Health Insurance Guide

Individual, floater, senior citizen, critical illness, top-ups and how cashless claims actually work.

Health insurance pays for hospitalisation. What separates a good policy from a cheap one is not the headline sum insured but the room-rent limits, sub-limits, co-payments, waiting periods and the insurer’s behaviour at claim time.

Choosing a structure

An individual policy gives each person a dedicated sum insured. A family floater shares one pool at a lower combined premium. A super top-up adds a large layer above a deductible for very little money. Most families are best served by a floater plus a super top-up rather than a single large policy.

Waiting periods

Expect an initial waiting period of around 30 days for everything except accidents, specific waiting periods of one to two years for listed conditions, and a longer period for pre-existing conditions. These start again if you switch insurers without porting credit — which is why porting properly matters.

Cashless versus reimbursement

At a network hospital, the hospital raises a pre-authorisation and the insurer settles directly. Elsewhere, you pay and claim back with original bills, discharge summary and reports. Keep everything; missing originals are the most common reason a valid claim stalls.

Information on this website is educational and advisory in nature. Insurance products, benefits, exclusions, waiting periods and claim outcomes are subject to the terms and conditions of the respective insurer's policy document and applicable IRDAI regulations. Please read the policy wording carefully before concluding a sale.

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