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Health Insurance: Make sure to review your health insurance at the year-end; Here’s why


One should review his/her policy preferably, 2-3 months before they are due for renewal: Experts

COVID has emphasised on the need to have health insurance along with the appropriate sum insured. Many people depend solely on the company provided group medical insurance policies, however, experts say that might not be sufficient.

Adarsh Agarwal, Appointed Actuary at Digit Insurance says, “Individual health insurance policy is very important than a family floater policy in such conditions so that the sum insured doesn’t get exhausted. Domiciliary cover becomes another important feature that can be looked for while buying a health insurance policy.”

With the rising cost of medical procedures and hospital expenses, one must have sufficient health insurance coverage to ensure one gets the best medical care.

Animesh Das, Head of Product Strategy, ACKO General Insurance, says “Health insurance rates are seeing an increase in premiums owing to the standardisation of inclusions and exclusions initiated by IRDAI. In the short term, it’ll increase the premiums for policyholders, but in the long term it’ll make understanding a policy very easy and bring transparency in claims.”

Hence, reviewing your health insurance each year is important. According to experts, one should review his/her policy preferably, 2-3 months before they are due for renewal. If improving your finances is on your new-year resolution checklist, it is as good a time as any to review your insurance policies too.

What are the things to keep in mind while reviewing your health insurance?

Reviewing health insurance once a year is a must. Mohit Goel, Co-founder, Chqbook says, “One needs to be aware and track policy details such as the types of claims made, the sum assured, no-claim bonus, coverage, and premium while reviewing their policy.”

The premium for health insurance is closely tied with the age of the oldest member in the plan. Most of the plans have slab based pricing. For instance, the premium might get a steep jump if you are going to move from an age slab of 26-30 yr to 31-35 yr slab. Having said that, many plans increase the sum insured for consecutive claim-free years.

Das, of ACKO General Insurance, says, “Some health insurance plans also have benefits like ‘Free medical checkup’ built into them, and they often remain unused. It’s always good to go through the policy to ensure you are not missing out on any such benefits. Why leave a free benefit unused?”

Here are some factors which you must re-evaluate while reviewing your health policy:

  • Increase in size of your family: This will require you to increase your health cover.
  • Cost of critical medical procedures: The current cost of critical medical procedures for heart, cancer, fractures, etc. These costs change every year.
  • Change in city of residence: The cost of medical treatment varies from one city to another.
  • Change in employment: Check the difference in health insurance provided by your new employer. Make sure you have adequate personal health insurance.
  • Family history: Past or recent ailments in your family may indicate a need for securing higher cover.
  • Health goals: If you are leading a healthy life, then you may relook at your health insurance provider and sign up for plans that reward you for maintaining good health.
  • Critical Illness Covers: Critical illnesses like heart and cancer can bring in extra burden. Having a benefit-based policy that pays on diagnosis is always better.
  • No claim bonus: Insurance companies reward you for not filing a claim in a given policy year. Some increase your sum assured by 150 per cent as a reward.
  • Review Claim settlement ratio: It is essential to review the company’s claim settlement ratio of at least the past five years, which becomes an indicator of its performance.
  • Cashless network: At the time of need, especially in hospitalizations that incur a high medical cost, experts say the company must have a strong cashless network so that the family is relieved of the financial stress during those difficult times.

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