Health

Compare Health Insurance in India
Nobody wants to halt their life or work because of ill health and wish to stay happy all the
time. But, the escalating count of diseases and their mounting cost of treatments have
become a concern today. Even a single visit to doctor can suck your wallet. Health
insurance in India has emerged like a savior for all. Taking care of your wellbeing as well
as your pocket, it has made things simpler for all. It pays off your heavy medical bills,
consultation fees, accident or emergency case charges. Helping out to shoulder the
financial burdens, mediclaim in India comes with easy buying and satisfying assurance.
Health Policies in India

Individual - Designed to cover an individual against various illnesses with cashless
hospitalization and other features.

Family Floater Mediclaim - Covers family members against diseases under a single plan,
this cover offers a fixed sum insured for the members that can be either availed by
individual member or as a sum total for treatment of one person.

Surgery & Critical Illness - Availed as a standalone plan or a rider incase of treatment
against serious illnesses like- cancer, kidney failure, heart attack, paralysis etc.

Senior Citizen - Covering you when you turn old and unable to resist severe sickness
because of your growing age. According to IRDA norms, every insurer needs to provide
cover for people up to the age of 65 years.

Preventive Healthcare - In charge of concerns related to expensive preventive care
treatments which include consultation charges and other tests or x-ray fees concessions.
Benefits and Features

For treasuring well being one must have a comprehensive health policy. From individual
to family floater plan, all come with some features and benefits; lets check a few major
covers-

Cashless treatment - Every insurer displays a network of hospital where when treated
the insured does not require to pay a penny from his pocket unless it is a voluntary
discount case.

Pre and post hospitalization - Under the medical plan in India, the insured is paid for the
pre and post hospitalization charges which include tenure of 30 to 60 days depending on
the insurer.

Ambulance charges - The policy holder is free from burden of transportation or
ambulance charges.

Pre-existing disease cover -After a waiting period of 2-4 years, various policies offer a
cover against the pre-existing diseases -e.g. - diabetes, hypertension etc.

No Claim Bonus - NCB or no claim bonus is a benefit provided if the insured does not
claim for any treatment in the previous year. Benefit could be in any form, either an
increment in the sum assured or a discount in premium.

Medical check up -Free check up is provided by few insurers if there is a good history of
no claim bonus.

Tax Benefits - If you are paying premium for medical policy then you are liable to get tax
rebate under section 80D of Income Tax Act for a maximum value of Rs.15000 for
regular and Rs.20000 for senior citizen.

Co-Payment - Providing you option to cut short your premium amount, medical insurance
offers co-payment option wherein there is a define amount of voluntary deductibles
mentioned in the policy which are paid by the insured. So in case of treatment, some
amount is paid by the insured and rest by the insurer.

Critical illness cover - You can extend your cover by opting for critical illness or various
riders depending on your age and medical history of your family.
Criteria To Choose Best Health Insurance

Caps and sub-limits - Imposition of sub limits, Co-payments or other caps might reduce
the premium you pay for the insurance policy but would limit the benefits in a similar or a
worse proportion.

Claim settlement record -This might be an ultimate decider for weighing the insurance
plans credentials. Although this information might not be available publicly or might be
present in a manipulated state, experts expect it to be of more value to the customers in
near future than it is currently.

Scope of coverage -Weighing premium vs. plans benefits is more necessary while
defining the plan to be a comprehensive one. Buying a plan just because its cheaper
than other plans is bad decision making.

Renewability - Most of the diseases confront you after you reach a certain age which is
bracketed as old, therefore it becomes highly important to buy a plan which has a very
high or a lifetime renewability so that you are not left on your own, when you need a
medical cover the most.

Cashless Hospital Network - Checking for the hospitals around you those are covered as
a network hospital by the plan you consider is imperative, as this allows you to avail the
service of that hospital without getting into the hassles of claim reimbursements from the
insurer, rather benefiting from the cashless facility given by the network hospitals.

Premium Loading - We would suggest one to always check the terms and conditions
pertaining to premium loading, this might save you from paying a high incremental
premium once you make a claim for the sun insured. The best practice would be to verify
the premium fluctuation data of the plan for previous 5 years the least.

Internal team - Check for the plans from insurers which have an internal team for
mediclaim, this might help in expediting the claim settlement process to a good extent.

Floater(family) size - Everyone has a different family size, one should always look for the
family floater size allowed under the plan before considering buying it, so that no
member is left uncovered for health related problems.
Medical Insurance Comparison Helps:

It might sound tricky to select one policy from this array of mediclaim plans. But, we at
policybazaar.com intend to offer a comprehensive comparison of policies depending on
your requirements. Offering affordable quotes along with details of benefit or riders
available, we generate an analysis report of plans you can choose from. Assisting our
customers on the selection of the best medical insurance in this competitive market,
policybazaar.com understands and spreads awareness regarding the need of good plan
in India.

Health insurance companies in India
Indian insurance sector is a substantial one and currently there are 24 non-life or health
insurance providers in India. The insurance regulatory body (IRDA) opened this sector in
2000 and investment up to 26% is currently allowed to invest by foreign companies in
India. This sector consists of private as well as public sector companies to solicit
insurance within the regulations of IRDA. There are lots of options as far as insurance
companies are concerned, public as well as health insurance private operators as well.
List of Health insurance companies in India
Following are the medical insurance companies in India:
Apollo Munich Health Insurance Company limited
This is a joint venture between Apollo hospitals and Munich Health who both as
individual companies have succeeded in providing healthcare services. Their joint
venture is also their effort to provide quality insurance services to people.
Star Health and Allied insurance Co Ltd
This company is the countrys first stand-alone health insurance company in India
dealing in Personal Accident, Mediclaim and Travel insurance.
Future Generali India Insurance Company Ltd
Future Generali is a joint venture between the India-based Future Group and the Italy-
based Generali Group. It is present in both life and non-life insurance business.
Bajaj Allianz General Insurance Co Ltd
Bajaj Allianz General Insurance Company Limited is a joint venture between Bajaj
Finserv Limited (recently demerged from Bajaj Auto Limited) and Allianz SE. Bajaj
Finserv Limited holds 74% and the remaining 26% is held by Allianz, SE.
ICICI Lombard General Insurance Co Ltd
ICICI Lombard GIC Ltd. is a joint venture between ICICI Bank Limited, Indias second
largest bank and Fairfax Financial Holdings Limited, a Canada based diversified financial
services company engaged in general insurance, reinsurance, insurance claims
management and investment management.
National Insurance Co Ltd
It is a government controlled undertaking and provides motor, health and fire insurance.
Iffco Tokio General Insurance Co Ltd
It is a joint venture between the Indian Farmers Fertilizer Co-operative (IFFCO) and its
associates and Tokio Marine and Nichido Fire Group, the largest listed insurance group
in Japan.
The New India Assurance Co Ltd
It is a nationalized general insurance company with its presence abroad as well.
The Oriental Insurance CO Ltd
It is a central government undertaking providing general insurance and has operations in
Nepal, Kuwait and Dubai.
Reliance General Insurance Co Ltd
It is one of the private insurance company providing motor, health, travel insurance etc.
United India Insurance Co Ltd
It is a nationalized general insurance company having its operation in whole country.
Royal Sundaram Alliance Insurance Co Ltd
It is a joint venture between Sundaram Finance, one of the most respected non-banking
financial institutions in India, and RSA, one of the oldest and the second largest general
insurer in the UK.
TATA AIG General Insurance Co Ltd
Tata AIG General Insurance Company Limitedis a joint venture between Tata Group and
the renowned American International Group, Inc. This insurance firm started operations
on April 1, 2001.
Cholamandalam MS General Insurance Co Ltd
It is a private general and health insurer having pan India presence.
HDFC ERGO General Insurance Co Ltd
HDFC ERGO General Insurance Company Limited is a 74:26 joint venture between
HDFC Limited, Indias premier Housing Finance Institution and ERGO International AG,
the primary insurance entity of Munich Re Group.
Universal Sompo General Insurance Co Ltd
It is a joint venture of four Indian companies (with three banks and a FMCG company)
and Japanese general insurance provider. It is a health insurer having operations in
whole country.
Bharti AXA General Insurance Co Ltd
It is a joint venture between Bharti Enterprises of India and AXA group of Europe.
SBI General Insurance Company Ltd
SBI General Insurance Company Limited is a joint venture between the State Bank of
India and Insurance Australia Group (IAG). SBI owns 74% of the total capital and IAG
the remaining 26%.
Raheja QBE General Insurance Co Ltd
Raheja QBE General Insurance Company Limited, a joint venture general insurance
company promoted by Prism Cement Limited, India and QBE Holdings (AAP) Pty
Limited, a wholly owned subsidiary of QBE Insurance Group Limited, Australia.
MAX Bupa Health Insurance Company Ltd
MAX Bupa Health Insurance Company is formed with a joint venture between Max India
Limited and the UK based Bupa Finance PLC, UK.
L & T General Insurance Co Ltd
L & T General Insurance Company Limited (L & T Insurance) is a wholly owned
subsidiary of Larsen & Toubro Limited.
Religare Health Insurance Co Ltd
It is a company formed by Religare enterprises, Corporation Bank and Union Bank of
India.
Magna HDI General Insurance Co Ltd
Magma Fincorp Limited and its Promoters signed a Joint Venture agreement with HDI-
Gerling International Holding AG, Germany on 28 July 2009 at Kolkata to enter into the
general insurance sector in India.
Liberty Videocon General Insurance
It is newest health insurance provider and a company formed with joint venture between
Liberty Videocon General Insurance, a joint venture between the Videocon Group and
the US-based Liberty Mutual Insurance Group.

DETAILS OF INSURANCE COMPANIES PROVIDING HEALTH INSURANCE PLANS

A. GENERAL INSURANCE COMPANIES PROVIDING HEALTH INSURANCE PLANS
S.No Name Address Phone Fax Email Website
Health
Insurance
Products
1
Bajaj Allianz
General Insurance
Co Ltd
GE Plaza 1st Floor,
Airport Rd., Yerawada,
Pune 411006,
Maharashtra
020-66026666
020-
66026667
info@bajaja
llianz.co.in
www.bajaja
llianz.co.in
click here
2
Bharti Axa
General Insurance
Co. Ltd.
RMZ Infinity Tower B, II
Floor, Old Madras
Road, Bengalaru.
080-40260100
080-
40260101
media@bharti-
axagi.co.in
www.bhar
ti-axagi.co.in
click here
3
Cholamandlam
MS General
Insurance Co. Ltd
Dare House' 2nd Floor,
No. 2 N.S.C Bose
Road, Chennai-600001,
Tamil Nadu
044-42166000
044-
42166001

www.cholain
surance.com
click here
4
Future Generali
India
Insurance Co.Ltd.
001, Trade Plaza, 414,
Veer Savarkar Marg,
Prabhadevi, Mumbai-
400025, Maharashtra
022-40976666
022-
40976868
care@futu
regenerali.in
www.fut
uregenerali.in
click here
5
HDFC Ergo
Genral Insurance
Co Ltd
6th Floor, Leela
Business Park, Andheri
Kurla Road, Andheri(E),
Mumbai 400059,
Maharashtra
022-66383600
022-
66383699
care@hdf
ceergo.com
www.hdf
cergo.com
click here
6
ICICI Lombard
General Insurance
Co. Ltd.
2nd Floor, Zenith
House, Keshavrao
Khadye Marg, opp.
Race Course,
Mahalakshmi, Mumbai,
022-24906999
022-
24927624

www.
Icicilombard.com
click here
Maharashtra
7
IFFCO Tokio
General Insurance
Co. Ltd.
4th and 5th Floor,
IFFCO Tower, Plot#3,
Sector 29, Gurgaon,
Haryana-122001
0124-2850100
0124-
2577923,
2577924
www. Itgi.co.in click here
8
National
Insurance Co Ltd
3 Middleton Street,
Kolkatta-700071, West
Bengal
033-22831705.
22831706
033-
22831712
admin@national
insuranc
eindia.com
www.nationalin
suranceind ia.com
click here
9
Reliance General
Insurance Co. Ltd.
570, Niagaum Cross
Road, Next to Royal
Industrial Estate,
Wadala(W), Mumbai
400031, Maharashtra
022-30479602
022-
30479650

www.relian
cegeneral
.co.in
click here
10
Shriram General
Insurance
Company Limited
Greamns Dugar, 5th
Floor, No 149, Greams
road, Chennai 600006.
0141-3220896,
898,, 900, 902
0141-
2770426
www.sriram.com click here
11
Royal Sundaram
Alliance Insurance
Co. Ltd.
Sundaram Towers, 45
& 46, Whites Road,
Chennai-6000014,
Tamil Nadu
044-28517387,
42227373
044-
28517376
customer.service
@royalsun
daram.in
www.royals
undaram.in
click here
12
Tata AIG General
Insurance Co Ltd
Peninsula corporate
Park, Nicholas Piramal
Tower, 9th Floor,
Ganpatrao Kadam
Marg, Lower Parel
Mumbai 400013.
1800-11-9966,
022-66939500

customersupport
@tata.aig.com
www.tata-aig.com click here
13
The New India
Assurance Co.
Ltd.
New India Assurance
Building 87 M G Road,
Fort, Mumbai 400001.
22674617-22 022-
22652811
www.newindia.co.in click here
14
The Oriental
Insurance Co. Ltd.
Oriental House, A
25/27, Asaf Ali Road,
New Delhi-110002
011-23279221,
222,223,224,225
011-
23287192-
193

www.orientalins
urance.nic.in
click here
011-
23283971
15
United India
Insurance Co. Ltd.
24, Whites Road,
Chennai-600014 044-28520161
044-
28523825
www.uiic.co.in click here
16
Universal Sompo
General Insurance
Co. Ltd.
310-311, Trade Centre,
3rd Floor, opp. MTNL
office, Bandra Kurla
Complex, Bandra
(East), Mumbai
022-40287777
022-
40287781
contactus
@univers
alsompo.com
www.universal
sompo.com
click here
B. LIFE INSURANCE COMPANIES PROVIDING HEALTH INSURANCE PLANS
17
Life Insurance
Corporation of
India
P&GS Unit, 14th Floor,
Yoga Kshema J.B.
Marg, Mumbai-400001
022-26137545
www.lic india.com click here
18
Aviva Life
Insurance
2nd Floor, Prakash
Deep Bldg., 7-Tolstoy
Marg, New Delhi-
110001
011-23313310

www.aviva
india.com
click here
19
Birla Sun Life
Insurance
Vaman Centre, 6th
Floor, Makhwana Road,
opp. Andheri-Kurla
Road, Andheri (East)
Mumbai-400059
022-66783333

www.birlas
unlife.com
click here
20
Bajaj Allianz Life
Insurance Co Ltd
GE Plaza, Airport Rd.,
Yerawada, Pune
411006,
020-4026666
020-
4026789

www.bajajallia
nzlife.co.in
click here
21
Bharti AXA Life
Insurance Co Ltd
601-602 6th
Floor,Raheja Titanium
Off Western Express
Highway Goregaon (E)
Mumbai-400063
022-40306300
/6301
022-
40306347

www.bharti-
axalife.com
click here
22
Future Generali
India Life
Insurance
Company Limited
001, Delta
Plaza,Ground
Floor,414, Veer
Savarkar Marg,
Prabhadevi, Mumbai-
400025, Maharashtra
022-40976666
022-
40976600.

www.future
generali.in
click here
23
HDFC Standard
Life Insurance
Company Ltd.
2nd Floor, Trade Star
Kondivita Junction
Andheri Kurla Road
Andheri East Mumbai-
400059
022-67516666
022-
28228844

www.hdfcins
urance.com
click here
24
ICICI Prudential
Life Insurance Co.
Ltd.
ICICI Prulife Towers,
1089, Appasaheb
Marathe Marg,
Prabhadevi, Mumbai-
400025.
022-56621996
022-
56622031

www.icicip
rulife.com
click here
25
IDBI Fortis Life
Insurance Co, Ltd.
Tradeview, Oasis
Complex, Kamala City,
P.B. Marg, Lower Panel
(W), Mumbai-400013
022-24908109
/10
022-
24941016

www.idbifor
tis.com
click here
26
Max New York
Life Insurance Co.
Ltd.
11th Floor, DLF
Square, Jacaranda
Marg, DLF City, Phase-
II, Gurgaon-122002
0124-2561717
0124-
2561764

www.maxnewy
orklife.com
click here
27
MetLife India
Insurance Co. Ltd.
Brigade Seshamahal,
No. 5, Vani Vilas Road,
Basavanagudi,
Bangalore-560004
080-26438638,
1-600-44-6969
www.metlife .co.in click here
28
Reliance Life
Insurance Co. Ltd.
1st Floor, Midas, Sahar
Plaza, Andheri Kurla
Road, Andheri
East,Mumbai-400059
022-30883434
/30887261
022-
30886587

www.relia
ncelife.com
click here
29
SBI Life Insurance
Co. Ltd.
Turner Morrison
Building, 2nd Floor, 16,
Bank Street, Fort
Mumbai-400023.
022-56392000
022-
56621471
www.sbilife .co.in click here
30
Star Union Dai-
ichi Life Insurance
Co. Ltd.
Star House, 3rd Floor,
(West Wing), C-5
Bandra-Kurla Complex,
Bandra (East), Mumbai-
400051
022-39546211

www.sudl
ife.in
click here
31
TATA AIG Life
Insurance Co. Ltd.
5th, 7, 6th Floor,
Peninsula Tower,
Peninsula Corporate
Park Ganpatrao Kadam
Marg, Lower Paral,
Mumbai-400013
022-66516000
022-
66550711
www.tata -aig.com click here
C. HEALTH INSURANCE COMPANIES PROVIDING HEALTH INSURANCE PLANS
32
Apollo Munich
Insurance Co Ltd
Masterpiece Bldg., Gold
Course Rd., Sector-54,
Gaurgaon-122002,
Haryana
0124-4584101
0124-
4584111
customerservice
@apollodkv.co.in
www.apoll
odkv.co.in
click here
33
Max-Bupa Health
Insurance Co Ltd
2nd Floor, Salcon Ras
Vilas, D-1, District
Centre, Saket, New
Delhi 110017.
011-30902000,
30902120
1800-3070-
3000
customercare@
maxbupa.com
www.maxbupa.com click here
34
Star Health and
Allied Insurance
Co. Ltd.
Corporate Office No. 1,
1 New Tank Street,
Valluvar Kottam High
Road, Nungambakkam,
Chennai-600034
044-28260053
044-
28260062
info@star
health.ini
www.starh ealth.in click here

HDFC Ergo Star Bajaj Religare
Name of plan Health Suraksha Plus Silver Health Optima Health Guard Family Floater Care
Sum assured INR 5,00,000 INR 5,00,000 INR 5,00,000 INR 5,00,000
Premium (approx.) INR 15,116 INR 10,826 INR 13,834 INR 12,505
Medical Tests No No No No
Top Features -
Personalized for you

Room Rent Coverage No sub-limits applicable INR 7500 (Normal Room) No sub-limits applicable No sub-limits applicable
Waiting Period (PED) 4 years 4 years 4 years 4 years
Maternity Coverage
provided after
Not Covered Not Covered Not Covered Not Covered
Claim Settlement Ratio
OPD Coverage Not Covered Not Covered Not Covered Not Covered
Hospitalization Benefits
Pre Hospitalization
Coverage
60 days 30 days 60 days 30 days
Post Hospitalization
Coverage
90 days

Upto 7% of hospitalization
expenses (Max. INR 5000)

90 days

60 days

Domicillary Hospitalization
Covered up to

5 Lacs

Not Provided

Not Covered

50000
Daily Cash Benefit Covered
up to

Not Provided

Not Provided

Not Provided

Not Provided

Network Hospitals Covered 9 16 5 -
Medical Benefits
Day Care Procedures
Covered
141 Covered 130 All
Organ Donor Coverage INR 5 Lacs Not Covered Not Covered INR 1 Lacs
Ambulance Service Covered
upto
INR 2000 INR 1500 INR 1000 INR 2000
Additional Benefits
Free Health Check Up's After 4 claim free years (Rs
5000).
Not Provided After 4 claim free years Annually
No Claims Benefits provided INR 2.5 Lacs enhancement
in sum insured
INR 1.75 Lacs
enhancement in sum
insured
INR 2.5 Lacs enhancement
in sum insured
INR 2.5 Lacs enhancement
in sum insured
Claim based Loading Not Applicable Not Applicable Not Applicable Not Applicable
Co-Payment Required Not Applicable 20% if age is above 60 yrs
at entry level
For treatment in non -
network hospitals (50K)
20% (If entry age is above
60 years)
Renewability Lifelong Lifelong Lifelong Lifelong

Apollo Munich IFFCO-TOKIO Royal Sundaram L&T Insurance
Name of plan Optima Restore Swasthya Kavach (Wider) Family Good Health my:health Medisure
Classic
Premium (approx.) 15337 11827 15362 14338
Medical Tests No No No No
Top Features -

Room Rent Coverage No sub-limits applicable Room rent sub limit -
Rs.5000 (normal room)
Rs. 10000 (ICU)
Rs. 10000 (Normal
Room) ; Rs. 20000 (ICU)
No sub-limits applicable
Maternity Coverage
provided after
Not Covered Not Covered Not Covered 4 years
OPD Coverage Not covered Not Covered Not Covered Not Covered
Pre Hospitalization
Coverage
Coverage
Covered up to

5 Lacs 1 Lacs Not Covered Covered
up to

Not Provided Provided (Rs. 250 per
day)
Provided Provided (Rs. 500 per
day)
Network Hospitals Covered - 5 15 9
Medical Benefits
Day Care Procedures
Covered
140 121 Covered All
Organ Donor Coverage Covered Covered Covered Covered
upto
Rs. 2000 Rs. 1500 Rs. 1000 Rs. 1500
Additional Benefits
Free Health Check Up's Not Provided Not Provided After 4 claim free years
(Rs. 750)
After 4 claim free years
(Rs. 5000)
No Claims Benefits provided Rs. 5 Lacs enhancement
in sum insured
Rs. 2.5 Lacs
enhancement in sum
insured
Not Provided Rs. 2.5 Lacs
enhancement in sum
insured
Co-Payment Required Not Applicable Not Applicable Not Applicable Co-pay of 10%, after the
age of 80 yrs

Max Bupa Reliance Cigna
Name of plan Heartbeat Gold Health Gain ProHealth Plus SB
Sum assured INR 5,00,000 INR 5,00,000 INR 5,00,000
Premium (approx.) INR 21161 INR 16329 INR 15816
Medical Tests No No No
Top Features -

Room Rent Coverage No sub-limits applicable No sub-limits applicable Single Private Room
Waiting Period (PED) 4 years 4 years 3 years
Maternity Coverage
provided after
2 years Not Covered Covered Upto Max.
25000/-

OPD Coverage Covered Not Covered Rs. 2000/-
Pre Hospitalization
Coverage
30 days 60 days 60 days
Coverage
60 days 60 days 180 days
Covered up to

25000 60000 Covered Upto S.I
up to

- - 5
Network Hospitals Covered
Medical Benefits
Day Care Procedures All Covered 171
Covered
Organ Donor Coverage Covered Rs. 3 Lacs Rs. 5.5 Lacs
upto
Rs. 2000 Rs. 1500 Rs. 3000
Additional Benefits
Free Health Check Up's Annually Not Provided Annually
No Claims Benefits provided Value added benefits of
10% Premium
Rs. 6 Lacs enhancement
in sum insured
Rs. 2.75 Lacs
enhancement in sum
insured

Claim based Loading
Co-Payment Required Co-pay of 20%, after the
age of 65 yrs
Upto Rs. 1.2L in case
eldest member >60 years
at entry level
Upto Rs. 110000/- in case
insured member > 65
years.

Renewability

The oriental insurance Future General National insurance HDFC Life
Name of plan Happy Family Floater Silver Health Suraksha Basic Parivar Health Assure (Silver)
Premium (approx.) INR 10184 INR 11556 INR 10694 INR 44775
Medical Tests
Top Features -

Room Rent Coverage Rs. 5000 (Normal Room) ;
Rs. 10000 (ICU)
No sub-limits applicable No sub-limits applicable Rs. 5000 (Normal Room) ;
Rs. 10000 (ICU)
Maternity Coverage
provided after
Not Covered Not Covered Not Covered Not Covered
OPD Coverage Not Covered Not Covered Not Covered Not Covered
Pre Hospitalization
Coverage
Coverage
Covered up to

Covered Not Covered Covered 5 Lacs
up to

Not Provided Not Provided Provided Provided
Network Hospitals Covered 1 4 5 9
Medical Benefits
Day Care Procedures 35 130 141 200
Covered
Organ Donor Coverage Not Covered Not Covered Not Covered Rs. 5 Lacs
upto
Rs. 3000 Rs. 1500 Rs. 2000 Rs. 2000
Additional Benefits
Free Health Check Up's After 4 claim free years (Rs.
5000)
After 4 claim free years After 4 claim free years (Rs.
5000)
After 3 claim free years
No Claims Benefits provided Not Provided Rs. 2.5 Lacs enhancement in
sum insured
Not Provided Rs. 5 Lacs enhancement in
sum insured
Co-Payment Required Not Applicable Not Applicable Total expenses payable for
any one illness is restricted
to 50% of the sum insured
20% - In case of non-
network hospitals

This list of Indian insurance companies is based on the list of insurance companies registered and approved with the Insurance
Regulatory and Development Authority.
General insurance companies
Public Sector
Oriental Insurance Comp. Ltd.
United India Insurance Comp. Ltd.
New India Assurance comp. Ltd.
National Insurance Company
The Motor Assurance India Comp. Ltd.
Private Sector
Bajaj Allianz General Insurance
Bharti AXA General Insurance
Future Generali India Insurance
HDFC ERGO General Insurance
ICICI Lombard
IFFCO Tokio
Liberty Videocon General Insurance Co Ltd
L&T General Insurance
Magma HDI General Insurance Co Ltd
Raheja QBE General Insurance
[1]

Reliance General Insurance
Royal Sundaram
Aegon Religare
Shriram General Insurance
Tata AIG General
Universal Sompo General Insurance
Cholamandalam MS General Insurance Company Limited
Apollo Munich Health Insurance
Standalone health insurance companies
Private Sector
Star Health and Allied Insurance company Ltd
Apollo Munich Health Insurance
Max Bupa Health Insurance
Religare Health Insurance Company Ltd
Cigna general insurance
Universal Sompo General Insurance
Export credit guarantee insurance companies
Public Sector
Export Credit Guarantee Corporation of India
Agriculture Insurance Companies
Agriculture Insurance Company of India Ltd
Life insurance companies
Public Sector
Life Insurance Corporation of India
Employee's State Insurance Corporation
Private Sector
AEGON Religare Life Insurance
[2]

Edelweiss Tokio Life Insurance Co. Ltd
Aviva India
Shriram Life Insurance
Bajaj Allianz Life Insurance
Bharti AXA Life Insurance Co Ltd
Birla Sun Life Insurance
Canara HSBC Oriental Bank of Commerce Life Insurance
Star Union Dai-ichi Life Insurance
DHFL Pramerica Life Insurance
Future Generali Life Insurance Co Ltd
HDFC Standard Life Insurance Company Limited
ICICI Prudential Life Insurance Company Limited
IDBI Federal Life Insurance
IndiaFirst Life Insurance Company
Exide Life Insurance
Kotak Life Insurance
Max Life Insurance
PNB MetLife India Life Insurance
Reliance Life Insurance Company Limited
Sahara Life Insurance
SBILife Insurance Ltd.
TATA AIA Life Insurance
Re-insurance companies
Public Sector Government of India Fully owns 1 company:
GIC Re (General Insurance Corporation of India - Re-Insuer)

AVAILABLE MEDICLAIM/ HEALTH INSURANCE PLANS
1) Individual Health Insurance Plan

3) Senior Citizen Health Insurance Plan

5) Group Health Insurance Plan

7)Overseas Travel Health Insurance Plan

9) Special Plans

9a) Daily Cash Plan

9b) Maternity Benefit Plan

9c) OPD Coverage Health Insurance Plan

2) Family Floater Health Insurance Plan

4) Critical Care Health Insurance Plan

6) Accident Health Insurance Plan

8) Student Health Insurance Plan

10) Health Covers from Life Insurance Companies

1.Individual Health Insurance Plan:

Largely, an individual Health Insurance Plan (HIP), or mediclaim, would cover expenses if you are hospitalized for at least 24 hours. These plans are
indemnity policies, that is, they reimburse the actual expenses incurred to the amount of the cover that you buy. Some of the expenses that are covered are
room rent, doctors fees, anesthetists fees, cost of drugs, blood, oxygen, and investigations, and operation theatre charges.

In case of a claim under the above plans, expenses incurred are reimbursed. The remaining amount can be claimed during the remaining period of the
policy.

In case the insured has not made any claim during the entire period of policy:
No-claim bonus ranging usually between 5-10% is given on the premium of ensuing year.
Some companies also enhance the amount of cover without any extra premium.
Individual General/Health Insurance Companies Products
1. Apollo Munich Insurance Co Ltd
Easy Health Individual
2. Bajaj Allianz General Insurance Company Ltd
Health Guard
Hospital Cash
3. Bharti AXA General Insurance Company Limited
Smart Health Individual Policy
4. Cholamandalam MS General Insurance Company Limited
Individual Health
5. Future Generali India Insurance Co Ltd
Health Suraksha Individual Plan
6. HDFC Ergo General Insurance Company Limited
Health Suraksha
7. ICICI Lombard General Insurance Co Ltd
Health Advantage Plus
8. IFFCO Tokio General Insurance Co Ltd
Individual Medishield
9. National Insurance Company Limited
Mediclaim Policy
10. Reliance General Insurance Co Ltd
Individual Mediclaim Insurance Policy
11. Royal Sundaram Alliance Insurance Co Ltd
Health Shield Individual Insurance
12. Star Health and Allied Insurance Co Ltd
Medi Classic
Medi Premier
True Value
13. Tata AIG General Insurance Co Ltd
Maharaksha
14. The New India Assurance Co Ltd
Mediclaim 2007
15. The Oriental Insurance Co Ltd
Individual Mediclaim Policy
16. United India Insurance Co Ltd
Mediclaim Policy
United Indias Top-Up and Super Top Up Policies
17. Universal Sompo General Insurance Co Ltd
Universal Sompo Individual Health Insurance Policy
2.Family Floater Health Insurance Plan:

This is a fairly new entrant in the health insurance market policies. It takes advantage of the fact that the probability of all members of a family falling ill
at the same time or even within the same year is quite low. Under this plan, the entire sum insured can be availed by any or all members, and is not
restricted to one individual as is the case in an individual health plan.

Its operation can be explained simply through the following example. Say, a family consisting of five members has individual covers (under conventional
individual health plans for each member) of Rs. 1 lakh each such that their total cover cost is Rs 5 lakh. But if the cost of treating one person crosses Rs. 1
lakh, incase, the balance has to be paid by the family, beyond what it has paid for the policy. If on the other hand, the entire family is insured for Rs 5
lakh under the family floater policy, then any one or more than one of the members can avail reimbursement of the medical expenses upto to a total of 5
lakh during the insured period. Of course, there always is a small but real possibility that multiple members fall sick in the same year, in which case they
might still have to pay out of pocket beyond the total coverage.

A Family Floater can be brought by an individual, who becomes the proposer along with spouse, dependent children up to 25 years, and/or unmarried,
divorced or widowed daughter and/or either parents or parents in laws.

A discount of upto 10 per cent (may vary from company to company) is allowed on renewal premium, if there is no claim in the year immediately
preceding the year of policy renewal.

In other respects, they are broadly similar to Individual Health Insurance Plans.
In case the insured has not made any claims during the entire period policy:
No-claim bonus ranging usually between 5-10% is given on the premium of ensuing year.
Some companies also enhance the amount of cover without any extra premium.
1 Family Floater Health Insurance products from General Health Insurance Companies
1. Apollo Munich Insurance Company Limited
Easy Health Family Floater
2. Bajaj Allianz General Insurance Company Limited
Family Floater Health Guard
Insta Insurei Family Floater Policy for Rs 1 Lacs
Star Package
Smart Health Essential Insurance Policy
Smart Health High Deductibles Insurance Policy
Smart Health Insurance Policy.
4. Cholamandalam Ms General Insurance Company Limited
Family Health.
Health Suraksha (Individual and Family floater)
6. ICICI Lombard General Insurance Company Limited
Family Floater Health Insurance
7. IFFCO-Tokio General Insurance Company Limited
Swasthya Kavach (Family Health)
Parivar Mediclaim for Family
Star National Swasthya Bima Policy
BOI National Swasthya Bima
9. Reliance General Insurance Co Limited
Reliance Health Wise Policy
10. Royal Sundram Alliance Insurance Company Limited
Health Insurance for Individuals and Family
Health Shield Online
11. Star Health and Allied Insurance Company Limited
Family Health Optima.
12. The Oriental Insurance Company Limited
Happy Family floater Health Insurance/Policy Wording
13. United India Insurance Company Limited
Family Medicare Policy India
14. Universal Sompo General Insurance Company Limited
IOB Health Care Plus Policy

2. Family Floater Health Insurance Products from Life Insurance Companies
1. Aviva Life Insurance Company India Limited
Aviva Life Shield Plus
2. Bajaj Allianz Life Insurance Company Limited
Family Care First
3. Bharti AXA Life Insurance Company Limited
Easy Health
4. ICICI Prudential Life Insurance Company Limited
Health Saver, Medi Assure
5. Life Insurance Corporation of India
Health Protection Plus
Health Plus
6. Max New York Life Insurance Company Limited
Life Line Healthy Family Plan
7. MetLife India Insurance Company Limited
Met Health Care

3. Senior Citizen Health Insurance Plan:

These plans as the name suggests designed to cater to the senior citizens. This is significant as till a few years ago, it was difficult for a senior citizen to
get a health cover though they are the ones who need it most. Most of these have a fixed sum insured of Rs. 1 lakh or Rs 2 lakh. Some compulsorily
require co-payment. These are, in essence, Individual Health Insurance Plans with minor modifications. Check for sub-limits on specific ailments.
Age of entry varies from company to company, and is usually between 60 to 80 years. Age limit can be extended to 90 years with loading of some
extra premium.
Critical illness as an optional cover is also available in some of the plans on paying extra premium.
Senior Citizens Health Insurance
Silver Health Policy
Varistha Mediclaim for Senior Citizens
3. Star Health and Allied Insurance Co Ltd
Senior Citizen Red Carpet
Senior Citizen Mediclaim Policy
5. The Oriental Insurance Co Ltd
Senior Citizen Specified Diseases Insurance
6. United India Insurance Co Ltd
Senior Citizen Policy
4. Critical Care Health Insurance Plan:

Critical illness plans work differently from other health insurance covers. They provide financial assistance when one develops a serious ailment such as
cancer or a stroke. In such cases, a critical illness plan pays the entire sum insured. Note that this is unlike a health cover which only reimburses the costs.
Such plans cover a specific number of ailments only and the cover ends once the sum insured is paid.
In case of a claim, the entire sum insured is paid on diagnosis of the specified illness
No-claim bonus is paid only by few companies
1. Critical Illness Health Plans From General Insurance Companies
Critical Illness
Smart Health
Critical Illness
Critical Care
Critical Illness Policy
Critical Illness Policy
Reliance Critical Illness Policy
Star Criticare Plus
9. Tata AIG General Insurance Company Limited
Criticare
Aapat Suraksha Bima Policy

2. Critical Illness Health Plans From Life Insurance Companies
1. Aviva Life Insurance Company India Ltd
Aviva Health Plus
2. Bharti AXA Life Insurance Company Ltd
Swasthya Sanjeevani
3. HDFC Standard Life Insurance Company Ltd
HDFC Critical Care Plan
HDFC Surgicare Plan
4. ICICI Prudential Life Insurance Company Ltd
Crisis Cover
5. Max New York Life Insurance Company
LifeLine Wellness Plan
LifeLine-Safety Net Plan
Lifetime Wellness Plus Plan
6. Met Life India Insurance Company Limited
Met Health Care
7. SBI Life Insurance Company Limited
SBI Health Product
Group Schedule of Critical Illness
8. Tata AIG Life Insurance Company Limited
Tata AIG Life Group Health Plus
Tata AIG Life Health First
Tata AIG Life Health Investor
Tata AIG Life Health Protector
5. Group Health Insurance Plan:

Group Health Insurance is similar to Health Insurance for an individual or a family. The difference is that this product is taken by a group, which is in
existence at the time of submission of the proposal with specified names of members/being available. A group comprises of an existing set of
persons/individuals on the basis of certain norms. It is always permitted to add new members in the group and delete those members who have left the
group.

The rates applicable are more or less same as applicable to individuals with discount being given at the different rates by different companies.
Group should fall under some specified categories for example:
Employer-employee relationship including dependents of the employee.
Pre-identified segments/groups where the premium is to be paid by the State/Central Governments.
Members of a registered co-operative society.
Members of registered service clubs.
Holders of credit card of Bank/Diners/Visa.
Holders of deposit certificates issued by Banks/NBFCs.
Shareholders of Banks/Public Limited companies.
Minimum number of Person: 100
Age limited, basic premium, benefits and exclusions are same as per individual mediclaim policy.
There are no family discounts, cumulative bonus and cost of health checkup. The policy should not be issued through intermediaries. Maternity Benefits:
The maximum cover available up to Rs () for maternity or the sum insured opted by the members of group, whichever is lower. This is an optional
cover which can be obtained on payment 10% of the total Basic premium for all the insured persons under the policy at the time of policy inception only.
Total basic premium means the total premium computed before applying group discount and/or high claim leading low claim discount and any special
discounts.
Option for this cover has to be exercised at the inception of the policy period and no refund is available in case the insured cancels this option during the
policy.

A waiting period of 9 months is applicable for payment of any claim relating to normal delivery or caesarian section or abdominal operation for extra-
uterine pregnancy. The waiting period may be relaxed only in the case of delivery, miscarriage or abortion induced by accident or other medical
emergency.
Claim in respect of delivery for only first 2 children and/or operation associated therewith is considered.
Voluntary termination of pregnancy during the first 12 weeks from the date of conception is not covered.
Pre and post-natal expenses are not covered unless hospitalized.
Group Discount:

The final group discount increase/decrease will be adjusted on the policy period provided the policy is renewed for the next 12 months.

The above mentioned points are common features being adopted by the companies, but there is always variation between the offers of two companies.
Groups getting insured should check the details from different companies before selecting one.
Group Health Insurance Plans For Corporate/Organizations
Group Health Insurance
Group Health Guard
Group Critical Illness
3. Cholamandalam MS General Insurance Company Limited
Group Health
4. Future Generali India Insurance Company Limited
Group Health Policy
5. HDFC ERGO General Insurance Company Limited
Group Health Insurance
Group Mediclaim Insurance Policy

Reliance Group Mediclaim Insurance Policy
Accident and Health
Group Multi Guard
Voluntary Employee Benefits
Group Mediclaim Policy
Mediclaim Policy
Group Health Insurance Policy
6. Accident Health Insurance Plan:

The personal Accident Policy provides the following basic benefits against death and disablement resulting from an accident, but not more than one of the
following:
Death Only
Loss of sight of two eyes, or loss of two hands or feet, or loss of the use of one hand and one foot, or loss of vision in one eye and loss of use of
one hand or foot.
Loss of vision in one eye or loss of use of one hand or one foot.
Permanent total disablement from injuries other than named as above.
Permanent partial disablement for loss of limbs as shown below:
Loss of toe All
Great both Phalanges
Great One phalanx
Other than great, if more than one toe lost each

Loss of hearing in both ears
Loss of hearing in one ear
Loss of four fingers and thumb of one hand
Loss of four fingers
Loss of thumb-body phalanges
One phalanx

Loss of index fingers-Three phalanges
Two Phalanges
One phalanx

Loss of Middle finger : Three phalanges
Two Phalanges
One Phalanx
Loss of Ring finger-Three Phalanges
Two Phalanges
One Phalanx
Loss of Little finger-Three Phalanges
Two Phalanges
One Phalanx
Loss of Metacarples-1st or 2nd (additional)
3rd, 4th of 5th (additional)
Any other permanent partial disablement.

Permanent total disablement.
Temporary total disablement
In the event of death of the insured person due to accident outside his/her residence, reimbursement of expenses incurred for transportation of the
insureds dead body to the place of residence are subject to a maximum of 2% of the capital sum insured or Rs1000, whichever is less.

The following extra benefits may be covered on payment of additional premium:

Reimbursement of Medical Expenses incurred following an accident upto 40% of the valid claim payable or 10% of the Capital Sum Insured for Personal
Accident Cover, whichever is less.( may differ from company to company and plan to plan) Sums insured under notified conditions is increased by 5%
for every claim free year of the policy to a maximum limit of 50% once the policy is renewed in time.

The cumulative bonus will be lost if the policy is not renewed within 30 days after its expiry.(may differ from company to company).

Classification of Occupational Risks:

For classification of occupational risks not specified below reference should be made to the company.

Risk Group I:

Accountants, Doctors, Lawyers, Architects, Consulting Engineers, Teachers, Bankers, persons engaged in administrative functions and persons primarily
engaged in occupation of similar hazard.

Risk Group II:

Builders, Contractors and Engineers engaged inn superintending functions only, Veterinary Doctors, paid drivers of motor cars and light motor vehicles
and person engaged in occupation of similar hazard and not engaged in manual labour.

All persons engaged in manual labour (except those failing under group III) cash carrying employees, garage and motor mechanics, machines operators,
drivers of trucks or lorries and other heavy vehicles, professional athletes and sports men, woodworking machinists and persons engaged in
occupations/activities of similar hazards.

Risk Group III:

Persons working in underground mines, explosive magazines, workers involved in electrical installation with high tension supply jockeys, circus
personnel, persons engaged in activities like racing on wheels or horse back, big game, hunting, mountaineering, winter sports, skiing, ice hockey,
ballooning, polo and persons, engaged in occupations/activities of similar hazard.

Note: Occupations not included in the above will be decided by insurer depending upon the merits of each individual case. Exclusion:

The policy does not cover death, injury or disablement resulting from:
Service on duty with any armed force.
Intentional self injury, suicide or attempted suicide, insanity, venereal disease or the influence of intoxicating drink or drugs.
Medical or surgical treatment (except where such treatment is rendered necessary within the scope the policy).
Aviation other than as a passenger (fare-paying or otherwise) in any duly licensed standard type of aircraft any where in the world.
Nuclear radiation of nuclear weapons materials.
Any consequence of war, invasion, act of foreign enemy hostilities (whether war is declared or not), civil war, rebellion revolution, insurrection,
mutiny military or usurped power, seizure, capture, arrests, restraint and detainments of all kinds,
Child birth, pregnancy or other physical causes peculiar to the female sex.
Whilst committing any breach of law with criminal intent.
Notes:
The cover is worldwide.
The capital sum insured shall be fixed at the commencement of the policy. No change in the CSI in permissible during the tenure of the policy.
Occupations not included in the above will be decided by insurer depending upon the merit of each case in consultation with RO/HO Technical
Dept.
Sum insured usually does not exceed 2 years income with a maximum of six year income.
Sometimes persons avail accident benefits as a part of other policies just like Life Insurance, Car Insurance, etc. The insured should have a
complete record of all the policies providing accident benefits as under unforeseen circumstances, one is eligible to get reimbursement from all the
policies.
1. Individual Personal Accident Policy
Individual Personal Accident Plan
Personal Guard
Sankat Mochan
Health Ensure
3. Bharti AXA General Insurance Co Ltd
Smart Personal Accident Individual Insurance
Chola Accident Protection Plan
Accident Protection Plan
Revive
Accident Suraksha
Individual Personal Accident Insurance
Individual Personal Accident
Personal Accident Policy
10. Raheja QBE General Insurance Co Ltd
Accident Personal
11.Reliance General Insurance Co Limited
Individual Personal Accident Policy
Personal Accident Insurance Online
13. Shriram General Insurance Co Ltd
Personal Accident Insurance
14. Star Health And Allied Insurance Company Limited
Accident Care
Accident Guard
Healthcare+
Hospital Care
Secured Future Plan
Personal Accident Individual
Janata Personal Accident
Gramin Accident Policy
Individual Personal Accident Policy.

2. Group Personal Accident Policy for Corporate/Organization
Group Personal Accident
4. Future Generali India Insurance Company Limited
Group Personal Accident Policy
Group Personal Accident Insurance
Group Personal Accident Insurance Policy
Personal Accident Insurance Policy (Group)
8. Tata AIG General Insurance Company Limited
Business Travel Accident
Small Business Travel Accident
Personal Accident Group
Group Personal Accident Policy
7. Overseas Travel Health Insurance:

Overseas travel health insurance is required because medical services are exceptionally expensive to those in comparison to our country. Initially such
policies were primarily taking care of emergency hospitalization/medical treatment but today this product is available with several additional features
(may differ from company to company and plan to plan) as listed below:
Medical expenses
Dental treatment
Repatriation of remains (covers the funeral expenses or expenses of repatriating the remains back to India, in case of death overseas)
Checked in Baggage loss
Passport loss
Personal accident (compensation paid in case of accidental death and PTD due to an accident).
Personal liability (Compensation of damages to be paid to a third party, resulting from death, injury or damage to health or property caused
involuntarily by the insured).
Bail Bond (for the bail amount, if arrested or detained by police or judicial authorities of the place, for any bailable offense whilst abroad).
Study interruption (Reimbursement for the remaining part of the current school semester fee, if studies are interrupted on account of a medical
condition or compassionate reasons on the family front).
Sponsor protection (Reimbursement of tuition fees in case of demise of person paying for studies due to an accident).
Two-way compassionate visit (In case of hospitalization exceeding 7 days of student or a family member, where a family member visits student,
or student visits India. Round trip economy class tickets for student/family-members and accommodation for the family member visiting abroad
would be reimbursed).
Treatment for mental and nervous disorders.
In-patient medical expenses related to pregnancy, subject to a waiting period of 10 months.
Medical screening and mammography expenses.
Children benefits (If the child is above 90 days of age, and is hospitalized for more than two days for any ailment, hospital cash benefit of US
$100 per day will be paid, subject to a maximum of 7 days).
At present the policies can be divided into:

1. Single trip policy
2. Annual Multi trip policy.

As the name indicates, single trip covers a single trip starting on a specific date and ending on a specific date. It is possible to extend the date on payment
of additional premium subject to condition that no claim has been made. Extension of policy is at the discretion of the insurance company.

Annual Multi trip policy is having validity of one year. Multiple trips are allowed with the condition that no single trip can be greater than 30 days. Some
insurance companies now offer an option of a maximum duration for a single trip of 45 days.

The terms and conditions of issuing this policy differ from company to company. One is advised to compare various offers being made by different
companies specially keeping in view the following:
Permissible upper age limit.
Whether pre existing diseases would be covered or not.
Name of the hospitals attached with the policy.
Any upper limit of reimbursement amount.
Overseas Travel Health Insurance Products
Easy Travel Individual Plan
Easy Travel Family
Easy Travel Senior Citizen
Easy Travel Annual Multi Trip
2. Baja Allianz General Insurance Company Limited
Travel Asia
Travel Assist
Travel Companion
Travel Elite
3. Cholamandalam Ms General Insurance Company Ltd
Short Term Travel

Travel Suraksha
Overseas Travel
Multi Trip
Asia Travel
Superior Care
Travel Insurance
Annual Multi Trip
Senior Citizen Plan
Single Round Trip
Travel Protector
Overseas Mediclaim
Reliance Travel Care Insurance Policy Asia
Reliance Travel Care Insurance Policy Schengen
Reliance Travel Care Insurance Policy for Individuals and Families
Travel Shield Online
Travel Individual
Travel Family
Travel Guard
Asia Travel Guard
Overseas Mediclaim Policy
Overseas Mediclaim Business and Holiday
Overseas Mediclaim Policy for Business and Holiday.

Group Overseas Travel Policy for Corporates and Organizations
Easy Travel Corporate
Group Travel
Group Travel Insurance
Corporate Overseas Travel
Reliance Travel Care Insurance Policy
6. Max New York Life Insurance Company Limited
Life Line Healthy Family Plan
7. MetLife India Insurance Company Limited
Met Health Care
8. Students Health Insurance Plan:
Policy for the students are being designed to provide health and personal accident cover to them. It also provides for the continuation of insured students
education in case of death or permanent total disablement of the guardian due to accident. Parents /Legal Guardian of an individual student in any
Registered Educational Institution affiliated to any State Board, Council, University and AICTE or any other Government Statutory Authority within the
territory of India, may take this policy. The Educational Institution may also take a Group Policy covering named students enrolled with them.

Policies for Students
National Insurance Company Limited
Vidyarthi-Mediclaim for Students (Domestic)
2-Star Health and Allied Insurance Co Ltd
Student Mediclaim (Domestic)
9a. Daily Hospital Cash Plans

As treatment moves away from home and towards hospitals, insurers have started offering daily hospital cash (DHC) plans. You can buy maximum daily
covers of anything between Rs. 500 and Rs. 5,000. The premium would depend on the age and amount. For stay in intensive care units, the amount is
automatically doubled. There is usually a cap on the number of days of claim per year. Expense benefit is paid on per day basis after hospitalization (most
plans mandate at least 48 hours of hospitalization). The pre-decided daily benefit amount is paid in full, irrespective of the actual expenses For example, a
person buys a DHC plan with a limit of Rs 2,000 per day. He gets hospitalized for 7 days and the total bill is Rs 35,000. He would be reimbursed Rs
14,000 (2,000x7). If the bill is Rs 8,000, he would still be reimbursed Rs 14,000.

9b. Maternity Hospitalization:

At present maternity hospitalization is being covered under group insurance policies by most of the companies. (See details under Group Insurance).
Some of the companies initially offered maternity cover as a part of individual policy but there was a paucity of information about the exact companies
providing this service.

9c. OPD Coverage Health Insurance Plans:

There are only two companies which are providing OPD coverage in their health insurance plans.
ICICI Lombards Health Advantage Plus ;
The Apollo Munichs Maxima.
The ICICI covers OPD expenses i.e. consultation, tests or medicines from the first day of the policy. The OPD cover may vary from Rs 2,000 to Rs
10,000 depending on the plan opted and the age profile of policy holder. One can claim OPD charges only once during the policy term so one has to keep
all the bills paid safely to get the reimbursements as and when the limit is reached.

The Apollo Munichs Maxima benefits includes, cash-less OPD expenses across trusted network of pharmacies for pharmacy bills, diagnostic centers for
diagnostic tests and annual health check up, dental and optical care centers for contact lenses, spectacles and dental treatments along with consultation
with family doctors.
OPD Coverage as a Part of Health Insurance
1. ICICI Lombard General Insurance Co Ltd
Health Advantage Plus
Maxima Health Insurance Plan
10. Health Covers From Life Insurance

In a fairly recent development Life insurance companies too have started offering health covers. Usually, these have a longer term then those offered by
general insurance and often fixed premiums for three, five or even 10 yrs. Contrary to popular belief, however, not all health schemes from life insurance
companies give you the insured amount as a lump sum irrespective of your actual spending. The plans from life insurance typically fall into the categories
discussed above. But they are often packaged as combinations (See Health Plans From Life Insurers: Whats On Offer) with an IHIP, or DHC, or even
with surgeries. Since the insurer will pay only for the benefits mentioned, it is prudent to find the exact nature of the cover before the purchase.
1. Health Products of Life Insurance Companies
Aviva Life Insurance Company India Limited
Aviva Health Plus
Aviva Lifeshield Plus
Protection Riders

Bajaj Allianz Life Insurance Company Limited
Family Care First
Care First
Health Care

Bharti AXA Life Insurance Company Limited
Easy Health
Swasthya Sanjeevani (Group)

4 Health Products of Life Insurance Companies
Birla Sun Life Insurance Company Limited
BSLI Universal Health
BSLI Health Plan

Future Generali India Life Insurance Company Limited
Future Sanjeevani (Riders)
Riders

HDFC Standard Life Insurance Company Limited
HDFC Critical Care Plan
HDFC Surgicare Plan

ICICI Prudential Life Insurance Company Limited

1. Comprehensive Health Coverage
Health Saver
2. Hospitalization Coverage
Medi Assure-(Family Floater)
Hospital Care
3. Critical Illness Coverage
Crisis Cover
4. Cancer Coverage
Cancer Care
5. Diabetes Coverage
Diabetes Care Active

IDBI Fortis Life Insurance Company Limited
Wealth Insurance Plan

Life Insurance Corporation of India
Health Protection Plus
Health Plus

Max New York Life Insurance Company Limited
LifeLine Medicash
LifeLine Medicash Plus Plan
LifeLine Wellness Plan
LifeLine Wellness Plus Plan
LifeLine-Safety Net Plan
LifeLine Health Family Plan

MetLife India Insurance Company Limited
Met Health Care

Reliance Life Insurance Company Limited
Wealth Plus Health Plan
?Riders Plan

SBI Life Insurance Company Limited
SBI Life-Group Criti9

Star Union Dai-ichi Life Insurance Company Limited
Critical Illness Benefit Rider
Accidental Death and Total & Permanent Disability Benefit Rider

Tata AIG Life Insurance Company Limited
Tata AIG Life Group Health Plus
Tata AIG Life Health First
Tata AIG Life Health Investor
Tata AIG Life Health Protector
Tata AIG Life Hospi CashBack
Tata AIG Life InvestAssure Care
Tata AIG Life InvestAssure Health

How to Choose Best Health Insurance in India
Today we will find out how to Choose Best Health Insurance in India . With so many Insurance companies , so many health insurance policies with
different names and complex features, it becomes an impossible task for a common man to pick a policy and be confident about it . So I requested
Mahavir Chopra from medimanage.com, a vetern in the Health Insurance sector having a vast experience to give some insights to readers on how to
choose health insurance product and explain the think step wise. Medimanage is a health insurance broker, which blends unbiased Health Insurance
Expertise, Technology Powered Delivery and Professional Claims Management into one integrated service model. Over to Mahavir from here on
Health Insurance, as its known worldwide is the only effective mechanism known and available that can ensure you to get the best healthcare at
affordable price. Whereas, the healthcare industry being more organized abroad, has resulted in insurance companies offering more comprehensive range
of products overseas. Comparing this to the Indian Healthcare system, in its current form, can be actually be called by Hospitalization Insurance. The
products that are available in country, only covers for the expenses related to hospitalization charges for accidents as well as sickness. This benefit of
course is subject to a looooong list of term and conditions.
Manish asked me to be very specific, and give the readers (of JagoInvestor.com, a blog I admire for its simplicity and rich content) a clear take away on
how they can zero in the best product in the market. With more than 25 General Insurance Companies marketing more than 40 Health Insurance products,
comparing multiple terms of such policies looks like a daunting task (see a common man complaint to a health insurance company) . Its not, if you first
come to terms with the following 2 things:
1. Settle to the fact that there is no Exact-match, no Perfect Product available.
2. You only compare the crucial features/benefits/terms that will affect your coverage in the long run.
Here are the most important things you must follow when you compare products. Of course, there are other features you can compare, which have been
left out in this article. These features (like 1, 2 year waiting periods, Pre and Post Hospitalization Expenses, Loading, No Claim Discounts have been left
out, looking at Health Insurance as a long-term product)
1. Cut out the frills. Go Basic
Most frilled products in India are not at all cost-effective. They are the products which take almost double the median premium and offers unnecessary
frills is a strict no no. We have all traditionally lived with and survived the cost of routine medical expenses like Consultation expenses, Dentists bills,
Medicine bills, and such costs are therefore manageable by most of us, unlike a huge hospitalization bill which could eat way more than a couple of
months salary or savings.
Bottom-line : You should first look at covering ALL members of your family for the larger unmanageable costs, which could burn a hole in your
overall financial planning before signing for any fancy product. (see two policies which are cost effective)
2. Dont Compare Premiums
Never start by comparing premiums. Health Insurance is long-term purchase and it is more than a Mumbai-Delhi Air Ticket, which you can compare and
buy from comparison/aggregator websites. Health Insurance is a long-term complex contract coupled with complex services. Comparison of premiums
could be largely misleading and could result in a disaster. Comparing Health Insurance requires deeper insights into the overall insurance contract (called
policy wordings) over and above price comparison. Either you need to get yourself into comparing the features in detail, or take help of an unbiased
health insurance advisor.
Bottom-line: Understanding the benefits and terms is more important than the cost you are paying.
3. Look for Maximum Renewal Age
Maximum Renewal age is the age on which the coverage on your health insurance would discontinue. This could be for all members or for a specific
proposer/member, depending on product to product. Remember, your core goal, when you buy Health Insurance is to save yourself from mounting
healthcare costs right through your life. A product, which ceases renewal, while you are still alive and when you need it more than any time before, is a
BAD product. Shift through all products and find out the maximum renewal age. Better, look for Lifetime products. Rule out all products, which do not
cover your family members for a reasonable lifetime. As medical science progresses and becomes more accessible to the common man, life expectancy in
India will move higher from the current average of around 70 years. A product with a lower renewal ceasing age than 70 years is a complete no no.

Bottom-line: An insurance product which does not work, when you most need it, is not insurance.
4. Look for Limits (Treatment wise limits & Copay)
Look for treatment wise limits in the products. Treatment wise limits basically cap the amount you can claim for a particular surgery under the policy.
Say, there could be limits for Cardiac treatments of Rs. 1.50 Lakhs or for Cataract for Rs. 20000 per eye. Such limits would cap your claim, even n when
you have a large sum insured under the policy. You need to weigh this in, before you sign up. Some products I remember are United Indias Family
Medicare, Star Healths Red Carpet have such limits. Bajaj Allianz General and ICICI Lombard have a limit only for Cataract. (Max Bupa Review)

Another condition is the COPAY it is basically the share of admissible claim that the customer would have to pay from their own pocket. For instance,
with copay option of 10%, the claim amount is of Rs. 50,000, and the admissible claim is Rs. 48,000 then the copay amount would be Rs. 4800. The
Total amount you would have to pay is Rs. 6800/- (Rs. 2000 deduction in the policy + Rs. 4800 of Copay) .
Couple of products which have Copay
Oriental Happy Family Floater at 10% of the Sum Insured upto Rs. 5 Lakhs Sum Insured.
Bajaj Allianz has a copay of 10% for treatment at Non-Network Hospitals in their Health Guard products, and 20% in Silver Health.
Star Senior Citizen Red Carpet has a copay of 30%. For Pre-existing the copay is 50%.
Bottom-line: Know what you will not get paid.
5. Understand Day wise Cash limit Health Products

There are some products marketed and sold as Health Insurance (Aegon Religare Life, Tata AIG General are the popular ones) which provide a daily cash
benefit for the no. of days one is hospitalization. Most surgeries require an average of 6-10 days, so at the Rs. 5000 per day limit multiplied by 10 Days
would pay Rs. 50000 per hospitalization, irrespective of the actual charges incurred. An Angioplasty in this will unknowingly burn a big hole in your
pocket. Please avoid this product for your core healthcare expenditure risks or as an alternative to a Standard Health Insurance product. This product is
more like an add-on cover, than the bigger solution.
Important Note : Do not confuse the above with products that have specific limits on Room Rent. Room Rent Limits, to an extent, make sense both for
the customer, as well as the Insurance Company, as they categorize people paying a higher premium in the higher eligibility bracket. This has been
further discussed in detail below in this article.
Bottom-line: All plans which are called Health Insurance may not be what you are looking for.
6. Zero in on a Coverage amount/Sum Insured
Sum Insured is the total annual liability under the policy. Since this is a long-term product, you
should look at the maximum available cover you can afford. Remember, a sum insured of Rs. 2 to 3 Lakhs will have no value, by the time you start using
it. As per a very recent report on Healthcare in India by Tower Watson, the medical inflation in India is rocketing anywhere between 17 to 20% annual
Option of Upgrading Sum Insured: The option of upgrading the cover at a later stage when you are older is dicey and complicated. There could be a
requirement for a medical test. Moreover, if you or any of the family members contact a new disease in the interim, the ailment would be excluded for the
upgraded amount. Upgrade would be almost like taking a new policy at that age, which I would not recommend.
Bottom-line: Look for the highest cover affordable. An I-will-upgrade-it-later option may not work.
7. Compare Premiums for age bands higher than 45 years
Premium in Health Insurance increases as per increase in your age, but, theres something about the no. 45. Insurance Companies dislike this no. Have a
look at the rate charts, and you will be surprised to see good jump in premiums after one cross the age of 45 yrs. In some cases, the increase in premium is
as high as 50%. You need to factor this, before you sign up. Ensure premium remains affordable in your retirement days, and does not kill your hard-
earned retirement savings.
Note: You need to factor in that these premium charts can change even tomorrow, like they have changed earlier, but looking at the current charts for
older brackets would get you a flavour of the companys pricing philosophy for older age bands.
Bottom-line: Know how the premiums change in the long run.
8. Credibility, Check. Look at the history of the company
If it is a new company, you could look at the history of the promoters and their businesses. Generally, a company or set of promoters known for their
ethics and excellent governance, venturing out into Insurance would be a decent bet. Get information from your advisor, on the overall claims experience,
on responsiveness, about changes and number of changes in the product, since it was launched. Too many or too large changes, indicates there could be
more tomorrow.
Bottom-line: History in the best teacher.
9. Products for older age/Senior Citizen family members.
Most Insurers, including the ones specialized in Health Insurance resist covering members above 45 years. Remember, you need to somewhere take the
responsibility of not covering your parents, earlier in their life, and not completely blame Insurance Companies for not covering them, now.
There is no perfect product available for Senior Citizens. All products for senior citizens are restrictive. You need to settle for a product, best affordable to
you, even if it has co-pay, exclusions and other restrictions. Again, if your parents have existing ailments, then this becomes more complicated.

Bottom-line: There is no Perfect Product. Definitely not, if you are a Senior Citizen.
10. TPA V/s Non TPA Insurance Companies
TPAs have unnecessary got caught in the blame game of high claims burning the health insurance industry. The point is, TPAs are just BPOs of Insurance
Companies, and are therefore as good as the Insurance Company itself. Remember, India is the worlds processing house, and there are Indian BPOs
which handle more complex health claims for large Insurance companies, the world over. Insurance Companies that have engaged TPAs better and
insisted on execution of hardbound contractual agreements have not faltered on their service.
11. Government V/s Private Insurance Companies
Some consider Private Insurers better due to their modern infrastructure, their responsiveness. Some consider Public Sector to be more reliable. Private
Sector would run for business and hence would be very responsive. Public Sector, are the Governments mechanism to ensure a great healthcare
infrastructure, and hence somewhat have a social angle, changes in the policy are not driven only by profits but also need to socially acceptable. You need
to understand the pros and cons diligently and hence set your own expectations right for your choice.
12. Finally, Ensure you have a Good Advisor
I have always said this, ensure you spend good time in deciding, who is your intermediary. Once you have taken pain to finalize a good advisor, you are
more than half way done. A good advisor is one who would provide -
a) Unbiased advice, without any special affiliation to any Insurance Company.
b) Provides Routine services like Pickups, Renewals etc.
c) Assists and Guides you at the time of Claims.
Health Insurance industry is witnessing huge changes both in products, price as well as processes, being an insider, it is sensible to have an expert on your
side, who updates you on changes, their impact on your coverage and suggest change in course, in case necessary.
Bottom-line: Insurance Companies will always have their own vested interests. Have someone on your side.
Note: The other terms & benefits comparable are Pre and Post Hospitalization, Benefits like No Claim Bonus/Discount, Loading of Premium, 1-2 or 4
year waiting Period for Specified Ailments have not been considered as they do not make a very big impact on the decision to purchase Health Insurance.

Points to be discussed with agents while taking medical insurance.

a) Difference between Individual Health Insurance Plan, Family Floater Health Insurance Plan, and critical illness or hospital cash
insurance. Which is preferable for me?
b) List of top 5 medical insurance companies.
c) What is Policy bazar suggested health policy?
d) What are the Top Features of the proposed policy?
e) What are the Hospitalization Benefits of the proposed policy?
f) What are the Medical Benefits of the proposed policy?
g) What are the Additional Benefits of the proposed policy?
h) Do I need to undergo a medical check-up while buying a health insurance policy?
i) Co-payment?
j) What is not covered (diseases) ie policy exclusions?
k) How to take policy ie a single policy for all family members OR split into two family members?
l) Tax exemption benefits, if any considering single & spilt policies.
m) Procedure for claiming OR cashless facility in near Paloncha hospitals.
n) List of hospitals in Paloncha, which are allowing the selected health policy.
o) What are the advantages to take a health policy through Policy bazar?
p) What are the services to be provided by Policy bazar after taking the policy?
q) What are the documents required for policy?
r) The below points to be checked before selection of policy.
Pre-hospitalisation in days
Post-hospitalisation in days
Day Care Treatments (Yes/No)
Room Rent (INR per day OR % of SI per day)
ICU Charges (INR per day OR % of SI per day)
Doctor's Fee etc (Limited OR No limit)
Other Medical Charges (Limited OR No limit)
Daily Allowance (INR per day OR % of SI per day)
Ambulance Cover (INR per claim OR % of SI per claim)
Domiciliary hospitalisation (% of SI)
Organ Donor Cover (INR)
Annual Health Check-up (Yes/No & frequency)
Second Opinion (Yes OR No)
No Claim Bonus (Yes OR No)
Auto-Recharge of Sum Insured (Yes or No)
In-patient care: Hospitalisation expenses such as room rent, nursing expenses, ICU charges, surgeons fees, doctors fees, anaesthesia, blood, oxygen, operation theater charges, etc.
Day care treatment: Medical expenses incurred if hospitalisation is less than 24 hours,
Pre and Post hospitalisation: Medical expenses incurred 30 days immediately before hospitalisation will be covered. Expenses incurred up to 60 days after being discharged from the
hospital such as follow-up visits to medical practitioner, medication, etc will be covered.
Ambulance charges: Charges of Ambulance provided by the hospital or any service provider will be reimbursed
Daily Allowance: Out-of-pocket expenses such as transportation, attendants cost, etc while visiting the hospital or doctor are also provided. A lump sum amount for each completed day
of hospitalisation is paid as Daily Allowance.
Organ Donor Cover: Medical expenses incurred by an organ donor while undergoing the organ transplant surgery if the organ is for the use of the insured person.
Second opinion: If the insured is suffering from a major illness as stated in the policy and wants to take a second opinion from any other doctor then Religare arranges the same free of
cost. This 2
nd
opinion is available to each of the members covered every year for each illness.
Domiciliary Hospitalisation: Medical expenses incurred by the insurer for treatment at home will be reimbursed. The medical treatment should be for a period exceeding 3 consecutive
days and should merit hospitalisation.
Health Check up: The policy pays for annual health check-up of the insured and those family members who are not covered as policyholders child under the policy.
Recharge of Sum Assured: If the Sum Assured in the policy is exhausted due to claims made, then the company reinstates the entire sum assured once in the policy year. This
reinstated amount can be used for future claims, not related to the illness / injury for which the claim has already been made during the same year.
Treatment anywhere in the world: For select diseases / ailments / treatments, the Company will reimburse the cost of medical expenses, whether the insured gets these treatments
anywhere in India or abroad. All payments under this benefit will be made in India, in Indian Rupees and on a re-imbursement basis only.

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