Health Insurance

Life is unpredictable. You never know when medical emergencies will occur. Added to this, hospitalization and medical expenses are very high which can dent even a rich person’s finances/savings

This is where having a Health Insurance Policy helps.

Medical Insurance Policy popularly known as Mediclaim Insurance covers most of the hospitalisation expenses on an indemnity basis.  Insurance company either reimburses the expenses incurred for the in-patient treatment in a recognised hospital, subject to policy terms and conditions or allows cashless facility through their network hospitals. 

The policy holder of Health Insurance are eligible for income tax benefit under Section 80D of the Income Tax Act, 1961.

Insurance policies are available from a sum insured of Rs. 1 lakh to a sum insured of Rs 50 lakhs or more. Individual / Family can decide what sum insured they should opt for.  Lesser the sum insured lesser are the coverages and the premium.  Higher the sum insured, higher are the coverages and premium.

Hospitalization Policy

  • Individual Policy
  • Family Floater Policy
  • Top-up Policy
  • Super top-up Policy
  • Critical Illness Cover

Critical Illness Benefit Policy

Policy pays lump-sum, upto the sum insured as a benefit on first diagnosis of any one of the critical illness named in the policy, subject to usual policy terms and conditions. Generally, Critical Illness cover are offered for dreaded diseases vi., Heart Attack, Open Chest CABG, Cancer, Kidney Failure, End Stage Liver Failure, Stroke, Coma, End Stage Lung Failure etc.

What’s covered

The insurance policy covers:

  • Room Rent, boarding and nursing expenses

  • Intensive Care Unit (ICU) / Intensive Cardiac Care Unit (ICCU) expenses 

  • Surgeon, Anesthetist, Medical Practitioner, Consultants’ Specialist fees.

  • Anesthesia, Blood, Oxygen, Operation Theatre Charges, Surgical Appliances.

  • Medicines & Drugs, Dialysis, Chemotherapy, Radiotherapy.

  • Relevant Laboratory/Diagnostic test, X-Ray and other medical expenses related to the treatment.

  • Day care procedures viz., Chemotheraphy, Radiotherapy.

  • Pre-Hospitalization Medical expenses

  • Post-Hospitalization Medical expenses

What’s not covered

The insurance policy does not cover:

  • Pre-Existing Diseases as defined in the policy until 48 consecutive months of continuous coverage has elapsed, since inception of the first policy with any Indian Insurer. Some insurers have kept the waiting period for pre-existing diseases to 2 years. Pre-existing ailments should have been declared on good faith basis in the proposal form.
  • Any disease contracted by the insured person during the first 30 days from the commencement date of the policy.
  • Expenses incurred in treating certain diseases during the first 2 years viz., Cataract, Sinusitis, Tonsillitis, Hydrocele, Varicose Veins, Hernia, Fistula etc.Varicose Ulcers, Benign Prostatic Hypertrophy, Deviated Nasal Septum, Sinusitis etc
  • Injury/Disease directly or indirectly caused by or arising from or attributable to War, Invasion, Act of Foreign Enemy, Warlike operations (whether war be declared or not)
  • Injury or Disease directly or indirectly caused by or contributed to by nuclear weapons materials.
  • Circumcision unless necessary for treatment of a disease not excluded under this policy or necessitated due to an accident
  • Inoculation or change of life or cosmetic or aesthetic treatment of any description, plastic surgery (other than as necessitated due to an accident or as a part of any illness)
  • Cost of spectacles and contact lens (in excess of what is specifically provided), hearing aids including cochlear implants, walkers, crutches wheel chairs and such other aids.
  • Dental treatment or surgery (in excess of what is specifically provided) unless necessitated due to accidental injuries and requiring hospitalization.
  • Convalescence, general debility, Run-down condition or rest cure, nutritional deficiency states, intentional self-injury etc
  • Charges incurred at Hospital or Nursing Home primarily for Diagnostic, X-ray or laboratory examinations not consistent with or incidental to the diagnosis and treatment of the positive existence or presence of any ailment, sickness or injury, for which confinement is required at hospital/nursing home.
  • Expenses on vitamins and tonics unless forming part of treatment for injury or disease as certified by the attending Physician

Waiting Period

There is a 30 days waiting period starting from the policy inception date, during which period any hospitalization charges will not be payable by the insurance company. However, this is not applicable in case of emergency hospitalization occurring due to an accident. There are also disease wise waiting period.

Policy Coverage After Claim Filed

After a claim is filed by the insured, the policy coverage is reduced by the amount that has been paid out on settlement. Some companies, offer the option of automatic re-instatement of sum insured on payment of additional premium / for higher sum insured.

Maximum No Of Claims

Any number of claims is allowed during the policy period subject to availability of sum insured.


Life time renewal is allowed as per IRDAI regulation. In case of fraud by the policy holder, renewal can be denied by the insurance company.