There are more than 20 health insurance companies in India. Each company offers more than 2 health insurance policies. So it becomes difficult to compare health insurance plans. Though a guide on health insurance can shed light on the importance of health insurance, there are a few points to consider while buying health insurance policies.
Remember these pointers while comparing health insurance plans.
Always check for the sum insured. This is the sum assured in insurance. The claim settlement will not go beyond the sum insured. So check for the maximum available sum insured for a reasonable health insurance premium. This is important because the health insurance costs are inflating at the rate of 17-20% annually.
Claim settlement ratio
Claim settlement ratio determines the credentials of an insurer. Always go for a company that has a good claim settlement ratio. A claim settlement ratio above 80% is always good. The claim settlement ratio will be mentioned in the IRDAI report annually.
Check for a cashless hospital near your location before buying a health insurance plan. This can be obtained from the list of network hospitals from a particular insurer. Getting treatment from a cashless hospital will ensure you are provided cashless treatment during the time of hospitalization, such that you don’t have to run around filing for reimbursement claims.
Waiting period in health insurance
Waiting period in health insurance is another important point to consider before buying a health insurance plan. This is the time required to cover a pre-existing disease. Usually the waiting period in health insurance is about 30 days from the day your health insurance plan is initiated. Except in the case of emergency, the insurer has the right to reject the claim if anything falls during this period. In most plans this period may be as short as 2 years or even as long as 4 years to cover pre-existing diseases like diabetes, hypertension.
Health insurance TPA
Health Insurance TPA or Third Party Administrator are the ones who will help you with the claims during the time of hospitalization. They help you with filing the claim and settlement of the claims for cashless hospitalization. In some cases these external TPAs for the claim settlement are avoided as the insurance company itself will have an in house claim settlement department. So, always check if the plan has a TPA or in house department for your claim settlements.
Incurred claim ratio
Incurred Claim Ratio or ICR is one of the factors that determine the credibility of an insurance company and also an important factor to check before comparing two health insurance companies. While taking Incurred Claim Ratio into account, check for the average of Incurred Claim Ratio of all health insurance companies and go for the one that is closest to this average.
Incurred Claim Ratio is calculated as
|Incurred Claim Ratio/ICR = Amount settled as claims/Amount collected as premiums.|
Last but not the least, while doing health insurance comparison always check customer experience and reviews online. This determines how the company will respond to your queries and future claims. Also check for the people’s opinion because if the customers are not happy then the insurance service or customer support is not upto the mark.
At Paz Care, we offer group health insurance for employees. Get in touch to know more.