What factors should I consider when choosing a health insurance policy?


I am 43 years old, two children and currently stationed in Mumbai. My partner is 39 years old. I want to purchase health insurance for my family of three dependents. Please suggest suitable health insurance policy options. Also, suggest what insurance coverage would be sufficient in Mumbai and what factors I should consider when choosing the right health insurance policy?


You must have at least 10 to 15 lakh of the basic plan in combination with a low cost super add-on plan from the same insurance company. We recommend the options below with premiums:

1. 10 Lakh of Niva Bupa’s Reassure Plan + 40 Lakh of Niva Bupa’s Super Refill – Rs. 24788(Base)+ 2079 (super recharge) = 26867

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2. 10 Lakh of Prohealth Protect Plan by Manipal Cigna + 30 Lakh of Super Supplement Plan – 28524 (base) + 2490 (Super Recharge) = 31014

3. 50 Lakh Lifetime Health Plan – Maid of Manipal Cigna Health Insurance Co. – 32214

Factors to consider before choosing the right health insurance:

1. Choosing the right amount of insurance/Sum insured: When choosing a health insurance plan, one should choose the amount wisely as it covers medical expenses for one year. One must also take a look at his income levels to analyze the affordable premium. One should have a sum assured which is 1.5 times your annual income (me + spouse combined).

2. No claim bonus: PNE refers to the incentive offered by the insurance company for all the years you have not filed a claim. Generally, it varies from 5 to 50% per year depending on the insurance company and the plan. Your coverage amount is increased on subsequent policy renewals for all claim-free years. This factor ensures that the policy is ready for the future to achieve a significant improvement in the sum insured each year. This will ensure that ever-increasing medical inflation does not eat away at your sum assured over a period of time.

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3. No cap per illness: This is a cap placed on various illnesses regardless of the sum insured in the policy. There should be no disease cap.

4. Capping room and intensive care costs in a hospital: This refers to the limit of room rent and intensive care costs per day. Consideration should be given to purchasing a policy that covers single occupancy rooms with the actual costs covered for admission to intensive care.

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5. Additional Features: There are features such as recharge/free annual health check every year/wellness features/OPD etc. which make a health insurance policy a “New Age health insurance plan “.

Question answered by Sanjiv Bajaj, Co-Chairman and Managing Director of Bajaj Capital.

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