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Insurance Analyser Series – Episode 2 – Health Insurance Checklist

Health insurance is an essential investment for anyone concerned about covering unforeseen medical expenses.

Yet, the world of health insurance can be complex, with policies varying significantly in their terms and conditions.

In this second episode of our Insurance Analyzer Series, we’ll break down the complexities of health insurance policies into a simple checklist to empower you in making informed decisions.

Here’s a checklist to keep in mind while buying health insurance 👇

Understanding Health Insurance

Health insurance operates on a simple premise: you pay a premium to the insurance company, and in return, they cover your hospitalization costs according to the policy’s terms and conditions.

However, the tricky part lies in the details, as different policies can have a multitude of variations.

  • Some enforce co-payment.
  • Some impose room rent limits.
  • Some offer higher new claim bonuses.
  • Some place caps on specific disease treatments.

Key Features to Look For

1. No Room Rent Limit: Some policies restrict daily room rent to a small percentage of the sum insured, potentially limiting your claim.
Opt for policies without such limits to ensure comprehensive coverage.

2. No Co-Payment: Certain policies require policyholders to share a portion of hospital bills upfront.
Seek policies without co-payment clauses for smoother reimbursement processes.

3. Restoration Benefit: Comprehensive policies often include a restoration benefit, replenishing the sum insured after hospitalization, ensuring continued coverage throughout the policy term.

4. Pre- and Post-Hospitalization Coverage: It is crucial to ensure the policy covers expenses incurred before and after hospital stays. This should include coverage for pre- and post-hospitalization expenses, including diagnostic tests and medications.

5. Low Pre-Existing Diseases Waiting Period: Pre-existing diseases may have waiting periods before coverage kicks in.
Look for policies with shorter waiting periods for pre-existing conditions.

6. Life-Long Renewability: Choose policies offering lifelong renewability, safeguarding against policy termination or changes in terms and conditions over time.

7. No Claim Bonus: No Claim Bonus (NCB) rewards policyholders with increased sum insured for claim-free years.
Be mindful of policies that offer NCB benefits without significant reductions in case of claims.

8. No Sub-Limits: Some policies impose sub-limits on coverage for specific diseases or treatments.
Opt for policies without such restrictions for comprehensive coverage.

9. Consumables Cover: Ensure the policy covers consumables like medical aids and equipment, minimizing out-of-pocket expenses during treatment.

10. Hospital Network: A wide network of cashless hospitals simplifies the claims process.
Prioritize policies with extensive hospital networks for hassle-free healthcare access.


Navigating the complexities of health insurance requires careful consideration of policy features.

By prioritizing key aspects like room rent limits, co-payments, and coverage extensions, you can ensure comprehensive protection for yourself and your loved ones.

Remember, the right health insurance policy is an invaluable asset in safeguarding your financial well-being during medical emergencies.

Read about Insurance Analyser Series – Episode 1 – Types of Insurance.

*Disclaimer – This is for information purposes only and not investment advice. Data credit to the rightful source.