Which are the Top 5 Best Health Insurance Plans in India 2020? How to shortlist and what the cares you have to take care of before buying the plans? Let us do the review and comparison.
Along with Life Insurance (Term Life Insurance), Health Insurance is also a must product one must-have. While in the case of Life Insurance, you have to buy it only if you have financial dependents. , However, this is not the case with health insurance. All of us have to buy as we don’t know when we get hospitalized due to illness.
An exception to this is, if you created enough corpus for your hospitalization need, then you may not need to buy health insurance. But many of us simply ignore the hospitalization cost in our life. Even salaried not worry about buying separate health insurance (even though company providing).
Cost of hospitalization as per my understanding inching up at the rate of 10%. Hence, in many cases, it is impossible to fund the hospitalization expenses from our own savings. A week’s hospitalization in expensive cities like Bangalore may ruin your few years of savings. Hence, one must take it as a serious need and buy it.
Before jumping into shortlisting your Top 5 Best Health Insurance Plans in India 2019, you must understand what are the points you have to consider.
Before jumping into shortlisting your Top 5 Best Health Insurance Plans in India 2020, you must understand what are the points you have to consider.
# Sum Insured: When you look at the rate of inflation of hospitalization, you find that it is nearly around 8% to 10%. Hence, always try to go for a sufficient sum insured health insurance base plan. Consider the members you are including in the policy. Based on that you have to take a call on the sum insured you are opting.
# Daycare Treatment: Choose the product which offers the highest daycare treatment coverage. A few years back, to treat a few diseases, we need to get hospitalized for 2-3 days. However, due to advancements in medical technology, nowadays many treatments are converted into daycare treatments. Hence, it is important to understand how many daycare treatments the health insurance product covers.
# Room Rent Capping:-Nowadays many health insurance companies offering NO ROOM RENT CAPPING. You have to choose a product where there is no such capping.
# Definition of Hospital: Many of us ignore this important aspect that what is the definition of the hospital as per the health insurance company. There may be certain eligibility to consider which is a hospital. Hence, if you admitted to such an undefined hospital, then health insurance companies may deny the claim. For example, refer to THIS about what is the meaning of the hospital as per New India Mediclaim Policy.
# Incurred Claim Ratio: You have to check the incurred claim ratio of Health Insurance Companies. Incurred Claim Ratio or ICR is a ratio of the total value of claims paid or settled to the total premium collected in any given year. This can be calculated as an Incurred Claim Ratio or ICR=(Total Value of Claims Paid/Total Premiums collected)*100.
For example, let us say Company ABC settled the total claim amount of Rs.90 Cr in the year 2015-16. In the same year, it collected Rs.100 Cr as a total premium. In this situation, the incurred ratio stands to be 90%.
This Incurred Claim Ratio is applicable only to non-life insurance companies. For life insurance companies, IRDA publishes Claim Settlement Ratio. But sadly many (even experts) complicate it.
If the incurred claim ratio of a company is more than 100%, then it indicates that for every Rs.100 they collecting as premium, they are paying more than Rs.100 as a claim for a year. In simple terms, your income is Rs.100 but your expenses are Rs.100 or more. So instead of profit, they are into a loss.
If the incurred claim ratio of a company is less than 100%, then it indicates that for every Rs.100 they collecting as premium, they are paying less than Rs.100 as a claim for a year. Such companies are making a profit as your income is Rs.100 but expenses are less than Rs.100.
However, rejecting claims only on grounds to profit will not work out for any company. They have to look for reputation, future growth, and regular guidelines. Hence, simply for the sake of profit-making, they can’t deny claims.
In my view, going with companies of high ICR or low ICR is risky. Hence, always choose a company which is in between both these points.
Do remember that Claim Settlement Ratio or CSR applies to Life Insurance products and Incurred Claim Settlement Ratio applies to Health Insurance Products.
Let us now look at the latest Incurred Ratio of all Health Insurance Companies. Below is the incurred claim settlement ratio of Public Sector and Private Sector Companies.
Below is the incurred claim settlement ratio of standalone health insurance companies.
# Buy early: Buying at an earlier age is the best than postponing it. We don’t know the health issues. Hence, the insurer may reject your proposal. Hence, always buy immediately and never postpone.
# Understand the cover: Identify the features you want to cover. Covering all NOT POSSIBLE. Hence, try to identify the product which covers many illnesses.
#Individual or Family Floater: Decide whether you want to go for an individual or family floater. It is always best to go for an individual if the age of any one member of the family is so high than the others. For example, in a family of 4 the oldest person’s age is 65 years and the rest of the other 3 members age is less than 50 years, then better to buy an individual plan for that 65 years old individual, and rest 3 members can buy a family floater.
Because the premium is fixed based on the age of the oldest person also.
# Entry Age and renewable clause: Check the entry age and for how long one can renew it. Currently, many insurers are offering life long renewal options. Hence, choose the one where you have the option to renew it forever.
# Waiting period: Identify the company which covers existing diseases early. Usually, all insurance companies have a waiting period of 3-4 years for existing diseases. However, if your concern is to cover the existing diseases, then give first priority to this point.
# Co-payment clause: Higher the co-payment means lower the premium for you. Co-payment means how much you also have to pay in a total bill. If the co-payment clause states 20% co-payment, then for all bills claimed, you have to 20% and the rest 80% will be payable by a health insurance company.
# Exclusions: Check for exclusions. If you feel the exclusions listed may be uncomfortable to you, then skip that product.
#Hospital Network: Check for hospital network availability in your city or town. The cashless hospital benefit is better than producing the bills and waiting for claim settlement.
# Policy Wordings: Read carefully the wordings of policy brochure. If you have doubts about any feature, then try to clarify it NOW itself.
# Common Features: Avoid all common features, which companies try to highlight.
# No Claim Bonus Offers: Check for No Claim Bonus company offers.
# Treatment wise limit: Check treatment wise limit if any.
# Premium: Check the premium rates. Especially check the rates for older age rates as few insurers jump the rate drastically for older age coverage.
# Super Top Up: Never rely on a base plan. Down the line, if your coverage is not sufficient, then go for Super Top Up Plans. They are cheap in nature compared to base plans. Make sure that your base plan and Super Top Up yearly renewal date should be almost close. There should not be a big gap in the dates between these two plans.
# Cashless is a facility, not a GUARANTEED feature:-It is just a facility to make sure hassle-free claim settlement. Hence, don’t think that this is your RIGHT.
Now let us jump into selecting the Top 5 Best Health Insurance Plans in India 2020 among those so many Health Insurance providers.
Here, my concentration is mainly on Day Care Treatments, Room Rent/ICU limit, Claim Incurred Ratio, and few basic features. Based on that I have selected the below products.
Note:-Refer our latest post on Top 5 Super Top Up Posts In India for 2020 at “Top 5 Super Top-up Health Insurance Plans in India 2020“.
Disclaimer:- Health Insurance actually depends on your age, family size, health status, and the particular feature you are looking for. Hence, my choice is based on certain generic considerations. It is always best to cross-check the product brochure before you jump into buying.
Also, I am not claiming that these are the ONLY BEST in India. If certain features are not suitable for you, then you can look for other products available in the market (but considering the above points which I have discussed).
Hope this article will help you in choosing the right health insurance for you or shortlisting the Top 5 Best Health Insurance Plans in India 2020.
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View Comments
Hi Basu sir,
I follow your blogs regularly and i have taken term insurances based on your blogs.
1. Any chances you will be writing blog on health insurances for 2024.?
2. I need a suggestion sir, For my parents aged 70 and 78 I am confused between niva bupa or star.
3. For self and my family (ages 40, 35 and 13) confused between HDFC ergo, Niva Bupa or star.
We all are having corporate group insurance planning to buy outside slowly come out this.
Can you guide or suggest as you do eveytime please.
Dear Satish,
1) Sure will write.
2) Better to avoid both and stick to old players like ICICI or HDFC or PSUs.
3) Better to go with HDFC or Niva.
Hello Basu,
Are there any good health insurance for my 7-yrs old autistic daughter?
Thanks for your reply.
Raja
Dear Raja,
I am unsure of such specific cover. But try with the same insruance companies which I have listed above.
Basu.
Sorry.
I was talking about 80DD.
M i eligible?
Dear Rekha,
Under Section 80DD, the major conditions are as below.
1) Dependent means - Spouse, Children, parents, brothers, and sister of the individual.
2) Such dependent should be disabled a person. Disability means - a disability of not less than 40%.
If both above conditions are satisfied, then you can.
HELLO BASU,
I'M Married , government salaried women... Because insufficient salary of my husband, i am paying expenses occurred on medical condition of my father and mother in since last FY.
M i eligible to claim those medical expenses occurred in my ITR u/s 80D?
Dear Rekha,
Medical expenses can't be claimed under Sec.80D as it is meant for insurance premiums.
Dear Sir,
I needed one clarification from your end .
what is the catch of "Single Pvt room" capping ? Like Star health policy mentioned in that their policy wording.
Dear Venkat,
It means that if you opt for a single private room, then there may be a certain limit to it.
Waiting for your detailed review sir
Dear Sumanth,
Sure.
Dear Sir,
Thanks for the reply.
Can I also request you to confirm the ideal Sum Insured for general public (not high networth). As it is recommended to take Super tops with health insurance and most of the Super Top ups have a deductible maximum of 5 Lakhs. So, does that mean is it enough to take 5 Lakhs SI and then a Super top-up? Will Super top have the policy coverage as base policy when taken from same insurer or will it have its own policy T&Cs. Will super top-ups be cashless when base policy is also from same provider ?
If Super top-ups have the same policy terms as base policy then it makes sense to go with 5 lakhs SI. But again why would an insurance lose business by explicitly selling Super top ups with only max deductible of 5 lakhs (i have only investigated HDFC & ICICI).
Initially I was planning to take 10 Lakhs SI and then a super top-up but all the Super tops from HDFC and ICICI have deductible max of 5 lakhs. So, does it make sense to go for high SI when taking a Super top-up
Dear Sumanth,
Ideally around Rs.5 lakh base plan is fine with super top up of at least Rs.25 lakh. Yes, majority of super top ups offer the same features which the base plan offers.
Can you please compare HDFC Ergo Optima Restore vs Optima Secure. Optima Secure has double the benefits of restore for same or a slight increase in premium. HDFC secure has the below add-ons in comparison with restore and these are lucrative benefits
1) Protect benefit - Complete non medical expenses (68 listed in policy) are covered [Ex: gloves, masks, pads etc which a general insurance will not cover
2) Secure Benefit - 100% on SI on buying or renewal (10 lakhs cover becomes 20 lakhs by default). Applied every year and no carry over.
3) Plus Benefit - On Renewal without a break, 50% of the Base Sum Insured under the expiring Policy will be added to the Sum Insured subject to max of 100% of SI. Any amount unutilized in the current Policy Year will be carried forward to the subsequent Policy Year
(Again 10 Lakhs cover becomes 15 lakhs by 1st year and 20 lakhs by 2nd year renewal). No strings attached and even if insured claims in previous year
3) Restore Benefit - Instant addition of 100% Basic Sum Insured on complete or partial utilization of Your existing Policy Sum Insured during the Policy Year (irrespective of any benefits used). The Total Basic sum insured will be restored only once to all Insured Persons for all claims under In-patient Benefit during the current Policy Year.
4) NCB - 10% of SI for no claims in previous years (this is 50% in Optima restore but hardly makes a difference with above benefits which are more permanent in nature as once claim is made that 50% is reduced)
5) Ayush Benefits (not in Optima Restore)
6) No sublimit
With all these benefits as 10 Lakhs SI is worth below
SI - 10 Lakhs
Secure Benefit - 10 Lakhs
Plus Benefit (after 2 years) - 10 Lakhs (carry over unutilized if claims made)
Restore benefit - 10 Lakhs
Total = SI + Secure + Plus+ Restore = 10 + 10 + 10 + 10 = 40 Lakhs (for premium of 10 Lakhs ??)
I have read the policy document comparing with optima restore. So what is the catch here ? Am I missing anything and the policy is too good to buy and I do not find any such policy in market. Am i missing anything.
Please help decide as you would also not need a super top off with this policy. What would be the use of top-up for this policy ? As we are getting 40 Lakhs for 10 Lakhs premium (not much higher than other policies having 10 lakhs SI just 10% increase)
Also, will super top have the same coverage as base policy ?
Dear Sumanth,
Let me write a detailed post on this.
Sir, HDFC Ergo Optima Restore Vs Optima Secure - looks like HDFC came up with new health insurance policy - Optima Secure. Which one is best among these two? Kindly advise..
Dear Babu,
Yes, Optima Secure is eye-catching with some gimmicks. You can opt that.
Sir,would you like to write a post on small case? There are lot of advertisements happening around smallcase. Fees seem to be bit high.
Your opinion is highly appreciated.
Thanks
A Banerjee
Dear Banerjee,
I am not an expert in direct stock reviewing. However, avoid anything which costs you a lot and creating NOISE.
Dear Sir,
Is it required to declare fresh illness during renewals of health policies ?
Dear Amartya,
No, not required.