General Insurance · verified 5 September 2026

Health Insurance

Turn a hospital bill into a planned financial risk.

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What is health insurance?

Health insurance pays admissible medical expenses or defined benefits in exchange for premium. The best plan is not simply the cheapest: room category, waiting periods, co-pay, sub-limits, hospital network, restoration rules, exclusions and claims service determine what you may actually receive.

Illustration of a family protected from hospital expenses — Visual guide: health insurance connects the family, hospital, eligible bills and insurer subject to the policy.

Buying process

How to choose and use a health plan

Before buying

List every member, age, medical history, medicines and planned treatment.
Choose cover for local hospital costs; consider separate policies for older parents.
Compare room rules, PED and named-disease waits, co-pay, sub-limits and restoration.
Check preferred hospitals in the live cashless network.
Declare everything in the proposal form and retain the submitted copy.

When claiming

For planned admission, request cashless approval in advance; for emergencies notify promptly.
Carry health card, ID, prescriptions and prior records.
Cashless approval is not a guarantee that every item is payable.
For reimbursement, preserve originals, discharge summary, bills, reports and payment proof.
Escalate through insurer grievance, Bima Bharosa and Ombudsman where appropriate.

Income requirement: Most indemnity health products do not publish one universal minimum income. Premium affordability, proposer details, medical underwriting, sum insured and plan-specific rules apply. Never invent income eligibility—read the prospectus and proposal form.

Plain-language guide

Important terminology with examples

Definitions are educational summaries. The issued policy wording and schedule control every claim.

Sum insured

The maximum admissible amount the insurer can pay in one policy year.

Example: A ₹10 lakh family floater is shared by all insured family members.

Cashless claim

The insurer or TPA pays the network hospital directly after authorisation.

Example: You may still pay deposits, deductibles, non-payables and excluded expenses.

Reimbursement

You pay the hospital first and submit originals for an admissible refund.

Example: Useful at a non-network hospital, subject to timelines and documents.

Network hospital

A hospital tied up with the insurer for cashless service.

Example: Always re-check the live network list before admission.

Pre-existing disease (PED)

A condition, symptom, diagnosis or treatment existing before policy start as defined in the wording.

Example: Diabetes disclosed at purchase may be covered after the stated PED wait.

Waiting period

A period during which specified claims are not payable.

Example: Accidents are generally treated differently from the initial illness wait; read the wording.

Co-payment

The percentage of an admissible claim that you must pay.

Example: With 20% co-pay on a ₹2 lakh admissible bill, you pay ₹40,000.

Deductible

The amount that must be crossed or paid before a top-up or base cover responds.

Example: A ₹5 lakh deductible means the top-up starts only after the defined threshold is met.

Room-rent limit

The permitted room category or daily room charge.

Example: Choosing a room above the limit can trigger proportionate deductions if the wording says so.

Sub-limit

A separate cap inside the overall sum insured.

Example: A cataract sub-limit of ₹40,000 applies even when total cover is ₹10 lakh.

Day-care procedure

A listed medically necessary treatment completed in under 24 hours due to modern technology.

Example: Dialysis or cataract treatment may qualify when listed.

Pre/post hospitalisation

Related tests, consultations and medicines before and after admission for stated days.

Example: Only expenses linked to an admissible hospitalisation are normally considered.

Restoration/refill

Reinstatement of sum insured after use, under defined rules.

Example: Check whether it works for the same illness, same person and first claim.

No-claim/cumulative bonus

Extra cover or premium reward earned under renewal rules.

Example: A 10% cover bonus can raise ₹10 lakh to ₹11 lakh, subject to policy caps.

Domiciliary treatment

Hospital-level treatment at home when policy conditions are met.

Example: It is not the same as ordinary home nursing or OPD consultation.

Consumables/non-medicals

Items such as gloves and registration charges that may be excluded unless a benefit covers them.

Example: Check the policy’s non-payable annexure and any claim-protect add-on.

Free-look period

Time after receiving a new policy to review and cancel subject to permitted deductions.

Example: Use it to read the schedule, CIS and wording—not only the brochure.

Portability

Moving at renewal while carrying eligible continuity credits under rules.

Example: Apply within the insurer’s prescribed timeline and disclose full claim history.

Clickable insurer directory

Companies offering relevant covers

Open a company page to review current plan families, eligibility guidance, coverage, exclusions and official documents.

National Insurance

National Mediclaim Plus · National Parivar Mediclaim Plus · National Senior Citizen Mediclaim

Health Insurance

What is health insurance?

How to choose and use a health plan

Before buying

When claiming

Important terminology with examples

Sum insured

Cashless claim

Reimbursement

Network hospital

Pre-existing disease (PED)

Waiting period

Co-payment

Deductible

Room-rent limit

Sub-limit

Day-care procedure

Pre/post hospitalisation

Restoration/refill

No-claim/cumulative bonus

Domiciliary treatment

Consumables/non-medicals

Free-look period

Portability

Companies offering relevant covers

National Insurance

The New India Assurance

The Oriental Insurance

United India Insurance

ACKO General Insurance

Bajaj General Insurance

Cholamandalam MS General Insurance

Generali Central Insurance

Go Digit General Insurance

HDFC ERGO General Insurance

ICICI Lombard General Insurance

IFFCO Tokio General Insurance

IndusInd General Insurance

Liberty General Insurance

Magma General Insurance

Navi General Insurance

Raheja QBE General Insurance

Royal Sundaram General Insurance

SBI General Insurance

Shriram General Insurance

Tata AIG General Insurance

Universal Sompo General Insurance

Zuno General Insurance

Zurich Kotak General Insurance

Aditya Birla Health Insurance

Care Health Insurance

Galaxy Health Insurance

Narayana Health Insurance

ManipalCigna Health Insurance

Niva Bupa Health Insurance

Star Health and Allied Insurance

Six checks that prevent avoidable surprises

Correct insured

Full disclosure

Coverage limits

Exclusions

Claims process

Official wording

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