Health Insurance

How to Buy Health Insurance in India: Complete Guide

Avni Mittal

Written by Avni Mittal

Insurance Writer

Gaurav Bhat

Reviewed by Gaurav Bhat

IRDAI-Certified Expert at Ditto

SP0738578124

Certified
How to Buy Health Insurance in India: Complete Guide

Overview

Buying health insurance ensures you’re financially protected from high medical costs due to hospitalization. To buy health insurance in India, you can instantly compare plans and purchase a policy online through major insurance advisory platforms like Ditto. Start by deciding who needs coverage, understanding the medical history, selecting a practical sum insured, checking exclusions, waiting periods, room rent limits, restoration benefits, and network hospitals.

According to Ditto’s proprietary 5-point rating framework, which evaluates insurer reliability (using IRDAI data), policy features, and affordability, our top pick is Optima Secure+ from HDFC ERGO with a 96.71% average claim settlement ratio for FY 2022–25. For this plan, a healthy 25-year-old pays ₹14,389 for a ₹25 lakh sum insured.

On paper, health insurance coverage in India looks extensive. As per IRDAI’s Annual Report 2024-25, general and health insurers covered about 58 crore lives. But here’s what that number does not show: only about 10.3% of these covered lives were under individual health insurance policies. The rest were largely covered through group policies and government schemes.

That is where the problem begins. Your office health plan does not stay with you if you switch jobs. A government scheme may not apply to your family or may not be applicable in your preferred hospital. Even when you are covered, the sum insured may not be enough.

This is why buying your own health insurance early matters. If you wait until you need it, pre-existing conditions, higher premiums, and waiting periods can make it harder to get the plan. Buying health insurance online is easier today, but knowing what to check before paying is still important.

This guide discusses the types of health insurance plans, how to choose the right sum insured, key features to check, how to compare insurers, and a step-by-step process for buying health insurance online through Ditto.

Types of Health Insurance Plans Available in India

Not all health insurance plans work the same way. According to IRDAI, health insurance policies can be broadly classified into two categories: 

Benefit-Based Health Insurance Plans

    • These plans pay a fixed amount when a specific insured event happens, regardless of the actual hospital bill.
    •  For example, critical illness insurance pays a fixed lump sum if the policyholder is diagnosed with a listed illness such as cancer, stroke, or kidney failure. 

Indemnity-Based Health Insurance Plans

These are the more common “standard” health insurance plans. They cover actual medical expenses, such as hospitalization costs, doctor fees, medicines, surgeries, and pre- and post-hospitalization expenses, up to the policy’s sum insured. 

Within indemnity health insurance, plans can be grouped into the following common types:

    • Individual Health Insurance: Covers one person, where the entire sum insured is reserved only for that insured member.
    • Multi-Individual Health Insurance: Covers multiple family members under a single policy, but each member has a separate sum insured.
    • Family Floater Plans: Cover the entire family under a single shared sum insured, which any member can use during the policy year.
    • Senior Citizen Health Insurance: Designed for people above 60 years and usually comes with higher premiums, stricter underwriting, and possible co-payment clauses.
    • Group Health Insurance: Usually provided by employers or organizations, but the coverage for group health insurance is tied to the group and ends when you leave the job or membership.
    • Top-Up Plans: Add extra coverage on top of a fixed deductible, and payouts occur only when a single hospital bill exceeds that deductible.
    • Super Top-Up Plans: Add extra coverage on top of a fixed deductible. But super top-ups consider the total hospital bills in a policy year, making them more useful for multiple or recurring hospitalizations.
    • Maternity Health Insurance: Covers delivery-related expenses and related care. But maternity insurance usually comes with waiting periods, sub-limits, and specific policy conditions.

Individual vs Family Floater vs Group Plans: What to Choose?

This is one of the most common questions people have when deciding to buy health insurance, and the answer depends on your life stage.

    • If you are single or have existing health conditions, an individual plan works better. The sum insured is not shared, and coverage is tailored entirely to your needs.
    • If you have a young family with a spouse and children, a family floater is usually more cost-effective. One policy, one premium, and the cover is shared across everyone. The trade-off is that multiple claims in the same year can exhaust the shared sum insured.

One Critical Point on Parents: Do not add them to your family floater. Parents are older and more likely to make claims, which can quickly exhaust the shared cover and leave the rest of the family underprotected. Their inclusion also pushes the premium up significantly. A separate plan (either individual or family floater) for your parents is the better move.

Group Insurance From Your Employer: It is a useful supplement, but not a replacement. It ends the moment you change jobs, take a break, or retire. Always maintain your own personal policy independent of your employment, which is renewable lifelong.

How Much Sum Insured Should You Buy?

Most people approach this backward. They try to predict the exact hospital bill they might face one day. 

Instead, try to pick a cover that prevents the “I had insurance, but still had to arrange a few lakhs” moment. 

Swapnil, one of our senior advisors, shared a simple rule of thumb. 

“Start with ₹5 lakh. Then add ₹5 lakh for every “YES” below:

Do you live in a metro city?

Do you prefer private/corporate chain hospitals over local ones?

Are you above 45?

Do you have any pre-existing conditions?”

Ditto’s Claim Story: Role of Sum Insured

A Ditto customer had a ₹10 lakh base cover, a common “round figure” many people choose, thinking it would cover most hospitalizations.

During a cancer treatment admission, the hospital’s initial estimate looked manageable and was close to the cover. But as treatment progressed, costs increased, and the hospital submitted an enhancement request for a higher cashless limit.

The insurer approved cashless in parts, but only up to the maximum sum insured. The final bill was confirmed at discharge, ₹12 lakh. The insurer paid ₹10 lakh, and the customer had to pay the remaining ₹2 lakh out of pocket.

Takeaway: Start with a decent base cover from day one. During claims, once your base sum insured is exhausted, the remaining bill comes straight from your pocket, since even the restoration benefit is applicable from the second claim.

So, if you want a practical number that can cover you in most situations, ₹15 to ₹25 lakh is a sensible base cover. 

    • ₹10 lakh can work if you are young, healthy, in a smaller city, and fine with local hospitals.
    • ₹15 lakh is a strong baseline for metro residents.
    • ₹20 to ₹25 lakh is a safer choice if you prefer chain hospitals, are older, have health conditions, or are buying a family floater.

Increasing your cover from ₹10 lakh to ₹20 lakh does not double your premium. The increase is around 20%-30%, a relatively small step up compared to the extra coverage you get with the policy.

Did You Know?

Your cover does not always have to be a fixed number. Some plans can make your cover grow far beyond the base amount over time.

For example, Aditya Birla Activ One MAX can increase your cover by 100% per annum up to 500% (even if you make a claim). It also has a refill feature that restores the sum insured unlimited times, during the year, which helps if there are multiple hospitalizations.

Key Features to Understand in Any Health Insurance Plan

Claim Pay-Out Restrictions

Check for room rent limits, co-payment, and disease-wise sub-limits before buying a plan. A room rent cap can trigger proportionate deductions, a co-payment makes you pay a fixed share of every claim, and disease-wise sub-limits restrict payouts for specific treatments. Ideally, choose a plan with no restrictions.

Waiting Periods

All plans come with waiting periods. IRDAI caps the waiting period for pre-existing diseases at 36 months. Specific illnesses, such as cataracts and joint replacements, typically have waiting periods of 1 to 2 years. The earlier you buy, the sooner these waiting periods will be over.

Coverage Boosters

Check how the plan improves your coverage through restoration, No-Claim Bonus (NCB), and loyalty bonus. Restoration refills your sum insured after a hospitalization claim. NCB increases your cover for claim-free years, while a loyalty bonus increases coverage simply for staying with the insurer. Ideally, look for unlimited restoration and bonuses that do not reduce sharply after a claim.

Pre and Post Hospitalization

Medical bills extend beyond your hospital stay. A solid plan should cover 30 to 60 days of pre-hospitalization expenses (tests, consultations before admission) and 60 to 180 days of post-hospitalization costs (follow-ups, medications, physiotherapy after discharge).

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How Ditto Can Help You Find the Right Plan

Choosing health insurance involves a lot of fine print. Getting it wrong can mean paying out of pocket, even with insurance. That is where Ditto helps.

On the Ditto website, you can explore health insurance in multiple ways. 

    • You can understand policies in simple language
    • Compare health plans side by side
    • Read detailed health insurance articles and guides

If you still have questions, you can book a free call with Ditto’s IRDAI-certified advisors. Our advisors are extensively trained in health insurance and can help you understand policy terms, choose the right sum insured, compare plans, evaluate premiums, and make sense of exclusions, waiting periods, room rent limits, restoration benefits, and claim-related conditions.

Did You Know?

Ditto goes beyond just helping you buy a policy. You can reach out for assistance with claims, policy changes, renewals, or any confusion that arises after purchase. And the best part? This guidance comes at no extra premium. Ditto’s service is free, so you get expert help at no extra cost on the same plan.

How to Pick the Best Insurer?

The policy is only as good as the insurer behind it. A plan with great features on paper can still fail you if the insurer has a poor claims track record. Here is what to check:

    • Claim Settlement Ratio (CSR): The percentage of claims settled vs. total claims received. Look for 90% or above, ideally 95% and higher.
    • Incurred Claim Ratio (ICR): How much of the premium collected goes toward settling claims. A balanced ICR of 50% to 80% suggests a stable, well-managed insurer.
    • Network Hospitals: Ideally above 10,000 across India, but do check whether the insurer's network includes hospitals in your city, especially those you would actually use for treatment.
    • Complaint Volume: Fewer complaints per 10,000 claims, as reported by IRDAI, is a sign of smoother customer service and claims handling.

Best Health Insurance Plans to Buy in India

Based on Ditto's policy and insurer rating framework, let’s take a look at the best health insurance in India.

PolicyCSR (Average FY 2022-25)Network HospitalsDitto Score
HDFC ERGO Optima Secure+96.71%13,000+4.6 / 5
Care Supreme93.13%11,400+4.5 / 5
Aditya Birla Activ One MAX95.81%12,000+4.4 / 5
Niva Bupa ReAssure 2.0 Platinum+91.62%10,000+4.3 / 5
SBI Super Health Platinum Infinite96.14%16,600+4.1 / 5

Premium Comparison to Buy Health Insurance Policy

ProfilesHDFC ERGO Optima Secure+Care SupremeAditya Birla Activ One MAX
(Individual Plan): Age 25₹14,389₹19,168₹11,214
(Family Floater, 2A) Couple: Ages 31 and 30₹22,662₹28,544₹18,300
(Family Floater, 2A 1C): Ages 35, 34, and 5₹27,981₹36,021₹24,072
(Family Floater, 2A) Senior Couple: Ages 62 and 61NA₹1,04,980₹75,904

Note: These are indicative premiums for a Delhi resident (Pincode: 110001) with a ₹25 lakh sum insured, including mandatory and recommended add-ons. Your premiums can change based on age, city, medical history, plan variant, and chosen add-ons.

For senior citizens, HDFC ERGO Optima Secure can be considered as an alternative to Optima Secure+. 

Documents Required to Buy a Health Insurance Policy

You do not need a long list of documents to buy health insurance online. Here is what is typically required:

    • Identity & Age Proof: Aadhaar card, PAN card, Voter ID, or Passport.
    • Address Proof: Aadhar card (for permanent address), Utility bills (for current address)
    • Medical Reports: Required if you have pre-existing conditions or are above a certain age, usually 45 years and above.

If you are adding family members to the plan, the same documents are needed for each person being insured.

How to Buy Health Insurance Online Through Ditto: Step-by-Step

Buying health insurance online through Ditto is straightforward. Here is exactly how it works:

Step 1: Book a Free Call or WhatsApp Ditto

Ditto's IRDAI-certified advisors help you shortlist 2-3 plans based on your age, city, family structure, and health history. This is completely free and takes about 30 minutes.

Step 2: Compare Shortlisted Plans

Compare plans and review options side by side. Check features, premiums, add-ons, exclusions, and waiting periods before deciding.

Step 3: Fill the Proposal Form

Once you select a plan, complete the proposal form online. This includes personal details, health declarations, and information on members being covered.

Step 4: Disclose Your Medical History Honestly

Declare all pre-existing conditions, past surgeries, lifestyle habits (smoking, drinking), and current or past medications. 

Step 5: Pay the Premium Online 

Pay via UPI, net banking, or credit or debit card. Once payment is confirmed, the insurer starts processing your application.

Step 6: Complete a Tele-Medical or Medical Test if Required

Some insurers may request a tele-medical call or a pre-policy medical test, depending on the age, sum insured, and medical history of the members being covered. In a tele-medical call, the insurer verifies your health declarations over the phone.

Step 7: Wait for the Insurer’s Decision

If there is some medical history, the insurer may also give a counteroffer. This could include premium loading, an additional waiting period for a disclosed condition, or changes in coverage terms. Ditto helps you understand the counteroffer before you decide whether to accept it.

Step 8: Receive Your Policy Document

If it is a simple application with no major medical history, the policy may be issued immediately or within a couple of days. However, if there is a complex medical history or multiple disclosures, the process may take 1 to 2 weeks because the insurer may ask follow-up questions, request additional documents, or review medical reports. Once the insurer approves the application, the policy document arrives via email. Store a digital copy and share it with your family.

Things to Keep in Mind Before Buying Health Insurance

Exclusions

Every plan has treatments, conditions, or situations it will not cover. Some exclusions apply only for a waiting period, while some may be permanent. Read this section carefully so you know exactly where the policy may not help.

Full Disclosure

Be honest about your health history, past surgeries, ongoing medication, and existing illnesses. Insurers use these details for underwriting, premiums, waiting periods, or specific exclusions. Hiding details can create trouble during claims that could have been avoided otherwise.

Premium Is Not Everything

A cheaper plan may look attractive today, but it will cost more during hospitalization. Watch out for room rent limits, co-payments, disease-wise sub-limits, and weak restoration benefits. Always opt for consumables coverage (PPE kits, cotton balls, gloves, etc.) since they form around 5%-10% of the hospital bill. A slightly higher premium is often worth it if the coverage is more comprehensive.

Moratorium Period

After 60 continuous months, insurers cannot question a claim for past non-disclosure or misrepresentation, except in cases of proven fraud or permanent exclusions. But this is not a free pass to hide medical details. The safest route is still to disclose everything upfront and renew the policy without breaks.

Why Talk to Ditto for Health Insurance?

At Ditto, we’ve assisted over 8,00,000 customers with choosing the right insurance policy. Why customers like Abhinav below love us:

buy health insurance customer testimonial
    • No-Spam & No Salesmen
    • Rated 4.9/5 on Google Reviews by 24,000+ happy customers
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    • Dedicated Claim Support Team
    • 100% Free Consultation

You can book a FREE consultation here. Slots are filling up quickly, so be sure to book a call or chat on WhatsApp with us.

Conclusion

Buying health insurance can feel confusing at first, but the decision becomes easier when you break it down. 

    • Start with who needs coverage, how much coverage you need, which hospitals you prefer, and what health conditions must be disclosed.
    • From there, focus on how the plan will behave during an actual claim. A good policy should protect you from unpleasant surprises later, especially when hospital bills are high, and decisions need to be made quickly.

The right health insurance plan is not always the cheapest or the most feature-packed one. It is the one that fits your age, city, family structure, and medical history. Take your time, compare carefully, and buy a plan you can continue renewing for years.

Disclaimer

We believe in full transparency around our partnerships. Our current insurer partners are HDFC ERGO, Care, Aditya Birla, and Niva Bupa. But as you can see in this list, the rankings include both partners and non-partners because the methodology is unbiased and applied uniformly across all insurers.

Frequently Asked Questions

What is the best health insurance plan to buy in India in 2026?

 Based on Ditto's policy and insurer rating framework, which evaluates insurer reliability using IRDAI data, policy features, and affordability, the top pick is HDFC ERGO Optima Secure+ with a Ditto score of 4.6 out of 5, and the insurer’s average claim settlement ratio is 96.71% for FY 2022-25. Other strong options include Care Supreme (4.5/5) and Aditya Birla Activ One MAX (4.4/5). The right plan ultimately depends on your age, city, family structure, and health history. You can explore all the top-rated options on Ditto's best health insurance plans in India page.

How much health insurance cover do I actually need in India?

At Ditto, we recommend ₹15 lakh to ₹25 lakh as a sensible base cover for most people. A quick way to find your ideal number is to start with ₹5 lakh and add ₹5 lakh for every yes you say to these questions: Do you live in a metro city? Do you prefer private chain hospitals? Are you above 45? Do you have pre-existing conditions? Going from a ₹10 lakh to a ₹20 lakh cover increases your premium by only around 20 to 30%, but gives you significantly stronger protection when hospital bills run high.

Why should I not add my parents to my family floater health insurance plan?

Parents are older and statistically more likely to make claims, which can quickly exhaust the shared sum insured in a family floater and leave your spouse and children underprotected. Their inclusion also significantly increases the premium because the insurer bases the plan's pricing on the oldest member. A separate individual plan or a dedicated senior citizen health insurance plan for your parents gives them adequate coverage without compromising your own policy. At Ditto, we consistently advise against adding parents to family floaters, and it is one of the most common mistakes first-time buyers make.

What documents do I need to buy health insurance online in India?

Buying health insurance online in India requires very few documents. You typically need a valid identity and age proof, such as an Aadhaar card, PAN card, Voter ID, or Passport. If you have pre-existing conditions or are over 45 years of age, the insurer may also request recent medical reports. If you are covering family members, similar documents are required for each insured person. The entire process, from filling the proposal form to making payment via UPI or net banking, can usually be completed within an hour on most platforms, including Ditto.

How do I buy health insurance online in India step by step?

Start by comparing plans based on your age, city, family structure, and health history. Once you shortlist a plan, fill the proposal form online with your personal details and health declarations. Always disclose pre-existing conditions, past surgeries, and lifestyle habits honestly. Pay the premium via UPI, net banking, or card. Depending on your age and health profile, the insurer may request a tele-medical call or a pre-policy medical test. Once the insurer approves your application, the policy document is sent to your registered email address. The full process through Ditto can be completed in about 30 minutes to an hour with free advisor support.

Can I rely only on my employer's group health insurance or do I need my own?

Group health insurance from your employer is a useful supplement but not a substitute for a personal plan. It ends the moment you resign, take a break, or retire, leaving you without coverage when continuity matters most. The coverage terms, sum insured, and insurer are also not in your control. As per IRDAI's Annual Report 2024-25, only about 10.3% of covered lives in India were under individual health insurance policies, with the rest relying on group or government schemes. At Ditto, we strongly recommend maintaining a personal policy independent of your employment from the very beginning, which is customizable and can be renewed lifelong.

What is claim settlement ratio and why does it matter when buying health insurance?

Claim settlement ratio (CSR) is the percentage of claims an insurer settles out of all the claims it receives in a year. It tells you how likely the insurer is to pay your claim when you actually need it. At Ditto, we recommend choosing an insurer with a CSR of 90% or above, ideally 95% and higher. IRDAI mandates public disclosure of claims data, which Ditto uses to calculate CSR data annually for all insurers. Always check the CSR alongside the incurred claim ratio, complaint volume, and annual business before finalizing a health insurance policy.

What is incurred claim ratio in health insurance and what is a healthy range?

Incurred claim ratio (ICR) is the percentage of total premiums an insurer collects that goes toward settling claims. It reflects both financial sustainability and the insurer's willingness to pay out. At Ditto, we look for a balanced ICR of 50-80%, as reported in IRDAI's annual report. A very low ICR may indicate that the insurer is rejecting too many claims or collecting far more than it pays out. A very high ICR could signal financial instability. ICR works best when read alongside the claim settlement ratio for a more complete picture of an insurer's reliability.

What is room rent limit in health insurance and how does it affect my claim?

The room rent limit is a cap on how much your insurer pays per day for your hospital room. Exceeding this cap does not just mean you pay the difference in the room price. Many insurers apply a proportionate deduction across the entire hospital bill, including doctor fees, nursing charges, and surgical costs. For example, if your policy covers a room up to ₹5,000 per day but you choose a ₹10,000 room, the insurer may cover only 50% of your total bill. At Ditto, we recommend choosing plans without room-rent restrictions to avoid surprise deductions on claims.

What is co-payment in health insurance and should I look for plans without it?

Co-payment is a clause that requires you to pay a fixed percentage of every hospital bill out of your own pocket, even when you are within your sum insured. For example, a 20% co-payment on a ₹5 lakh bill means you pay ₹1 lakh, and the insurer pays the rest. Co-payment clauses are more common in senior-citizen health plans or in plans with lower premiums or plans offered to people with severe existing medical history. At Ditto, we recommend choosing plans with no co-payment wherever possible, since it can significantly increase your out-of-pocket costs exactly when you are already dealing with a medical emergency.

What is restoration benefit in health insurance and is it worth having?

Restoration benefit refills your sum insured after it is exhausted due to a hospitalization claim during the policy year. It matters most if you or a family member faces multiple hospitalizations in a single year, such as during cancer treatment or recurring surgeries. Look for plans with unlimited restoration, meaning the benefit can be activated more than once per year without a cooling-off period, and the amount should be usable for both the same and different illnesses, even after partial exhaustion of the sum insured. At Ditto, we prioritize plans like Care Supreme, which can restore the sum insured an unlimited number of times.

What is the no-claim bonus in health insurance and how does it work?

No-claim bonus (NCB) is a reward from your insurer for completing a policy year without making any claim. It increases your sum insured for the next year at no additional premium or gives you a discount. Some plans also offer a loyalty bonus that increases your cover simply for staying with the insurer, even if you do make a claim. At Ditto, we look for plans where the NCB is not wiped out entirely after a single claim. A strong NCB structure means your sum insured can grow meaningfully over the years, giving you significantly better coverage without a proportionate increase in premium.

What is the moratorium period in health insurance?

The moratorium period is an IRDAI-governed provision that applies after 60 consecutive months of health insurance coverage. After this point, insurers cannot challenge a claim on the basis of past non-disclosure or misrepresentation, except in cases of proven fraud or permanent exclusions. This provides long-term policyholders with added protection against claim disputes related to undisclosed conditions. However, the moratorium period is not a workaround for hiding health details at the time of buying. If a claim is disputed during those first 5 years due to non-disclosure, it can still be rejected. Honest disclosure upfront remains the safest and most reliable approach.

What is the difference between a top-up and super top-up health insurance plan?

Both top-up and super top-up health insurance plans provide a cost-effective way to get extra coverage beyond a fixed deductible, but they work differently. A top-up plan triggers only when a single hospital bill exceeds the deductible. A super top-up plan totals all hospital bills over the policy year, making it far more useful if you have multiple hospitalizations or ongoing treatment costs in the same year. For people supplementing a base policy with a lower sum insured, a super top-up plan from the same insurer is generally the smarter and more practical upgrade for comprehensive coverage.

How much does health insurance cost in India for a 25-year-old in 2026?

Premiums vary by insurer, plan, city, and sum insured. As a reference, at Ditto, the indicative premium for a 25-year-old in Delhi with a ₹25 lakh sum insured is ₹14,389 per year for HDFC ERGO Optima Secure+, ₹11,214 per year for Aditya Birla Activ One MAX, and ₹19,168 per year for Care Supreme. These are indicative premiums, including recommended add-ons, and can change based on your pincode, health history, and plan variant. Buying younger keeps premiums lower by avoiding loading charges and gets waiting periods out of the way earlier.

What is critical illness insurance, and how is it different from regular health insurance?

Critical illness insurance is a benefit-based plan that pays a fixed lump sum if you are diagnosed with a listed serious illness, such as cancer, stroke, or kidney failure, regardless of your actual hospital bill. A standard indemnity health insurance plan, on the other hand, covers actual hospitalization expenses, such as doctors' fees, medicines, and surgical costs, up to the sum insured. Critical illness cover is not a replacement for a base health plan. It works better as a supplement, particularly to cover income loss, home care costs, or expenses that a standard hospitalization policy does not pay for.

Do I need to disclose pre-existing conditions when buying health insurance in India?

Yes, always. Disclosing pre-existing conditions, past surgeries, ongoing medications, and lifestyle habits like smoking or drinking is both mandatory and critical. Insurers use this information to set your premium, add waiting periods for specific conditions, or include permanent exclusions in your policy. Hiding health details may lower your premium initially, but if the insurer discovers the omission during a claim, the claim may be rejected entirely or the policy canceled. The moratorium period provides protection after 60 continuous months, but claims disputed for non-disclosure before that mark can still be denied. Honest disclosure at the time of buying is always the safest path.

What does maternity health insurance cover and what should I check before buying?

Maternity insurance covers delivery-related expenses, including normal and cesarean deliveries, prenatal and postnatal care, and sometimes newborn coverage for the first few months after birth. Most maternity benefits are offered as add-ons to a base indemnity health plan rather than as standalone policies. One critical thing to check is the waiting period, which typically ranges from 9 months to 4 years, meaning you need the policy well before you plan to start a family. Maternity plans also often have sub-limits on the payout amount, so verify the actual coverage carefully before buying, rather than just relying on the headline feature.

What is the free-look period after buying a health insurance policy online?

After your health insurance policy is issued, you get a 30-day free-look period from the date you receive the policy document. Use this time to check the benefits, exclusions, waiting periods, sub-limits, room rent rules, and claim process. If the policy does not match what you expected, you can cancel it within this window. The insurer may deduct charges for the period you were covered, medical tests, and stamp duty, but the remaining premium must be refunded as per applicable rules.

What policy documents should I check after buying health insurance online?

Once your policy is issued, do not stop at the premium receipt. Check the policy document, proposal form, and Customer Information Sheet (CIS). The CIS is useful because it gives a quick snapshot of key buyer rights and policy terms, such as coverage, exclusions, waiting periods, limits, sub-limits, free-look cancellation, portability, migration, moratorium, claim process, and grievance contacts. This helps you verify whether the insurer issued the policy as promised. If anything looks different from what you disclosed or selected, raise a correction request immediately.

What are the IRDAI timelines for cashless and reimbursement health insurance claims?

 For cashless claims, inform the insurer or hospital insurance desk early. For planned hospitalization, do this 48 to 72 hours before admission. For emergencies, inform them as soon as possible, ideally within 24 hours. As per IRDAI timelines, insurers should respond to cashless authorization requests within 1 hour and give final discharge approval within 3 hours. For reimbursement claims, submit complete documents after discharge. Once all required documents are received, the insurer should settle or reject the claim within 30 days. Investigated claims may take up to 45 days.

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