April 22, 2019


With the increase in number of nuclear families in India, especially in urban areas, people can no longer rely on their extended family for support during times of crisis. That is the reason why health insurance is necessary to provide cover for oneself as well as rest of the family members during medical emergencies.

Over the last couple of years, improvement in quality of health care has been accompanied by an increase in the cost of treatment. These days, if a person is not covered by a health insurance policy, he or she might have a hard time paying the medical bill.

A good health insurance policy is the one which not only provides optimum cover in the time of need, but also at a reasonable cost. India’s insurance sector is swarming with health insurance providers that offer comprehensive health insurance policies aimed at providing cover against a wide variety of ailments and diseases.

However, there are certain points that one must keep in mind while buying a health insurance policy. In this blog, Student Cover outlines certain ‘Dos’ and ‘Don’ts’ that one must follow while choosing a health insurance policy.


Identify your needs

Before deciding what to buy, it is important to first ask oneself the simple question – Why do I need health insurance?

This is very important because unless one is sure about what one expects from health insurance, one cannot take the right decision about which insurance policy to choose. If the purpose of buying health insurance is to provide cover during medical emergencies only, then one can simply buy a Mediclaim policy. However, if the purpose is long term and holistic health care, then one should go for a particular Health Insurance plan.

Check all available options

It is often seen that people purchase health insurance policy from the very first vendor that they encounter. The reason for that is people know very less about health insurance. At first sight, it might look like the health insurance policy that is offered by the agent covers almost everything that can be covered under any insurance plan and it might be so.

However, one should go through the offerings of at least a couple of health insurance plans to check the extent of coverage and the difference in the premium, before zeroing on the one that suits the buyer.

Read the document carefully

While discussing about the benefits offered by a particular insurance plan, one must not solely rely on the agent’s word. If a buyer finds any benefit suspicious, he or she should check the policy document to ensure that the offerings suggested by the agent are true.

Although an insurance policy document is a lengthy piece containing terms and conditions, going through the document also helps the buyer to identify certain costs and benefits which the agent might have missed out during the briefing.

Check for exclusions

Health Insurance policies provide cover against most of the common diseases and ailments. However, there are certain specific diseases and ailments which that are not covered by every Insurance plan. These may include diseases like HIV, congenial diseases, cancer etc. In addition to that, certain treatments like cosmetic surgery, dental surgery etc. are also excluded in many health insurance policies.

Check for waiting periods

Health insurance policies usually have a waiting period for those diseases and ailments categorized as pre-existing diseases. They may include kidney stone, appendix, cataract etc. There is usually a waiting period of 6 months to 2 years before a policy holder can avail the benefits of insurance for treatment of those diseases and ailments. Every insurance policy document has a list of such diseases and ailments which one must go through.

Evaluate the insurance agent, agency and company

The insurance industry in India is regulated by IRDAI (Insurance Regulatory and Development Authority). It sets the rules and regulations regarding the functioning of insurance companies in India. Before buying any Insurance plan, one must ensure that the insurance agent, agency or the Insurance company from which he or she is buying is recognized by IRDAI and has valid license to operate.

Check the claim settlement record

A health insurance policy is useful only if it is able to provide cover at the time of need. If the insurance company has a poor track record in settling the claim of the insured, it might not be of any use to the buyer. Therefore, before buying insurance from an insurance provider, the buyer should check the claim settlement record of the insurance company from which he or she is buying the health insurance.


Don’t hide the facts

Insured should not conceal a presence of pre-existing ailment from the agent. This could lead to trouble at the time of claim settlement if it is found that a previous disease about which the buyer has not made any disclosure has led to a covered disease for which the buyer is claiming insurance.

In such scenario, health insurance companies do not accept the insurance claim made by the buyer. Therefore, one is advised not to conceal any information from the insurance agent or the company.

Don’t give false information

The premium to be paid for a health insurance policy depends on a number of factors such as age, gender, pre-existing diseases etc. In order to save money on insurance premium, one should never furnish false information to the insurance company. This could not only lead to rejection of the insurance claim but also cancellation of the policy.

Don’t let it lapse

Health insurance policies are generally valid for a period of one year. At the end of the year, insurance companies intimate the client regarding renewal of the policy. One should make sure that the insurance policy does not get lapsed.

If it gets lapsed, one might have to pay the penalty during renewal of the policy if done during grace period. After grace period, the policy holder has to buy a new health insurance. It also refreshes the waiting period attached with pre-existing coverage.

Don’t shy away from asking questions

People often shy away from questioning the insurance agent If they do not understand any terms, clause or procedure of claim settlement. One must not shy away from clarifying any doubt that he or she has. It is better to clarify doubts or queries with insurance agent or the company before buying insurance than be sorry afterwards.

We hope that you will find the contents of this blog useful and use the “Do’s and Dont’s” as a guide to purchase the health insurance policy for yourself and your family.

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