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How to Compare Health Insurance Plans in India

Posted On:4th Sep 2019
Updated On:3rd Nov 2025
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Purchasing Health Insurance, like any other major investment choice, takes careful planning and preparation. Assume you want a flat-screen TV but are undecided between a few options. The few things you would look at to decide are the screen type, size, sound, and other features. You then compare various brands’ costs to see which one fits your bill. That is precisely how you should select Health Insurance plans as well.Factors such as the sum insured, premium payable, inclusions and exclusions, sub-limits, etc., play a part when comparing Health Insurance plans and providers of such plans.However, with so many Health Insurance companies in India and various plans, selecting the proper Health Insurance policy can be challenging, particularly if this is your first policy. To arrive at a decision, it is advisable to do a thorough comparison of various Health Insurance policies using the following criteria: Also read: What is the difference between Term Insurance and Health Insurance?

Select the right sum insured:

Health Insurance plans provide financial protection against expenses arising from a medical emergency. It includes hospitalisation charges, laboratory tests, medicine bills, etc. However, the extent to which your insurer will pay these expenses depends on the sum insured or your policy coverage. The sum insured is referred to the maximum amount your insurance provider will pay yearly to cover your medical costs. The greater the sum insured, the higher will be the premium.Consider your age, health, and income levels to determine your needed coverage. For example, if you get sick frequently, opt for a greater sum insured amount.

Choose an optimal premium:

Health Insurance provides you with the benefits listed above, but only in exchange for regular payments to your insurer. These payments are known as premiums. Regularly paying premiums becomes a key investment decision and might be the most important factor to consider when comparing Health Insurance plans.Regularly paying premiums becomes a key investment decision and might be the most important item to consider when comparing Health Insurance plans.Avoid selecting a policy only because it has the lowest premium, as it might not cover your needs. Similarly, if your medical needs are minimal, avoid paying a hefty premium. For instance, if you are young and healthy, there is a limited chance that you will require a hefty cover.

Check additional benefits, and policy exclusions:

Nowadays, many insurance companies offer different types of benefits and features with their health policies to match the needs of their customers. Examples of such benefits include maternity cover, pre/post-hospitalisation, critical illness cover, and so on.When comparing plans, scan the features and benefits of different policies and select one that offers you the best value for money.On the other hand, consider the deductible (the amount you need to pay before insurance coverage kicks in), co-payment (your share of the medical expenses), and any such charges accompanying your insurance policy. Check for any sub-limits that put a cap on certain expenses.

Consider pre-existing diseases and waiting period:

Pre-existing diseases are medical conditions diagnosed up to 48 months before buying Health Insurance. They can influence your waiting period, which is when you must wait before claiming benefits under your policy. If you suffer from a pre-existing disease, your insurer might impose a waiting period, which can go as high as 3-4 years. It is usually the case if you suffer from terminal illnesses. However, not all policies come with a waiting period. Therefore, when you compare Health Insurance plans, you go for one with the lowest waiting period so that your policy benefits kick in as early as possible.

No-Claim Bonus (NCB):

Suppose you have an active Health Insurance plan, but no medical costs arise during a year. You may wonder if the premium you have paid towards your policy is a needless expense that has chipped away at your savings. It is where the No-Claim Bonus comes into the picture.The No-Claim Bonus is a monetary benefit for not claiming during a particular period. NCB can be of two types – The first is a cumulative bonus, which increases your sum insured amount by a certain percentage. The second is a discount on premiums, which lowers the premium you pay for the next term by a certain percentage.When comparing Health Insurance plans, you should pick one with the maximum NCB to get the most out of your policy.

Network of hospitals and cashless settlement:

Every Health Insurance provider has tie-ups with certain hospitals, called network hospitals. If the hospital you opt for medical requirements is a partner of your insurance provider, then you can avail of cashless treatment during the claim process. It means your insurer will settle your medical expenses directly with the network hospital rather than reimbursing you later. Hence, opt for an insurance provider with the most network hospitals. It will help you out during the claim process. Usually, you can find the list of these hospitals on the insurer’s website.

Look at the Claim Settlement Ratio (CSR) and ratings of your plan:

The Claim Settlement Ratio is a vital metric that gives you much insight into an insurance plan and its provider. The CSR is the percentage of claims an insurance company settles in a year out of the total claims. A higher CSR reflects good credibility. It means the insurance provider is more likely to honour your claim than insurers with a lower CSR.Similarly, you can review customer ratings to see which insurer or insurance plan offers the best customer experience. For a more comprehensive view, you can check out ratings assigned by the Credit Rating Information Services of India Limited (CRISL), which evaluates insurance companies' financial strength, performance, and creditworthiness based on various factors. Also Read: How to compare Medical Insurance plans?

Key Takeaway

  • You should balance the sum insured amount and the payable premium by evaluating your health conditions and medical needs.
  • Factors such as pre-existing diseases and waiting periods are crucial when comparing Health Insurance plans. Try to go for a plan with the lowest waiting period if you have certain pre-existing diseases.
  • Similarly, opt for plans that provide better No-Claim Bonus benefits to maximise your policy.
  • When comparing insurers, look at the number of network hospitals, their claim-settlement ratio for specific plans, and customer ratings.

Also Read: How to buy Private Health Insurance?

FAQS - FREQUENTLY ASKED QUESTIONS

Why is it important to compare Health Insurance plans ?

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Where can I compare Health Insurance plans in India ?

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Are there any online tools to compare Health Insurance plans ?

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Can I switch my Health Insurance plan ?

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Should I compare Health Insurance plans based on the sub-limits and exclusions ?

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Disclaimer

The information contained herein is generic in nature and is meant for educational purposes only. Nothing here is to be construed as an investment or financial or taxation advice nor to be considered as an invitation or solicitation or advertisement for any financial product. Readers are advised to exercise discretion and should seek independent professional advice prior to making any investment decision in relation to any financial product. Aditya Birla Capital Group is not liable for any decision arising out of the use of this information.



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