While the excitement of parenthood may require some time to subside, if you have adequate maternity insurance, you won't have to stress about the associated costs. Couples should consider several other things before and after the baby is delivered. The best insurance plan for pregnancy will also cover the newborn child up to a specific time. Financial protection during pregnancy, pre- and post-natal care, pre- and post-hospitalisation costs, ambulance fees, and delivery costs, regardless of whether you have a normal delivery or a caesarean section, are all advantages of maternity insurance. Therefore, one of the best ways to deal with such costs is to purchase maternity insurance, which many health insurance companies provide.

What is maternity insurance?

Maternity insurance is a specialised health insurance plan that is designed to cover expenses related to pregnancy and childbirth. This includes costs associated with both normal and caesarean deliveries, prenatal and postnatal care, and sometimes extends to cover the newborn's medical needs for a specified period.

What is pregnancy insurance so important?

The following list includes maternity insurance benefits in India:

• Acting as a Financial Backup:

Maternity insurance is a safety net for the family’s finances by covering the expenses related to normal and caesarean birth. You need not worry regarding the payment of treatment. Some plans include pre- and post-hospitalisation expenses, paying all associated costs up to 30 days before admission and related expenses up to 60 days after admission.

• Expensive delivery in an intimate setting:

People today prefer private clinics because they want high-quality healthcare. Caesarean delivery may cost an additional Rs 50,000 to Rs 1 lakh in a private hospital, while a normal birth may cost Rs 50,000 to Rs 70,000. Your insurer provides all these costs.

• Coverage for the newborn from Day 1:

Typically, health insurance begins to cover infants once they’re at least 90 days old. A maternity insurance policy, however, starts to pay benefits as soon as the child is delivered. In addition, some plans will pay for the newborn's immunisations until the end of the policy year.

• Prepares the couple for complications:

A newborn requires an incubator for a specified time for complications like premature birth. The price of such treatment can reach Rs 10,000 per day. However, if you have a good maternity insurance plan covering most expenses, you can find respite from the financial pressure.

Features of maternity health insurance

The benefits of purchasing pregnancy insurance online include the following:

• Cashless hospitalisation:

Leading insurance companies offer maternity plans to provide cashless hospitalisation services at hospitals nationwide. At network clinics, you can access medical services without paying for them.

• Claim-free Bonus:

If you do not make a claim during a policy year, some insurance companies will reduce the insurance payment for the following year or increase the amount covered at the same premium. Moreover, insurance companies provide an online application facility to make the process straightforward for policyholders.

• Choice of the covered amount:

Policyholders can choose the insured amount. When purchasing a maternity insurance policy, they can select the desired amount insured.

• Tax benefit:

Section 80D of the Income Tax Act of 1961 allows policyholders to receive tax benefits for insurance premiums paid for pregnancy coverage.

When you are ready to become a parent, maternity insurance coverage is an excellent addition to your healthcare plan. Growing medical inflation and the possibility of unpredictably high hospitalisation costs typically make it challenging to pay for medical expenses and can interfere with parenting pleasure. Therefore, buying maternity insurance is advised for an economically secure pregnancy. You can purchase these insurance policies online, as the process is seamless and easy.

Key benefits of maternity health insurance

The key benefits of maternity health insurance are-

• Financial Security: Reduces the financial burden of maternity-related medical expenses.
• Quality Healthcare: Facilitates access to better medical facilities and services.
• Comprehensive Coverage: Encompasses a wide range of maternity-related expenses, ensuring holistic care.

What is covered under a maternity insurance plan?

Inclusions are circumstances in which an insurer will accept a maternity benefit claim. The coverage extends to both the woman and the newborn child's related costs and those associated with delivery and childbirth. The following are the standard benefits of maternity health insurance:

1. Support for both pre- and post-hospitalisation

• Delivery and Labour Costs:

The maternity add-on insurance covers all birth-related expenses. However, the insurance may only cover a certain number of pregnancies due to the coverage limit.

• C-Section:

Your insurer will cover all costs if the doctor recommends a C-section for the mother's or the child's health.

• Hospitalisation and Room Rent:

All hospitalisation costs and room rent incurred while receiving medical care are covered by your health insurance policy with maternity benefits. This also includes the cost of natural and c-section births and pregnancy termination in a life-threatening, medically essential scenario.

• Newborn baby coverage:

Up to 90 days after birth, a newborn will receive coverage at no extra expense. The infant must be added to the basic plan as an insured individual after 90 days.

• Vaccination coverage:

A newborn infant needs to receive vaccinations frequently. The maternity advantages of a medical insurance policy cover the expenses of routine vaccinations, such as:

• Measles
• BCG
• Tetanus Toxoid
• OPV+IPV-B1/OPV
• Hib
• Hepatitis B-1
• MMR-1
• Typhoid
• DTPw booster-1 or DTPa booster-1
• HPV (female child)
• Meningococcal

What is not covered under maternity insurance plan?

Maternity insurance has several exclusions too. First, one should increase the coverage or amount insured under the plan to pay maternity expenses. The typical range of coverage offered by health insurance plans with maternity benefits is between Rs 20,000 and Rs 70,000, which needs to be revised to cover delivery expenses.

Second, there may be circumstances where the insurance company chooses not to settle the claim even though you think the policy covers all expenses. For example, an insurer may reject a claim in the event of a delayed pregnancy (for women aged 35 and more). Let’s have a look over the critical exclusions that apply to maternity insurance policies:

• Spending on vitamins and tonics listed in the plan as well as other dietary supplements
• During the pregnancy, costs associated with diagnostic procedures and medical visits.
• Costs associated with treating infertility
• Price of collecting and preserving stem cells, including the possibility of doing so as a preventative step.

The list above includes some factors; additional exclusions may be relevant depending on your selected maternity health insurance plan. Maternity insurance coverage plans vary, and it would be wise to read the terms and conditions related to the exclusions before you decide on one.

Is there an option to buy maternity health insurance while you are pregnant?

Typically, insurers do not provide maternity coverage as a part of your standard healthcare plan. Insurance companies consider pregnancy and it-s related expenses as a pre-existing condition. However, you can still buy maternity coverage as an add-on with your regular healthcare insurance policy. You might be wondering why you should buy maternity insurance. You might have to wait between 9 months and six years to make a claim for expenses related to becoming a mother. Therefore, purchasing pregnancy insurance after getting pregnant is not a good plan. Instead, consider buying it much ahead in preparation to avoid having to wait.

Unfortunately, inflation has increased the expense of healthcare and will probably continue to do so in the future. This includes maternity-related costs too. Women must buy pregnancy insurance as quickly as they can afford it. By doing this, you can enjoy the arrival of your kid without worrying about expensive medical bills. You can leave that in the care of your insurance provider.

Waiting until the very last minute when attempting to conceive will only lead to unnecessary worry. So, we suggest that you invest in a comprehensive maternity insurance policy well in anticipation. This will also help you complete the waiting period and help you to receive coverage when you start planning for a family.

One can have a medical emergency at any time, irrespective of age. Additionally, the stress associated with finding a work-life balance and our lifestyles is taking a toll on most of us. While medical services constantly improve, newer diseases like COVID-19 are becoming more prevalent. The exorbitant cost of medical services such as hospitalisation or treatment procedures adds to our woes. There is no right age for health insurance; investing in one as early as possible ensures coverage and lets you avail of the best treatment, particularly in medical emergencies.

Therefore, purchasing a comprehensive health insurance policy and ensuring your peace of mind is the best way to combat the rising cost of healthcare.

When is the Right Age to Buy Health Insurance?

In India, one can buy an individual health insurance policy as soon as he/she turns 18. Anyone who invests early in a healthcare plan will be better prepared for medical emergencies as well as enjoy financial security. Buying health insurance at the age of 26 or in your 30s could be a sensible decision with an eye on your future as well as your loved ones.

When your age falls in the bracket of 20 to 30 years, you can plan ahead and purchase maternity coverage if you want to start a family soon. If you are in your 40s or 50s, you could opt for a family health insurance policy. But you will need more add-on coverage as you could be at risk for diabetes, high blood pressure, and other hereditary health concerns or lifestyle-related issues.

Purchasing a health insurance policy post-retirement can be expensive as senior citizens are prone to severe health issues and may require hospitalisation and prolonged therapy. Moreover, one might need to purchase more add-ons like critical illness coverage.

Whether you are considering purchasing health insurance for students under 26 or looking at plans customised for senior citizens, the earlier you invest in one, the more benefits you can enjoy. Investing in a healthcare plan in your 20s is prudent as the premium is lower. You can easily cover the waiting period that comes with purchasing a new healthcare policy. If you don’t make a claim, you can enjoy the benefit of cumulative bonuses. You can opt for a family floater plan at a later age with a low premium, but it's still more expensive than a policy bought at a younger age.

Reasons Why Health Insurance is Important Irrespective of Your Age

Let's look at some reasons why we should invest in getting a health insurance plan as soon as possible:

• Creating a compelling claim history:

The best moment to purchase a health insurance policy is when one is physically healthy. Young and healthy people pay cheaper premiums and are less likely to make a claim.

• Earning Bonus:

One benefits from the no-claim bonus (NCB) incentive if there isn't a claim in any given year. A policyholder receives supplemental coverage each year without a claim at no additional expense. The extent of coverage continues to expand over time.

• Coverage for pre-existing conditions:

The most significant benefit of purchasing earlier in life is completing the waiting period associated with pre-existing conditions. There are waiting periods in health insurance policies before some or all of the policyholder’s pre-existing diseases will be covered. While some health issues have a waiting period of 12 to 24 months, typically, insurers cover pre-existing conditions after 48 months.

• Tax benefit:

There is an additional advantage to purchasing a health insurance plan if you are young and employed. The 1961 Income Tax Act states that if you pay a premium for health insurance, you are eligible for tax advantages up to Rs 25,000 in a financial year. Additionally, the tax benefit for the premium paid for a health insurance plan bought for your parents can increase to Rs 50,000 if they are dependent on you.

Benefits of Buying Health Insurance at A Younger Age

Health insurance is there for us when we require it the most. It is sensible to purchase a health insurance policy as early as feasible, although there is no set age for health insurance for investing in a healthcare plan. Let's examine the benefits of buying health insurance online at a young age:

• Lower quotations & premiums:

The likelihood of developing a medical problem is lower if an individual is young. For instance, you can purchase a policy with INR 5 lakh as the sum assured for INR 5000 if one purchases health insurance coverage before age 30. The premium becomes costlier as you get older. The same coverage may cost between INR 6000 and INR 8000 when you are in your 40s.

• Financial alignment:

Buying a healthcare plan earlier in life ensures that a person has coverage for multiple illnesses, including diabetes, renal failure, cancer, and heart disease. These ailments begin to affect individuals as they turn older. You will be left dealing with significant financial woes if you purchase health insurance benefits at a later age when diagnosed with an ailment or hereditary illness. The premium for a policy will be much higher, or you may even have to purchase add-on covers for an additional premium.

• Renewability:

According to the Insurance Regulatory and Development Authority of India (IRDAI), one can always renew a health insurance plan. However, 65 to 70 is typically the upper age limit for health insurance coverage extension. Lifetime renewability is available if you purchase a policy earlier.

Health insurance is becoming increasingly important in India, with rising medical costs. Every health insurance policy carries a premium, which you need to pay to avail of the benefits of the healthcare plan. And this premium is determined by various factors. The amount one needs to shell out is a major concern, particularly if you are considering a senior citizen insurance premium.

The amount of the premium you must pay for this coverage is a crucial factor to consider, as it can act as a financial safety net in the event of unanticipated medical problems. Your health insurance premium will be determined based on numerous variables and specific situations. Knowing the variables that will affect the cost of your premiums will empower you to make the most of your insurance plan.

What is senior citizen health insurance?

Senior citizen health insurance is a specialised policy created for people aged 60 years and above. It provides coverage for medical expenses incurred due to illnesses or injuries, ensuring that healthcare costs do not become a financial burden during the golden years.

How do senior citizen health insurance plans work?

These plans function by offering coverage for hospitalisation expenses, pre-existing conditions (after a waiting period) and sometimes even domiciliary treatments. Policyholders pay a premium, which is decided at the beginning, and in return, the insurance company covers eligible medical expenses up to the sum insured.

Key features of medical insurance for senior citizens

The main features of a health insurance policy for senior citizens are:

• Hospitalisation Coverage: This covers expenses related to hospital stays, including room rent, doctor's fees and medical procedures.
• Pre and Post-Hospitalisation: Expenses incurred before and after hospitalisation, such as diagnostic tests and follow-up consultations, are covered.
• Daycare Procedures: These cover treatments that do not require prolonged hospital stays.
• Pre-existing disease Coverage: After a specified waiting period, pre-existing conditions are covered.
• Cashless Treatment: Access to a network of hospitals where treatments can be availed without upfront payments.
• Domiciliary Treatment: Some policies cover treatments taken at home under medical supervision.

Benefits of senior citizen health insurance

The key benefits of buying a senior citizen health insurance policy are: 

• Financial Security: Protects savings from being depleted by high medical costs.
• Access to Quality Healthcare: Ensures timely medical attention without financial constraints.
• Tax Benefits: Premiums paid are eligible for deductions under Section 80D of the Income Tax Act, offering health insurance tax benefits.
• Peace of Mind: Reduces stress related to potential healthcare expenses.

How to calculate the premium for senior citizen health insurance?

Premium calculation considers factors like the insured's age, medical history, chosen sum insured, policy tenure and any add-on covers. Utilising online premium calculators provided by insurers can offer a quick estimate, aiding in budget planning and policy comparison.

Things to consider when buying a medical policy for senior citizens

Your health insurance premium will depend on the type of healthcare plan you choose. A family floater plan, for instance, is usually less expensive than an individual health insurance policy. But remember that the age of the oldest family member will determine the cost of the premium for a family floater plan.

• Coverage Scope: The scope of coverage and the sum insured will also impact your health insurance premium. A lesser insured sum can lead to the lowest premium health insurance for senior citizens, while a higher premium will ensure a greater sum insured. Your insurance will only pay you up to the amounts insured in reimbursement for medical costs. However, you will be responsible for covering additional expenses if your total medical bills exceed the amount specified as the sum insured in your healthcare policy.
• Renewability: Remember to choose a plan that offers lifetime renewability and not just the lowest premium health insurance for senior citizens. Look for a plan that covers pre-existing diseases, adequate pre- and post-hospitalisation expenditures, a minimal waiting period after which one can avail of coverage for pre-existing disorders, add-ons, top-ups, family floater policies and benefits and other discounts. Also, opt for a plan that provides adequate coverage for critical illnesses, as with age, there can be a higher risk of senior citizens being diagnosed with such ailments.
• Waiting Period: When you search for a healthcare plan, look for one that provides coverage for a maximum number of pre-existing diseases. Check the waiting period and select one with the least time so that you can easily complete it. Sometimes insurers waive the waiting period for an additional fee. Consider this option if you are aged over 60 or purchasing a policy for your senior citizen parents. You can calculate the premium with a senior citizen health insurance premium calculator and get an idea of the plan’s cost.
• Policy Requirements: Many people think that skipping the tests or not disclosing any pre-existing medical conditions will let them get a healthcare policy for a lower premium. It is sensible to opt for a policy requiring medical tests so that the insurer can customise the right plan for you. It is better to pay a slightly higher senior citizen insurance premium than be denied a claim in times of need.
• Payment Options: Understand the available payment options for the health insurance you are planning to choose. Although opting for co-payment is optional for people aged less than 60, it is mandatory for senior citizens. Anyone can find the co-payment value with the help of a senior citizen health insurance calculator.
• Network Hospitals: It is also important to consider the network hospitals, especially in case of critical illness or senior citizen health care plans, to see if they are located in an area that can be easily reached in case of emergency.

Key factors affecting senior citizen health insurance premium

Some significant factors that affect a senior citizen’s health insurance premium include pre-existing diseases or health issues, add-on covers, co-payment, habits and lifestyle and family medical history. Moreover, if you live in an area where there is a high level of pollution or severe climatic conditions, you might have to pay a high premium. Environmental issues play a crucial role in determining the premium of healthcare policies, as senior citizens are prone to health issues arising from living in such regions.

Age of the Insurer

A comprehensive health insurance policy for people aged over 60 years is a must-have as it provides financial security as well as peace of mind. Age is one of the most significant factors that affect senior citizens’ health insurance premiums. The reasons behind this are listed below:

• As we age, the risks for increased hospitalisations, hereditary illnesses and the need for medical supervision increase.
• As it gets harder to anticipate risk factors and medical expenditures as people age, some insurance companies do not reimburse pre- and post-hospitalisation expenses.
• Several health insurance plans include the option of lifetime renewals, but some insurers only permit renewal until age 80.

Pre-Existing Illness

Let’s look at how pre-existing diseases affect the premiums for health insurance plans, particularly for senior citizens.

• If a person has a history of medical conditions which affect his/her health in the long run, he/she is more likely to spend more money on consulting doctors and specialists, hospital care and other healthcare services.
• You cannot avail of any benefits until you complete the waiting period for pre-existing conditions as stated in your policy documentation.
• The amount of your premium will increase depending on the severity of the pre-existing health condition, as evaluated by a professional.
• If your close family members have a medical history of a pre-existing condition like heart disease, diabetes, hypertension, etc., you are more likely to have a risk of acquiring it at a later stage in life.

Medical Test Results

Medical tests enable the insurance company to learn as much as possible about an individual's health. The insurer may tailor a term policy just for you, down to the details like the length of coverage you need, the cost of premiums and other perks. The findings of the examinations that your insurance provider requests will decide the inclusions and exclusions of your healthcare plan, especially if you're applying for senior citizens' health insurance. The factors listed below may change based on the outcomes of a medical exam for a health insurance policy:

• The insurance company’s main objective is determining the premium you'll have to pay for your healthcare plan. Based on an applicant's perceived level of risk, the insurer will provide a quote for the plan's premium. Your premium will be minimal if you are in excellent health. If you have any pre-existing problems revealed in the test results, the insurer will consider you a greater risk and you might need to pay a higher premium. But it will reduce the chances of your claim being denied or rejected.
• If your medical tests come out reasonably healthy, you may be eligible for a larger sum assured.

Co-Payment Option

The part of the sum insured you'll be obliged to pay for your medical insurance is a co-payment. In other words, you and your insurer share the expense of your healthcare. Health insurance coverage for those aged over 60 or senior citizens includes a compulsory co-pay clause due to the exorbitantly greater medical care costs faced by the elderly compared to younger individuals.

• Some insurers let you choose the size of your co-payment. Opting for a co-payment reduces the amount you pay as a premium for your healthcare policy. It's important to remember that a larger co-pay will result in a lower overall premium, but you will still be responsible for paying a higher amount for claims.
• The insurer will pay the majority of the claim, but the insured will be responsible for paying a certain amount. Co-insurance varies in proportion based on the kind of medical care received.
• Typically, a co-pay clause mandated the policyholder to pay 50 per cent of the cost for a claim due to a pre-existing condition and 25 per cent for hospitalisation.

Why should senior citizens buy a health insurance policy?

It has become crucial for every person to purchase suitable health insurance coverage for their loved ones, especially for parents who are senior citizens. Even if you have an employer-sponsored group health insurance plan that covers your parents, a separate health insurance policy customised to meet the needs of senior citizens is a sensible investment. The premium for senior citizen health insurance can offer your parents the appropriate coverage.

Senior citizens are more vulnerable to various diseases and hereditary medical conditions with age and may even require hospitalisation and domiciliary care. A majority of insurers provide annual health check-ups at no cost to the policyholder. This could help diagnose any ailment that a senior citizen may have developed in its early stages and help the person seek timely medical intervention. As healthcare policies for senior citizens are customised, keeping their needs in focus, they provide adequate coverage. Spending a little more on a senior citizen’s health insurance premium could provide add-ons that could help the person in cases of chronic diseases or critical illnesses.

When one obtains health insurance, particularly for senior citizens, he/she may relax knowing that in the event of a medical emergency, most of the financial commitments will be taken care of by the insurer.

FAQs

• Can pre-existing conditions be covered under senior citizen health insurance?

Yes, but typically after a specified waiting period as defined by the policy.

• Are there tax benefits associated with paying premiums for senior citizen health insurance?

Yes, premiums paid can be claimed as deductions under Section 80D of the Income Tax Act.

• Is there an age limit for purchasing senior citizen health insurance?

While policies are designed for those aged 60 and above, the maximum entry age varies among insurers.

• What is a co-payment clause?

It is a provision where the policyholder agrees to pay a certain percentage of the claim amount, with the insurer covering the rest.

• Can I avail cashless treatment with senior citizen health insurance?

Yes, if the treatment is taken at a network hospital associated with the insurer, you can choose for cashless claim settlement.

Conclusion

Timely purchasing a comprehensive health insurance policy for senior citizens is one of the most important steps for ensuring a healthy and stress-free time for the person insured as well as their family. By understanding the factors that have an impact on policy premiums and evaluating policy features, you can select a plan that best suits your needs or the needs of their loved ones.

Disclaimer: The information provided in this blog is for educational and informational purposes only. It is not intended as a substitute for professional advice, diagnosis or treatment. Please consult a certified medical and/or nutrition professional for any questions. Relying on any information provided in this blog is solely at your own risk, and ICICI Lombard is not responsible for any effects or consequences resulting from the use of the information shared.

Updated on - 20 Feb 2026

Over time, alcohol has become more prevalent in people's lives, especially among younger generations. Consuming it in moderation is not an issue, but if it becomes a habit, that is cause for concern. It can lead to various illnesses, including liver cirrhosis and cardiac disease. Many people today are unsure of insurance for alcohol consumers and the benefits of a policy that provides coverage to such people. Also, many believe their insurance providers will reject their claims because of their consumption of alcohol.

If your insurance provider learns you regularly consume alcohol, the insurer might deny or reject your claim. This is because greater alcohol use may result in health risks that your insurer may not be willing to pay for. The catch is that your insurance provider might ask you to shell out a higher premium because your chance of contracting diseases may increase. As a result, drinking alcohol affects your insurance cost in many ways. Let’s understand the link between alcohol consumption and health insurance in more detail.

Alcohol consumption and health insurance: What's the relation?

When applying for health insurance, one of the first things an insurer will ask is about your lifestyle. This includes questions about smoking, physical activity, existing medical conditions and alcohol use. Insurers assess such factors to determine your risk level.

This is because long-term alcohol use is linked to a variety of health conditions such as liver disease, heart problems, digestive disorders and mental health issues. These increase the likelihood of filing an insurance claim, which can lead to higher premiums.

What is the impact of alcohol on health insurance premiums?

Health insurance premiums are calculated based on how risky you are to insure. If you drink occasionally and in moderation, insurers may not consider it a major risk. However, if you drink heavily or frequently, your premiums could be higher or, in some cases, your application could be declined altogether.

The insurer might ask for a medical test to assess the impact of your alcohol consumption on your health. They can also check your medical history for any alcohol-related illnesses, which can influence the final decision.

Do insurance companies offer health insurance to those who consume alcohol?

Yes, health insurance companies do offer policies like family health insurance to people who consume alcohol. The key factor is how much and how often you drink. Occasional or social drinking is usually not a problem. However, heavy drinking or a history of alcohol dependency can make things more complicated.

Insurers often categorise alcohol users into the following groups:

• Non-drinkers
• Social/occasional drinkers
• Regular drinkers
• Heavy drinkers
• Recovering alcoholics

Your classification will influence whether your application is accepted and how much you’ll pay.

Why should you buy health insurance if you drink alcohol?

If you consume alcohol even occasionally, it’s still wise to have health insurance. Here’s why:

1. Protection from unexpected costs: Alcohol can contribute to accidents or health problems that require expensive treatment. Health insurance helps cover these costs.
2. Better access to healthcare: With insurance, you can access a wider network of doctors and specialists.
3. Peace of mind: Knowing you’re protected financially allows you to focus on recovery, not bills.

Should you declare to your insurance company if you are an alcohol consumer?

Yes, always be honest about your alcohol consumption when applying for medical insurance. Providing wrong information can lead to claim rejection in the future. Insurers have the right to investigate your lifestyle and medical history when you file a claim. If they find out that you lied or withheld information about your drinking habits, they can deny your claim or even cancel the policy.

How to reduce your health insurance premiums if you consume alcohol?

If you consume alcohol and want to reduce your premiums, here are some useful tips:

1. Drink responsibly: Stay within recommended limits. Moderate drinking is less likely to impact your premiums.
2. Maintain a healthy lifestyle: Exercise regularly, eat well and don’t smoke. This helps balance any negative impact of drinking.
3. Undergo regular health check-ups: Showing proof of good health can help you negotiate a better premium.
4. Choose the right insurer: Some insurers are more lenient toward alcohol use than others. Compare quotes and read the fine print.
5. Buy insurance early: The earlier you buy health insurance, the lower your premiums. This also applies when buying medical insurance for parents, especially if they are nearing retirement age.
6. Avoid alcohol-related hospital visits: Claims related to alcohol can increase your future premiums. Seek help for alcohol issues before they affect your health seriously.

Conclusion

Alcohol consumption can have a significant impact on your health insurance premiums. Insurers assess the risk posed by your lifestyle habits, and alcohol is a major factor in this evaluation. That said, drinking alcohol doesn’t mean you can’t get insured; it just means you need to be honest, informed and proactive.

Taking responsible steps such as moderating alcohol use and maintaining a healthy lifestyle might help you secure a more affordable and comprehensive policy.

Health insurance is not just a product, it’s a long-term investment in your health and peace of mind.

FAQs

1. Will my health insurance cover treatment for alcohol addiction?

Some policies do, but coverage is often limited or comes with conditions. Always check the policy documents.

2. Can I buy health insurance if I am a recovering alcoholic?

Yes, but it depends on how long you’ve been sober and your overall health. You may face a waiting period or a higher premium.

3. Is there a medical test for alcohol use during an insurance application?

Sometimes. If you disclose regular or heavy drinking, the insurer might ask for a liver function test or related medical evaluation.

Disclaimer: The information provided in this blog is for educational and informational purposes only. It is not intended as a substitute for professional advice, diagnosis, or treatment. Please consult your general physician or another certified medical professional for any questions regarding a medical condition. Relying on any information provided in this blog is solely at your own risk, and ICICI Lombard is not responsible for any effects or consequences resulting from the use of the information shared.

Many reputable insurance companies require you to undergo certain medical tests when you seek health insurance coverage. These pre-medical exams are necessary for obtaining health insurance because they play a significant role in establishing your eligibility for coverage. However, it does not entail that you cannot get health insurance without a medical test. 'Insurance providers that require you to take a health insurance test are the most accommodating when filing a claim.

However, it is crucial to remember that even if the insurance company has not requested that you undergo these tests, this does not suggest that you conceal a pre-existing medical condition. Fraud is intentionally misrepresenting facts, resulting in the insurer denying or rejecting your claim. Therefore, before your insurance provider determines your premium amount, you must declare any pre-existing medical condition to avoid the chances of your claim being denied or rejected in the future.

What are the Pre-Medical Tests?

Pre-medical inspections, or pre-medical tests, are a set of medical assessments performed by licenced medical professionals to determine the applicant's current health status. Before issuing a healthcare policy, most insurers insist on pre-medical tests as they want to assess the prospective policyholder’s medical condition. Also, the premium for a policy depends on the results of the pre-medical tests that you have to undergo.

In most cases, the insurance provider's coverage and the number of tests doctors perform are correlated. Additionally, most testing is done based on the applicant's age and the plan's benefits. According to the general tendency, most people seek insurance without medical exams.

The age of a potential customer and the scope of the insurance coverage determines how many pre-policy medical examinations are required. For example, if the beneficiary is older than 45, most health insurance firms demand a pre-policy medical assessment, including several parameters.

The world has seen one of the most dreadful pandemics in human history. As a result, how people generally live their lives in the present has undergone a complete transformation due to COVID-19. In addition, many sectors, along with the health insurance sector, have been impacted by this pandemic. As a result, how the health insurance market works has undergone considerable change.

Nowadays, most insurers insist on a pre-medical investigation for prospective policyholders. Although it is not mandatory, pre-policy medical tests are gaining popularity.

Is Pre-Medical Examination Compulsory for Buying Health Insurance?

A prospective policyholder with a pre-existing condition views medical exams as a barrier as they can lead to higher premiums or even coverage denial. However, most individuals over 45 undergo regular medical examinations to be aware of any dormant health issues. Insurance providers advise them to give accurate information when applying for insurance to guarantee a smooth claims procedure. Furthermore, most policies have a waiting period for pre-existing conditions. Insurance providers usually reject claims related to pre-existing health issues made during this tenure.

Regular medical exams are always advisable because they give you an update on your health condition and act as a benchmark for medical professionals. Without medical exams, disputes over whether policyholders concealed or misrepresented their illnesses could arise when claims get settled. Your insurer can reject your claim if the insurance provider finds you have concealed information about a pre-existing illness.

The premiums for plans that cover pre-existing ailments are comparatively high than a standard policy. They also have more stringent restrictions than plans with standard coverage. However, you will still have to give detailed information even though buying a policy without a medical exam may seem simple.

A comprehensive medical evaluation will establish your actual degree of fitness. If there are any possible health problems, you will be in a position to opt for medical intervention and timely treatment.

Although it is not mandatory, you should go for a medical examination before buying health insurance coverage.

A cashless Mediclaim policy is a progressive new way to manage medical expenses. Traditionally, when someone falls ill or requires medical attention, they must pay for the costs upfront and then submit a claim to their insurance provider for reimbursement. However, with a cashless Mediclaim policy, the entire process is streamlined and simplified.

What is cashless health insurance?

A cashless Mediclaim policy allows you to walk into any of your insurance provider’s network hospitals and receive the necessary medical treatment. The payment for the treatment is then directly settled between the insurance provider and the hospital without the need for you to pay any money upfront. This arrangement eliminates the burden of arranging for funds in times of medical emergencies while also allowing for a seamless and hassle-free medical experience.

How does cashless mediclaim work?

Cashless Mediclaim insurance works in the following manner.

• Choose medical insurers that provide coverage for the majority of diseases.
• Provide information about your current and previous medical conditions and then pay the premium.
• Review the network hospitals in your area.

If you become ill, you can go to any accredited hospital listed on the insurer’s network and get treated without having to pay anything out of pocket.

Benefits of cashless health insurance

Here are the major advantages of opting for a cashless health insurance plan:

• Immediate access to medical care without upfront payment.
• Peace of mind during emergencies.
• No need for reimbursement paperwork.
• Wider network of hospitals ensures accessibility.
• Helps manage finances better, especially during high-cost treatments.

For families, opting for a health insurance policy for family with cashless benefits ensures that each member is protected without added financial pressure.

Types of cashless health insurance plans

Cashless mediclaim is available in various types of insurance plans to suit individual needs:

• Individual health insurance plans: Covers one person with cashless hospitalisation.
• Family floater plans: Offers shared coverage for the entire family under a single sum insured.
• Senior citizen plans: Tailored for older adults with specific health conditions.
• Critical illness plans: Offers cashless treatment for predefined life-threatening illnesses.
• Group health insurance: Common in corporate sectors; employees get cashless treatment benefits.

Inclusions and exclusions of cashless health insurance

Understanding what’s covered and what’s not is crucial when choosing any health insurance plan, including cashless Mediclaim-

Common inclusions:

• Hospitalisation expenses (pre and post)
• Daycare procedures
• ICU charges
• Ambulance fees
• Some diagnostic tests and medicines

Common exclusions:

• Cosmetic treatments
• Dental and vision not related to accidents
• Self-inflicted injuries
• Pre-existing diseases during the waiting period
• Non-network hospital treatments (unless reimbursed later)

Things to consider when buying cashless health insurance

Before purchasing a cashless health insurance plan, keep these points in mind:

• Hospital network: A wide hospital network increases accessibility.
• Claim settlement ratio: A higher ratio means better reliability.
• Pre- and post-hospitalisation coverage: Look for comprehensive benefits.
• Inclusions and exclusions: Read policy documents carefully.
• Waiting period for pre-existing diseases: Shorter waiting periods are better.
• Customer service support: Quick claim assistance is crucial during emergencies.
• Top-up options: Useful when you want to extend your coverage.

Especially for families, evaluate the health insurance policy for family based on the number of members, age, and existing health conditions.

FAQs

• Is cashless health insurance available in all hospitals?

No, cashless benefits are available only at network hospitals listed by the insurer.

• Can I convert a reimbursement claim into a cashless claim?

No, cashless claims must be pre-authorised. Reimbursement is a separate process.

• What should I do if a cashless claim is rejected?

You can pay the hospital bill yourself and then file for reimbursement with valid documents.

• Is cashless mediclaim available for pre-existing diseases?

Yes, but only after the waiting period as mentioned in your policy.

• How can I check the list of network hospitals?

Visit your insurance provider’s website or app to check the latest network hospital list.

Conclusion

Cashless mediclaim insurance brings convenience and peace of mind when you need it most. Whether you’re buying an individual health insurance plan or a health insurance policy for family, ensuring it offers comprehensive cashless benefits can significantly ease the burden during medical emergencies. Do thorough research, compare policies, and choose what aligns best with your family’s healthcare needs.

Disclaimer: The information provided in this blog is for educational and informational purposes only. It is not intended as a substitute for professional advice, diagnosis or treatment. Please consult a certified medical and/or nutrition professional for any questions. Relying on any information provided in this blog is solely at your own risk, and ICICI Lombard is not responsible for any effects or consequences resulting from the use of the information shared.

Today, where medical costs are skyrocketing and can drain one’s finances, a Mediclaim policy has become an essential shield to safeguard against unexpected medical expenses. It offers financial assistance during medical emergencies, ensuring you and your loved ones receive the best medical care without any economic burden. However, with various payment options available, people are often uncertain about the payment methods for their Mediclaim premiums. Let’s explore whether Mediclaim premiums can be paid in cash and understand the answer in detail.

Before delving into the topic, it is essential to understand the basics of Mediclaim. A Mediclaim policy covers the expenses incurred during medical treatment, consultation charges, and pharmacy bills. It provides financial assistance to you, ensuring you do not face any economic burden due to unexpected medical emergencies. To avail of these benefits, you must pay a premium to the insurance company at regular intervals, as specified in the policy document.

Can you make a cash payment for the Mediclaim premium?

Yes, most health insurance companies will accept cash payments for Mediclaim premiums. However, checking with the specific insurer about their preferred payment methods is always a good idea. You should make cash payments directly at the insurer’s branch office and remember to obtain a valid receipt for future reference. For added convenience and security, you should use electronic payment methods such as online transfers or debit/credit card payments.

No tax benefit when you pay cash for Mediclaim Premium

If you pay the premium for your Mediclaim insurance policy in cash, you will not be eligible for any tax benefits. Under Section 80D of the Income Tax Act, tax deductions are available only on premiums paid through digital modes of payment like Net Banking, credit cards, or debit cards. Therefore, choosing a suitable payment method to maximise your tax savings while purchasing a Mediclaim policy is essential.

• You are eligible for a tax break of up to Rs 25,000 for Mediclaim insurance premiums paid for yourself, your spouse, and your dependent children.
• An additional benefit of up to Rs 25,000 is available for Mediclaim insurance premiums paid for your parents.
• If you or your parents are senior citizens (age 60 years or above), the deduction limit increases to Rs 50,000.
• If you and your parents are both senior citizens, the deduction limit increases to Rs 1,00,000.
• It is important to note that the total deduction for Mediclaim insurance premiums, including those paid for parents, cannot exceed Rs 1,00,000.

However, you can still get a tax benefit if you spend money on preventive healthcare, such as routine health tests, and pay for it in cash. In this case, the maximum allowable deduction is Rs 5,000, and the benefits are limited to a cap of Rs 25,000.

When it comes to healthcare expenses, medical insurance is a saving grace for many people. However, even with insurance, the costs can add up quickly, leaving many policyholders struggling to pay their medical bills. That is where hospital discounts come into play.

A hospital discount is a reduction in a hospital’s total bill amount for medical treatment, surgery, diagnostic, or any other healthcare service provided to you. Typically, insurers offer these discounts to help you reduce your out-of-pocket expenses. Insurance companies provide hospital discounts in collaboration with their network hospitals.

The Insurance Regulatory and Development Authority of India (IRDAI) issued an order in 2015 requiring all insurance providers to make it mandatory for hospitals to disclose any and all discounts on the final hospitalisation bill. This move aimed to increase transparency and ensure that policyholders are aware of any discounts offered by the hospital on their medical treatment bills.

Now that you are aware of hospital discounts, it is time to look at some methods for obtaining them.

Why do hospitals offer discounts?

Hospitals offer discounts for several reasons, many of which are tied to maintaining positive relationships with insurance providers and ensuring timely payments. Here are a few common reasons:

• Negotiated rates with insurance companies:

Hospitals often have agreements with health insurers to provide services at discounted rates. In return, they receive quicker payments and a steady stream of insured patients through referrals.

• Encouraging early or cash payments:

For patients who are not using insurance, some hospitals offer discounts for early or full payments. This helps make healthcare more affordable and simplifies the billing process.

• Minimising outstanding balances:

Offering reasonable discounts can encourage timely payments. This helps the hospital maintain steady cash flow and continue providing high-quality care.

• Strengthening patient relationships:

Discounts can make healthcare more accessible and show that the hospital is committed to patient well-being. This helps increase trust and long-term relationships with the community.

• Supporting preventive care:

In some cases, hospitals offer discounts on check-ups or health screenings. This promotes early diagnosis and helps patients stay healthy, reducing the need for more complex care later.

• Partnering with employers or organisations:

Hospitals may work with companies or community groups to provide health packages or discounted services. This improves access to care while expanding the hospital’s reach.

• Offering package deals for common procedures:

Fixed-price treatment packages for surgeries or other procedures make costs clearer for patients and help them plan better, while ensuring affordability.

How hospital discounts work in mediclaim policy

Hospital discounts play a crucial role in Mediclaim, which is a type of health insurance policy that reimburses medical expenses or provides cashless treatment. Here’s how it works:

• Cashless claims:

If you're admitted to a network hospital, you may receive treatment without paying upfront. The hospital bills the insurance provider directly at a pre-negotiated, discounted rate.

• Reimbursement claims:

If you visit a non-network hospital, you can still claim reimbursement. The final bill may reflect standard hospital charges, but any discounts you receive will reduce the amount you're eligible to claim.

• Impact on family health insurance:

If you have a health insurance policy for your family, these discounts can help conserve the overall sum insured.

• Helps stay within sub-limits

Some policies have sub-limits (for room rent, surgery or doctor’s fees). Hospital discounts make it easier to stay within these limits and avoid extra out-of-pocket costs.

• Supports faster claim settlement

Discounted and itemised bills are easier for insurers to process, leading to quicker claim approvals and reimbursements.

How to avail of a hospital discount while billing?

To make sure you don’t miss out on hospital discounts, follow these simple steps:

• Spot billing errors: Be vigilant about billing errors to save money on your medical bills. If you notice any discrepancies, connect with the hospital billing department immediately. Requesting an itemised bill can also help provide a detailed breakdown of charges for various services, pharmacy bills, inpatient stays, and other factors.
• Go for a health card: A health card with a No-Cost EMI option can help you pay your medical bills in convenient monthly instalments, reducing your financial stress. This benefit is available at all network hospitals affiliated with your insurer. Furthermore, various insurers provide hospital bill discounts when you swipe their health card.
• Negotiate: You can negotiate with the healthcare provider for a discount on your medical bill. Explain your financial situation and ask if they offer any discounts, payment plans, or other options to help reduce the cost.
• Upfront payment: Depending on the hospital, medical bills can also provide benefits similar to other cash payment discounts. This can be particularly helpful if you are dealing with expensive medical bills. Certain hospitals may offer a substantial discount if you settle the entire treatment cost upfront but remember that this offer requires immediate payment.

Tips to maximise hospital discounts

Hospital bills can add up quickly, but the good news is that there are ways to reduce costs without compromising on care. By having the knowledge and making smart decisions, you can take full advantage of the discounts available. Here are some handy tips:

• Choose network hospitals: These facilities often have pre-negotiated discounted rates with your insurer.
• Keep medical records organised: It helps in quicker processing and reduces disputes during claim settlements.
• Understand your family policy coverage: If you hold a health insurance policy for your family, know who is covered, the sum insured and any sub-limits, if applicable.
• Check for cashless treatment options: Many network hospitals offer cashless services, where the insurer pays the hospital directly. This saves you from having to pay out of pocket first.
• Ask about hospital packages: Some hospitals offer fixed-price packages for certain treatments or surgeries. These can be cheaper than paying for each item or service separately.
• Use preventive health check-ups: If your insurance offers free check-ups, take advantage of them. Early detection can help you avoid big hospital bills later on.
• Be aware of waiting periods: Some treatments, like dental or maternity, may have a waiting period. Knowing this can help plan better and avoid surprises.
• Negotiate when paying yourself: If you're paying without insurance or for anything not covered, you should ask for a discount or payment plan. Many hospitals are open to discussion.
• Know what’s not covered: Understand what your policy excludes, for example, cosmetic procedures or alternative therapies, so you’re not caught off guard.
• Use your insurance helpline: If you’re unsure about something, call your insurance provider’s helpline. They can guide you on how to get the most value and avoid unnecessary costs.

Conclusion

Hospital discounts in mediclaim policies are a valuable tool for reducing medical expenses and preserving your insurance benefits. Especially when you have individual health insurance, every rupee saved through discounts helps in making the plan more sustainable and beneficial.

When you understand how hospital discounts work and take proactive steps during hospitalisation, you can ensure a smoother, more affordable healthcare experience. Whether it's a routine check-up or an emergency, being informed puts you in control financially and otherwise.

Disclaimer: The information provided in this blog is for educational and informational purposes only. It is not intended as a substitute for professional advice, diagnosis, or treatment. Please consult your general physician or another certified medical professional for any questions regarding a medical condition. Relying on any information provided in this blog is solely at your own risk, and ICICI Lombard is not responsible for any effects or consequences resulting from the use of the information shared.

Mediclaim is basically health insurance that covers your medical expenses. It includes costs related to hospitalisation, diagnostic tests, consultation fees, and OPD treatments. Pre-hospitalisation expenses cover costs, such as medical tests like blood tests, urine tests, or X-rays. Post-hospitalisation expenses cover those tests prescribed by the physician to ascertain the recovery or progress of the patient. Not all therapies, like physiotherapy, are covered under post-hospitalisation expenses. Nonetheless, you can claim and obtain coverage for physiotherapy prescribed by the doctor after hospitalisation under post-hospitalisation expenses. The policyholders have the option to claim both pre- and post-hospitalisation expenditures by submitting authentic invoices, pertinent duplicates of the doctor's certification and discharge summary.

Comprehensive health insurance plans usually offer coverage for physiotherapy. It's good to check what your policy covers. The financial strain during medical emergencies is reduced with health insurance or Mediclaim plans, making them an essential component of fundamental financial planning.

Having health insurance or Mediclaim is essential as it covers medical costs during emergencies. These plans include annual health check-ups and day care treatments. It also offers a no-claim bonus (NCB) and domiciliary hospitalisation. It's essential to check the list of inclusions in your policy to get maximum benefits from them. Standard policies may not cover physiotherapy expenses, but you can make a claim if the policy covers OPD expenses. Comprehensive health insurance plans usually offer coverage for physiotherapy, which is beneficial in case of unexpected injuries or medical conditions that require physiotherapy treatment.

Add-on for Covering Physiotherapy Sessions

• To cover Physiotherapy in your policy, you can also buy add-ons by paying a little extra premium. E.g. ICICI Lombard’s Befit add-on covers several out of hospital medical services which allow you to talk to a general physician, specialist, or super-specialist doctor online or at a clinic or via teleconsultation, 24/7.
• These add-on usually cover everyday health needs that don't require hospitalisation, including physiotherapy sessions.
• The benefits of such add-ons include access to medical practitioners through audio, video, online portal, chat, or mobile application, 24/7 e-consultation, and coverage for laboratory tests and minor procedures recommended by the network medical practitioner.
• You can acquire cashless coverage for medications and medical supplies.
• You can receive coverage for the evaluation, diagnosis, and treatment of ailments related to bones and joints from physiotherapists within the insurer’s network.
• When buying add-on covers, you should consider factors such as the scope of coverage, the waiting period, and the additional premium amount.

Updated on 29 Nov 2025

Health expenses are often unpredictable and can strain your finances. A mediclaim policy helps ease that burden by covering hospitalisation costs. But what exactly is a mediclaim policy, how does it work and how is it different from regular health insurance? This blog breaks down its features, types and benefits to help you make an informed choice.

What is a mediclaim?

Mediclaim is a type of health insurance that pays for hospital expenses if you fall ill or get injured. In simple words, if you have a mediclaim policy, the insurance company will help pay your hospital bills, either directly to the hospital or by reimbursing you after treatment. This gives you peace of mind and protects your savings during medical emergencies.

Features of a mediclaim policy

Mediclaim policies come with some important features:

• Financial protection:

The primary benefit of a Mediclaim policy is financial protection. It can help you pay for expensive medical treatments and hospitalisation costs, which can put a strain on your wallet.

• Cashless hospitalisation:

With a Mediclaim policy, you can get cashless hospitalisation at network hospitals. That means you can get treatment without having to pay cash upfront. The insurance company will settle the bills directly with the hospital.

• Tax benefits:

You can claim a tax deduction for the premium paid towards your Mediclaim policy under Section 80D of the Income Tax Act.

• Pre- and post-hospitalisation expenses:

Mediclaim policies also cover pre- and post-hospitalisation expenses, including doctor's consultation fees, medicines and diagnostic tests.

• No-claim bonus:

Mediclaim policies offer a no-claim bonus if you do not make any claims in a policy year. This can be in the form of a higher sum insured or a reduction in premium.

• Critical illness coverage:

Many Mediclaim policies offer coverage for critical illnesses, such as cancer, heart attack and stroke.

How mediclaim insurance works?

When you buy a mediclaim policy, you select the sum insured, which is the highest amount an insurer will pay for hospital expenses. If you fall ill and need treatment, you can either choose a network hospital for cashless treatment or go to any hospital and claim reimbursement later.

Types of mediclaim policy

There are different types of mediclaim policies to suit various needs:

• Individual mediclaim policy: Covers one person for a fixed sum insured.
• Family floater mediclaim: Covers the entire family under a single sum insured. Anyone in the family can use it as needed.
• Senior citizen mediclaim: Specially designed for older people, usually with higher premiums and different benefits.
• Group mediclaim policy: Usually offered by employers to their staff.
• Critical illness mediclaim: Offers coverage if diagnosed with major illnesses like cancer, heart attack, or stroke.

Each type of mediclaim policy has different features, limits and costs. It is a good idea to compare them before deciding which suits you best. For those looking for personalised coverage beyond hospital expenses, individual health insurance can be a better option as it offers wider protection compared to a basic mediclaim plan.

Inclusions and exclusions of mediclaim coverage

Mediclaim policies usually include:

• Hospital room rent
• Doctor’s consultation fees
• Nursing charges
• Surgery expenses
• ICU charges
• Anaesthesia and operating theatre costs
• Pre- and post-hospitalisation expenses for a certain period
• Day-care treatments that do not need long hospital stays

However, there are also exclusions you should know about. Mediclaim policies typically do not cover:

• Cosmetic surgery (unless needed due to an accident)
• Dental treatments (unless caused by injury)
• Pregnancy and childbirth-related expenses (some policies may offer maternity cover as an add-on)
• Pre-existing diseases until the waiting period is over
• Alternative treatments like Ayurveda, unless stated otherwise
• Injuries from war, self-harm, or substance abuse
• Costs above the sum insured

Tips for choosing the right mediclaim policy

Selecting the right mediclaim can feel confusing, but here are some simple tips to help:

• Look at the sum insured: Choose enough coverage to handle expensive treatments. Medical costs are rising, so do not pick a very low sum insured.
• Check network hospitals: Make sure your preferred hospitals are part of the insurer’s network to benefit from cashless treatment.
• Understand the waiting periods: Know the waiting periods for pre-existing diseases and other conditions before buying.
• Look at co-payment clauses: Some policies ask you to pay a small part of the bill yourself. Understand these terms to avoid surprises later.
• Review sub-limits: Policies sometimes have caps on certain expenses, like room rent. Check these limits.
• See renewal conditions: Prefer a policy that offers lifelong renewability.
• Compare policies: Do not buy the first policy you see. Compare benefits, exclusions, premiums and customer reviews before choosing.
• Check claim settlement ratio: This tells you how reliable the insurer is in paying claims.

Mediclaim health policy vs health insurance

Let’s look at the differences between mediclaim policy vs health insurance:

Conclusion

Mediclaim policies are a vital part of financial planning. They protect you and your family from the high costs of hospital treatment and medical emergencies. By paying a yearly premium, you get peace of mind knowing that you can access good healthcare without draining your savings.

Not sure which mediclaim or health insurance cover is right for you? We can help. Just fill out the form on this page to get simple, clear advice based on your needs. Let us guide you in finding the right health insurance plan for yourself or your family.

FAQs

• Can I buy mediclaim for my family?

Yes, family floater mediclaim plans cover your spouse, children and sometimes parents under one sum insured.

• Does mediclaim cover pre-existing diseases?

Mediclaim policies cover pre-existing diseases after a waiting period of usually 2–4 years.

• Is mediclaim the same as health insurance?

Mediclaim is a type of health insurance that mainly pays for hospitalisation expenses. Broader health insurance can cover more than hospital bills.

• What happens if I cross my sum insured limit?

If your medical bills are higher than your sum insured, you must pay the extra amount from your own pocket.

Disclaimer: The information provided in this blog is for educational and informational purposes only. It is not intended as a substitute for professional advice, diagnosis or treatment. Please consult a certified medical and/or nutrition professional for any questions. Relying on any information provided in this blog is solely at your own risk, and ICICI Lombard is not responsible for any effects or consequences resulting from the use of the information shared.

Updated on 30 Nov 2025

When you or a loved one is admitted to the hospital, dealing with medical costs can be stressful. This is where a mediclaim policy helps. It offers financial support to manage hospital bills. But to get your claim processed smoothly, you’ll come across a term called CCN, which stands for Claim Communication Number. It’s a very important part of the mediclaim process. Let’s understand this in detail.

What is the CCN in mediclaim policy?

The Claim Communication Number (CCN) is a special number given to you when you raise a claim under your mediclaim policy. Think of it as a unique ID for your claim.

Every time you talk to the insurance company or third-party administrator (TPA) about your claim, they will ask for your CCN. It helps them find your file quickly and give you updates.

What is the purpose of CCN in mediclaim?

The main purpose of the CCN is to track and manage your claim easily. Here are some of the things it helps with:

• Faster processing: Your claim file is linked to the CCN. When you mention it, the staff can pull up your file quickly, which saves time.
• Status updates: Whether your claim is approved, needs more documents or is under review, all updates are shared based on your CCN.
• Clear communication: If there is any confusion or issue, giving your CCN helps avoid mix-ups. It ensures you’re getting information about your claim and not someone else’s.
• Record keeping: The CCN is useful for keeping a record of your claim. If you want to refer back to it in the future, this number will help locate the correct details.

Whether you’ve opted for a basic mediclaim policy or a more comprehensive health insurance plan, having a CCN ensures your claim is properly identified and processed without confusion.

How to get a CCN from mediclaim policy?

Getting your CCN is quite simple. Here’s how the process generally works:

1. Cashless claim

If you are going for a cashless hospitalisation, the hospital sends a pre-authorisation request to the insurance company or TPA. Once the request is verified and accepted, you will receive a CCN via SMS or email.

1. Reimbursement claim

If you have already paid the hospital bills and are claiming reimbursement, you will need to submit documents such as:

• Hospital bills
• Medical reports
• Discharge summary
• Doctor’s prescriptions
• Identity proof

After submitting these, the insurance company or TPA will review your documents. Once the claim request is registered, they’ll send you your CCN.

In both cases, it usually doesn’t take more than 24–48 hours to get your CCN once the initial claim is submitted. If you’ve taken a family health insurance, each member's claim will still receive a separate CCN, even though they’re all covered under the same plan.

When can you expect to get your CCN?

The CCN is usually shared soon after you raise a claim. The timing depends on the type of claim and how quickly the documents are submitted:

• Cashless hospitalisation: If the hospital has tied up with the insurer, you might receive your CCN within a few hours after admission, once the pre-authorisation form is sent.
• Reimbursement claim: You will usually get your CCN within 1-2 working days after submitting all the necessary documents.

Importance of CCN in mediclaim

Here’s why the CCN matters:

• Reduces confusion

Imagine two people with the same name submitting a claim on the same day. Without a unique number like the CCN, their files could get mixed up. The CCN prevents this kind of confusion.

• Required for all follow-ups

If you call or email to ask about your claim status, the first thing they’ll ask is your CCN. It helps them find your claim file instantly.

• Faster settlements

Since your claim is linked to the CCN, all documents and updates are stored under one reference. This makes it easier for the insurance company or TPA to process your claim quickly.

• Used in all records

If you need to check your past claims, your CCN will help pull up the right records. It’s also helpful during audits or tax filing if needed.

Conclusion

The Claim Communication Number (CCN) is a vital part of the mediclaim process. It’s a unique ID that keeps your claim details safe, organised and easy to access.

Taking care of medical bills can feel confusing, but you don’t have to figure it all out alone. If you’re thinking about getting health cover or have questions, fill in the form on this page. We’ll help you choose the right health insurance based on your needs.

FAQs

• Is CCN and Claim Number the same thing?

Yes, CCN (Claim Communication Number) is often called a claim number. It’s the unique number used to identify your specific claim.

• Can I get a CCN without submitting documents?

No. The CCN is given only after you submit a claim request with at least the basic required documents.

• What if I lose my CCN?

You can contact the insurer or TPA with your policy number and other details. They will help you retrieve your CCN.

• Is CCN needed for both cashless and reimbursement claims?

Yes, it is required for both types of claims. For cashless claims, you get the CCN after hospital admission. For reimbursement, you get it after submitting your documents.

• Can I track my claim using CCN?

Yes, most insurers and TPAs allow you to track your claim status online using the CCN.

Disclaimer: The information provided in this blog is for educational and informational purposes only. It is not intended as a substitute for professional advice, diagnosis or treatment. Please consult a certified medical and/or nutrition professional for any questions. Relying on any information provided in this blog is solely at your own risk, and ICICI Lombard is not responsible for any effects or consequences resulting from the use of the information shared.

Women are often considered the backbone of their families, the caretakers, and the decision-makers. In a world where women's voices are becoming more prominent and powerful, they now play an even more important role in household decisions, especially the financial ones. It's a startling number: Globally, when women can earn an income, they typically reinvest 90% of it into their families and communities to provide better nutrition, health care and education to their family & children.

In India, according to the fifth National Family Health Survey fact sheet in 2022, nearly 88.7% of currently married Indian women tend to participate in the critical household decision about healthcare for themselves and are decision-makers in major household purchases, including those related to insurance. They are researching, comparing, and choosing policies offering comprehensive coverage and flexible payment options.

Whether it's a health policy that covers their specific medical needs, a vehicle policy that protects them while driving or riding on the road, or a travel policy that provides comprehensive coverage on the go, women in India are making intelligent and informed decisions about their insurance needs. Below are a few key takeaway points from our initial sample study on understanding women's behavioural preferences when purchasing health, vehicle & travel insurance online.

What does insurance mean to women?
Insurance is a financial product that protects against unforeseen risks. For women, insurance means financial security and peace of mind.

How do women decide on buying insurance policies?
Most women prioritise their family's financial safety, and they believe insurance is a helpful tool for achieving this goal. Healthwise, women are more exposed to specific health conditions, including breast cancer and gynaecological-related complications requiring specialised medical care. Therefore, women favour health insurance that covers these healthcare expenses so that they do not add additional costs to their family budgets.

While deciding on an individual health policy, women prefer health insurance policies that offer cashless hospitalisation and a wide network of hospitals. The need for convenience and ease of access to medical facilities drives this preference.

When it comes to vehicle insurance, women have different preferences compared to men. While they believe that the person using the vehicle most should be making the insurance purchase decisions for a family-owned vehicle. However, for their own car or bike, they prefer affordable, comprehensive vehicle insurance policies that cover their personalised needs, such as vehicle damage due to rat bite—indicating their preferences for customised coverage & add-ons. Add-on covers provide additional protection and help women feel more secure while driving & maintaining their vehicles.

For travel insurance, most women prefer to avoid getting involved in the purchase decision as they believe it's insurance for only a short duration and is not a major investment. Most are strapped for time and trust the travel agent's recommendation.

Updated on - 11 Feb 2026

Vitamin D is key when it comes to maintaining healthy bones, supporting immune function and regulating mood. Our body makes it from sunlight but food sources also matter, especially if sun exposure is low. Finding the right foods can be challenging, as vitamin D is naturally present in relatively few items.

In this guide, you'll find the best vitamin D foods for vegetarians and non-vegetarians. It’s a simple way to choose what works for your lifestyle.

Benefits of vitamin D

Some benefits of vitamin D include:

1. Fights bone diseases: Vitamin D is an essential component for calcium absorption. Without vitamin D, you cannot have calcium in your body in active form. Absorption of calcium allows the body to maintain the required amount of phosphate in the body which is again essential for bone health and development.
2. Helps maintain good mental health: While it is not clear how essential vitamin D is in checking clinical depression, it is highly effective in managing seasonal depression. Since there is less sunlight in winter, the body absorbs relatively much lesser vitamin D. This adversely affects the neurotransmitter serotonin.
3. Fights respiratory infections: If you have a significantly low vitamin D level, chances are high that you may suffer from more respiratory issues such as cold and flu. Research shows that deficiency of Vitamin D can worsen the post-COVID consequences.
4. Protects against heart ailments and diseases: An adequate amount of vitamin D reduces the risks of heart failure, stroke and several heart diseases. Medically, it is not clear if Vitamin D is solely responsible for the prevention of heart diseases, but it definitely helps.
5. Keeps the risks of diabetes in check: Cell-based observational studies show that vitamin D augments insulin sensitivity, improves beta cell function and reduces inflammation. All these factors are extremely important in controlling Type 2 Diabetes.
6. Reduces cancer risk: More and more scientific sample studies are reinforcing the role of vitamin D in managing and reducing the threat of cancer. The potential correlation between vitamin D and colon cancer, ovarian cancer, breast cancer and prostate cancer is evident. Vitamin D helps in controlling the growth of cancer cells.
7. Guards against autoimmune conditions: Vitamin D plays a very important role in regulating the immune system, thus preventing autoimmune disorders. Studies show that people who intake or absorb sufficient vitamin D are less prone to autoimmune disorders such as arthritis, thyroid, etc.
8. Helps check cognitive inefficiency and dementia: Our brain tissues have vitamin D receptors. This indicates the role of vitamin D in cognitive development and health. Since vitamin D enhances cognitive function, it also helps in preventing conditions such as dementia.

Top vitamin D foods for vegetarians

Given below is a list of vitamin D foods for vegetarians. To ensure an adequate amount of vitamin D in your body, include these vitamin D-rich foods:

1. Fortified orange juice: Most store-bought fortified orange juice is supplemented with calcium and vitamin D, making it a reliable source of nutrition for lactose-intolerant people. One cup of enhanced orange juice has 100 IU of vitamin D.
2. Mushrooms: Similar to humans, mushrooms can produce Vitamin D when exposed to sunshine. With 2300 IU of vitamin D2 per 100g, they are rich in vitamin D. However, professionally raised mushrooms have very little vitamin D2. Although some varieties receive UV light treatment, making them a good source of vitamin D. These mushrooms contain 130 to 450 IU of vitamin D2.
3. Fortified soymilk: For vegans and vegetarians, soymilk is a nutritious meal alternative because it contains the same nutrients as cow's milk. Each cup of soy milk contains 120 IU of vitamin D. However, before purchasing soy milk, read the label to determine whether it contains vitamin D. Little vitamin D is present in non-fortified brands.
4. Cheese: Cheese makes one of the best vitamin D-rich foods for vegetarians. Cottage cheese has particularly higher amounts of vitamin D. Other cheeses with vitamin D include Cheddar, Fontina and Monterey. Any type of cheese has about 24 IU of vitamin D per 100g serving.
5. Yoghurt: Because yoghurt is fortified with vitamin D, dairy and non-dairy yoghurts have high levels of this vitamin. It contains around 120 IU of vitamin D per cup.
6. Fortified almond milk: Each serving of fortified almond milk has 2.4 mcg (96 IU) of vitamin D. Numerous almond milk brands also add calcium to enhance its nutritional value.

Top vitamin D foods for non-vegetarians

Some of the vitamin D foods for non-vegetarian people are:

1. Salmon: Salmon is an oily fish that has a lot of vitamin D. According to the Food Composition Database of the United States Department of Agriculture (USDA), 100g of Atlantic salmon contains 526 IU of vitamin D per serving. When compared to farmed salmon, wild salmon has greater vitamin D. The amount of Vitamin D in a 100g plate of wild salmon is 988 IU compared to 25% in farmed salmon.
2. Tuna: Canned tuna has 268 IU of vitamin D which makes it a superior source of the vitamin. In addition, it is less expensive than purchasing fresh fish. Consuming canned tuna also increases the amount of niacin and vitamin K in the body. However, avoid overconsumption of this food item as it contains the toxic metal methylmercury. High levels of methylmercury in the body can cause serious health conditions.
3. Cod liver oil: If you are not too fond of eating fish, then include a cod liver oil supplement in your diet. Cod liver oil contains 448 IU of vitamin D per teaspoon. This can be easily given to kids who need more vitamin D. It is also a rich source of omega-3 fatty acids and vitamin A. However, avoid consuming excessive amounts of cod liver oil because high levels of vitamin A in the body can be harmful.
4. Sardine: Sardine is an excellent vitamin D food. It contains 177 IU of vitamin D. Fatty fish like halibut and mackerel are also good sources of vitamin D.
5. Herrings: Whether it is served canned, smoked, pickled or raw, herrings are a great source of Vitamin D. It has 216 IU of vitamin D per 100g serving. Additionally, pickled herring contains salt and 112 IU of vitamin D, both of which are essential to human health.
6. Fortified cow milk: Cow milk has phosphorus, calcium and riboflavin. With 115–130 IU of vitamin D per cup, it is a fantastic source of vitamin D.
7. Egg yolk: You can get 37 IU of this vitamin from eggs. Note that the chicken’s exposure to the sun and the vitamin D concentration of chicken feed determine the vitamin D content of eggs. Eggs from chickens that have access to pasture and sunlight are three to four times more vitamin D-rich. They have 6000 IU of vitamin D.

What is vitamin D deficiency?

A shortage of vitamin D in the body or its inadequate absorption is called vitamin D deficiency. This usually happens if a person does not consume adequate vitamin D-rich foods or has very little exposure to the sun.

Tips to increase the intake of Vitamin D

If you're looking to improve your vitamin D levels, here are some effective ways to do it:

1. Get sun exposure

Spending time in sunlight is the most natural way to boost vitamin D. Aim for 10-30 minutes of midday sun exposure, thrice a week, depending on your skin tone and location. Be cautious of overexposure to avoid skin damage.

2. Incorporate vitamin D-rich foods

• Fatty fish: Salmon, mackerel and tuna are among the richest sources of Vitamin D.
• Egg yolks: A single egg yolk contains a small amount of Vitamin D.
• Fortified foods: Many dairy products, orange juices, cereals and plant-based milks are fortified with Vitamin D.
• Mushrooms: Some varieties, like shiitake and maitake, can provide Vitamin D when exposed to sunlight.

3. Consider supplements when necessary

Vitamin D supplements are a reliable option, especially for those with limited sun exposure. Take it with a fat-containing meal to improve absorption. Always consult a healthcare provider before starting any supplement.

4. Utilise UV lamps or bulbs

For people living in regions with little sunlight, especially during winter, UVB lamps can help the skin produce vitamin D. Make sure the lamp emits UVB rays, not just UVA. Use them in moderation, as overuse can damage the skin and eyes.

5. Engage in outdoor activities

Regular physical activity outdoors helps increase your sun exposure naturally. Walking, gardening, or exercising outdoors not only supports general wellness but also encourages your body’s vitamin D production.

Conclusion

Maintaining healthy vitamin D levels is important to support bone strength, immunity and overall well-being. It’s also important to remember that proactive health habits go hand-in-hand with financial security. Having the right health insurance ensures you're covered in case of deficiencies or related health issues that may require medical attention. For older adults, investing in a comprehensive senior citizen health insurance plan can provide added peace of mind and support in managing age-related health needs.

FAQs

1. Which fruits and vegetables contain Vitamin D?

Among fruits, oranges contain Vitamin D. Apart from that you can eat mushrooms, tofu, cheese, cereals and yoghurt. All these food items are good sources of vitamin D.

2. What does Vitamin D do?

Vitamin D is a fat-soluble nutrient that helps the body absorb calcium, magnesium and phosphate, which are essential for bone development.

3. What are the different forms of vitamin D?

There are primarily two types of vitamin D—vitamin D2 and vitamin D3 which are also called ergocalciferol and cholecalciferol, respectively.

4. What is vitamin D toxicity?

Too much consumption and/or absorption of vitamin D, much more than required by the body, can cause calcium accumulation in the body. This overabsorption of vitamin D can damage kidneys and bones. Excess vitamin D in the body is called vitamin D toxicity.

5. How can vegans get sufficient vitamin D?

Vegans can get vitamin D from plant-based milk yoghurt, tofu, mushrooms, almond milk, rice milk etc. Many vegetarian and non-animal dairy food items are good sources of vitamin D.

Disclaimer: The information provided in this blog is for educational and informational purposes only. It is not intended as a substitute for professional advice, diagnosis, or treatment. Please consult your general physician or another certified medical professional for any questions regarding a medical condition. Relying on any information provided in this blog is solely at your own risk, and ICICI Lombard is not responsible for any effects or consequences resulting from the use of the information shared.

Tax Benefits On Preventive Health Check-ups

Life, today, is only getting faster and faster. Long working hours, a sedentary lifestyle, unhealthy eating habits, and stress are harming your health far more than you realise. Hypertension, thyroid problems, diabetes, and high cholesterol are among common health issues among young and middle-aged people. While you must try to develop healthy habits to steer clear of these and similar conditions, you should not ignore the importance of regular preventive health check-ups.

Preventive check-ups not only help you monitor your health status, but they also allow early detection of major illnesses. To top it all, they come with tax benefits, thus, offering an edge to your financial planning.

Preventive health check-up income tax benefits can help you reduce your tax liability significantly. Section 80D of the Income Tax Act allows preventive health check-up deduction from your income tax liability even if you do not have a health insurancepolicy.

Read on to know all about preventive health check-up income tax relief under Section 80D of the Income Tax Act.

What is preventive healthcare?

Several factors contribute to maintaining a fit and healthy body and mind. These include proper nutrition, a balanced diet, regular exercise, good and proper sleep, and healthy recreational activities, among others. Although these things help you in living a healthy life, they offer no assurance that you will never fall sick. Therefore, it is essential to monitor your health closely and take all sorts of preventive measures to avoid any health complications. These measures include:

Periodic health check-ups, shots and immunisation.

Go for periodic blood tests for common conditions such as diabetes, thyroid, and high cholesterol.

Going for other sets of preventive healthcare tests such as cancer screening, HIV tests and more.

The need for preventive healthcare becomes even more important after the age of 40 years. This is when the body's immune strength starts decreasing.

Nowadays, almost all insurance providers offer preventive healthcare check-up coverage. In case your insurer does not cover health check-up costs, you can always buy a separate add-on or a preventive healthcare insurance package. There are different types of preventive healthcare insurance packages such as the family package, cancer package, dental package, package for children and likewise.

What is Section 80D of the Income Tax Act?

Under Section 80D of the Income Tax Act, you can get preventive health check-up income tax benefits. Section 80D allows tax benefits against the medical insurance premium that you pay for yourself, your spouse, children and your parents. The benefit can go up to Rs 25,000-Rs 50,000 depending on the age of the insured person. In addition, you get tax deductions up to a certain limit on the expenses incurred over preventive healthcare check-ups. The preventive health check-up ITR benefit amounts to Rs 5000 under the overall limit of Rs 25,000-Rs 50,000.

You can avail of tax deductions for preventive health check-ups for yourself, your spouse, children and dependent parents. This benefit applies even if the payment for preventive health check-ups is paid in cash.

Features and benefits of preventive health check-ups

These features of preventive health check-ups make them highly beneficial:

• Early detection of diseases:Preventive health check-up allows early detection of disease, thus, helping you against major financial and mental stress.
• Assists in the diagnosis of other medical conditions:It is possible to have some underlying medical condition that has no symptoms to show. Preventive health check-up allows the identification and diagnosis of the same.
• Better chance at prevention of health risks:With early detection of a dormant medical condition, you can do the needful on time.
• Reduces healthcare costs:Pursuing treatment for a medical condition becomes easier and cheaper if the disease is diagnosed at an early stage.
• Control the risk of complications: Diagnosis of a medical condition at an early stage reduces the risk of complications as you can take necessary steps on time.
• Tax benefits:A part of the expenses incurred for preventive healthcare check-up limit is eligible for tax deduction under Section 80D of the Income Tax Act. Therefore, health check-ups help not only in monitoring your health but also support your financial planning.

Deduction under Section 80D for health insurance premiums paid for parents

Section 80D allows tax relief for the insurance premium paid for yourself, your spouse, children, and parents. Read the table below to understand how tax deduction works for each category:

Who can claim a deduction for preventive health check-ups under Section 80D?

Anybody with valid health insurance who undergoes preventive health check-ups can avail of a tax benefit of Rs 5,000. Note, this tax benefit for preventive healthcare comes under the overall limit of Rs 25,000 medical insurance tax benefit as per Section 80D of the Income Tax Act.

If you pay a premium for the health insurance of your spouse, children and dependent parents, and incur preventive health check-up expenses for them, even that is eligible for claim deduction under Section 80D. However, the preventive health check-up deduction limit is Rs 5000 only.

The unique feature of this preventive health check-up ITR relief is that even if you do not have a health insurance plan for your parents, you can still avail of the claim deduction of Rs 50,000 which is inclusive of the Rs 5,000 for preventive health check-up expenses.

What is the maximum amount you can claim?

Following the outlines of Section 80D of the Income Tax Act, you can get a maximum claim deduction of Rs 25,000 in your tax liability if your and your family are less than 60 years of age. You may avail of a claim deduction worth Rs 50,000 if the insured person’s age is more than 60 years. Now, if you, your spouse, and your children are less than 60 years old, but your parents are above 60 years, you can claim a deduction of Rs 25,000 for your family and Rs 50,000 for your parents.

Refer to the table above to understand the claim norms under Section 80D.

The maximum limit of Rs 25,000 or Rs 50,000 includes expenses incurred on preventive healthcare check-ups as well. Remember, the maximum amount that you can claim against preventive healthcare check-ups is Rs 5,000.

So, how does this work? Let us use an example:

Suppose you are 35 years old and your parents are in the age bracket of 52-57 years. In this case, you are eligible for a maximum claim deduction for your medical insurance up to Rs 25,000. Suppose you paid Rs 20,000 toward your health insurance premium and incurred Rs 7,500 for preventive healthcare check-ups. Since your claim deduction limit is Rs 25,000 and you paid out Rs 20,000 for the premium limit, you are left with a balanced deduction limit of Rs 5,000. You can claim this Rs 5,000 for preventive health check-up limit for a deduction. The remaining Rs 2,500 (7500-5000) must be borne by you.

Tax benefits on cash payment

The Section 80D preventive health check-up tax benefits can be availed of even if the preventive healthcare payments are made in cash. Unlike the payment of the health insurance premium amount, which must be made through a proper banking process to make claims, there is no rigid financial process requirement for claims on preventive healthcare check-ups. This means when you go for a preventive healthcare test or diagnosis - be it a blood test or any other monitoring test - you can pay the charges in cash. Just keep a record of the bill payment to claim the deduction from your tax liability.

Deduction under Section 80DDB: Treatment of specified illness

Chapter VI A of the Income Tax Act specifically lays down the various provisions of deductions that can be availed of by a taxpayer. A wide range of tax claim deductions is explained in different sub-sections ranging from 80C to 80U.

Apart from Section 80D, some other sections and sub-sections offer tax claim benefits on expenses made on healthcare and healthcare insurance.

Under Section 80DDB, individuals and Hindu Undivided Families (HUFs) who are residents of India can claim a tax deduction against the expenses incurred for the treatment of specified diseases or ailments. They can claim an amount up to the actual expense or a maximum amount as capped under Section 80DDB.

• If you are less than 60 years of age, you will get a deduction amounting to Rs 40,000 or the actual expense, whichever is less.
• If you are more than 60 years of age, you will get a deduction amounting to Rs 100,000 or the actual expense, whichever is less.

Remember, the deduction is based on the age of the person undergoing treatment and not the one bearing the expenses. Also, the deduction is not related to health insurance or premium payment or preventive health check-up. This is an additional provision crafted to help people get tax relief if they or their dependents suffer from some specified diseases as mentioned in Rule 11DD of the Income Tax Act. The specified diseases include:

Neurological disorders where the damage is at least 40% or more. The same has to be corroborated by a designated specialist.

• Chronic renal failure
• Malignant cancer
• Critical haematological disorders
• AIDS

The deduction can be availed of only by the person who is actually bearing the expenses. However, you could be paying for yourself and/or your dependents such as spouse, children, parents, and/or siblings. In the case of HUFs, the deduction can be claimed if expenses are incurred for the treatment of any family member of the HUF.

Deduction under Section 80DD of the Income Tax Act: Treatment of a dependent with a disability

Under Section 80DD of the Income Tax Act, individuals or HUFs who take care of disabled dependents can claim a tax benefit. The tax relief deductions are essentially based on the expenses of the disabled dependent. However, this deduction cannot be claimed by the dependent but by the one who takes care of the disabled dependent.

Disabilities include conditions such as blindness, loco-motor disability, mental disability, hearing impairment and leprosy affected.

Under this section, deductions can be claimed for the insurance premium paid for the disabled dependent. However, this benefit is restricted to some insurers. You will have to check if your insurance company offers this benefit or not. If the disability of the dependent is 40% or more or there is more than one disability, then you can claim a deduction of up to Rs 75,000. If the disability of the dependent is 80% or more, then as a caretaker you are entitled to a deduction of Rs 125,000 per annum.

Documents Required for Claiming Tax Deduction for Preventive Health Check Up

You don't have to submit any documents to claim tax deductions for preventive health checkups under section 80D of the Income Tax Act. However, it is recommended that you maintain a record of the bill payment made during the policy year on doctor consultations, diagnostic tests, etc. The reason is that your employer may ask for proof of all deductions when issuing Form 16 for filing income tax returns. The second reason is if you are filing on your own, maintaining the bills can simplify the process of claiming deductions. For preventive checkups, you can make the payments in cash, unlike the payment of health insurance premiums, which must be made in any mode but not in cash.

Claim settlement ratio (CSR) is one of the most important factors that you should consider when buying an insurance policy. It is one of the best parameters to check the credibility and integrity of the insurance company that you are planning to buy your insurance from.

What is a claim settlement ratio?

The claim settlement ratio is a percentage figure that shows how many claims have been settled by the insurance company in a financial year against the total number of claims received in that financial year. Every year, the Insurance Regulatory and Development Authority of India (IRDAI) publishes the claim settlement ratio of all the registered insurance companies.

You can easily check an insurance company’s credibility by checking its claim settlement ratio using the IRDA Claim Settlement Ratio 2022 annual report.

Importance of the claim settlement ratio

Your insurance company’s claim settlement ratio is important for two reasons:

• Insurer’s credibility:

A higher claim settlement ratio implies that the insurance company has honored a higher number of claims. This is an indicator that the company is committed to settling the claims raised by its policyholders. This shows their credibility.

• Security for you:

The purpose of buying health insurance is to be financially protected in times of crisis. If you cannot get the required financial cushion when you need it the most, the whole purpose of investing in an insurance plan gets defeated. A good and healthy credit settlement ratio ensures financial security for you and your family.

Updated on - 04 Feb 2026

The rising cost of healthcare in India underscores the importance of a cashless health insurance plan. In an emergency, only a policy can cover the bills and ensure effective treatment. However, the process can be tedious if you are not aware of it. Therefore, understanding how a cashless claim settlement works is important to avail the benefits on time.

The blog outlines everything you need to know about cashless individual health insurance and how it differs from reimbursement. It also discusses the steps to avail the claim and common reasons for rejection.

What is cashless health insurance?

Cashless health insurance refers to policies that offer cashless claim settlement. Under such policies, when a policyholder is admitted to a network hospital, the insurer and the hospital coordinate to settle the medical expenses directly. To avail of this facility, the policyholder must inform the insurer within a specified timeframe, usually at least two days before planned hospitalisation and within 24 hours in case of emergencies. The hospital administration then contacts the insurer, sending a pre-authorisation form to initiate the claim settlement process.

Cashless health insurance is when the policy provides claim settlement without requiring payment up front. The insurer and the network hospital coordinate to settle the medical expenses. In such a situation, the policyholder has to inform their insurer within the stipulated timeframe. There is generally a 48-hour time limit for general admission and a 24-hour time limit in case of an emergency. After you fill out and submit the pre-authorisation form, the claim settlement process is initiated.

What is cashless claim settlement?

As a policyholder, there are two ways you can make a claim: cashless claim settlement and reimbursement claim settlement.

Cashless claim settlement

Remember, you can avail of this benefit only at a network hospital. Under your policy terms, with cashless coverage, you can seek treatment at a network hospital. All you need is your insurance card and policy details. The insurer will settle your bills directly with the hospital.

Reimbursement claim settlement

Reimbursement claim settlement is primarily used in cases where the insured either cannot access or wishes to seek service at a network hospital. Most insurance policies allow you to utilise the services of a network hospital of your choice. However, in such situations, you must pay the bills upfront and later claim reimbursement from the insurer. To claim reimbursement, you will have to submit the original documents, bills, reports, etc., along with the duly filled-out claim request form. Once your documents are verified, the insurer transfers the reimbursed amount to your bank account.

How does cashless claim settlement work?

Given below is the cashless claim settlement process for health insurance:

• In case of a medical emergency, get admitted to a network hospital.
• Every network hospital has an insurance desk. You can get all the information regarding claim settlement here.
• Ask for a pre-authorisation at the insurance desk. Or, get a declaration from the Third Party Administrator (TPA). Get a printout of the same. You can also get a declaration form from TPA.
• Submit the necessary form along with the pre-authorisation letter or the TPA declaration.
• You will get an email confirming coverage and the maximum sanctioned amount.
• Once the treatment is completed, if the bill incurred is within the sanctioned amount, you will not have to pay anything. If the bill exceeds the limit, you are liable to pay the additional amount.

Steps for cashless claims

To effectively utilise the cashless claim facility, policyholders should follow these steps:

1. Choose a network hospital: Ensure the hospital where treatment is sought is in the insurer's network. This information is typically available on the insurer’s website or through customer service.
2. Inform the insurer:

• Planned hospitalisation: Notify the insurer at least two days before the scheduled admission.
• Emergency hospitalisation: Inform the insurer within 24 hours of admission.

1. Provide necessary documentation: Present your health insurance card and a valid ID at the hospital. The hospital will assist in filling out the pre-authorisation form and submitting it to the insurer.
2. Await approval: The insurer will review the pre-authorisation request. Upon approval, the treatment can proceed without any upfront payment from the policyholder.
3. Post-treatment process: After discharge, ensure that all original documents, bills, and discharge summaries are retained, as the insurer may require them for their records.
4. Settlement: The insurer will directly settle the approved amount with the hospital. Any non-covered expenses or exclusions will be the policyholder’s responsibility.

Documents required for a cashless health insurance claim

The documents needed at the time of availing a cashless insurance claim are:

• Cashless claim form
• Discharge summary
• Past medical records
• Hospital bill
• Pharmacy bill and prescriptions
• Consultation papers
• Photo ID card with a cancelled cheque

Benefits of cashless claim settlement

A cashless medical insurance policy helps simplify the treatment process for you. Here is why it is a trusted option for many:

• You can access any of the network hospitals listed under the policy.
• You don’t need extensive documentation, as the authorised TPA person will take care of everything.
• You don’t need to incur any expenses at the time of an emergency or planned treatment.

Steps to avail a cashless health insurance claim

Here is how you can easily access a cashless claim through your individual health insurance agent:

• Find the nearest network hospital and inform the TPA for smooth processing.
• Show your health card and ID proof to the hospital insurance desk.
• You can either download the claim form from the official TPA website or pick it up at the hospital.
• The hospital will share the form with the TPA for authorisation.
• The patient should admit themselves within 15 days of TPA approval.

Difference between cashless and reimbursement claim

The table below explains how a cashless claim differs from reimbursement:

Common reasons for cashless claim rejection

There are a few reasons why your cashless claim might be rejected:

• Waiting period: Certain diseases require a waiting period. In case that period isn’t exhausted, you cannot file a claim.
• Certain diseases: Your insurance policy might not cover a few of the listed diseases or illnesses.
• Withholding of information: In case you don’t disclose your pre-existing condition, you would not be able to file for a claim.
• Wrong information: Mentioning false information about a pre-existing health condition can lead to termination of your insurance policy.
• Lapse of policy: You cannot request a claim on an expired or invalid policy.

Network hospitals and their role in cashless claims

A network hospital streamlines the process of cashless treatment. You don’t have to pay the medical costs upfront, reducing your overall financial burden. Here is how the hospitals play a key role in processing your insurance claim:

• Quality Healthcare Service: Network hospitals have to adhere to the insurance company’s care standards. Therefore, they have advanced medical facilities and equipment.
• Cost-Effective Process: Hospitals have pre-negotiated rates with companies to save costs for policyholders.
• Smooth Claim Settlement: The network hospitals have a smooth claim process that minimises the administrative work.
• Wide Coverage: Hospitals are available across locations, making it easier to access healthcare facilities.

How to find network hospitals for cashless health insurance

You can find a trusted network hospital for your health insurance plan through one of the following ways:

• Scan the policy documents for the dedicated list of hospitals.
• Insurance companies list their affiliated network hospitals on their official mobile app and website.
• Connect with the insurance company’s customer care representative to retrieve the information.

Tips to ensure smooth cashless claim processing

Here are the tips to follow so you can claim your individual health insurance smoothly:

• Understand your policy details and be aware of the expenses and treatments that are not covered.
• You need to disclose your pre-existing health conditions, as misleading the insurer can lead to rejection.
• Access the list of network hospitals to avail of cashless benefits easily.
• Keep your documents readily available to submit to the hospital on time.

Conclusion

A cashless claim settlement can help you stay prepared in times of need. Instead of arranging finances for a medical emergency, you can depend on your insurance to take care of the admission, diagnostic tests, and consultation expenses.

Let us take care of your well-being in times of injury and illness with the right policy. Fill out the form on this page, and our insurance experts will consult and curate a plan specifically for you.

FAQs

1. How can I avoid a cashless claim rejection?

Mention your pre-existing illness to the insurance company, get treatment only at a network hospital, and inform your insurer that you are being admitted to a hospital before you visit.

2. Which medical illnesses are not covered under a cashless insurance?

Pre-existing diseases (waiting period of 2 to 4 years), STDs, congenital diseases, and substance abuse-related diseases are not covered under the insurance plan.

3. Is a cashless claim better than reimbursement?

Yes, a cashless claim is safer than reimbursement, as you don’t need to pay an upfront cost to the hospital.

4. Does a cashless insurance policy offer tax benefits?

Yes, a cashless health insurance offers tax benefits under Section 80D. You can claim it while filing your tax return.

Disclaimer: The information provided in this blog is for educational and informational purposes only. It may contain outdated data and information regarding the topic featured in the article. It is advised to verify the currency and relevance of the data and information before taking any major steps. ICICI Lombard is not liable for any inaccuracies or consequences resulting from the use of this outdated information.

Updated on 7 Jan 2026

Vitamin D is key when it comes to maintaining healthy bones, supporting immune function and regulating mood. Our body makes it from sunlight but food sources also matter, especially if sun exposure is low. Finding the right foods can be challenging, as vitamin D is naturally present in relatively few items.

In this guide, you'll find the best vitamin D foods for vegetarians and non-vegetarians. It’s a simple way to choose what works for your lifestyle.

Benefits of vitamin D

Some benefits of vitamin D include:

1. Fights bone diseases: Vitamin D is an essential component for calcium absorption. Without vitamin D, you cannot have calcium in your body in active form. Absorption of calcium allows the body to maintain the required amount of phosphate in the body which is again essential for bone health and development.
2. Helps maintain good mental health: While it is not clear how essential vitamin D is in checking clinical depression, it is highly effective in managing seasonal depression. Since there is less sunlight in winter, the body absorbs relatively much lesser vitamin D. This adversely affects the neurotransmitter serotonin.
3. Fights respiratory infections: If you have a significantly low vitamin D level, chances are high that you may suffer from more respiratory issues such as cold and flu. Research shows that deficiency of Vitamin D can worsen the post-COVID consequences.
4. Protects against heart ailments and diseases: An adequate amount of vitamin D reduces the risks of heart failure, stroke and several heart diseases. Medically, it is not clear if Vitamin D is solely responsible for the prevention of heart diseases, but it definitely helps.
5. Keeps the risks of diabetes in check: Cell-based observational studies show that vitamin D augments insulin sensitivity, improves beta cell function and reduces inflammation. All these factors are extremely important in controlling Type 2 Diabetes.
6. Reduces cancer risk: More and more scientific sample studies are reinforcing the role of vitamin D in managing and reducing the threat of cancer. The potential correlation between vitamin D and colon cancer, ovarian cancer, breast cancer and prostate cancer is evident. Vitamin D helps in controlling the growth of cancer cells.
7. Guards against autoimmune conditions: Vitamin D plays a very important role in regulating the immune system, thus preventing autoimmune disorders. Studies show that people who intake or absorb sufficient vitamin D are less prone to autoimmune disorders such as arthritis, thyroid, etc.
8. Helps check cognitive inefficiency and dementia: Our brain tissues have vitamin D receptors. This indicates the role of vitamin D in cognitive development and health. Since vitamin D enhances cognitive function, it also helps in preventing conditions such as dementia.

Top vitamin D foods for vegetarians

Given below is a list of vitamin D foods for vegetarians. To ensure an adequate amount of vitamin D in your body, include these vitamin D-rich foods:

1. Fortified orange juice: Most store-bought fortified orange juice is supplemented with calcium and vitamin D, making it a reliable source of nutrition for lactose-intolerant people. One cup of enhanced orange juice has 100 IU of vitamin D.
2. Mushrooms: Similar to humans, mushrooms can produce Vitamin D when exposed to sunshine. With 2300 IU of vitamin D2 per 100g, they are rich in vitamin D. However, professionally raised mushrooms have very little vitamin D2. Although some varieties receive UV light treatment, making them a good source of vitamin D. These mushrooms contain 130 to 450 IU of vitamin D2.
3. Fortified soymilk: For vegans and vegetarians, soymilk is a nutritious meal alternative because it contains the same nutrients as cow's milk. Each cup of soy milk contains 120 IU of vitamin D. However, before purchasing soy milk, read the label to determine whether it contains vitamin D. Little vitamin D is present in non-fortified brands.
4. Cheese: Cheese makes one of the best vitamin D-rich foods for vegetarians. Cottage cheese has particularly higher amounts of vitamin D. Other cheeses with vitamin D include Cheddar, Fontina and Monterey. Any type of cheese has about 24 IU of vitamin D per 100g serving.
5. Yoghurt: Because yoghurt is fortified with vitamin D, dairy and non-dairy yoghurts have high levels of this vitamin. It contains around 120 IU of vitamin D per cup.
6. Fortified almond milk: Each serving of fortified almond milk has 2.4 mcg (96 IU) of vitamin D. Numerous almond milk brands also add calcium to enhance its nutritional value.

Top vitamin D foods for non-vegetarians

Some of the vitamin D foods for non-vegetarian people are:

1. Salmon: Salmon is an oily fish that has a lot of vitamin D. According to the Food Composition Database of the United States Department of Agriculture (USDA), 100g of Atlantic salmon contains 526 IU of vitamin D per serving. When compared to farmed salmon, wild salmon has greater vitamin D. The amount of Vitamin D in a 100g plate of wild salmon is 988 IU compared to 25% in farmed salmon.
2. Tuna: Canned tuna has 268 IU of vitamin D which makes it a superior source of the vitamin. In addition, it is less expensive than purchasing fresh fish. Consuming canned tuna also increases the amount of niacin and vitamin K in the body. However, avoid overconsumption of this food item as it contains the toxic metal methylmercury. High levels of methylmercury in the body can cause serious health conditions.
3. Cod liver oil: If you are not too fond of eating fish, then include a cod liver oil supplement in your diet. Cod liver oil contains 448 IU of vitamin D per teaspoon. This can be easily given to kids who need more vitamin D. It is also a rich source of omega-3 fatty acids and vitamin A. However, avoid consuming excessive amounts of cod liver oil because high levels of vitamin A in the body can be harmful.
4. Sardine: Sardine is an excellent vitamin D food. It contains 177 IU of vitamin D. Fatty fish like halibut and mackerel are also good sources of vitamin D.
5. Herrings: Whether it is served canned, smoked, pickled or raw, herrings are a great source of Vitamin D. It has 216 IU of vitamin D per 100g serving. Additionally, pickled herring contains salt and 112 IU of vitamin D, both of which are essential to human health.
6. Fortified cow milk: Cow milk has phosphorus, calcium and riboflavin. With 115–130 IU of vitamin D per cup, it is a fantastic source of vitamin D.
7. Egg yolk: You can get 37 IU of this vitamin from eggs. Note that the chicken’s exposure to the sun and the vitamin D concentration of chicken feed determine the vitamin D content of eggs. Eggs from chickens that have access to pasture and sunlight are three to four times more vitamin D-rich. They have 6000 IU of vitamin D.

What is vitamin D deficiency?

A shortage of vitamin D in the body or its inadequate absorption is called vitamin D deficiency. This usually happens if a person does not consume adequate vitamin D-rich foods or has very little exposure to the sun.

Tips to increase the intake of Vitamin D

If you're looking to improve your vitamin D levels, here are some effective ways to do it:

• Get sun exposure

Spending time in sunlight is the most natural way to boost vitamin D. Aim for 10-30 minutes of midday sun exposure, thrice a week, depending on your skin tone and location. Be cautious of overexposure to avoid skin damage.

• Mushrooms: Some varieties, like shiitake and maitake, can provide Vitamin D when exposed to sunlight.
• Fortified foods: Many dairy products, orange juices, cereals and plant-based milks are fortified with Vitamin D.
• Egg yolks: A single egg yolk contains a small amount of Vitamin D.
• Fatty fish: Salmon, mackerel and tuna are among the richest sources of Vitamin D.
• Incorporate vitamin D-rich foods
• Consider supplements when necessary

Vitamin D supplements are a reliable option, especially for those with limited sun exposure. Take it with a fat-containing meal to improve absorption. Always consult a healthcare provider before starting any supplement.

• Utilise UV lamps or bulbs

For people living in regions with little sunlight, especially during winter, UVB lamps can help the skin produce vitamin D. Make sure the lamp emits UVB rays, not just UVA. Use them in moderation, as overuse can damage the skin and eyes.

• Engage in outdoor activities

Regular physical activity outdoors helps increase your sun exposure naturally. Walking, gardening, or exercising outdoors not only supports general wellness but also encourages your body’s vitamin D production.

Conclusion

Maintaining healthy vitamin D levels is important to support bone strength, immunity and overall well-being. It’s also important to remember that proactive health habits go hand-in-hand with financial security. Having the right health insurance ensures you're covered in case of deficiencies or related health issues that may require medical attention. For older adults, investing in a comprehensive senior citizen health insurance plan can provide added peace of mind and support in managing age-related health needs.

FAQs

• Which fruits and vegetables contain Vitamin D?

Among fruits, oranges contain Vitamin D. Apart from that you can eat mushrooms, tofu, cheese, cereals and yoghurt. All these food items are good sources of vitamin D.

• What does Vitamin D do?

Vitamin D is a fat-soluble nutrient that helps the body absorb calcium, magnesium and phosphate, which are essential for bone development.

• What are the different forms of vitamin D?

There are primarily two types of vitamin D—vitamin D2 and vitamin D3 which are also called ergocalciferol and cholecalciferol, respectively.

• What is vitamin D toxicity?

Too much consumption and/or absorption of vitamin D, much more than required by the body, can cause calcium accumulation in the body. This overabsorption of vitamin D can damage kidneys and bones. Excess vitamin D in the body is called vitamin D toxicity.

• How can vegans get sufficient vitamin D?

Vegans can get vitamin D from plant-based milk yoghurt, tofu, mushrooms, almond milk, rice milk etc. Many vegetarian and non-animal dairy food items are good sources of vitamin D.

Disclaimer: The information provided in this blog is for educational and informational purposes only. It is not intended as a substitute for professional advice, diagnosis, or treatment. Please consult your general physician or another certified medical professional for any questions regarding a medical condition. Relying on any information provided in this blog is solely at your own risk, and ICICI Lombard is not responsible for any effects or consequences resulting from the use of the information shared.

The Insurance Regulatory and Development Authority of India(IRDAI) is the insurance sector regulatory body in India. The IRDAI’s objective is to optimise the existing insurance industry and make sure the operations and conduct of the sector are fair. The insurance market is undergoing constant changes, upgradation, and high competition. Consequently, the role of the IRDAI is essential.

Who is IRDAI and its role in health insurance?

The IRDAI is the topmost organisation in India responsible for the smooth operation of its vast insurance sector. Among its primary responsibilities are regulating the insurance companies (both government and private), protecting the rights and interests of the policyholders and creating conditions for fairness and transparency. In the field of medical insurance, IRDAI sets rules for the claim settlement process and makes sure that insurance providers properly handle the claims and provide the needed financial support to people.

IRDAI guidelines for claim settlement

The IRDAI has laid down some rules for health insurance claim settlement for all insurance providers registered under it. These rules are laid down to help both the insurer and the insured. Listed below are some of the rules for health insurance claims laid down by the IRDAI:

• A health insurance may not have an exit age if the policyholder renews it on schedule without any interruptions in renewal.
• A Group Health Insurance policy comes with a validity of a maximum of one year.
• The insurer is responsible for providing the policyholder with information regarding the terms and conditions of the policy concerning receiving care at a hospital in India.
• The insurance provider must give the policyholder the choice to switch to another plan after meeting the exit conditions for their health insurance policy. Additionally, insurers must award appropriate credits if the policy was renewed without any gaps.
• The insurance provider must give the applicant a fair, justifiable, and open explanation in writing if their request to purchase health insurance is declined.
• A policyholder will receive rewards if they renew their coverage on time, purchase it early in life, or have a positive claims experience with an insurance provider. The prospectus and policy document should include explicit references to the benefits as agreed by the board.
• Before issuing the policy, the insurance company should give the policyholder a list of medical facilities, government or otherwise, from whom the firm will accept the medical reports.
• Particularly for senior individuals, the premium amount should be reasonable, equitable, and clear. Additionally, the total sum should be made clear to the potential policyholder.

IRDAI’s protection for policyholders

IRDAI has rules for claim rejection and settlement as well. Some of them are:

• If the policyholder maintains the coverage for 8 years without a break, the health insurance provider cannot deny a claim. These 8 years are called the moratorium period.
• Except in cases of fraud and/or a claim brought against the exclusion of the health policy after the moratorium period, the insurance company cannot appeal to the IRDAI against the settlement of such a claim.
• A claim cannot be denied by the insurance company due to misrepresentation or non-disclosure.
• A claim cannot be denied on that basis since IRDAI has allowed the insurance company an 8-year window for validating the information provided by the policyholder.
• The insurance company is responsible for paying interest on the claim amount at a rate that is 2% higher than the bank rate if the insurer's claim payment is delayed.
• The claim should be resolved within 30 to 45 days of the date the policyholder received the last necessary document.

How to ensure a smooth claim process?

Policyholders can facilitate efficient claim settlements by:

• Understanding Policy Terms: Familiarize yourself with coverage details, exclusions and claim procedures.
• Maintaining Records: Keep all medical bills, reports and related documents organized for easy access during claims.
• Timely Intimation: Inform your insurer about hospitalizations or treatments promptly, adhering to specified timelines.

If you understand the details of your medical insurance plan, it can ease the claim process, particularly when you are managing medical insurance for parents.

FAQs

What is the time frame for claim settlement as per IRDAI?

Insurers are required to settle or reject a claim within 30 days of receiving all necessary documents as per the rules set by IRDAI.

Can insurers ask for additional documents after the initial submission?

Insurers needed to ask for all the required documents at once. In case any additional requests need to be made, they should be exceptional and justified.

What if my claim is rejected unfairly?

You can approach the insurer's grievance redressal cell. If unresolved, escalate to the Insurance Ombudsman or IRDAI.

Conclusion

IRDAI's regulations aim to create a transparent and efficient health insurance claim settlement process. In this blog, the guidelines set by IRDAI have been explained, which will help you understand and make better decisions regarding your medical insurance plan, which will go a long way in securing your overall health.

Disclaimer: The information provided in this blog is for educational and informational purposes only. It is not intended as a substitute for professional advice, diagnosis or treatment. Please consult a certified medical and/or nutrition professional for any questions. Relying on any information provided in this blog is solely at your own risk, and ICICI Lombard is not responsible for any effects or consequences resulting from the use of the information shared.

You must always check the claim settlement ratio (CSR) of a health insurance company before buying a policy from them. In fact, you should compare different insurance providers, their plans, terms and conditions, coverage, and waiting period for pre-existing diseases before paying the premium amount. Also, compare their health insurance claim settlement ratio. This is because a medical emergency would already put you under immense mental stress. In such a situation, the last thing you would want to do is follow up through a complex claim settlement process, and worse, face claim rejection. An insurer with a good claim settlement ratio will help you with a seamless and hassle-free claim settlement process.

What is a claim settlement ratio?

The Claim Settlement Ratio (CSR) is the percentage of health insurance claims settled by an insurer compared to the total claims received in a given period. It indicates the insurer’s efficiency in processing claims and honouring policyholder benefits.

Formula for Claim Settlement Ratio:

For example, if an insurer receives 10,000 claims and successfully settles 9,500, its CSR would be 95%.

Types of health insurance claim ratio

There are different types of claim ratios used to assess an insurance company’s performance:

1. Claim Settlement Ratio (CSR): Measures the percentage of claims successfully settled.
2. Incurred Claim Ratio (ICR): The ratio of total claims paid to total premiums collected by the insurer.
3. Claim Rejection Ratio: Percentage of claims rejected by the insurer.
4. Claim Pending Ratio: The proportion of claims still under process.

Why is the claim settlement ratio important when buying health insurance?

The CSR is crucial when selecting a health insurance plan because:

• It reflects the insurer’s credibility and efficiency in claim settlement.
• A higher CSR indicates a greater probability of claim approval.
• Helps policyholders avoid insurers with a high claim rejection rate.
• Ensures health insurance for senior citizens offers financial security without unnecessary claim delays.

What is considered as a good claim settlement ratio?

A good CSR is generally considered to be above 95%, meaning the insurer successfully settles a vast majority of claims. However, a very high CSR (near 100%) might indicate relaxed claim processing, leading to financial instability for the insurer.

How does claim settlement ratio help you choose the right health insurer?

When selecting a health insurer, a high CSR indicates:

• Faster claim processing.
• Fewer claim rejections.
• Financial stability of the insurance provider.
• A more seamless claim experience for policyholders.

Is the claim settlement ratio enough for evaluation?

Besides the claim settlement ratio, consider the following factors to ensure a smooth claim settlement of your health insurance:

• While it is suggested that you should always opt for an individual health insurance provider with a high claim settlement ratio, it is equally important to check the settled claim amount. If the average amount is low, the company may settle a large number of claims for a smaller sum insured.
• You also need to check the claim settlement process of the insurance company you are buying your health insurance The process should be easy and hassle-free.
• Go for insurers with a good digital presence and equally good online customer service.
• While checking the claim settlement ratio, check the company’s CSR for the last 4-5 years. A one-time high CSR does not ensure consistent performance. Choose a company like ICICI Lombard that has been consistently performing well. You can check the ICICI Lombard Health Claim Settlement Ratio from the IRDA Claim Settlement Ratio 2022 annual report.

Importance of claim settlement ratio

Understanding the claim settlement ratio is important because it-

• Helps in choosing a reliable insurer.
• Provides assurance of claim approval.
• Reflects the efficiency of the insurance company.
• Prevents financial distress during medical emergencies.

Required documents for claim settlement

To file a claim, policyholders must provide:

• Duly filled claim form.
• Medical bills, hospital discharge summary and doctor’s prescription.
• Policy document and insurance ID.
• KYC documents (Aadhaar, PAN, etc.).
• Pre-authorisation form (for cashless claims).

How to check health insurance claim settlement ratio?

Before zeroing in on a health insurance plan, run through the following steps:

• Every year, the Insurance Regulatory and Development Authority (IRDA) publishes the claim settlement ratios of all insurance companies registered under it.
• Visit the official website of the IRDA and check the IRDA health insurance claim settlement ratio of your preferred insurance company. Look for the IRDA Annual Report and download the PDF for the latest financial year.
• Make a list of insurance companies with a high IRDA Claim Settlement Ratio in 2022. The higher the claim settlement ratio, the better your chances of getting the sum insured in times of medical emergency.
• Now, compare the coverage benefits of the available health insurance plans of companies with a high claim settlement ratio.

Where to check the claim settlement ratio of a health insurance company?

To check the CSR, you can use the following platforms-

• IRDAI official website.
• Insurance provider’s website.
• Insurance aggregators provided by insurance providers online

How is the health insurance claim ratio calculated?

The CSR is calculated annually by dividing the total claims settled by the total claims received, then multiplying by 100 to get the percentage.

Types of claim settlement processes

These are the types of claim settlements you will see in the insurance claim process-

1. Cashless Claim Settlement: The insurer directly settles bills with network hospitals.
2. Reimbursement Claim Settlement: The policyholder pays the bills first and later claims reimbursement.
3. In-house vs. Third-party Claims Processing: Some insurers handle claims internally, while others outsource them to Third-Party Administrators (TPAs).

FAQs

1. What is a good claim settlement ratio for health insurance?

A CSR above 95% is considered good, ensuring a higher probability of successful claim settlements.

2. Does a high claim settlement ratio guarantee a hassle-free process?

Not necessarily. Other factors like customer service, hospital network and turnaround time should also be considered.

3. Where can I find the claim settlement ratio of my insurer?

You can check the IRDAI website, the insurer’s official website, or insurance comparison platforms.

4. Is CSR relevant for health insurance for senior citizens?

Yes, CSR is crucial in health insurance for senior citizens as they require higher medical coverage and faster claim processing.

5. Can I trust an insurer with a 100% claim settlement ratio?

A 100% CSR may indicate relaxed claim approvals, potentially leading to financial instability. A ratio between 95-98% is ideal.

Conclusion

Remember, a health insurance plan may come with good coverage and several additional benefits at a competitive price. But, if the claim settlement ratio of that health insurance provider is not good, you may face a hard time getting your claim settled when you need it the most. This would defeat the whole purpose of getting health insurance. While a high CSR increases the likelihood of claims being settled, it should be evaluated along with other factors like network hospitals, customer service and financial stability. Whether purchasing a health insurance plan for individuals or health insurance for senior citizens, choosing an insurer with a strong claim settlement record ensures peace of mind during medical emergencies.

Disclaimer: The information provided in this blog is for educational and informational purposes only. It may contain outdated data and information regarding the Insurance industry and products. It is advised to verify the currency and relevance of the data and information before taking any major steps. ICICI Lombard is not liable for any inaccuracies or consequences resulting from the use of this outdated information.

Updated on - 04 Feb 2026

A sudden toothache or an unexpected dental procedure can be stressful. Beyond the pain, there’s the worry about cost and whether your health plan will help. Many people assume it will, but routine dental care is often not covered. Depending on your insurer, plan type and any riders, coverage may be limited. This means fillings, cleanings or crowns could come out of your pocket.

Knowing how dental coverage works can help you make smart choices and manage costs without stress, and in this blog, we explain how to do just that.

Why is dental work not included in health insurance?

In many health plans, routine dental work is not included. Coverage depends on the insurer and the type of policy. The main reasons are:

1. Historical Context: While health insurance covers serious illnesses and emergencies, dental care has been traditionally seen as a luxury and not a necessity.
2. Cost Containment: Dental work as a part of insurance policies increases the premium, making health insurance costly.
3. Preventive Nature: Dental care is generally considered preventive by insurers, meaning some routine treatments may not be covered.

What is dental insurance?

Dental insurance helps cover the expenses of dental treatments and procedures. Some basic dental coverage may occasionally be included in regular health insurance, but it is usually limited. For more comprehensive protection, you can choose a stand-alone dental insurance plan that covers significant treatments, cleanings, fillings and preventive care. This provides flexibility and helps protect your oral health without added financial strain.

Note: Coverage and benefits may vary by insurer and plan. This is an indicative explanation; always check the policy wording for details.

Why is dental insurance necessary?

Dental insurance is more than an add-on to your medical policy. It helps you access care without delaying treatments or routine check-ups due to cost.

• Maintain good dental health: Some plans include routine treatments, helping prevent problems with timely care.
• Manage rising dental costs: Dental insurance can protect you from unexpected bills as treatment costs increase.
• Access necessary care without compromise: It helps you get treatments on time, supporting both your oral health and finances.

What do dental insurance plans typically cover?

Dental insurance plans can help cover a range of treatments, depending on the insurer and plan. Typical coverage may include dental consultation fees, routine treatments like fillings, root canal procedures, extractions, care for dental injuries, gum care, X-rays and other diagnostic tests. Some plans also cover preventive care and scaling.

Note: Coverage can vary by insurer and plan. This is an indicative overview; please read the policy wording for full details.

What are the common exclusions in dental insurance?

It’s important to know what dental insurance does not cover so you can plan for unexpected expenses. Common exclusions typically include cosmetic dental treatments, procedures for jaw alignment and dentures, prosthetic devices and dental implants. Being aware of these limits can help you manage your oral health, finances and schedule necessary treatments without surprises.

Note: Exclusions may vary by policy and insurer. This is an indicative overview; please read the policy wording for full details.

Who should buy a dental insurance plan?

Whether dental insurance is necessary depends on your personal needs and financial situation. It may be worth considering if your health insurance does not cover dental care, if you are prone to dental issues, work in environments with higher accident risk or do not have enough emergency funds for unexpected costs.

Dental insurance can help manage expenses and make accessing care more affordable, while also providing financial support for timely treatments, depending on your coverage.

Are there scenarios when dental emergencies might be covered by health insurance?

Depending on the reason and whether you have an outpatient (OPD) dental rider, medical insurance policy may sometimes cover dental emergencies. Standard health insurance usually does not cover dental procedures, as most are considered cosmetic or non-essential.

Coverage may be available in cases such as accidents or injuries, where treatment is needed for trauma like a fractured jaw or knocked-out tooth.

Complex oral surgeries requiring hospitalisation and anaesthesia, or dental issues linked to a covered illness such as oral cancer, may also be included with prior approval and documentation, depending on the policy.

Conclusion

Dental issues can strike unexpectedly and become expensive without the right coverage. Having dental insurance helps you plan ahead, manage costs and access timely care, so you don’t have to delay treatments or worry about surprise bills. Taking action today, even with a simple plan, ensures you are prepared for routine care and unexpected emergencies, making your health decisions easier and stress-free.

If you're unsure about the right plan or want to understand your individual health insurance options in a simple way, you can reach out by filling out the form on this page.

FAQs

1. How can I make the most of my dental insurance plan?

Check your policy details for coverage limits, waiting periods and in-network providers. Schedule preventive check-ups early to maximise benefits and avoid out-of-pocket costs.

2. Are there ways to reduce dental expenses even without full coverage?

Yes, you can combine partial insurance with wellness programmes, discount dental plans or payment instalment options at your dentist to manage costs efficiently.\

3. Can dental insurance cover family members differently?

Some plans offer separate limits or benefits for dependents, so review your policy to ensure coverage for spouses or children if needed.

4. What should I do in a dental emergency abroad?

Keep your insurance documents handy, contact your insurer immediately and confirm coverage before treatment. Emergency dental care abroad may only be covered under certain policies or riders.

Disclaimer: This blog provides information regarding dental care not covered in health plans in India. The information is provided for educational and informational purposes only. It may contain outdated data and information regarding the topic featured in the article. Verify the currency and relevance of the data and information before taking any major steps. ICICI Lombard is not liable for any inaccuracies or consequences resulting from the use of this outdated information.

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