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Insurance Article

What to look for in a health insurance policy in India?

April 15 2013

To extract maximum benefits from an insurance plan, you should know about things that are excluded in your plan. Here are some of the most important exclusions to take into consideration when buying health insurance policy in India:

Health Insurance Policy Exclusions

Pre-existing Diseases

These diseases are excluded from the policy at the time of purchase. Moreover, complications arising from pre-existing disease will also be measured as part of pre-existing health condition. An insurance company usually covers an individual after excluding these illnesses (if any).

Tip: You must disclose the physical conditions you are aware of. In case, you don't, problems may occur during insurance claims.

Specific Diseases

Did you know some diseases are excluded in the initial (1st) year of the health insurance policy?

Nuclear Weapon Damage

Disease, illness or a physical condition developed due to nuclear weapon risks are usually excluded from health insurance benefits.

War Related Damage

All kinds of injuries, illnesses and diseases caused by war are excluded from health insurance policy and critical care insurance plan.

Tip: You should discuss with an insurance representative about what is covered under terrorist activities

Accident Related Diseases/Injury

Health insurance in India will not cover you for expenses on injury or diseases incurred especially if it has been incurred during the initial thirty days from policy initiation (with an exception of accident related problems).

Tip: Remember that first thirty days are not covered by a health policy.

Pregnancy and childbirth

Usually this facility is excluded in general medical insurance plan. However, many companies are still offering this facility. You need to check out with your insurance provider about these facilities prior to actually signing the dotted line.

Tip: In case, you are planning a family, it is crucial to check this facility in your insurance plan prior to investing your hard earned cash.

Cosmetic Treatment

The health insurance policy will not cover you for cosmetic dental treatment, plastic surgeries for cosmetic reasons, spectacles costs etc.

Tip: Plastic surgery required for treatment after accident or illness can be covered.

Alternative Treatment

All kinds of treatment and medication options other than allopathic such as Unani, homeopathy, naturopathy, ayurvedic etc are excluded from health insurance plan.

Tip: You need to check with your insurance service provider if any of the psychological and physiological treatments are covered.


All medical expenses incurred due to the treatment of HIV or AIDS are excluded from the health insurance cover. You should check this clause with your insurance provider. Know whether or not it excludes the condition and expenses incurred due to the same.

Liquor and Drugs

Any damage, illness or injury occurring due to misuse/abuse of drugs or alcohol is not covered in health insurance policy.

Tip: You may check with an insurance provider about accidents that happen under influence of alcohol.

The above mentioned are a standard list of exclusions maintained by health insurance companies in India. However, it is always wise to read the terms and conditions before you actually take a decision. Know what the company has to offer at various circumstances.

Tip: When buying health insurance policy and critical care insurance plan, it is crucial that you take utmost care and go through the policy document carefully. You must take care of this prior to signing the insurance papers.
How to Reduce Health Insurance Policy and Critical Care Insurance Plan Premium Prices? Early Buying

Buying a health insurance early will help you pay lesser on premiums. There are less chances of getting ill during young age. Hence, most companies charge less premium rates.

Don't Smoke

Smoking exposes you to a variety of cancerous disease and health problems. Reducing or quitting smoking now will help you prolong your life.

Timely Payments

Paying your insurance bills late is not a good sign. This will make you lose the benefits. The best way is to opt for auto payment through banking. This will avoid any delay in payments.

Reputed Bigger Company

It is crucial to buy premium only from bigger companies. Most reputed health insurance companies are offering better premium rates to their customers with guarantee for better protections. Reputed and bigger companies are also trustworthy as they have a huge and loyal customer base.

Records from the Doctor

It is very important that you log your health properly by a health care practitioner. A simple error may cost you a fortune. Hence, make sure you get the report to your family medical practitioner and get him to verify it for you.

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