receive any benefit from that.

      Reply
  152. Hi
    In continuation with previous question… If I add some other policy to national family floater and keep both..if at any time my hospital bill cross limits of one policy.. Can I get rest of billing from other company…
    How bills are divided if there r two policies and bill crosses limit of policies individually.
    Thank you in anticipation
    Appreciate urs help

    Reply
    • Jai-You can claim. Initially, you approach one company for the claim. Once they approve the claim then take the photocopies of bills and settlement summary and submit it to another insurer for approval of remaining cost. Otherwise, you can inform to the hospital about your multiple insurance companies. Hospital will send the request for approval to all insurers and accordingly it will be settled directly with the hospital.

      Reply
  153. Hi
    I have parihar – mediclaim family policy from national insurance for myself 41 yr wife 35 yrs two sons 8 and 5 yr for sum of 5 lac. I find it inadequate. I have this policy for 5 yrs. if I want to shift to some private insurance co or some other govt insurance co ( who give more sum assured like oriental for 10 lacs )…will the benefits accrued after 3 yrs of policy will be granted to me in new policy or not.

    If I take policy from national itself for all members individually ..will the same benefits be granted to us.
    How many companies offer 1 adult + 1 child type policies..will these better if I need higher insurance cover
    Thanx
    Jai

    Reply
    • Jai-First check for moving to the different plan in National only. In that case your existing benefits will get transferred to the new plan. Otherwise, you can use portability option to move from National to the different insurer.

      Reply
  154. Hi,

    I was looking at Religare, TTK, Max and Apollo.. and all of them looks good to me… Can you please suggest me one..

    Is there any advantage of public sector companies like national.

    I have only one requirement.. Company which settle claims and the process is simple

    Reply
    • Sunny-Go with Apollo, Max or Religare (I am not aware about TTK). There is no advantage. But in case of settlement they may be bit generous.

      Reply
  155. We are having health insurance at new india assurance myselfage31 father64mother55for 3 lake each with accumulated bons 30000 each now I feel new India peri mum is high I want to change company for the fast 10 years with new India so tell me which one best in public sector pls mail me thank u

    Reply
  156. Hello,

    I need health insurance coverage of my parents (father age 65 yrs & mother age 59 yrs). please advise options of good and best health plans and scheme.

    Regards,
    Sunendra

    Reply
  157. Dear sir as per claim ratio and services and future of policy which is better please send reply from these below companies Apollo, Cignattk, Marbury, Star health and Riligare

    Reply
    • Apollo, Cignattk, Maxbupa, Star health and Riligare

      Reply
    • Sreenivasulu-I prefer Apollo, Star and Religare. I am not aware about Cigntattk.

      Reply
    • Dear sir, please send reply immediately I want term insurance policy which is better for claim ratio and services and low cost premium my age 37 and I want term maximum how much is there that requires and give priority 1to 6 Companies sequence give names and please send reply THANQ Sreenivasulu

      Reply
      • Sreenivasulu-You can go with LIC, HDFC, LIC, SBI, Max, Bajaj enough?

        Reply
  158. Hi

    My father age is 72 Years old kindly advise for if any medical policy available either for his. or attached with my family flotter plans.

    Regards
    Suresh

    Reply
  159. Hi,
    Great article.
    Can you also help me with my query: I need to buy health insurance for my father (age 69 years) and mother (age 58). Which policy would you recommend for a SI of Rs 3 lacs each.
    Thanks,
    Kaushik

    Reply
    • Kaushik-You can check with Star and Apollo senior citizen plans. If you need lesser sum insurance then go for National Insurance.

      Reply
      • HI Basavaraj,

        First of all thanks for sharing such useful article.
        I have gone through your other comments based on people queries.
        I am a bit confused here. As you said in your article “higher the incurred claim ratio then it is good for you”. From the above table Apollo Munich is having 65.59% of ICR where as Oriental is having 115.23 %. But for few people you suggested to go for Apollo Munich. Can you please elaborate the reason behind it. And If I want to take a new health policy, which one should I go for. I don’t have any issue with a higher premium, but I need the best claim settlement and service.

        The second part is , My wife is a Cancer survivor. Four year back She got diagnosed with breast Cancer. Its god grace that it was in very initial stage. We did the complete treatment in Tata Memorial and now she completely cured. Last three years there is no re-occurrence of cancer and she is not going under any medication. Is any Health policy available for her . (I asked almost all insurance company, but everyone denied tough even I am fine with the waiting period)
        Waiting for your earliest response

        Thanks
        Bappaditya

        Reply
        • Bappaditya-I recommended Apollo based on the requirment and looking at the features of plans. Do remember that, considering incurred claim ratio for plan selection is one creteria but not the sole creteria. Hence don’t look too much on this data. There may be many reasons for hospitalization and there may be many reasons for rejections, which not known to us. Hence if the plan suites to you and premium within a budget then go ahead. Regarding your wife’s insurance, check with public sector insurers than private insurers. I am not sure who issues. Because it is purely a decision of insurers.

          Reply
          • Hi Basavaraj,
            I want to a family floater health policy pls. suggest any best policy,how is HDFC Ergo based on service and claim?

            Reply
        • Dear ,

          In Health Insurance Sector claim ratio means the profit and loss of the company.
          the higher it is, the higher the loss.
          it is just opposite of the Life Insurance Companies.

          please buy a policy from the company which has lower claim ratio.

          Regards

          Anil Lohia

          Reply
          • Anil-You mean to say the company the company which settles higher claims and be under loss is not good? In that case all Public Sector companies are totally BAD for you right?

            Reply
  160. Hi Basu,

    Thanks for sharing such a valuable article.

    Looking for a health insurance plan for my Father(63) and mother (57). I have selected floater Religare Health insurance Pan due to some of its unique features like no sub limit on Room and ICU charges, Auto recharge of the policy Sum Insured if exhausted,No ‘Claim based’ loading ever & Get Lifetime renewability,Get health check-ups for insured members every year.

    I am concerened with its low Incurred Claim ratio as compared with PSU and some private companies having TPA.Also have seen lot of negative reviews abouth Religare during claim settlement.What’s your take on this?

    Looking for Company having hassle free cashless treatment and smooth claim settlement when its required.

    Which is better option to buy a Policy ,to buy policy through company itself of through financial website like PolicyBazar,etc.

    Please guide me.

    Reply
    • Abhishek-I have policy with Religare. Better to go directly to Insurance Companies. I don’t believe neither financial websites nor policybazaar.

      Reply
    • Dear Abhishek

      I had also almost finalised a religare policy for parents (aged 57 & 54) . All other features are good compared to other companies. Only shortcoming is Religare doesnt cover the cost incurred towards prosthesis. I dropped religare at that point of time. These days after 50 years, knee/hip joint replacement are not uncommon. Cost of prosthesis is very high.

      Take a decision based on family history.

      Reply
      • Dear Abhishek

        You please download the policy wording from Religare website and go through it word-by-word. It make take some time but its worth doing.

        Reply
  161. Dear Basavaraj,

    I am a 30 year old software engineer working in bangalore. I dont have any pre-existing illness.

    Below are my existing policies:

    Oriental Family Floater Silver Plan (Myself, Spouse and My Mother) : Sum assured of 6 Lakhs
    HDFC CLick to Protect Plus Term Insurance (Myself) : Sum assured of 1 crore

    I am thinking of going for a critical illness plan for myself and policy bazaar recommend me Religare Assure and after reading the product brochure it sounds good.

    Could you please suggest me can i rely upon Religare Assure or should i go for Max Bupa or Bharti Axa?
    What sum assured should i go for or how do i know how much sum assured i should go for?
    Should i go for Individual/Family when it comes to critical illness?
    And finally am i insured sufficiently with my existing insurance portfolio or do you recommend any other extra add on to my insurance portfolio?

    Many thanks for your assisstance in advance

    Thanks and Best Regards,
    Raghavendra P

    Reply
    • Raghavendra-If Religare plan features attractive to you then go ahead. How much you need and whether the current life and health insurance are suffice or not depends on many things. So I can’t say in one word. Better you buy family floater critical illness cover.

      Reply
  162. Dear Mr.Basavaraj,

    I , Am 37 Years Old , Looking For A New Medical Insurance For Me And My Family. Wife Is 33 Yrs And Son 5 Yrs. Looking For A Cover Of Around 10 Lakh Rupees. I Have Zeroed In On Religare- Care , Star- Optima , ICICI – Complete , And Max Bupa – Heart Beat( Its Expensive). Could U Please Suggest Which One is Better. Many Thanks In Advance.

    Basawaraj Tegnoor.

    Reply
  163. i have checked the claim settlement ratio and claim incurred ratio of new india assurance. both the percentages are very good.

    Reply
  164. Mr basu you will yourself know that religare never replies for customer queries .totally inefficient staff

    Reply
  165. Mr basu u have purchased your health policy from religare .if u go for hospitalization they will never pay u
    Believe my words
    I wish u get your claim when u are in most need of money

    Reply
    • brother you are very rite… chor hai sale kutte. mera 73000 ka claim reject kr dia or no reply

      Reply
      • Vishal-Please use a proper language. I will not allow such harsh words.

        Reply
  166. Hi Basu,
    Very Interesting blog.

    I have a 6 Lakhs cover from Reliance General Insurance and I liked their services so far.
    In none of your blogs, I could read Reliance. Do you suggest to change from my existing insurer to some other company.

    Reply
  167. First of all thanks for such valuable information.
    I am looking for a health insurance, Comparing with these three: Apollo Munich, Max Bupa and Religare? Which One you recommend although i know you have Religare for yourself. But i am little bit confuse about these three’s claim settlement. My Age: 27, Wife:26. Lived in Gurgaon, Looking for 2lac Yearly Packages for two member. No pre existing diseases to both.
    Regards
    Anirban

    Reply
  168. Dear Basavaraj,
    Need a suggestion. I am 36yrs, planning to get a health insurance for myself for a cover of 5 Lakhs. I am thinking to split the sum insured in half and go with 2 different company. One with Private player, other with Govt firm. Reason being that govt players’ settlement/claim ratio is always higher than private players, but at the same time private players have more better coverage for cashless hospitalization. So basically putting money in 2 basket approach. Is this planning correct or better go with one firm? In that case which one will be better govt or private.

    Secondly – Which private players you would suggest – I have shortlisted ICICI Lombard – But premium too high; Religare – dont know if its reliable + claim ratio very avg/low ; Apollo Munich – Claim Ratio again very very low.

    Public player – United Insurance ; Oriental.

    Please help in the following matter.

    Reply
    • Rahul-I don’t think it is wise to split. You can check with ICICI, HDFC, Bajaja, and the companies you mentioned.

      Reply
      • So you are suggesting me to better go with a Private player. Any specific reason for that (since this suggestion will really help me in purchasing, as I am about to buy a health insurance today).

        Secondly Religare settlement ratio is on the lesser side and thats a stand alone firm, will it adviseable to purchase it.

        Reply
        • Rahul-I have not specified any particular company. First you must understand your requirement, premium budget, company existence and service part. Then go ahead with buying. I prefer standalone companies mainly because of expecting claims settled at earliest.

          Reply
          • So this is where my problem of selection is coming. Premium is fine with me, but service is a major aspect, where I am not getting that comfort with Public firm, but then their claim settlement ratio is probably the best.

            Now for example – In private player, Religare is giving a product which is value for money; but their sustainability in the insurance business is a question mark. Whereas ICICI is a stable company, but their product has lot of loop holes.

            So what should I do, please help.

            Reply
            • Rahul-A hint to go ahead ๐Ÿ™‚ I personally have my insurance with Religare. Because of it’s features, affordability and service they provided.

              Reply
  169. Hello ,
    I want to take General Insurance agency ,with whom i can go New India Assurance or Religare.

    Regards,
    Atul
    9595452646

    Reply
  170. i would like to know your views on the following with regard to health insurance.
    1. for a family of 4 (2adults and2 children), instead of taking a single family floater policy, would it be wiser to go for 2 floater policies each for 1A+1C. logic is the chances of adults getting ill is more with age.

    2. your opinion about top up/super topup plans.
    3. which of the 3 is better–a) single plan with large sum insured say 10 to 15lakh coverage or b) one plan for 10L and a top up of another 5 to 10lakhs or c) one small plan, family floater of 2 to 3 lakhs to cover small illness and a top up orseperate policy for a larger sum.
    4. there are conflicting opinion regarding need of critical illness plan. your take on that.

    i am presuming a small healthy middle aged family of 35 to 40 yrs with no history or predisposition to any major illness for self or in family

    Reply
    • Sunil- 1) What about the cost? 2) Its good option. 3) It depends on your requirement and affordability. 4) Yes…because it is complicated product. Also I suggest to you have if you have any family history of such critical deceases.

      Reply
  171. Dear Sir,

    I am 35 years of age and I want to go for the Happy Family Floater of Oriental Health Insurance. I want to cover my mother, 60 years of age and my sister (31 years) and brother (25 years). We don not have any preexisting illness but my father has cancer, detected on 2011 who cannot be covered under the plan now. The IRDA chart provided by you gives a good policy claim percentage to Oriental Insurance but is it hassle free? I have read certain online reviews which say that in Oriental the insurer has to run from pillar to post during claim settlement and hence private companies like Star and Religare are the better ones during settlement. Kindly provide me your suggestion regarding this matter. Public sector companies have less premium which suits my budget as my father’s treatment needs a good amount of money.

    Reply
    • Sumi-No need to worry about Oriental. But it concerns you then opt Star or Religare (both are best and I personally have insurance with Religare).

      Reply
  172. Dear Mr. Basavaraj,

    I am Ram. .
    My age is 26 Years. (Single)
    Father’s age 63 Years. (existing disease blood pressure)
    Mother’s age 52 Years (Asthma – but not been in any major treatment)

    Currently I am having health insurance for self of 2Lakhs and family health insurance of cover 3 Lakhs for parents from one of the corporate plan from mediassist ,
    From coming march i want to opt for one private company health insurance of cover 5 Lakhs or more for me and my parents either individually for me or group wise.

    Please suggest me on this.

    BR,
    Ram

    Reply
    • Ramkrushna-Is there any specific reason for opting of private insurer?

      Reply
  173. Dear Mr.Basavaraj
    I am very much impressed on this financial planning blog.At present ,I don’t have any health insurance.I have decided that I would like to buy Apollo Munich family floater plan in online mode.To resolve my query,one support staff called me and described the query.He also said that insurer do not require to send any document regarding KYC,no photo whereas in offline mode Kyc would be accepted.Would it be better to buy without Kyc and photograph and no signature in online mode?Waiting for your valuable suggestion.

    Reply
    • Uttam-Nothing wrong in this. At the time of claim you need to produce the ID Proof.

      Reply
  174. Hi Sir,

    Pls advise on this Money Back plans from AXA “Bharti AXA Aajeevan Sampatti” Whether this is a good product to buy benefit ot expense ratio ? pls advise looking forward to your suggestion on this.

    Reply
  175. Hi Mr.Basavraj,

    I am 35 yrs of age based at Chennai & would like to take a family floater policy for 10 lakhs ( wife -28yrs of age & Son – 07 yrs & daughter – 03 yrs ).No pre existing deseases. Have short listed Apollo Munich and ICICI lombard.But confused between these two due to the Incurred claim ratio data available at IRDA. Request your valuable suggestion regarding these 02 policies.

    Reply
    • Vijay-In my view both are good. So you can go ahead any one of your choice.

      Reply
  176. Hi basu season greetings.
    I would like to invest Rs. 20000/ in NFO from BIRLA SUN LIFE MANUFACTURING EQUITY FUND. Bcoz I am thinking that it would be advantageous to invest now in such funds as campaigning is going on MAKE IN INDIA during MODI term.
    what ll u suggest. Is it wise to invest in such funds? Pl share your knowledge.

    Reply
    • Hi basu pl I am waiting for ur reply.

      Reply
      • Sudheer-Investing based on political gimmick? what if the next day BJP outs Modi from PC chair? Be optimistic. But not over optimistic on political issues. Because anything can happen when it comes to politics. Instead think of long term growth. Stay away from NFOs. Instead choose the fund which is consistent performer. NFOs are meant for agent’s lucrative business module but not investors.

        Reply
        • Thanks basu. U r right.

          Reply
  177. Hi Basavaraj ,

    Thanks for sharing such a valuable information to all of us. thanks a lot.
    Need your valuable advise to continue with same company or change it and sum assured needs to increase or continue with same.

    I am 30 years old, spouse and 2 kids. Income: 30-35 K/Month

    1. Life insurance : LIC policy Jeevan saral , Period: 20 years, Sum assured 5 Lacks, Premium half yearly 12.5 k ….. pl. advise continue with same plan or buy any new plan from LIC only….suggest sum assured also.

    2. Health Insurance: Iffco Tokio SKP (Family Health Policy), Persons covered : 4 ,
    1 year (renewal lifetime) , Sum assured 3 Lacks , Premiun 5 K Yearly …. pl. advise continue with same plan and company or buy a new one from any other company (please suggest company name and plan).

    3. Term Insurance: Bharti AXA eProtect , 1 year (renewal lifetime) , Sum assured 50 Lacks , persons covered , 1, Premiun 5 K Yearly …. pl. advise continue with same plan and company or buy a new one from any other company (please suggest company name and plan).

    Father and Mother : Need separate health and life insurance plan for both.
    Father age: 54 Years till 20th March 2015, Mother age: 52 Years.

    1. Life insurance : LIC policy Jeevan saral and Money Back , Period 20 years , Sum assured 5 Lacks.
    pl. advise if needs to buy any new plan from LIC only….suggest sum assured also.

    2. Health Insurance: Iffco Tokio (Individual Health Policy) : Persons covered : 2,
    1 year (renewal lifetime), Sum assured 2 Lacks , Premiun 5 K Yearly …. pl. advise continue with same plan and company or buy a new one from any other company (please suggest company name and plan).

    3. Term Insurance: NO term insurance. …. pl. advise

    Reply
  178. I am lucky to come across your blog three days ago while surfing.I am really impressed.
    1)I do not have any health insurence for me and family.Suggest me best one which covers family,spouse & 2 kids.Suppose I do not claim anything for 5 years in a row how the premium will be calculated.
    2)I also do not have any term plan as I was not aware either its importance,heeded to advices of friends and relatives who happen to be LIC agents and took many policies like plus,money back and recently Jeevan anand for 10lac cover with yearly premium 80k.Is it possible to reduce this to 5 lac,close,surrender or post paid(wait for maturity without paying now).kindly advice.
    Many thanks.

    Reply
    • Didagur-You can buy the health insurance from any of the public sector or in private sectors, I prefer star, apollo of maxbupa. First understand how much insurance you need. Check the premium affordability and features. Then go ahead. Regarding term insurance, you can go with LIC (online), HDFC, ICICI, SBI or MaxLife. I don’t think you can reduce the sum assured. But still suggest you to contact LIC branch and discuss the same with them (avoid agents for this).

      Reply
      • Grateful to you Basavaraj,Many many thanks for the advice.

        Reply
        • Dear Basu,
          But can you tell me wheather I can surrender or stop paying premiums of Jeevan Anand and wait for the policy to mature. I have paid 4 years with 80k/annum premium.This is huge on me and that too with low returns.Or will you advice me to continue?
          Kindly reply ,your advice and guidance appreciated.
          Thanks again.

          Reply
          • Didagur-First visit LIC office. Check for both surrender and paid up value. Share with me then we discuss.

            Reply
            • Thank you Basavaraj.
              Sure I will visit LIC office,I am on official assignment for few months abroad.( I could visit many sites including yours,the best one, to know about finacial management during my free time)I am grateful to you for guiding me.So many eye-openers for me after going through your blog.Love to meet up with you once.
              Many Thanks again.

              Reply
  179. Sir,
    In such scenario is it not better to take an health insurance from a company which does not have claim based loading?

    Reply
    • Sevan-It is hypothetical also to say that loss making companies load the premium. It is just an assumption or one way of filling their loss.

      Reply
  180. Hi, I am looking for a mediclaim policy for my senior citizen parents. The yave a pre history of diabets and BP. I have gone through many policies for now bu confused now. Can you help me guide on which policy can be benificial?

    Reply
  181. The link to policyadvisor is and affiliate link which is not explicitly mentioned. While using affiliate link is okay but in the interest of transparency such details should be mentioned.

    Reply
    • Dev-I understand your concern. But I am not promoting myself that one must use their facility. If you found interesting and customer friendly then why can’t use it?

      Reply
  182. Dear Basu hope all is well. Now I am doing Mutual Funds i full fledge. NOw my AUM crossed 5 Lakhs. Just in 5 months. All from your guidance. NJ welath providing good service and technology. thank you.
    I am still in confusion about Health Insurance. Let us say I am doing X company Health Insurance. which CIR is 67.21%. Is that worth doing business with that company.
    Thank you.
    Nagaraj.

    Reply
    • Nagaraja-Nothing wrong. Let your client be disclosed all facts and if claims are genuine then why to worry?

      Reply
  183. Good to know. Thanks for the information.
    So, the public sector companies are in loss..:)
    Does it also mean that they can recover the loss by rejecting some of the cases?

    Thanks
    – Sandeep

    Reply
    • Sandeep-They not recover the loss by rejecting claims, but every possibility that of loading your premium next time.

      Reply
  184. i want know about policy.

    Reply
  185. Do u have any data Claim settlement ratio’s ?

    For a layman the incurred claim ratios doesn’t make any sense ??

    Reply
    • Sashikumar-For General Insurance companies, usually the data will be Incurred Claim Ratio rather than claim settlement ratio. I stated the difference between two. Claim Settlement ratio will be for Life Insurance companies. This is how the data is compiled and presented by IRDA.

      Reply
      • hello
        i am 30 years old and was looking for a health plan for my family….. my husband and 2 kids. out of various options i have short listed two companies religare and new india assurance. can you suggest me which would be a better option. which company would be more efficient in settling my claims?

        Reply
        • Shweta-Frankly to say, both are good. But first understand who fulfills your plan features or premium budget. Then go ahead.

          Reply
          • obviously religare is providing better features but , but my concern is about faith… in case if any emergency arises who will full fill my needs better religare or new india assurance.. can you list out few dis advantages of new india assurance which i m not able to find out

            Reply

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