Health Insurance is crucial to every financial portfolio as it provides financial comfort and mental peace during medical emergencies. Health plans can be indemnity-based or fixed-benefit. Most Health Insurance policies sold in India are indemnity benefit plans, implying that the insurance company reimburses expenses you incur during medical emergencies, subject to your sum insured limit.
While selecting a health plan, you have two options–an Individual Health Insurance policy or a Family Floater Health Insurance.
Let us look closely at key factors when picking between Individual Health Insurance and Family Floater plans.
What is an Individual Health Insurance plan?
An Individual Health Insurance is a type of health plan that covers the insurance needs of an individual. In such a plan, you are the sole policyholder who gets cover of the sum insured amount against your medical expenses.Individual plans usually cover hospitalisation expenses, including room rents, ambulance charges, doctor fees, diagnostic test expenses, and sometimes even home care where hospitalisation is difficult.
Also read: What is a Family Floater Health Insurance Plan – Everything you wanted to know
How is an Individual Health Insurance beneficial?
No dependency:
In an individual cover, you have more control over the policy regarding coverage, claims, decisions regarding renewal, etc. It is also more flexible as you can add riders or add-ons to each policy depending on your requirements.Coverage limit:
Individual covers typically include higher coverage limits than floater plans. It is essential if you have health conditions that require frequent treatments or medical care.Policy changes:
In individual covers, there are fewer worries to manage the policy when there are changes in the family structure. For instance, floater policies do not cover dependent children after a certain age. You need to move them to a separate individual plan or buy another floater plan to protect them.Are there any limitations of Individual Health Insurance plans?
Higher premiums:
Individual health covers usually have a higher premium than family floater plans. The premium depends solely on your age and health factors.Multiple policies:
Maintaining individual covers for each member can be tedious. You need to keep track of premium payments, individual policy terms, etc.When should I buy an Individual Health plan?
You can consider individual coverage if you have chronic conditions or specific medical requirements and require a higher sum insured based on your health condition. If you face these circumstances, an Individual Health Insurance plan allows you to customize coverage according to your requirements. Also, if there is a significant age difference between you and your parents, who may already be covered, an individual plan is more suitable for you.What is a Family Floater Health Insurance plan?
A Family Floater Health Insurance plan includes other family members under one policy, with a single premium payment. In this plan, one or all members can utilise the entire sum insured. In a family floater plan, you can cover your spouse, dependent unmarried children up to a certain age, divorced or widowed daughter, and dependent parents. Such a plan allows everyone to access benefits up to the total sum insured, providing greater coverage for the entire family.Family Floater Insurance plans also cover all the hospitalisation and other medical expenses listed under Individual Health Insurance coverage.
How are Family Floater policies beneficial?
Simplifies managing policies:
A Family Floater Health Insurance policy covers all members of your family under a single policy. This advantage eliminates the hassle of managing multiple policies for family members with different due dates and policy conditions.Cost-effective:
Floater health plans have relatively lower premiums and are cost-effective. For example, if you buy individual health plans with a sum insured of ₹1 lakh each for four family members by paying ₹5,000 per year for each plan, you pay a cumulative premium of ₹20,000 annually. However, under a family floater plan, you can opt for coverage of ₹4 lakhs covering all the members, where each member gets four times more coverage than their individual plans, and at a relatively lower premium.Do Family Floater policies have any limitations?
Limited coverage for every member:
All members share the sum insured in a Family Floater Health Insurance policy. So, if one member requires medical treatment, the cover for the remaining members is reduced by the amount you claim.For instance, suppose you have a ₹20 lakh Floater Health Insurance policy that includes you with your spouse and children. You get hospitalised, and the treatment bill amounts to ₹10 lakhs. Your floater policy can cover this treatment bill. However, during the year of the claim, your cover amount for your spouse and children will be down to ₹10 lakhs.
No Claim Bonus:
Each year you do not file a claim, your Health Insurance company increases your coverage or decreases your yearly premium amount. This benefit is called a No Claim Bonus (NCB). Thus, if a member covered under the Floater Health Insurance policy claims in a particular year, then the entire NCB is unavailable for the remainder of the year.Age Limit:
After a certain age, your children cannot be a part of the Floater Health policy. Once your child, covered under the policy reaches a certain age, they are treated as adults and have to be removed from the Family Floater Health Insurance plan for the policy to continue. The specific cut-off age limit ranges between 18 and 25 and differs across policies.Dependency on policyholder:
Family Floater Health Insurance plans cover all the family members under a single policy. For any reason, if the policyholder wants to opt out of the policy or switch to another plan, the coverage for other members gets affected.When should I buy a Family Floater policy?
You can consider a Family Floater Health policy when you are a young couple with children. When you and your spouse are in similar age groups and have just started your career, such a plan is more viable and easier to manage. But remember that this is applicable only if you are all healthy. If any member has health conditions that require constant medical attention, it is advisable to opt for an individual cover for that individual.Also read: Family Floater Health Insurance - Who all can be included in the policy?
Do Individual and Family Floater policies have tax benefits?
Under Section 80D of the Income Tax Act, you can enjoy certain tax deductions for all premium payments on your Health Insurance policies. Remember, these are applicable only if you opt for the old tax regime.| Condition | Premium paid on Health Insurance (₹) | Deduction under Section 80D (₹) | |
|
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Self, family including children | Parents |
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| If you and your family including parents are all under 60 years of age | 25,000 | 25,000 | 50,000 |
| If you and all other family members are under 60 years except your parents | 25,000 | 50,000 | 75,000 |
| If all family members including parents are over 60 years | 50,000 | 50,000 | 1,00,000 |
Family Floater vs Individual Health Insurance – list of differences
Check the key differences to decide between a Family Floater and Individual Health Insurance.| No | Criteria | Individual Health Insurance | Family Floater |
| 1 | Coverage | Covers a single individual | Covers the entire family under one policy |
| 2 | Premium payment | You pay a premium separately for each member | You pay a single premium for the whole family |
| 3 | Sum insured | Sum insured is specific to each individual | Shared sum insured for the entire family |
| 4 | Premium calculation | Based on individual's age and health | Generally based on the eldest member’s age |
| 5 | Claim | Claim is made for an individual's medical expenses | Shared coverage allows any family member to claim |
| 6 | No Claim Bonus (NCB) | Is more likely to remain intact since the plan covers you, if you do not face any health-related challenges during that period. | If a plan covers more family members the NCB is less likely to stay intact, since there are more chances of a health insurance claim in a particular policy year. |
| 7 | Additions/Removals of Members | Separate process for adding or removing members | Easy inclusion or exclusion of family members |
| 8 | Tax benefits | Individual tax benefits under Section 80D | Combined tax benefits for the whole family |
| 9 | Cost efficiency | Expensive when paying for more individual premiums in a family | Cost-effective when covering the entire family with a single premium |
| 10 | Age factor | Policies available for all age groups | Age restrictions may apply for family members |
Key Takeaway
- Individual health plans provide coverage for a single person. So, you are more in control of the policy terms, coverage, claims, renewal decisions, etc.
- Premiums of individual health plans are usually higher and depend on your age and health.
- However, managing individual health plans for each member can be cumbersome.
- Family Floater health plans cover your entire family under a single policy. So, each member gets better coverage.
- Floater plans are more cost-effective, and the premiums usually depend on the age of the eldest member.
- Individual plans are usually more beneficial if a family member has chronic illnesses or needs regular medical attention, as they may end up exhausting the sum insured limit of a floater plan faster.
- You can claim certain tax benefits under Section 80D for premiums you pay towards all health plans.
FAQs – Frequently Asked Questions
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What are the special features of a Family Floater policy ?
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Can a Family Floater Insurance policy be converted to an individual policy ?
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Can I convert Individual Health Insurance to Family Floater ?
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Can I add newborn babies to a Family Floater plan ?
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Are there any waiting periods when it comes to Family Floater plans ?
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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- You agree not to use the facilities for illegal purposes or for the transmission of material that is unlawful, harassing, libelous (untrue and damaging to others), invasive of another's privacy, abusive, threatening, or obscene, or that infringes the rights of others.
Restrictions on Commercial Use or Resale
Your right to use the facilities is personal to you; therefore, you agree not to resell or make any commercial use of the facilities. In addition, the Website welcomes your feedback as a user of the facilities. Any feedback you provide will become the confidential and proprietary information of the Website, and you agree that the Website may use in any manner and without limitation, all comments, suggestions, complaints, and other feedback you provide relating to the Website. The Website shall have a worldwide, royalty-free, non-exclusive, perpetual, and irrevocable right to use feedback for any purpose, including but not limited to incorporation of such feedback into the Website or other Website software or facilities.
No Endorsements
All product and facilities marks contained on or associated with the facilities that are not the Website marks are the trademarks of their respective owners. The Website would require you to respect the same. References to any such names, marks, products or facilities of third parties or hypertext links to third party sites or information does not imply the Website’s endorsement, sponsorship or recommendation of the third party, information, product or facilities.
Promotional Offers
You may receive from time to time, announcement about offers with intent to promote this Website and/or facilities/products of ABC Companies (“Promotional Offers”). The Promotional Offer(s) would always be governed by these Terms of Use plus certain additional terms and conditions, if any prescribed. The said additional terms and conditions, if prescribed, would be specific to the corresponding Promotional Offer only and shall prevail over these Terms of Use, to the extent they may be in conflict with these Terms of Use. The Website reserves the right to withdraw, discontinue, modify, extend and suspend the Promotional Offer(s) and the terms governing it, at its sole discretion.
Charges for use of Website
There are no charges or fees to be paid by you for use of this Website. However, you are responsible for all telephone access fees and/or internet service fees that may be assessed by your telephone and/or internet service provider. You further agree to pay additional charges, if any levied by Third Party Service Provider(s), for the facilities provided by them through the Website (Additional Charges).
No Endorsement
You are advised to be cautious when browsing on the internet and to use good judgment and discretion when obtaining information or transmitting information. From this Website, users may visit or be directed to third party web sites. The Website makes no effort to review the content of these web sites, nor is the Website or its licensors responsible for the validity, legality, copyright compliance, or decency of the content contained in these sites.
In addition, the Website does not endorse or control the content of any other user and is not responsible or liable for any content, even though it could be unlawful, harassing, libelous, privacy invading, abusive, threatening, harmful, vulgar, obscene or otherwise objectionable, or that it infringes or may infringe upon the intellectual property or other rights of another. You acknowledge that the Website does not pre-screen content, but that the Website will have the right (but not the obligation) in their sole discretion to refuse, edit, move or remove any content that is available via the facilities.
Electronic Communications
These Terms of Use and any notices or other communications regarding the Facilities may be provided to you electronically, and you agree to receive communications from the Website in electronic form. Electronic communications may be posted on the Website and/or delivered to your registered email address, mobile phones etc either by Facilities Provider or ABC Companies with whom the services are availed. All communications in electronic format will be considered to be in "writing". Your consent to receive communications electronically is valid until you revoke your consent by notifying of your decision to do so. If you revoke your consent to receive communications electronically, the Facilities Provider shall have the right to terminate the facilities.
Assignment
You shall not assign your rights and obligations under this Agreement to any other party. The Website may assign or delegate its rights and/or obligations under this Agreement to any other party in future, directly or indirectly, or to an affiliated or group company.
Legal Disclaimers
The information provided on or through the Website is for general guidance and information purposes only and they do not in any manner indicate any assurance or opinion of any manner whatsoever. Any information may be prone to shortcomings, defects or inaccuracies due to technical reasons. Certain information on Website may be on the basis of our own appraisal of the applicable facts, law and regulations in force at the date hereof.
The information (and opinions, if any) contained on the Website may have been obtained from public sources believed to be reliable and numerous factors may affect the information provided, which may or may not have been taken into account. The information provided may therefore vary (significantly) from information obtained from other sources or other market participants. Any reference to past performance in the information should not be taken as an indication of future performance. The information is dependent on various assumptions, individual preferences and other factors and thus, results or analyses cannot be construed to be entirely accurate and may not be suitable for all categories of users. Hence, they should not be solely relied on when making investment decisions. Your investment or financial decision shall always be at your own discretion and based on your independent research; and nothing contained on the Website or in any information would construe ABCL/ABC Companies or any of its employees/authorized representative as having been in any way involved in your decision making process. Any information and commentaries provided on the Website are not meant to be an endorsement or offering of any stock or investment advice.
Nothing contained herein is to be construed as a recommendation to use any product, process, equipment or formulation, in conflict with any patent, or otherwise and Facilities Provider / ABCL/ABC Companies makes no representation or warranty, express or implied that, the use thereof will not infringe any patent, or otherwise. Information on this Website sourced from experts or third party service providers, which may also include reference to any ABCL Affiliate. However, any such information shall not be construed to represent that they belong or represent or are endorsed by the views of the Facilities Provider or ABC Companies. Any information provided or sourced from ABCL Affiliate belongs to them. ABCL is an independent entity and such information from any ABCL Affiliate are not in any manner intended or to be construed as being endorsed by ABCL or Facilities Provider. The information does not constitute investment or financial advice or advice to buy or sell, or to endorse or solicitation to buy or sell any securities or other financial instrument for any reason whatsoever. Nothing on the Website or information is intended to constitute legal, tax or investment advice, or an opinion regarding the appropriateness of any investment or a solicitation of any type. Investment in the securities market and any financial instruments are inherently risky and you shall always assume complete and full responsibility for the outcomes of all the financial or investment decisions that you make, including but not limited to loss of capital. You are therefore advised to obtain your own applicable legal, accounting, tax or other professional advice or facilities before taking or considering an investment or financial decision.
No Solicitation
No Information at this Website shall constitute an invitation to invest in ABCL or any ABC Companies. These are meant for general information only or to meet statutory requirements or disclosures. ABCL or any of its employees are in no way liable for the use of the information by you, when making any decision or investing or trading through any investment vehicles or ABC Companies, or any other third party which may be engaged in offering of these services.
The information contained on this Website does not represent and should not be used to construe (i) the terms on which a new transaction would be entered into by ABCL or ABC Companies, (ii) the terms on which any existing transactions could be unwound by ABCL or ABC Companies, (iii) the calculation or estimate of an amount that would be payable following an early termination of any past/existing transactions or (iv) the valuations given to any transactions by ABCL or ABC Companies in their books of account for financial reporting, credit or risk management purposes.
Statutory Disclosure
ABCL and ABC Companies are engaged in a broad spectrum of activities in the financial services sectors. You understand and acknowledge that Aditya Birla Money Limited (‘ABML’), Aditya Birla Finance Limited (‘ABFL’) and Aditya Birla Sun Life Asset Management Company Limited and trustees and sponsor of Aditya Birla Sun Life Mutual Fund (‘ABSLMF’) are group companies and ABML / ABFL also acts as a distributor of ABSLMF. Any recommendation or reference of schemes of ABSLMF if any made or referred on the Website, the same is based on the standard evaluation and selection process, which would apply uniformly for all mutual fund schemes. You are free to choose the execution facilities in the manner deemed fit and proper and no commission will be paid by ABSLMF to ABML / ABFL if you choose to execute a transaction with ABSLMF on the Website, unless otherwise agreed by you and ABML/ABFL separately. Information about ABML/ABFL, its businesses and the details of commission structure receivable from asset management companies to ABML/ABFL, are also available on their respective Website.
Similarly Aditya Birla Money Insurance Advisory Services Limited and Aditya Birla Insurance Brokers Limited are insurance intermediaries and engaged in the distribution of Insurance Products and it may services may include products of Aditya Birla Sun Life Insurance Company Limited and Aditya Birla Health Insurance Company Limited. However there is no conflict on these services and commissions if any payable are in accordance of the extant regulations.
Force Majeure
The Facilities Provider, ABC Companies and any of its Third Party Service Providers shall not be liable for any delay or failure in performance resulting directly or indirectly from acts of nature, forces, or causes beyond their reasonable control, including, without limitation, Internet failures, computer equipment failures, telecommunication equipment failures, other equipment failures, electrical power failures, strikes, virus, other malicious computer code, hacking, labour disputes, riots, insurrections, civil disturbances, shortages of labour or materials, fires, flood, storms, explosions, acts of God, war, earthquake, governmental actions, orders of domestic or foreign courts or tribunals, non-performance of third parties, or loss of or fluctuations in heat, light, or air conditioning.
Indemnification
You agree to protect and fully compensate Facilities Provider, ABCL, ABC Companies, subsidiaries, licensors, suppliers and facilities providers, employees, officers and directors, from any and all third party claims, liability, damages, expenses and costs (including but not limited to reasonable attorneys fees) caused by or arising from your use of the facilities, your violation of the Terms of Use or your infringement, or infringement by any other user of your account, of any intellectual property or other right of anyone.
No Waiver
The Facilities Provider, ABC Companies or any of its third party service providers and processor bank/merchants etc. shall not be deemed to have waived any of its/their rights or remedies hereunder, unless such waiver is in writing. No delay or omission on the part of Facilities Providers and ABC Companies, in exercising any rights or remedies shall operate as a waiver of such rights or remedies or any other rights or remedies. A waiver on any one occasion shall not be construed as a bar or waiver of any rights or remedies on future occasions.
Exclusive Agreement
You agree that these Terms of Use are the complete and exclusive statement of agreement supersede any proposal or prior agreement, oral or written, and any other communications between you and the Facilities Provider and its Third Party Service Providers or processor bank/merchants relating to the subject matter of these Terms of Use. These Terms of Use, as the same may be amended from time to time, will prevail over any subsequent oral communications between you and the Website and/or the processor bank.
Termination
Either party can terminate this Agreement by notifying the other party in writing. Upon such termination You will not be able to use the facilities of this Website.
Governing Law and Jurisdiction
The Website specifically prohibits you from usage of any of its facilities in any countries or jurisdictions that do not corroborate to all stipulations of these Terms of Use. The Website is specifically for users in the territory of India. In case of any dispute, either judicial or quasi-judicial, the same will be subject to the laws of India, with the courts in Mumbai having exclusive jurisdiction.
These Terms and Conditions are governed by and to be interpreted in accordance with laws of India, without regard to the choice or conflicts of law provisions of any jurisdiction. You agree, in the event of any dispute arising in relation to these Terms and Conditions or any dispute arising in relation to the Website whether in contract or tort or otherwise, to submit to the jurisdiction of the courts located at Mumbai, India for the resolution of all such disputes.
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