10 Things to Check Before Buying Health Insurance
The cheapest premium isn't always the best deal. Here's what really matters when choosing health insurance.
Medical costs in India are inflating at 14% annually. A hospitalization that costs ₹5 lakhs today could cost ₹15 lakhs in 10 years. The right health insurance is crucial—but many people focus only on premium while ignoring terms that matter during claims.
Sum Insured (Cover Amount)
Start with at least ₹10 lakhs for a family. In metros, even ₹20-25 lakhs is reasonable. Medical inflation means today's adequate cover becomes insufficient in 5 years.
Room Rent Capping
If your policy caps room rent at ₹5,000/day but you take a ₹10,000 room, all other expenses (surgeon fees, medicines) are also reduced proportionally. This can leave you paying 40-50% out of pocket.
Co-Pay Clause
Some policies require you to pay 10-20% of every claim. A ₹5 lakh claim with 20% co-pay means you pay ₹1 lakh from your pocket.
Pre-Existing Disease Waiting Period
Most policies have a 2-4 year waiting period for pre-existing conditions. Some conditions like diabetes or hypertension may have permanent exclusions.
Claim Settlement Ratio (CSR)
CSR tells you what percentage of claims the insurer actually pays. A low CSR means higher chances of claim rejection.
Network Hospitals
Cashless treatment is only available at network hospitals. Check if good hospitals in your city are on the list.
Pre & Post Hospitalization Cover
Medical expenses don't just occur during hospital stay. Diagnostics before admission and medicines after discharge add up.
Day Care Procedures
Many procedures (cataract, dialysis, chemotherapy) don't require 24-hour admission. Older policies may not cover these.
Restoration Benefit
If you exhaust your sum insured in one claim, restoration benefit refills it for subsequent claims in the same year.
No Claim Bonus (NCB)
Your sum insured increases every claim-free year. This compounds over time, giving you higher coverage without paying more.
🔍 Quick Comparison Checklist
Before buying, compare at least 3-4 policies on these parameters:
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