Introduction to Health Insurance in India

POSTED BY Jagoinvestor ON January 7, 2010 COMMENTS (260)

How many accident you need to realise that you need Health Cover? It takes just one visit to a hospital to make us realize how vulnerable we are, every passing second. For the rich as well as poor, male as well as female and young as well as old, being diagnosed with an illness and having the need to be hospitalized can be a tough ordeal. Heart problems, diabetes, stroke, renal failure, cancer – the list of lifestyle diseases just seem to get longer and more common these days. Thankfully there are more speciality hospitals and specialist doctors – but all that comes at a cost. The super rich can afford such costs, but what about an average middle class person. For an illness that requires hospitalization/ surgery, costs can easily run into five digit bills. A Health insurance policy can cover such expenses to a large extent. Read why Health Insurance is more Important these days compared to Old days

Types of Health Insurance

There are mainly three types of Health Insurance covers:

  • Individual Mediclaim : The simplest form of health insurance is the Individual Mediclaim policy. It covers the hospitalization expenses for an individual for up to the sum assured limit. The insurance premium is dependent on the sum assured value. Example : If you have 3 family members you can get an individual cover of Rs 2 lacs each . In this case each of you are covered for 2 lacs , if 3 members face a need for hospitalization , all 3 of them can get expenses recovered upto Rs 2 lacs . All the 3 policies are independent .
  • Family Floater policy : Family Floater Policies are enhanced version of the mediclaim policy. The sum assured value floats among the family members. i.e  each opted family member comes under the policy, and it covers expenses for the entire family up to the sum assured limit. The premium for family floater plans is typically less than that for separate insurance cover for each family member. Example : In this case if suppose there are 3 family members , you can take a Family floater policy for Rs 6 lacs in total . Now anyone can claim upto 6 lacs in expenses , but then the cover will go down by that much amount for that year . So if one of the family member is hospitalised and the expenses are 4.5 lacs . It will be paid and then the cover will be reduced to 1.5 lacs for that particular year . Next year again it will start from fresh 6 lacs. Family floater makes sense for a family because that way each one in family gets a big cover and probability of more than 1 getting hospitalized in same year is too low untill and unless whole family is travelling together most of the times in a year .
  • Unit Linked Health Plans : Taking the ULIP route, health insurance companies too have introduced Unit Linked Health Plans. Such plans combine health insurance with investment and pay back an amount at the end of the insurance term. The returns of course are dependent on market performance. These plans are very new and still in development phase . This is only recomended for people  who can handle market linked products like ULIP and ULPP . Read who should buy ULIPs .

For a number of reasons, it is advisable to steer clear of unit linked health plans. The best way is to treat insurance purely as an expense. So if you are single, opt for an Individual Mediclaim policy and if you have family, opt for a Family Floater policy. The amount paid (by cheque or debit/ credit card) for health insurance premium provide tax exemption under section 80D for a maximum of Rs.15,000.

What is the Ideal Cover for Health Insurance

As mentioned earlier, the cost of Health Insurance depends on the sum assured , age, current health condition and your previous medical history. Higher the sum assured, higher the premium. So what is the ideal health insurance cover requirement? There is no standard answer or thumb rule for this. If we agree that health insurance is important, one has to look at his/ her own lifestyle, health condition, age/ life stage, family history of illnesses and affordability. Keep in mind that most insurance companies limit the sum assured to a maximum of 5 lakhs. Also note that many health insurance policies “provide additional benefits” such as daily allowance, ambulance charges, etc. for hospitalization. Not only are such “benefits” superfluous, they tend to drive the premiums higher. So it is best to avoid such plans and stick to something basic and simple.

Image courtesy

Health Insurance provided by Employer

Many employers provide health cover for their employees. Isn’t that sufficient? Three aspects need to be considered in such a case – Is that cover sufficient? Is the insurer good enough? What happens if you change your job? Health insurance is provided as a perk to the employees. So it is important to understand the policy a bit more in detail and to check for coverage. The best way is to ask the HR Department for policy details. Get into details , what is covered , what is not covered ? Many times Employees just think that they have health Insurance and are just relaxed only to find later that it does not cover X and covers Y only upto a limit . That can be a painful situation .

Health Insurance for the aged

Till a few years back, health insurance companies were reluctant to provide cover for the aged. But nowadays there are a lot of insurance companies providing policies for the senior citizens. Insurance cover paid for a person of age 65 years and above, can provide additional tax exemption of up to Rs.20,000. But keep in mind that the premium rates are higher for senior citizens. For the employed, another option is to approach the employer to negotiate with the official insurer to provide an option for additional cover to parents. Since the volumes are high, the insurer can provide such added cover at attractive premium rates.

One of our readers Pattu has shared a great calculator which he discussed in his comment is uploaded here , If you want to download it , Click here

Tax Exemption from Health Insurance Premiums

Sec 80D covers Health Insurance . You can get exemptions of

  • Upto Rs. 15,000 paid for self + spouse + cildren.
  • Upto Rs 15,000 paid for Parents (Rs 20,000 if parents are senior citizens)

So in total if you pay your health insuance and your parents health Insurance premium , you can save upto maximum of 35,000 .

Note : If you take Health Insurance riders with Term Insurance like Critical Illness cover , the extra premium paid for that will be actually be covered under Sec 80D , not sec 80C . See Tax Rules

What is TPA (Third Party Administrators) ?

TPA stands for Third Party Administrator. TPA is a middlemen between Insurer and the Customer . Customer can directly deal with TPA at the time of claim and TPA will help with with all the process of claim settlement . A TPA is a specialized health service provider rendering variety of services like networking with hospitals, arranging for hospitalization and claim processing and settlement. The concept of TPA has been introduced by the IRDA (Insurance Regulatory and Development Authority of India) for the benefit of both the insured and the insurer. While the insured is benefited by quicker & better health service, insurers are benefited by reduction in their administrative costs, fraudulent claims and ultimately bringing down the claim ratios. An insurance company can have more than one TPA and a TPA can serve more than one insurance company. Some of the services TPA provides are

  • Maintain database of policyholders
  • Issue of identity card to all policyholders
  • Provide ambulance service
  • Provide information to policyholders about hospitals.
  • Check various investigations
  • Provide Cashless service
  • Process claims

Health Insurance Claims settlement process

A bit on how health insurance claims processing works. In most cases, the Insurance companies appoint a third part administrator (TPA) for claims processing. That means once the health insurance policy is sold, the insurer passes on the baton to the TPA. In case of a claim, the insured has to get in touch with the TPA for all versification and formalities.

There are 2 ways by which health insurance claims are settled:

  • Cashless : For availing cashless treatment (only at authorized network hospitals), the TPA has to be notified in advance (for planned hospitalization) or within the stipulated time limits (for emergencies). The insurance desk at hospitals usually helps with all paper work. The claim amount need to be approved by the TPA, and the hospital settles the amount with the TPA/ Insurer. Typically there will be exclusions and such amount will have to be settled directly at the hospital.
  • Reimbursement : Reimbursement facility can be availed at both the network and non-network hospitals. Here the insured avails the treatment and settles the hospital bills directly at the hospital. The insured can claim reimbursement for hospitalization by submitting relevant bills/ documents for the claimed amount to the TPA.

The TPA mode of claims settling has its own problems. The TPA is incentivized to limit insurance claims and they are not the one’s who sells the policy. There are many cases where the insured had a tough time to claim for his hospital expenses. So before taking health insurance it would be useful to check who the TPA is and how good are they when it comes to claims processing. Internet search and a friendly chat with the hospital staff can give you good insight on the insurer/ TPA. There are also some health insurance providers who do not employ TPAs and does claims settlement directly (this is called Inhouse TPA) .

Comments , What are the best health Insurance policies you are aware of ? Do you feel it makes sense to buy health insurance at early stage or after getting married only ? Please share your views on this .

This is a Guest Article from Ganesh who is an avid follower of this blog and his blog is My Graffiti Page. Please note that this post is NOT intended to promote or suggest any Health Insurance plan. If anyone is planning to take Health Insurance this New Year, the post can possibly provide some useful tips and pointers for selecting a suitable plan. Your comments and thoughts are most welcome.

260 replies on this article “Introduction to Health Insurance in India”

  1. Sharanya says:

    Hi Manish,

    I am 25 and currently do not have a health policy other than what is provided by my employer. I wish to take a policy of my own. But if i take an individual policy for myself, will i be able to migrate through portability and get a family floater policy after marriage and still be able to retain the pre-existing and other such benefits

  2. amit says:

    i want a mediclaim policy where i want to add my mother
    my age is 35 and mother age is 60
    reply with premium and procedure

  3. Sachin says:

    Hi Manish,

    My father is covered under a policy with sum assured of 3 L. He is recently diagnosed with Liver disease and doctors have suggested him to go for liver transplant, which is a very costly affair. Is there any policy in India which covers and big percentage of liver transplant in India? What is Jeevan Aarogya from LIC? Can I buy something to cover my father now?

    Appreciate your support here.


  4. KishoreRP says:

    Hi Folks,
    I have a health policy with good coverage upto 5L provided by employer which covers my parents as well.
    Am looking at a independent health care insurance policy Can you please provide your inputs on the below policy provided by Indian bank in association with United india assurance

  5. Poorna says:


    Which would be a good insurance to buy for my Parents who are both 63 years of age and in good health.
    I am looking for a cover between 3-5 lakhs (Family floater)

    1. I think Oriental would be a good choice !

  6. AK says:


    I am 44 Years old and my wife is 37. We have a daughter who is 11.

    I already have a Health Insurance of 5 Lakhs through my employer. I plan to take a family floater policy of my own which I will continue after my retirement. I have heard that it might be difficult to get a new policy once I retire with a high coverage. My criteria are:

    1. Sum Insured – 15 Lakhs

    2. Co-Pay of about 3 Lakhs. Since I already have a health insurance through my employer and most likely will have it till I retire – I want to opt for co-pay to reduce premium. Once I am close to retirement – I can then buy another policy for about 5 Lakhs to cover for the co-pay amount. Is it possible to remove the co-pay clause later once I retire?

    3. Recharge option if available

    4. Do not need any daily cash, ambulance cost, personal accident cover (as I have a term policy) to reduce the premium.

    5. Critical Illness coverage (is it necessary?)

    Do you think I am thinking on the right lines. Since, we are already covered by my employer – should I buy the plan now or wait for a few more years.

    Please advice. It would also help if you can suggest the right insurance plan that would meet my needs

    Thanks in advance for your time.

  7. Nitesh says:

    I want to purchase the family floater policy from National Insurance for 3 lakhs. Should this be a good option? Some body suggested me to go for Apollo Munich. Are the claims settled immediately with cashless with National Insurance? I stay in Bangalore. Which one do you suggest I should go for – National or Apollo?


  8. Amit J says:

    Dear Manoj

    Could you please advice on my step forward for Health Insurance. I am opting for Health Insurance from Oriental Health Insurance – Happy Family Floater covering (My Father 64, My mother under 60, Myself, My Wife and my 2 children) without Accidental Cover.

    Am I right in doing so or there are better splits like (For my father Natioanl Varishta and for my rest of family OIC – Happy Family Floater)

    Your help will keep things rolling.

    Amit J

    1. Amit J says:

      I am taking cover of 500000 under Silver plan

    2. Amit J says:

      Thanks Manoj for your quick reply!!

  9. Viir says:

    Hi Manish,

    Can we port mediclaim from one bank to another bank?
    Currently i have Synd Arogya mediclaim policy (individual). Can i port it to Canara Apollo Munich ?

    1. I dont think so . Bank policies are special tie ups with the company.

  10. Ashish Chavan says:

    Hi Manish,

    I really appreciate the good work you are doing to help us out of ever so cluttered world of insurance.

    My Query is regarding Health Insurance for me(age 35) and my spouse (age 36) + Kid(currently no kids), I currently have a employer provided health insurance cover for 3 lakhs and I am planning to take an additional health cover (as company provided will only last till my employment).

    I am looking for ….
    1. Coverage on maximum number of critical and non-critical illness
    2. Provide health check up at regular intervals
    3. Easy claims processing (as I don’t expect my wife to run from pillar to post if I am ill)
    4. Long term benefit as I am currently looking at this as backup medical insurance but this will be the only one post my employment/retirement, I am OK if this costs me a little more in premium.

    Please advise.

    Thanks and Regards
    Ashish Chavan

    1. Thanks for asking Ashish. I would recommend you look at Religare Care as one of good options . Others you can explore more on . Let me connect you with our partner on this.


  11. C.M Krishnan says:

    hi, i just went through all the Q and Ans and your site as well. thanks , it is very informative. I have a query my wife was hospitalised for an Ovarian cyst and hysterocomy, the expenses for which went up to Rs. 1,35,600. I put in all the papers for claim, but the TPA has passed only 1,02,000. Can you expalin this to me because I am at a loss of thought process because of the huge cut put forth by the TPA.

    1. I am sure there were few things for which payment was not made and it must be as per terms and conditions . Things like registration charges are not paid by health insurance . Check this with the TPA only /

  12. says:

    Hi Manish,

    Thanks for this helpful article, I am going to buy medi-claim policy for me and my family, but I have following few doubts in it. Please help me to decide.

    I am 29 years old, My wife is 27 years old, expecting baby in next few months. My Mother is 58 years old. Me and My wife are healthy, My mother is having diabetes and hypertension since 2 years.

    Q1. Should I buy Family floater policy or Individual? Or, individual policy for my mother and family floater for my rest of the family? Please suggest.

    Q2. Is it true, that in family floater, If senior most person expires then whole policy lapse and rest of the member need to take policy again?

    Q3. Is it possible to add new member in policy? as I am expecting baby in next few months. If yes, then will it affect pre-existing deseases waiting period and how?

    Q4. I am thinking to buy policy without maternity cost cover because people says that that will increase premium considerably. I am planning to cover this cost from the mediclaim policy offered by my company. Am I doing right thing, Is it correct decision? Please suggest.

    Q5. In my specific case which insurance company you would suggest, which best suite to my requirements? I have few in my list: Oriental ,Star Health, Apollo Munich , Max Bupa.

    Q6. What is good when we renew policy continue for 2-3-4-5 years? (a) Increase in policy cover OR (b) Decrease in premium?

    Thank you,

  13. How much medical insurance does a person need?

    1. There is no fix formula for this.

  14. suryansh gupta says:

    Well explain manish i got lot of information one more thing if u hv govt co mediclaim calculator in excel please send me

  15. Mandy says:

    Dear Sir,
    I am 35 yrs old and looking for long term health plan .
    I am very much confused for the following reasons.
    I did some research on the Health Insurance packages available in the MKt right now.
    I observed that maxbupa, Apollo munich and Star health are offering some good plans.
    But Medical insurance plan are of max for 2 yrs term afterwards renewal is required + they have premium based on age band like
    (1yrs – 35) ( 35-45)…. But i observed that at the age of 55-60 there premiums are floating anywhere between ~60k to 1lakh.
    I was in thought what if a person take such health plan and continue to 15-20 yrs with no claim bonus then on attaining the age of 60
    if he would be unable to pay such high premium ( 60k to 1 l) becoz of some reason or other reason.
    then he will be no longer get any benefit from such medical insurance even though he paid a premium for good long length.
    My question :-
    Is there any Plan in mkt (just like general insurance)that offer flat premium let’s say 15k/annum for a term of 20-30 yrs.
    Don’t mind if the medical coverage will be less. At least a person can secure himself by such insurance with less benefits.
    Or what will your suggestion in above scenario.


    1. I just replied you over your issue on your email

  16. Satish says:

    Hi Manish,

    Thanks for sharing the knowledge. I got a lot of info from your forum when I took home loan from SBI. Now it’s health insurance turn.

    I realized the importance of health insurance recently when one of my aunt was diagnosed with breast cancer. It was in initial stages and she was operated in Apollo hospital, Hyd. It costed them around 8 to 10 lakhs including many other things. My uncle being a govt. employee, the amount was taken care of. I imagined myself in that situation and realized the effect of future uncertainties. Coming to my current situation, I am planning to take policies for my father and mother aged 53 and 49 respectively.

    (i) Is it better to take individual policy for each of them or single family policy in view of future? Also suggest some policies which are relevant
    (ii) I aged 29, covered by my employer for 1.5 L and I know that it is not sufficient. Suggest some policy for me as well.


    1. You can go for individual policies also , but there are good family floater plans available these days ! .. You can look at Religare , Max bupa or Oriental !

  17. The insurance scene is exploding in India to say the least and that gives the consumers an opportunity toy to make judicious buying decisions.

    1. Thanks for sharing !

  18. Bharti says:

    Hi, I had purchased LIC health protection plan in 2009/2010. My annual premium is 15000. I would like to know if I should continue this policy. If no, what are my options.
    Thanks so much!

    1. But whats the status of your policy , what are the returns you have got till now ?


  19. Nirav says:


    I am 29 yrs old with Type-1 Diabetes. Recently I checked with 1 of the companies for medical insurance for me and my mother (aged 59) and they quoted a premium of about 25000/- for a cover of 5 lacs.
    Now I want to check whether paying such a huge premium makes sense, as within next 20 yrs I would pay 5 lac as the premium amount.


    1. The question you have to answer is , are you ready to pay Rs 5 lace from your pocket if something happens in next 3-4 yrs ?

      1. Nirav says:

        Thats true,

        But the thing I wanted to check was whether the 5 lac cover gets renewed every year. Suppose I use my 5 lacs in next few months, then for the rest of the year I won’t be left with any cover available. But will I be eligible for 5 lacs next year again?


        1. Yes, you will be 🙂 . Thats how it works ! . Its a per year thing . Not a One time thing !

  20. Vivekanand S says:

    Dear Manish,

    What proportion of premium paid goes towards agent commissions (initial/trail)? Is there any way I can take a health insurance directly from the insurer? If so, what are the hazards/pitfalls of the same?

    PS: Keep up your great work!

    1. Around 7.5% goes as commissions .

      1. Vivekanand S says:

        Thanks for clarifying, can you please address the other queries:
        1) taking a health insurance directly from the company, thereby saving the ~7.5% commission. Is there a way that I can do so in a manner comparable to that of life insurance companies?
        2) If the above is possible, then kindly shed some light on the benefits/pitfalls of the same.
        3) Role of an agent in health insurance. Is an agent really necessary?

        1. 1. NO

          2. Not possible

          3. yes .. there has to be a health insurance agent in between

  21. raj says:

    Can there be any difference in Health policy coverage if taken from an Agent vs taken from BANK (AS AN AGENT)?

    Regards and thanks

    1. No there is no difference , when you take from bank , the policy will pay the bank the commission thats all !

  22. vivek says:

    I have an individual policy for my father from NIC (National insurance company ) for SA 2 lakhs, morever i also have covered my father through our group insurance policy from Bharti Axa General Ins ltd (Policy Type – Voluntary Parents – Group Mediclaim Policy) with SA of 1,50,000.
    My fatherwould be undrgoing a bypass surgery in next week which would cost 2.8 lacs, can my claim be settled by both insurers, if yes then could you elaborate the detail process for same. Please help.

    1. Yes, it can be claimed by both .. in the proportion of cover .. You will have to keep the records and documents and check with the companies before hand .

  23. Gautam Sarkar says:

    I am to retire from my job in Nov 2012 at the age of 58. I require a health insurance policy for self,my spouse aged 52 and son aged 20. All of us are in sound health with no medical complications. Could you suggest me the best options. SA should be around 3-4 lacks for all.

    1. You can look at Apollo Optima Restore

    2. You can look at Apollo Optima restore or Max Bupa policies !

  24. RAJESH DOSHI says:

    for people above 55 yrs old & NRI , wants to move back t India with some health issues are elligible to get health Ins in India ? & are they cover the policy in USA also ?

    1. Yes you can buy health insurance in India, but regarding US health cover, it would depend on the terms and conditions they have

      1. RAJESH DOSHI says:

        may I have your contact number & what is the best time to call you . I would appreciate if you please let me know . i would like to talk to you

        1. For what purpose ?

          1. RAJESH DOSHI says:

            i would like to know proper way before I decide to take health Insurance in India. Chatting like this does not give me any answer or satisfaction .It looks like general talk. I have specific questions regarding health issues & health insurance

            1. RAJESH DOSHI says:

              thanks. looks like you are not interested in the business or you don’t know how to take care of your customer . Any way I thought India is doing better & people have changed attitude but I think I am wrong

            2. RAJESH DOSHI says:

              Thanks 4 ur reply . I was not expecting answer from ur side , but I m impressed . Once again thanks 4 ur help

      2. raj says:

        But Sir,
        Then why there is such a huge difference in the premium of health insurance if taken from an Agent vs taken from BANK? Bank’s insurance is much cheaper

        1. Thats a different thing … bank as an agent is different and a health insurance from bank is different . If a bank has a tie-up with some health insurance company and they launch a custom made health plan, then its not a complete health insurance, it has many flaws .

          What I thought from your comment is that you bought a regular health plan , just that bank sold it to you like any other agent.

  25. bimal Mehra says:

    I am looking for family health insurance which needs to cover my parents (Dad-63 mon-56) as well as wife+myself.I got following queries:
    (1)Is it possible to cover my Dad who is 60+ under the same policy , (he has a sound medical record).
    (2)I’m 30 yrs and planning to have kid in near future , is it possible to pull the young one under the same policy, is there any Min age limit to cover.
    (3)my annual sal. is in 7fig. premium amount shuld not be prob. suggest me good cover amount.
    (4)will it be good if I take “Varishtha Mediclaim Policy ” as mentioned above in your post for my parents and take separate FF for my family.
    Thanks in advance.

  26. Manoj says:


    First am really surprised and congratulate all the persons for giving such informative inputs.

    My query is as follows:

    I want to take a health Insurance policy which should provide the following:
    1. Economy premium.
    2. Sum insured, 2-3 Lakhs max.
    3. Family Floater of me ( age 30 years), spouse 28 years and Daughter 1 year.
    4. Maternity cover ( good to have but not must)
    5. Initially I will take 2-3 lakhs policy, which I would like to increase to 5 Lakhs after 4 years and at end of 2020, I would make it as 10 Lakhs.
    6. Renewal of policy upto maximum, I read religare covers upto 85 years of age in Health cover.

    I am seeing Max bupa -silver, Oriental happy family policies.

    Please suggest any other option which I should look for.


    1. rajendran says:

      sir, Iwould like to take a medi claim policy for my family , My self aged 58, my wife aged 55, and my son aged 20 years. My wife was undergone a surgery for anurism 4 years back and she is diabetic, and BP patient both controlled with medcine and now she is all right. No complication with her surgery so far . she is healthy, doing his work without any problem. So now I ask you ,whether she is eligible for a mediclaim policy and which is better. thanking you sir

      1. The premiums will be extremelly high now, you can look at Maxbupa and Apollo policies

  27. poo says:

    the info which you have given is good the content where i can share with my friends thanks for giving this info

  28. c r patil says:

    hi .
    i want to know abt the health insurence/mediclame policies for my parents
    mom aged 48 and dad 52 they both have sound health till now (no bad medical history) please send me the health insurance plans which are available in the market
    we are a family of 5 persons & i m more interested in family plans which are pure health covers only (not intrested in ulip etc) and additional benefits.
    thanking you

    1. Mahavir Chopra says:

      Hello Chetan,

      You have choice of Max Bupa Family First and Oriental Happy Family Floater.

      As mentioned earlier, you need to catch hold of a good health insurance advisor, with experience in health claims management and one who is unbiased across Insurance Companies. This adviser will help you understand small nitty grities, and help you decide on a suitable cover, according to your needs. Having a good adviser is as important, as having a good product.

    2. CR Patil

      You can look plans from Max Bupa and Appolo


  29. Bhavya says:

    Please suggest me good LIC Health Insurance plan for my Mom and Dad.
    I got job recently and have no good idea about Insurance plans.
    Please help.

    1. Mahavir Chopra says:

      Hello Bhavya,

      LIC would not be suitable for your mom and dad’s health insurance cover.

      Can you please let us know what is the age of your parents, and whether they have any existing ailments or medical history?

      Ideally, you would need a good health insurance advisor to help you finalize a product and also service the policy, year on year.


  30. Anurag says:

    Hi Jagoinvester friends,
    Can anyone plse suggest me Health insurance plan for my 66 yr old mother and also plse send me list of the health insurance plans which are available in the market for senior citizen.


    1. Anurag

      Does your mother have any illnesses ? Because with this age of 66 and any bad medical record it will get extremelly tough to get any medical insurance .


  31. Mohan says:

    Hi Manish,

    My dad had to undergo Total Knee Replacement surgery. Below is the expense details,
    Total hospitalization Charges: 2.5lacs
    Payment from the Health Insurance Company: 2lacs
    Payment from my hand: 50K
    Now the question is, do i get any tax benefit on the 50K that i paid from my hand ?


    1. Mohan

      no , why you should get ? The tax benefits are only on the premiums paid , thats all


  32. Pingback: Type of Health Insurance | Insurance Club India
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  34. Madhuri Chakraborty says:

    want to know the schemes and tariffs for the cashless medical insurance for a family of 4 members and sr. citizen . and also lie to get the excel calculator as mentioned.

    1. Madhuri

      You need to find it from varios sites


  35. Abhinav says:

    Hi Manish

    Nice article. Thanks a lot. What is your view on the fixed benefit plans offered by life insurance companies?


    1. Abhinav

      A lot of companies have that kind of plans . People generally mistakenly think these plans cover everything . So you need to see if it suits your condition or not


  36. mahesh says:

    I had LIC health Protection Plus plan , Recently I got married .

    I want to include my spouse into this policy , is it possible to include the spouse ?

    1. Mahesh

      I assume its a individual policy , hence its only for one person , better you now increase your cover with Family floater


  37. sumeet gupta says:

    Dear Pattu,

    Please e-mail me the Excel Calculator that you have mentioned in your comment above? My e-mail is



  38. Mehul Makwana says:

    Health insurance fo persons with Autism, Cerebral Palsy, Mental Retardation & Multiple Disabilities.

    I was searching for health insurance of 31 year old brother who is mentally retarded but i was not successful as most of the companies do not provide cover to mentally retarded.
    Than i came across a health insurance scheme run by government called “NIRMAYA” for persons with Autism, Cerebral Palsy, Mental Retardation & Multiple Disabilities. It provides sum assured of 1 lakh to such persons.It has uniform premium throughout the life span
    i.e if income of parents of such person fall below poverty line its free of cost,if income is less than 15000 than there is premium of 250 and more than 15000 than there is premium of 500 per year.
    For more information u can check the below link

    I have just taken this policy for my brother if you have any other policy in mind regarding persons with disablility pls let me know.
    Mehul Makwana

    1. Mehul

      Thats pretty nice information 🙂


      1. sumeet gupta says:

        Hi Mehul,

        great job 🙂



  39. Jessi Kaur says:

    Thanks for such informative article.. !! Initially I was planning to get ULIP.. but realized its better to stick with life insurance and health insurance in India. Have heard mixed responses about ULIP plans so decided to play it safe 🙂 Now planning to have mediclaim policy and am confused between Max Bupa and Appollo Munich, whats your take on this 2 policies. I’m more inclined towards since have 6 family members including me. PLease guide me if theres any suitable plan for joint family or group health plans.

    1. Jessi

      Max Bupa is recommended as they have nice features . Two points I would like to mention

      1. 20% Copay after the age of 60

      2. Pre-existing Ailments mostly would be excluded permanently instead of 4 years.

      Having said that I dont deny that even Appollo Munich is a good one . You need to see the features yourself if they suit your situation or not .


  40. Ritesh Guha says:

    Dear Sir,
    I can effort rs.2k per annum for health insurance please advised me which is the best policy for me and kindly sent me a health plus calculator.

    Thanking U…

    Ritesh Guha.

  41. raj says:

    1. I understand that a health policy taken through a Bank is a Group Health policy? Then what happens if the contract between Bank & Insurance company terminates?
    (a) The pee-existing cover is transferred i.e. is taken to One’s next Policy from same insurance company? OR
    (b) Loose all the benefits incurred till that date & Start afresh.

    2. Is it possible, there could be difference in coverage aspects between policies taken from same Insurance Company through an Agent or BANK AS AN AGENT?

    3. What about portability differences of these health policies? (Same insurance company but one purchased through an Agent & other through a Bank (as an agent))

    4. Why such a huge difference between premium of Policy taken through an agent VERSUS Policy taken from BANK (as an agent) from same insurance company?

    Regards and thanks

  42. Rajiv Kapoor says:

    I am a NRI , 52, planning to come back to India after 1-2 years. Should I start my Health Insurance in India in advance to save higher premiums on a later date? Or are the premeiums as per age range bracket i;e same irrespective of at age we start?

    At 52 what is more appropriate Crital Illness alone, Critical Illness as a rider over a investment (I have some extra money to spare) or go for General Health Insurance.?

    What is the difference in life long policy and some policres (like icic lombard) that finish at 70/80 years. How do they cover after this age in this case?

    Thanks a lot sir. If you can answer before 28th March, I can take advantage in my I.T return :-). Given the authority on the subject that is visible from your articles, And you please select the best plan for me from your favourite companies as I have no mind or time to select.

    1. Rajiv

      The earliar you take health insurance , better it is , so if you are plannign to comne to india before your “final” move , you should consider takint it ,but it would not be easy as it takes some documentation also .

      There is no thumb rule that which policy is better, you have to find out which policy suits your exact requirement .


  43. Namita says:

    Why health insurance doesn’t cover conservative(Outpatient treatments without admissions, rehabilitations etc.) medical treatments?
    People pay lot of money for various medical procedures, rehabilitations, dental treatments, nanotechnology problems, diagnostic procedures etc.
    What should they do, if they are not getting reimbursements for such treatments?

    1. Namita

      health Insurance is business, it does not make any sense to companies to cover those treatments .


      1. Noorul says:

        In U.S this is possible. Don’t you think that those companies are also doing business. Do you think this is the right time government should take some active steps to improve health care in our country?

  44. Kunal v says:

    Hi All.

    Would like to know which is good place to go for health insurance, I would like to sum assured approx 5 lak( may include my parents) also. somoe one suggested me for apollomunich.

    would appreciate your expert opinion.


    1. Kunal

      Apollo can be a good option as it covers many things , but premium wise its on higher side . For questions related to Health Insurance, you can ask it here :

      Also , have the look at existing questions and their answers :

      1. CHITHRA RAJ N says:

        I would like to know the network of hospitals covered within the state of Kerala for VARISTHA Mediclaim for Senior Citizens under the National Insurance Company Limited

        1. Did you try to find the info on the website they have or contact customer care ?

  45. Sir,
    I am 33 years old, my wife is 29 years and my only son is 3 years old. I want to purchase PARIVAR of National Insurance Company. I want to spend Rs 3,500/- p.a. as premium. How much cover can be obtained from this? Is there any other better plan in market ? Please suggest for me.

    Please mention who is TPA for PARIVAR plan of NIC in West Bengal ?

    1. Pijus

      The TPA for them will be same across India . DId you see the policy documents on the website ? U can ask your questions at :

  46. amol says:


    I saw this advertise today

    Royal Sundaram offers affordable Medical Insurance Plans.
    Cover your hospital bills and emergency hospital expenses at just Rs 5 per day.

    what do u think about it. its very cheap for its price

    1. Amol

      You have to ask for how much is the cover for in that Rs 5 a day . It can be for a very small cover .


      1. shekhary2k2000 says:

        Manish / Amol

        The Premium of Rs 5 a day work out to be 100,000/- Minimum sum assured for the above policy in the age group from 26 yrs – 40 yrs with yearly premium being Rs 1861


  47. kunal says:

    Hi , I’ve applied for ICICI pru life health saver, wanted to know if it has loading charges after first claim and is the OPD charges in co-pay fashion?

    1. Kunal

      What stops you from looking the policy document ? Do you have it with you ? Are you not able to find it on internet ?


      1. kunal says:

        Hi Manish,
        Thanks for quick resp. I don’t yet have the policy document as its successor is not present in market and this one health saver 2(or revised) is about to come in, the pdf available online is of health saver, which has no mention of loading.

        1. Successor ? What is it ? You should ask the agent about the policy document


  48. RAM says:

    Can somebody tell me anything about Aegon Religare Health Plans?

  49. RK says:

    Dear Manish,
    I am an NRI residing in Kenya, I am looking for a medical insurance provider from India for essential medical cover like inpatient in my country of residence as well in India. please advice

    Thank you in advance

    1. RK

      You might find it little tough as you will have to travel to India for medical checkup . You need to find out from portals like for more info on this .


  50. ninglen says:

    1st of all, Pardon me if I am posting in the wrong article.
    I do have lots of problem with my financial status and responsibilities. Frankly speaking, I am going crazy if I start thinking of my responsibilities and financial status.
    Manish, below is my condition:

    family background:
    1.I am married and have 1 daughter of 4.5 yrs and wanted to have 2nd baby.
    My daughter education cost is around 50K /annum, including everything.
    and I have a sister of 25 yrs old -may get married by this year end for which I may need to spend around 1 Lac.
    2.Father is 60 yrs and mother is 55+ yrs old.
    3. We have a joint family -Father, fathers elder brother (67 yrs) with his family, fathers younger brother (57 yrs old) with his family …In short 3 big family living in a single house and take care of each other.
    worst part is I am only person earning somewhat Ok (~50K /month).
    4. A grandma of 75 yrs old [-I love her a lot:-) ]

    ===My aim ====
    1.Want to take care of all my family for health related problems.
    Say Per family, min amt of 1-2 Lacs health insurance. I know it is low but can dream big as I am financially not in that good shape.
    2.Wanted to help other two families (two uncles) arund 50K/annum for their kids study.
    3.Want to have term insurance for at least 15 Lacs (should be more I feel as I have more responsibility) for me and my family.
    4.Want to buy a car of around 4.5 lacs by next year beginning.
    5.Want to buy a 2BHK aptmnt by the end of next year with with EMI of arn 15K.

    ======What Do I have as of now====
    1.Have around 2 Lacs of Cash, and around 1.5 lacs in ULIPS, and tax saving MFs.
    2.Other than normal salary(50K/month in hand), around 2 Lacs I will get by December.
    3.So far, health insurance from my company is taking care of my parents and family (3 lacs/annum )

    I do Live in bangalore and my parents and uncles are not with me. Since they are living in Imphal, where the kind of facilities (health insurance,term insurance from pool of companies-pvt/govt) we have here in banglore is not available, I getting confused to deal with this.Will the health insurance company say that they (uncles) are not in city where they(companies) have their branch ?

    These are the conditions .
    Is it not possible to achieve my goals ?Please help me to ,how do I do the health insurance planning and financial planning for my future.

    I hope I will get help from you.



    1. Ninglen

      Tough situation , but you can do few things .

      – First priority is to make sure you have a good insurance cover of around 1 crore (term insurance only) . This will cost of anywhere from 25-40k per year depending on your age .
      – Get Health insurance for some basic amount for people who are not covered from your employer
      – Make sure the money which you get in Dec , you dont put it anywhere and have it purely as emergency fund , put it in Liquid fund or in Bank which you can access and use anytime , this is critical for a situation where you have to run around , Dont look for growth from this money .
      – Dont think about second baby right now , or may be forget about it , harsh decision , but first ask will you be able to give the second baby who you really want to provide in life .
      – Delay your decision about Buying car and Home , Dont rush for buying home , Stay on rent at the moment, if you buy house at the moment , you might need a much bigger , but may be after some years , it much more than you require .

      Other than this , it would depend a lot of your goals.


  51. Chiradeep says:


    Has anyone looked into or taken the Aegon Religare Health Plan? It looks to interesting with good benefits and reasonable premiums. If anyone has any info please let me and others know. i am utterky confused in deciding what health insurance to go for:(.


    1. Chiradeep

      The best thing would be to first filter things , filter all policies which you dont need ,then out of what ever remains, buy one without thinking much . this is becasue if you think too much , you will never be able to decide .


  52. Ash says:

    Hey as NRI’s can we have a health insurance in India…Do you think it better to get one done for future…we do not plan to settle beck in India atleast till the nxt 5 yrs…we have medical insurance covered in the country we currently reside in..Can I go for a family floater for myself and my husbnd with star health insurance,? How does this health insurance thing work?

    1. Ash

      You can avoid it in that case .


  53. jayram says:

    Hi Manish,
    I need a suggestion
    I was paying a medical insurance for me.
    In my new company they are providing the similar kind of insurance.
    But I haven’t claimed even for once.
    So I was thinking to stop paying for the next year as the other is mandatory.
    Please suggest me as soon as possible.

    1. jayram

      You can do that if there is duplication . make sure the single cover is enough to cover the worst case .


  54. Pingback: Health Insurance premiums might increase in future
  55. NARASIMHA says:

    i have a lic health plus for self, wife and a son, am paying yearly Rs 12,000 as premium from april 2008 onwards.
    my HCB allocated is 1200 and MSB allocated is 240000
    wife HCB 1000 and MSB 200000
    Son HCB 600 and MSB 120000

    my question is suppose if am supposed to undergo hernia operation, what will be my claim(max limit).

    i haven’t claimed so far

    please clarify

    1. Narshmha

      What is the doubt here ? Your total amount of claim will be restricted at your cover amount with subject to cover for HCB and MCB as per your policy cover.


  56. Rohan says:

    Hi manish,

    I just loved your article and the fact that you’ve taken the trouble to respond to all the queries.

    I have purchased a health insurance policy with New India Assurance for myself and my wife for a limit of Rs. 5 lakhs each. I was offered – and I accepted – a personal accident coverage policy – again for myself and my wife – for a sum assured of Rs. 5 lakhs each. The total premium for the whole package (medical and accident insurance) came to approx rs. 11,500 which is categorised as medical insurance premium and qualifies for tax deductions.

    What are your views on this? Is it common to offer an accident policy as a package along with a medical insurance policy?

    1. Rohan

      I would say that mainly its a sales pitch to push products to the customer along with some other product , but look at it from need’s point , May be its a required product for you .


  57. Madhu says:

    Hi manish,

    If I have taken 2 health insurance policy of 2 different companies.
    Can I claim for hospital charges for both the companies.

    Thanks in Advance

    1. Madhu

      You can claim only upto the expenses incurred by you or total limit . You cant make any profit out of it . If you have taken a cover of 2 lacs and 4 lacs from 2 companies and your actual expenses are 1.5 lacs , you will have to claim this expense from both of them in ratio of the SA , so it will be 1 lacs and 50k from each of them , as the SA was in ratio of 1:2 . Incase of Life insurance , you can claim the full amount from both .


      1. Byju says:

        Also it is required to submit original hospital documents for claiming purpose. How is it possible that you can submit it to both the providers?

  58. Manish says:

    Could you please explain what you mean by health Insurance riders with term inusrance?
    “If you take Health Insurance riders with Term Insurance like Critical Illness ”

    Does term insurance comes with Health insurance option also ?

  59. kaushal says:

    Dear manish bhai,

    i have diffrent type of lic policy , FD, so all data in filed excel sheet. if have excel format so pls send my on this id :


    kaushal parekh

    1. Kaushal

      I am not sure what you want here ? Which excel ?


  60. Saurabh Aggarwal says:

    hi , i have taken health insurance of 4 lakhs from apollo dkv for premium of 6618 last year in august , now i got married two months back , i have got following questions : this company good or should i change to star as suggested in your forum ?
    B.with rising cost should i raise insurance it to 10 lakhs , it is the maximum limit provided by them and want to know how to include my wife name ?

    1. Saurabh

      You should not change company just because its discussed here , it might not make sense in your situation , talk to the company and find out if it fits you


  61. DK says:

    Issues I see with family floater are as follows: (1)A few years down the line, if only the primary member is to be covered (others are removed due to whatever reason), than will the company create a new individual policy (since family floater requires more than one member) with all the medical history and benifits continued at that age (say 60 or 70 +)? (2) Similarly, if the primary member expires, will the company give a new policy for the remaining members (since a policy is in the name of the primary member) with all the medical history and benifits continued? To the best of my knowledge, no company guarantees this or gives in writing. Please update on this and also if IRDA has any regulation for this.

    1. DK

      yes , those are issues with Family Floater .


  62. manish n shah says:

    health insurance awerness in india is very less. Even 5 lacs mediclaim policy is insufficient, as medical & hospitilastion costs are risen very much. bajaj allianz is giving a family floater plan for additional 10 lacs over and above existing 5 lacs (extra care plan).premium is reasonable. can u guide me?

    1. Manish

      I dont have bandwidth to look at individual plans .. better compare at or start a thread on forums .


  63. Chiradeep says:

    Hi Everyone,

    Very informative section. With all due respect to observations made on Apollo DKV, I wanted to make one more observation(not that I am a great fan of anything to do with Apollo’s). The issue is about pregnancy of your spouse. In general pregnancy is only covered by company’s group medical insurance. I found that there are a very very few independent providers who cover pregnancy related costs. However, Apollo DKV’s policies do seem to have an option of covering pregnancy at an additional cost. Any thoughts or experiences people?

  64. Hi
    Your blog entry is very informative and its very interesting. you have mentioned all the details regarding the health insurance.

  65. Chandrakant Dhutadmal says:

    Manish, Hearty Congraulations for this website. I recently came across your website, but i must say, its a wonderful work to voluntarily keep posting such an information which is worth millions!…


    1. ChandraKant

      Welcome to Jagoinvestor . I am sure your experience here would be wonderful .. keep commenting and get involved in discussions 🙂


  66. Narinder Sharma says:

    Hi Manish,

    I am a retired bank employee and have recently become a member of Group Mediclaim policy of my ex-employer. In this policy, retired employees, who are not members, can join whenever they wish and their date of commencement of insurance depends upon their date of joining.

    Please give me information that in which time frame, TPA has to intimate its new member, the policy plan period along with date of commencement of insurance. What is the rule for TPA/insurance company for it as knowledge of day of commencement of insurance policy is very important in case Mediclaim policy. Please also suggest some websites which can provide related information.


    Narinder Nath
    Email :

    1. No much idea on this …

      Anyone ?


      1. anonymous says:

        If insurance company/your employer has sent letter of Adding an member to TPA, and TPA is lagging behind,
        you should/would get insurance claim benefit during that period. For example if You enrolled on 1st Jan 2010 and TPA was intimated (around same day/time) and TPA hasn’t updated their record, (TPA update record on 1st march 2010)… You would get Mediclaim benefit from 1st Jan.
        In case of rejection you may need to submit the Copy of letter sent by employer/company.

        Not sure if above solves your query

        1. Anonymous

          Thanks for the answer 🙂 . why dont you use your real name ?


  67. Prashant says:

    Hi Manish,
    I am looking for Mediclaim for my parents (aged near 50 yrs) for 2-3 lacs. I found Reliance Gen.Insurance is having one plan for 3 lacs for parents (floating) for just Rs.4048 (incl.ST)

    I inquired with other insurance co’s and found reliance is very cheap (at least less than 50 %) fo other. I inquired the TPA and found its Medi assist co.

    Once I take Reliance HI , I need to contact TPA for further processing. I inquired abt Medi assist and found it OK.

    Coud you pls comment on the above why Rel.HI is very cheap ? Shall i go for it? Thank you

    1. Prashant

      As per Pattu , Varishtha Mediclaim Policy Life & Health Insurance from National Insurance Company is a good option for senior citizens , check that .

      reliance may be cheap because they might having sub limits very less for everything and covereing less tehing .


  68. anonymous says:

    Since you guys have brought up I would tell my exp (might be special case, but worth reading, Hopitalization Discharge was in Dec 08, claim was submitted in march 09, Got cheque on Oct 09 )
    I submitted My Father’s hospitalization claim after 90-100 days of hospitalization and after more than 60 days of discharge. Policy is from Oriental and TPA is Vipul Medcorp. (Standard policy is to sumit claim in 30 days after discharge for all the insurance company in india)..
    There were queries, which we resolved via sending appropriate medical reports. Later they rejected the claim saying “Not filed in 30 days after discharge”, this was communicated over email and phone by TPA. But they sent letter to insurance company saying that “Rejected Due to Pre existing disease” and same letter was forwarded to us by insurance company. (mistake from TPA end)

    On receiving it, I submitted last 10 yr policy doc to TPA, along with copy of letter received and explanation letter and fhew .. they started reprocessing the claim. After this They never looked at Claim submission/discharge date difference. Later I got cheque as well. I feel it was error at TPA/ TPA-process end, and not sure who is gonna pay for it (TPA or insurance company), as claim should have rejected on Late filling basis. But it worked for us !!

    You may try, who know if it works for you as well. Let me know if I am not clear …

    1. Sriram says:

      Thanks for sharing your story, as of now it seems special to me!! I’m not one of those who gives up on things, i will surely pester them to the core till they pay me the money. Just like you I hope to share my story with some unfortunate soul!

      1. Sriram

        For some motivation , read this :

        You send them a threatening letter and tell them you will go to insurance ombudsman and consumer forum and last thing is that you will back off .. I am sure it will affect them 🙂


  69. pattu says:

    Sriram, Manish,

    There is a finer point reg. deadlines which can be exploited. Since your wound has not healed fully, you can get a certificate of full fitness from the doctor when it does and submit the claim within 30 days of the date of the certificate. All expenses from date of discharge to the date of certification come under post-hospitalization expenses and can be claimed.
    Try this route. However since you have already sent claim papers inform your TPA about this. Its a long shot but worth a try.

    1. Sriram says:

      Thanks both of you for your guidance! Appreciate it!!

      Pattu, i shall give it a try, i’m talking to Insurance company directly. Hopefully they will not create issues.
      But honestly Meidassit are the worst TPA I ever came across. Their IVR is crap, doesn’t give out any instructions and it keeps the customer on wait for almost 40 minutes. Every time i called, i had to hold on listen to their shit music and i used to run out of patience after 20-30 minute wait and disconnect. Finally one fine day i decided to not to hang up and it took me 38 minutes to get through to a rude contact center executive. Don’t know if we can do something about it.

      Thanks anyways!

      1. Sriram says:

        Hi Mahavir,

        Thanks for the clarification. Its been an old issue not got sorted out but not without testing my guts. I have now changed my job so the insurance co & TPA also has changed.
        If there is any assistance required in future, will contact you.

        Thanks once again!

  70. Sriram says:

    I underwent a surgery at a non network hospital. So i couldn’t go for a cashless facility and i didn’t submit my claim within 30days after discharge, its over 70 days after discharge. Now the TPA has refused to accept my claim, i have initiated talks with the insurance company.
    Can they also refuse to accept my claim? why do they disallow the claim after 30 days? my wound has still not healed and i’m still going for regular dressings.
    Is there a way to ensure that my claim is accepted? Though there was a delay in claiming reimbursement, my surgery and bills are genuine.

    thanks in advance!

    1. Sriram

      If there Term and Conditions says that “You have to submit the bills within 30 days of discharge” then you cant do anything because you have signed the document and accepted the rules . You should try to talk to the company and incase you feel that they should accept your claim in anycase , then you should approach consumer forum .


  71. Sathya says:

    Hi Manish,
    My mother is 57 yrs old with no health insurance. I m 21 yrs old. I m thinking of taking a family floater policy from Oriental Insurance Co. Ltd. This is one of the companies which provides health insurance w/o any health check ups. My advisor has suggested this. I need to get a reconfirmation be4 i go forward. So pls suggest abt the co. etc….

    1. Sathya

      As per Pattu , Varishtha Mediclaim Policy Life & Health Insurance from National Insurance Company is a good option for senior citizens , check that .

  72. vibhav shah says:

    thank you for the article and discussion on the subject. i seek guidance for the following:
    we, my parents and my family i.e. my spouse and achild(living together) got MC : 1. individual Health Insurance for 0.5 lacs for each of us five through U.I.I.C.L.’s two policies(one in my name and other in my father’s name) 2. insured for total Rs.3.5 lacs for all us five through Indian Bank’s AROGYA RAKSHA plan of U.I.I.C.L. this is to reduce premium for some worth health cover. But i am not aware of the procedure for claiming 1. if the claim is less than 50000/- 2. if the claim is more than 50000/- whether to raise claim to both policies, is it essential to inform to both TPA at time of any hospilisation, how to raise bills to both TPA after hospitalisation etc.
    vibhav shah

    1. Vibhav

      So what you have is a family floater , for the family floater you can claim for any amount less than 3.5 lacs for anyone of you (total should be less than 3.5 lacs) . You have to inform the TPA for any claim .


      1. vibhav shah says:

        dear manish,
        thank you for your reply. however my inquiry was basically to know whether it is mandatory to inform both TPAs for hositalisation, if you are covered by two policies, and the claim is less than the limit of one cover.
        vibhav shah

  73. Ningthem says:

    Hi Manish,
    I need some help on the health insurence.
    I am form a joint family and hence need to take care of my uncle and his families health above my parents health.
    I am not sure how to deal with health insurance. They are not ready to take any insurance for themselves.So I only will suffer for their health related problem.Above this, non of their family members are working and staying in village and hence difficult to get insurance in their son/daughter’s name.I feel I am the only one who can help them.So What I can do ?
    Is there any policy that I can take in favour of them and I being the policy holder?

    As always,
    Thanks for your help

    1. Ningthem

      No , As per the rules, its not possible that you take the Policy and they get the benefit , Company will only issue the policy for someone whom they have daigonised , Why dont you ask your uncle and family to take the policy as you are paying the premium , what is their argument ?

      Just also understand that you will “not” get tax benefit on the premiums paid as they are not your parents . Tax benefits is only for self , spouse ,children and father , mother .


  74. yogesh says:

    Hi Manish,

    Whats the logic for taking 2 insurance policies?Suppose
    any body wants insurance of 50lachs.why shd he divide 25lachs-25 lachs
    and take 2 insurance policies??

    Does this save some premium or Is there any other advantage?


  75. Mithlesh says:

    It is iterm manish.It is a new company so wasn’t very comfortable. Still it’s so cheap ,I went for it.I divided my insurance needs into two halves and thinking of taking another term plan from a established comp like Sbi life.
    Also I read abt LIC health plus and it seems interesting.
    What ya say?

    1. manish says:


      I have no idea about LIC Health Plus at the moment . You can take the rest half of your insurance with LIC or SBI life .


      1. mithlesh says:

        thanx a lot mate…I think it makes sense to divide the insurance needs into two considering the very cheap iterm policy while taking the other one from a reputed insurer.

        Also, i have a mediclaim policy from my employer. So. i would just like to take LIC health plus in addition to that at the moment . I’ve received good feedback about this policy from my friends and colleagues and i think its good option to take it in addition to your traditional mediclaim policy.

        Thanks again for the excellent articles like this.I would like to see more on these topics and would like to involve in the discussions and share my knowledge(learned thru such blogs :)-) in certain areas in personal finance as well.

        1. manish says:


          yes , I have got good review of it from my side also . Its a good one for now . Keep coming and involve in discussions . Its the best way to learn .


  76. mithlesh says:

    Cheers manish!!
    i’ve already done some planning .i’ve already been investing actively in stock market and mutual fund SIP as equity and have taken life insurance as well from religare.

    1. manish says:


      Was that iTerm plan or regular term plan ?


  77. mithlesh says:

    thanks a lot guys!!(esp . manish et al)

    you are doing a wonderful job here helping the novice about different things of personal finance.
    I open this website everyday to check on the new reviews and articles
    keep it up guys!!

    1. Mithlesh

      Nice to hear that . So I hope you have learned a lot from this blog . Are you working towards your financial planning now 🙂 . Feel free to ask questions 🙂


  78. Vivek Rastogi says:

    I am safe with Mediclaim policy of United India. and also my Father and Mother get full amount which spend in hospitalisation. Till now I have individual plan for family of 2 lacs each. but from this year I will go for Family Floater.

    I have seen LIC’s Health Plus, but there is some less features as other policies.

    Thanks a lot on Health Insurance Stuff.

    I am also writing some Personal Finance and Insurance stuff in Hindi at

    1. manish says:


      Can you give more details about the Policy you have , Name of the policy ?
      Nice to hear that you are blogging in Hindi , its a different target market all together 🙂


  79. Abhishek says:

    Link is good, you can see that Health insurance cost is increasing year by year (which is same). Again it is not written that Health insurance cost be same even if claims are being made. My father had Mediclaim from Oriental, after claims they have increased premium though haven’t denied the renewal

    1. manish says:

      Err .. Abhishek

      Why dont you click on “reply” and then write your comment . that way it will appear just below Alok comments .

  80. Raju Shinde says:

    Dear Venky, pls email me Excel calculator my email is

    – Raju shinde

  81. aloksharma says:

    Other 2 important dimensions to consider are Term & Type.

    Most of the products offered by Gen Insurance Cos. (popularly known as Mediclaim) offer a term of 1 year. These are annually renewable contract. Here the Insurer has the right to NOT renew your policy next year or also increase the premiums based on the claim that you have made. So one is not sure of his outgo on premiums over the years.

    On the other hand, Health Insurance Products launched by Life Insurers offer long term health plans which have a level premium across the term.. For eg. Health Saver from ICICI Prudential being discussed above has a level premium with cover cessation age at 75yrs.

    Mainly there are 2 types viz. Fixed Benefit & Reimbursement.
    Fixed Benefit:
    These type of products offer fixed benefit based on parameters like no. of days stayed in hospital, surgery undergone etc. Here the actual expenses are not considered. In this case if one has a health cover from his/her employer, he/she can avail the benefit from both. Eg. Health First from Tata AIG.

    Here the claims payout are done on the basis of actual expenses incurred. Consider the foll. eg:
    1. Group Health Cover from employer: 3 Lacs
    2. Personal Health Cover from Insurer: 3 :Lacs
    3. Actual expenses incurred: 4 Lacs

    Here, the person can claim 3 lacs from group mediclaim from employer and the rest 1 lac from this personal insurance policy. In case the actual exp incurred is just 2 Lacs, then he can claim it either from group mediclaim or personal policy, but not both.

    1. manish says:


      Amazing stuff . I will try to read more on this and post .

      I have a doubt , From your comment 1 . It looks like Health Policies from Life insurance is always better, Is it so ?


    2. Ganesh says:

      Is the premium guaranteed to be constant in ICICI Health Saver plan?
      The policy wordings document ( says that they can alter it.

      And another thing to not is that the “insurance charge” is deducted based on the age of the primary insured. So even though the plan provides cover till age 75, insurance charges will be deducted every month by cancellation of units and i am not very clear on this charge. I assume that it will be very much on the higher side. (For a family floater option, if i understand correctly, the insurance charge based on the age of the primary insured, would be applied across the entire family!) And don’t forget the other charges like premium allocation charge, policy administration charge and fund management charge.

      I am still not convinced. If the health benefits are on par (which of course is the primary objective of health insurance), “returns” from a unit linked health insurance plan would not be better than that from a good MF.

      Doing a cost-benefit analysis of these products are getting more and more confusing. But reader comments are adding a lot of useful information!! Wow!!!
      .-= Ganesh´s last blog ..Personal Accident Insurance =-.

      1. manish says:


        I feel market linked health plans are still very new in India and just like other Unit linked plans, its also for people who can take informed decision of switching , else here also the same funda applies like Term + MF .

        Here we can go for pure Health + MF options 🙂

        What do you say ?


      2. aloksharma says:

        To resolve your queries for Health Saver, pls visit or cilck on “Premium Quote” on the homepage of ICICI Prudential Website. The illustration will clearly show the deductions across the policy term.

        The level premium is more evident in Fixed Benefit types or products like Hospital Care from ICICI Pru or Hospital Cash from Bajaj Allianz.

        I am not sure if these are better or no, but atleast one has guaranteed cover over long term, no increase in premium due to claims made in the past year etc.
        Imagine if someone undergoes any Heart surgery and then claims from the Mediclaim. Now the GIC can either deny to renew the policy or charge huge extra premium as the life insured is now a sub-standard life.

        1. manish says:

          OK .. thanks for your views .


  82. raag says:

    I too have a family floater from Star Health and Allied. I would second Ganesh’s comment above. Star “looks” to be a decent player. I am very very skeptical about Apollo DKV (my personal opinion) – in fact, I would be very very skeptical about anything associated with the Apollo group. So, please do your due diligence before you buy from Apollo DKV.

    Now, Manish, I am not sure if family floater schemes can be inherently termed as better than individual schemes. captures the disadvantages of family floater (FF) schemes very well. I had following doubts about family floaters:
    1. Let’s say Mr and Mrs Sharma and their son Bunty have a FF scheme. Now, let us assume a claim made by Mr Sharma was rejected on the grounds of “pre-existing illness”. Subsequently, Bunty fell ill and they made a claim again. Will Mr. Sharma’s pre-existing illness fact affect the claim made for the son’s illness. Are guidelines clear on this? What I am saying is the one claimant’s history shouldn’t affect/harm other claimant’s status.
    2. Under FF, What happens when the eldest person (in the above case), Mr. Sharma reaches senior citizen status?

    In my view, since there are so many unknowns in Family Floater schemes, it would be better to go for individual schemes for each member since the cost difference won’t be that much for a young family.

    1. manish says:


      No product in the world can be termed as “Best” . its always suitable or unsuitable . Family floaters have their own issues like discussed in the link you gave . Now its you who have to decide if those things matter to you or not . Or how can you mix family floater and individual policies to create the best health plan for yourself .

      Regarding your doubts :

      1. I am not sure . But one person conditions should not affect others . It does not make any sense from design perspective of a product .
      2. In the same link , its given that when the eldest member reaches the limit , the policy will end , in which case they have to take a new policy .


  83. I am 24 and working in an IT firm… My company provides a Medical emergeny of 1 lac in case I need medical assistance… In addition there is a life cover for 10 lacs…

    But i think that is not enuf. Can you suggest any product that is gud for me?
    .-= Amandeep Singh´s last blog ..How are the Interest- free days calculated for my credit card? =-.

    1. manish says:

      You should take more . It might happen that for some particular year you current cover is enough , but you have to understand that it can badly hurt you in some particular year when expenses reach 4-5 lacs .It will not be a good situation then . regarding life insurance, you should increase your cover asap .

      Regarding suggesting a policy , its you who has to find out on your own 🙂 . We teach how to think , the action part is yours .


      1. 🙂 Thanks for the advice manish ///
        .-= Amandeep Singh´s last blog ..How are the Interest- free days calculated for my credit card? =-.

  84. As a US Health Insurance broker your rage I found you guys while looking into International health insurance, this was a great introduction for the Indian system of health care.

    1. manish says:

      Thanks for the comment ? What country are you from ?


  85. Venky says:

    Dear Manish and other JagoInvestor users,

    I am an NRI living in Bahrain (with wife and 5 year old daughter). I want to obtain health insurance in India (family floater). I will be in Bangalore for a week from 20th Jan and will appreciate if you guys can advice me on some of the beter health insurance policies especially as I will be having just 5 working days to complete my personal work, get the health insurance and return. Also, will my wife and daughter need to get thier medicals done for the family floater policy?



    1. manish says:


      It can be little tough to get a family floater if case is complicated and Insurance company needs your Medical done . I would say better get more details on and compare different products .

      Get a family floater plan . You can look at Star Health as an option .


      1. Venky says:

        Thanks Manish.

        I will be in Bangalore on 15th Jan and will stay for 8 days and hope to get a good health insurance in that period. I hope 6 working days are enough to get the medicals and the insurance paperwork done!!


        1. manish says:

          Yes . That should be enough . Be ready to choose the insurance policy name and better contact them already and talk . Be prepared .

          Which policy are you taking ? Is it family floater ?


          1. Venky says:

            Thanks Manish for your reply.

            I’m looking at family floater and/or hospital cash benefits(LIC Health Plus). Please advice.


            1. manish says:


              For now , we cant suggest a policy because its your individual situation . So better try to find out what all policies have to offer and how it will suit your needs . Try . We will come up with more posts in future on health insurance .


  86. Mahesh says:

    Hi Manish,

    Thanks a lot for this article, It is really much awaited post for so many readers.

    Dear friends,

    If you guys know about any good health insurance products for parents, please share the details.

    Thanks in advance, Mahesh

    1. manish says:


      As per Pattu , Varishtha Mediclaim Policy Life & Health Insurance from National Insurance Company is a good option for senior citizens , check that


  87. puneet says:

    I am subscribed to ICICI Health Advantage Plus since last 3 years.
    They have something like Outpatient claims worth 7.5K which has been hassle free claims for me till now. Have not used the actual (inpatient) claim yet though.

    1. manish says:


      How cost it compare with other policies with same cover and features ? Is it one of the costly ? I dont think so ?

      btw , what is inpatient claim ?


      1. Puneet Gupta says:

        Here’s my calculation:
        Anual premium: 15k
        In patient : 3L
        OPD claims: 7.5K (gets refunded easily with all medical and OPD bills). (less)
        Claim sec 80D benefits: 30% tax exemption: 4.5k (less)
        Remaining : 3k is what you effectively pay for 3L medical in-patient cover.
        Is it costly? I don’t think so.
        Plus: everything (literally everything) is covered after 2nd renewal premium. Including dental and maternity covered right from first year.

        1. R Kathju says:

          Which policy is this one – which gives maternity cover – I am interested in a policy that gives maternity cover

          This was posted by Puneet Gupta on May 10, 2010


          1. I guess its ICICI Health Advantage Plus

  88. Narayan says:

    Hi all,

    A very informative & timely article. Thanks a lot Manish and all others who are participating in the discussion above.

    I am also in the process of buying a family floater health plan, Few observations from my side:
    In my case, I have a group mediclaim from my employer which is serving the need of my family very well for the time being.
    I am looking to buy a basic Family Floater policy with minimum coverage, which I can enhance at the time of my retierment or while moving to a new employer, and to avoid hassles of medical test later on.
    Till now I find Apollo DKV as a good candidate with a unique feature of no age limits for policy renewal among other things. Though a bit expensive but removing the age limit does make it attractive.
    Coverage can be enhanced any time later on with most of the insurers with Reliance as noteable exception.

    Pattu can you please mail me your excel sheet for LIC HP at Thanks.


    1. manish says:


      It looks like a good policy , I cant say it will fit everyone needs , but if it fits yours then its a great thing : ) . Go ahead . just make sure you compare it with others also so that that later you dont regret 🙂


  89. Angshuman Ganguly says:

    Hi Manish,

    Can u pls send excel sheet calculator to me?
    My email id:

    Angshuman Ganguly

  90. Abhishek says:

    Hi Pattu,

    ICICI plan “Health Saver” is different than “Hospital care”, former being sort of Mediclaim cum investment plan, Hospital care seems to be copy cat of LIC Health Plus

    1. You can click on the link here

      People just blindly go for anything with the name ‘LIC’. the problem with LIC HP is that it does not offer ‘cashless’ facility.
      In an emergency, it is quite rare we will be having cash and just imagine running around for cash at that time of a crisis.

      I do not know, but I would go for ICICI Health Saver rather than LIC Health Plus.

      Though, the best option would be a Pure Mediclaim and the difference of premium being in Diversified Equity Funds. There is nothing to beat this combo.

  91. pattu says:


    Here is a comparison bet Health plus and ICICI’s similar plan. Not sure if this is what you had in mind. This is written by a LIC officer. However the comparison is fair and leans towards ICICI in some cases.

  92. Abhishek says:

    has any one seen ICICI health saver plan similar to LIC HP, puttu please send me excel sheet at abhishekkabra at gmail

    1. manish says:

      Not sure .. pattu might help 🙂


  93. Abhishek says:

    People who looked into LIC Health Plus, there is same kinda policy from icici named “Health Saver”, seems cheaper wrt LIC HP

    Pattu can you send me detail excel sheet for LIC HP

  94. Rakesh says:

    Nice Article Manish, These days everyone should have a health insurance, you never know when you might need it. I have health insurance from National Insurance Co., also claimed expenses last year. Though they took 3 mts. for settlment, they deducted 20% of the re-imburesment, there was a clause in the policy. Overall they seem to be good.


    1. manish says:


      Nice to know that readers already are smart enough . can you summerize the policy features in 6-7 lines for others 🙂


  95. Ganesh says:

    I have myself opted for Star Health’s Family Health Optima (floater plan). Reasons are multiple – (1) they seem to be only focused on Health Insurance and nothing else (2) they don’t have a TPA, and settle the claims directly (3) at the time when i took the policy (2 years back), though Star Health was not necessarily the cheapest, the premiums were still low (4) decent customer service (not that i didn’t had problems, but they were at least receptive) (5) when checked with the insurance desk of my preferred hospital, they seemed okay with Star in terms of claims settlements and customer complaints (6) Overall i felt comfortable and two years later i hold the same opinion.

    Here are some useful links for further research if you like:

    The last link has a lot of useful information on health insurance policies, premiums, etc.
    .-= Ganesh´s last blog ..Personal Accident Insurance =-.

    1. manish says:

      Yes ..

      I have also heard that Star health is one of the best players in health insurance . great links 🙂


  96. Yogesh says:

    Hi Pattu,

    Can u send excel sheet calculator to me?
    My email


  97. pattu says:

    Dear Vikram,

    What you are asking is contrary to the idea of Jago investor. What Manish is trying to is to create awareness. You want everything spelt out for you. No one except an agent can blidly say something is good for you. You need to go to website look for terms and exclusions look at you needs and make a choice. It could be right or wrong but you have to the hard work. That’s what Jago investor means! Nothing is easy in life if you listen to others blindly when it comes to financial planning you will end up regretting it.
    Maybe you should look at
    So Jago!

    1. manish says:

      Great !! ..

      Thats exactly what I told vikram 🙂 . Thanks Pattu


      1. vikram says:

        Thank Pattu.
        But I am a good learner with the help of Jago Blog , I am confident that I blindly wont take any poilicy.
        I am doing full study on the links provided by Alok.


  98. aloksharma says:

    Vikram, If you are looking for a list of health family floater products available then foll. is what I could get after doing a quick search on the net:

    Offered by General Insurance Companies:

    1. ICICI Lombard Gen. Ins. Co. – Family Floater Health Plan
    2. Apollo DKV Ins. Co. Easy Health – Family Health Insurance Plan
    3. Star Health & Allied – Family Health Optima Insurance Plan
    4. National Insurance Co. – PARIVAR-Mediclaim for Family Policy
    5. Cholamandalam Chola Health Insurance – Family Health Plan
    6. Reliance General Ins. Co. – Reliance Health Wise Policy
    7. United India Ins. Co. – Family Medicare

    Offered by Life Insurance Companies:

    1.Bajaj Allianz – Family Care first.
    2.ICICI Prudential – Mediassure.
    3.Max Newyork Life – LifeLine Healthy Family Plan

    4.Birla Sun Life – Universal Health Plan

    Hope I am not confusing people with the laundry list 🙂

    1. manish says:

      Alok Sharma

      Thanks a lot for links , you are doing great !!


      1. vikram says:

        @Thanks Alok! Very informative links.

  99. vikram says:

    Blog readers,

    Correction for the above comment – Typing speed created mistake ;), English mistakes 🙁

    But Manish and the jagoblog freinds- here we are helping out with information perfect, but we are not doing exact help like which is the best product ??

    Example : Appolo DKV after going through this product name suggested by Naveen I came to know about this.
    So if this kind of product names are avialable we can compare and review about those and we can suggest to every one of freinds as well.

    I am advising to my relatives , family friends and my friends to have one family floater policy only because with the frequent prompts given by manish by his nice articles.

    Thanks Manish! , you will have lot of people blesssings , I am sure about that!

    .-= vikram´s last blog ..The Top 100 Web Sites of 2009 =-.

  100. vikram says:

    Thanks manish for the article and ganesh good stuff!
    But Manish and the jagoblog freinds- here are we helping out with information , but not doing exact help like which is the best product ??

    Icici Lombard or Bajaj Allianz or something else……..
    Please tell us one or two good product names that will be enough.

    I am waiting from you all to give your good product names…. even as manish said i am waiting for the good prodcut name this is the best you can & must take if someone is looking for the RIGHT PRODUCT!

    the next minute I will take my Health Floater Policy to my family + to my parents individually.

    Manish , if you know the right product you can update us 🙂


    1. manish says:


      We have started with Health Insurance introduction for now . Surely we will come up with reviews and discussions 🙂

      However , the most important thing is the education and way you should think , the choosing of product should be done by you . you can definately filter out bad policies , but at the end you have to compare things on your own and then see what fits your needs .


  101. pattu says:

    Naveen, How do you know Claim Settlwement for Apollo is good?

    ‘being themselves a hospoital chain, they understand health insurace better than anyone in India”

    You could say that again! A kid went into Apollo hospital with Typohid. She stayed a week. All they did was give saline and Typhoid drugs. The doctor on admission asked her what her insurance amount was? She replied it was Rs. 30, 000 (it was a student group plan). So the doctor wrote on the expected charges (on the day of arrival when they had not diagonised!) Rs. 28,000 and gave it to billing!
    Yes I am sure thye understand insurance quite well!

    1. manish says:

      Really !! . is that the true story 🙂 . Sad

      I checked the irda report for last year , Seems like they dont have honoured all the claims , but they thing is that they didnt receive lot of claims , they are still small players compared to another big public general insurance companies .

      also their Solvency ratio is not worth excitement .


  102. Naveen says:

    I guess for a family of couple+2 kids, 4-6 lacs of Family floater cover is OK to start with. The best company to provide family floater is Apollo DKV. They are the best w.r.t. claim settlement ratio and the illness they cover( more than anyone). Also I guess they have the highest networked hospitals(5000+), cashless facility and inhouse TPA. being themselves a hospoital chain, they understand health insurace better than anyone in India.

    Comments are welcome!


    1. manish says:

      I also like Appolo DKV . Indeed they have very good policies .

      Will have to look into the claim ratio more . However it might be the case that for a person it might not work out to be the best policy .Everyone has different needs .

  103. pattu says:

    Links for LICs health plus

    Interesting links written by LIC officer. Includes info on how agents will sell it to you!

    Good review by outlook money

    I agree with the review about keeping investment and insurance separate. However this policy from LIC has a good surgical assistance feature (max 5 laksh) which maybe useful at an young age. I am thinking of buying this. In addition to mediclaim this could be treated as as pure debt instrument and some money can be allocated to equity to build an old age health corpus.
    Suggestions reg. alternative policies and drawbacks of health plus are welcome.

  104. Yogesh says:

    what will be right age/time for me to go for personal health insurance policy ??

    1. manish says:

      As soon as you get married , its a must have . Buy family floater


  105. Yogesh says:

    manish..i don’t have any health insurance policy till now.
    Only using company age is 30.

    what is the right age to go for health insurance policy ??

    My company one is mayfair insurance.Insurance cover is of very huge amount.
    something 10,000 USD for me n my wife.

    1. manish says:


      Its who who has to decide if 10k USD is enough or not for for of you . What is the average case expenses ? If more then it wont hurt to take. anyways its not that expensive that it breaks your back , So think about it

      and the right time was to buy it was yesterday . the next best time is now .


  106. aloksharma says:

    Fellow readers, certain fine prints of Health Insurance:

    1. Exclusions:
    This is the list of items explicitly excluded from the cover. Based on the product features, it could be either Maternity Procedures or Day care surgeries like Cataract etc. Also in some cases, exclusions come with a certain waiting period.
    Other type of exclusions is pre-existing illness. These are the ailments the customer is suffering while buying the policy. Based on the underwriting norms, these can either be excluded permanently of with a certain waiting period.
    Please disclose all medical details honestly.
    2. Limits:
    Hospital Cash like products are priced and sold on the basis of DHCB i.e Daily Hospital Cash Benefit. This is the sum which the customer gets for each day spent in Hospital. All other limits are multiples of the DHCB. There are limits like Lifetime Limit, Annual DHCB Limit, Surgery Limits etc.
    Also such products have something like Convalescence or Recuperating benefit, which is provided mostly when the customer has stayed for more than 5 days in hospital.

    3. Eligibility:
    Claim is admissible only on a minimum 24 hrs of stay in Hospital. Not applicable for day care procedures.

    4. Co-Pay:
    Certain products are priced that if a customer gets treated in an out-of-network hospital, the Insurer will not bear the entire amount and hence a certain % will have to be borne by the customer.

    5. ULIPS:
    Understand the rules for partial withdrawal from Fund. Mostly its against presenting the medical bills. Normally there is a vesting age which is either 3yrs of policy or certain age specified whichever is earlier.

    6. Network Coverage:
    Examine the list of network hospitals. Insurers boast having huge no. of network hospitals, however the network coverage should be appropriate and not just large in nos. Check for reputation, locality, facilities etc. for hospitals. Most of the claim incidences happen in the 20% of the network hospitals.
    Keep a print-out of list of network hospitals and phone nos. at a place known to all family members.

    7. Ground reality:
    Visiting a network hospital does not guarantee a cashless facility. Generally hospitals face a lot of issues in getting their claims reimbursed from TPA/Insurer. Hence even if a hospital is a part of network, they are resistant to provide cashless facility. In most of the cases, customers end up paying first and then claiming reimbursement. Know your right, inform the Insurer.

    8. TPAs
    These days, Insurance cos. have been pulling out the outsourced claim process from TPA and managing themselves. This gives a better claims experience to the customer and tighter control on the claims process.

    9. Pre & Post Hospitalization:
    Certain products also cover expenses pre & post the hospitalizations. Normally it is 30 days pre and 60 days post the hospitalization.

    10. Rejections:
    Generally consumables like gloves, cotton etc are not covered.

    11. No Claim Bonus:
    Some products provide an % increase in sum assured based on a claim free year, however with a certain max cap on the same.

    We all know that Insurance is a long term commitment and hence I am not sure why should one opt for a Mediclaim which has a term of just 1 year. In case of Mediclaims, the insurer can increase the premiums based on the claims experience.

    I would rather go a long term health insurance which provides me with a level cover across the term.

    What say guyz?

    1. manish says:

      Thanks Alok

      These are really some fine points one has to consider 🙂 . good work . I appreciate it .


      1. aloksharma says:

        Now lets have a look at some broader points which can change the dynamics of the Health Insurance Industry in the near future:

        IRDA has always been a very active regulatory body for Insurance Industry. In the recent past, it has come up with various norms which can change the business models and operations of the Insurers.

        Foll. Are some of it:

        1. Life Insurers can now sell Health Policies offered by Non-Life/General Insurance Cos.:

        “Health plus Life combi Product’ would be the new product class emerging out of this norm. As per IRDA, “A tie up is permitted between one life insurer and one non-life insurer only. Thus, a life insurer is permitted to tie up with only one non-life insurer and vice-versa,”.
        This will help the penetration of health insurance in India leveraging on the sales & distribution channels of Life Insurers.

        For more details, please visit

        2. IRDA may phase out the TPAs:

        Due to the inefficiencies displayed by the TPAs over past years, the chairman of IRDA indicated that TPA system remains a concern as they are not performing as per customer satisfaction.
        There have been increasing instances where TPAs were found to have forwarded inflated medical bills to insurance companies.

        For more details, please visit

        3. TPAs/Insurers to cut TDS on Hospital Payments:

        CBDT has issued a circular to deduct 10% TDS on the payments made to the hospitals.
        TPAs had asked the tax authorities to keep them out of the TDS ambit as they made payment to hospitals on behalf of individuals and individuals did not have to deduct tax. Moreover the new provisions would apply retrospective from 2003.
        IRDA has asked CBDT to consider exemption of TPA from the TDS provisions, however its still under discussions.

        For more details, please visit

        1. nice points .. you are adding wealth of information here . Excellent job


    2. vikas ranjan says:

      Dear Alok,
      I went through your post. you have written
      9. Pre & Post Hospitalization:
      Certain products also cover expenses pre & post the hospitalizations. Normally it is 30 days pre and 60 days post the hospitalization.

      I got a PARIVAR mediclaim from NIC(National Insurance Company). The brouchre is written in english/hindi version. In english it is written 15 and 30 days, whereas in hindi it is written 3o and 60 days respectively for pre and post hospitalization.My TPA agent is trying to convince me 15 and 30 days for pre and post hospitalization, in case of PARIVAR medical.
      i will be obliged to go through your soonest response. Your response is awaited on the following email address,

  107. Pradip says:

    Great to see an article elucidating Health insurance at last. Was waiting for it for a long time. Nicely done

    1. manish says:

      Thanks Pradip 🙂

      Which policy do you have ? Do take a Family Floater soon


  108. pattu says:

    Dear Manish,

    1) Reg. Health ULIPS: You write “This is only recommended for people who who are eligible for market linked products like ULIP a” This doesn’t make sense. How can someone be eligible for a ULIP!

    2) Here are two good links on choosing critical illness or major surgery plan in addition to medicalim

    4) One should invest in MFs+DEbt similar to ret. plan to create a health corpus for expenses in old age or after mediclaim expires.
    Once also do this in a health-ULIP like LICs health plus in addition to mediclaim
    This is a surgical assistance+ ULIP plan which invests in nearly 50 % debt instruments. Although it has some drawbacks and not as good as simple MF route it does provide surgical assistance for several surgeries (better than most CI plans) and can help if need at young age.

    So I would recommend:
    (a) medclaim
    (b) MF+debt for old age corpus
    (c) Surgical assistance plan which also has ULIP component.
    LICs health plus has premium which is fixed by daily hospital benefit and not age. Anyone who can spare Rs. 2000 a month can afford this. I have an excel calculator. I can send it to you if anyone needs.

    1. Err .. My english is killing me 🙂

      “Who are eligible for market linked products” , by that I mean , people who can understand market linked products and can handle ULIPs . as you know ULIPs are more than just buy and hold kind of financial products 🙂 .

      I am adding your links in the original article as they seem to be good reads .

      As you explained LIC Health plus can be looked upon once 🙂 . thanks for suggestions . You are doing a great job 🙂


    2. Venky says:

      Dear Pattu,

      Can you please e-mail me the Excel Calculator that you have mentioned in your comment above? My e-mail is



      1. pattu says:

        Dear Venky,

        I have sent the health plus calculator to your email.


        1. Venky says:

          Thanks Pattu. I have received the Excel File.



        2. Nilesh Panchal says:

          Dear Pattu,

          Can you please send the Excel Calculator to me also on

      2. chintan says:

        can u sent me excel calculator

    3. manish says:

      hey .. send me the excel sheet . I will see if I can put up on the article for others .


    4. Nikhil says:

      Dear Pattu,

      Can you please e-mail me the Excel Calculator that you have mentioned in your comment above? My e-mail is


    5. Ashish says:

      Can u Please mail me the Excel Calculator


    6. Venky says:


      I have gone ahead and bought LIC’s Health Protection Plus Policy (for Self + Wife + Daughter). My annual premium is Rs. 24,000/- and my HCB is Rs. 2500 (Rs. 1500 for wife and daughter). I did compare this with ICICI’s Health Saver and Reliance’s Health is Wealth plans but LIC’s plan came up on the top probably because of the low ULIP charges and probable because it is from LIC!!

      I am curious to know your thoughts on this policy(or any one else’s in this forum!).

      1. pattu says:

        Dear Venky,

        Its a good buy. Do you have a mediclaim for your family? Not just your companies mediclaim but personal one? Because Health plus is not a standalone policy but works best with a mediclaim. My view is that the HCB is not that relevant if you have large enough mediclaim cover. However the Rs. 5 lakhs MSB will come in handy if someone needs a surgery when young. Also the most important part of the plan is the corpus which you build using the ULIP. This will help when you grow old. If I am not wrong in Health protection plus domiciliary benefits are paid for entire lifetime, if enough money exists.

        The point is the corpus for old age can be obtained by MF route however the MSB (+HCB of course) helps if there is a major health crisis at young age. So LICs health plus acts like a critical illness cover in some sense.

        1. Venky says:

          Thanks Pattu for your comments and adice. I have not gone for mediclaim as I am an NRI (living in Bahrain) and I don’t think we can have much benefits from mediclaim in India while we (my family & I) continue to live in Bahrain. I have gone for LIC’s Health Protectio Plus mainly to build up the corpus which I am sure will be useful later in life. I don’t mind looking at the mediclaim policy if it is really useful for me (as an NRI who spend a maximum of 30 days in India every year)

          1. Venky is my friend. And though I am very very happy with his choice of mutual funds, I am NOT happy with his choice of Health ULIP plan.

            You can click on the link here

            People just blindly go for anything with the name ‘LIC’. the problem with LIC HP is that it does not offer ‘cashless’ facility.
            In an emergency, it is quite rare we will be having cash and just imagine running around for cash at that time of a crisis.

            I do not know, but I would go for ICICI Health Saver rather than LIC Health Plus.

            Though, the best option would be a Pure Mediclaim and the difference of premium being in Diversified Equity Funds. There is nothing to beat this combo

    7. vibhav shah says:

      dear Pattu, Manish and all other friends,
      the calculator is very useful to arrive the cost of such insurance. for rs.25000/- yearly premium family of 3, age 33,30,4 years, it comes around rs.14300/- to rs.17100/-for different interest rate consideration 6, 10,12%. ‘LIC Health plus has premium which is fixed by daily hospital benefit and not age’ ,though correct on face, but in reality, in ral sense, i.e.actual deduction for the benefits, it is rightly increasing with age.however the positives are: covering long long time,say whole life, in one go and the actual cost of cover may be on lower side, may be because it is group insurance in a sense that cover may be,wholesalely tied up from other general insurance company by LIC.the pinch is that we have to buy m.f. for about half the actual cost of the health cover cost forcebly alongwith. this is the situation as in life insurance before entry of term insurance in India, for which , Shri A.N. Shanbagh has rightly observed in ‘in wonderland of investment’ that it is not affordable to whom it is needed and being bought by those who do not need it!.is there any pure health policy now available for such long time,65-75 years?kindly guide.

      1. vibhav shah says:

        dear manish ,pattu and other friends,
        kindly refer my observation on LIC Health plus on dt.19-03-10. let me correct the cost of the policy per year comes as rs.6400/- to rs.7000/- for family of 3: 33,30 4 yrs for annual premium of rs.25000/-.sorry for mistake! so though it becomes more attractive, but the pinch remains, as we have to buy m.f. forceibly alongwith for more than two and half times the cost of the cover, and makes it unaffordable to whom it is needed the most!

    8. Vikas says:

      Dear Pattu,

      Please e-mail me the Excel Calculator that you have mentioned in your comment above? My e-mail is



    9. manish says:

      Can you please e-mail me the Excel Calculator that you have mentioned in your comment above? My e-mail is

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