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A Health Insurance Checklist

Simplify your health insurance decisions with this checklist. Covering family, networks, reputation, pre-existing conditions, and exclusions.

  • 30 Oct 2017
  • 3 min read

Buying health insurance plans can be one of the most confusing decisions for anyone. There are a multitude of options available in the marketplace, but the widely varying premiums and coverage options make it very difficult for us to zero down on a particular policy.

Well, worry no more! Listed below is a detailed checklist that is an absolute must-have for anyone looking to buy health insurance. Make sure you are thinking through each of the points detailed here before making a decision.

Family coverage

While individual policies for each member of the family would be ideal and provide the best coverage, it may not be a financially feasible decision because of the significant premium payout. However, when you go in for family plan, make sure you check the "Sum Insured" before choosing your plan. Any expenses above this amount will not be covered, so it's important to take adequate cover right from the start. Remember, this amount cannot be increased once you've made a claim. You also need to ensure that the amount is sufficient for hospitalisations for more than one family member.

Network hospitals

While it may not seem relevant now, travel is a significant deterrent when someone is hospitalised. Hence, when choosing an insurer, make sure that they have reputable hospitals from your vicinity, within their network. This will also help you receive cashless treatment, a boon when you have so many other things to worry about!

Reputation in the marketplace

While this may seem like an obvious point, it deserves special mention. Look up your insurer's reputation online, and speak to friends and others who have some experience with insurance. Find out about their claim settlement process, the size of their network. Don't go for too-good-to-be-true providers, because when you need them the most, they will prove to be just that.

Pre-existing conditions

Many of us have pre-existing health conditions for which we need coverage. Any mention of a pre-existing condition could impose a waiting period on your insurance plan. Make sure you check the waiting period carefully. While some cap it off at 2 years, others can go up to 4 years! Certain procedures like knee replacement, cataract operations, etc., could also have a waiting period.

Also read:

Co-payments & Capping limits

Give preference to plans that do not impose any restrictions in the form of co-payments (where the insurer pays only after your expenses go beyond a set limit), treatment or room charge limits. While you may find that the premiums of such plans are higher, you are almost always at an advantage when emergency strikes.


Always take special note of the treatments, tests or illnesses that are excluded by your policy. Fail to do so, and you may end up either paying for a treatment that is already covered, or be stuck with a huge bill after the treatment is done.

Important things to remember:

  • Ensure that you follow and maintain a healthy lifestyle. Not only is this good for you, it is also good for your pocket. 
  • Don't wait too long to get insured, and don't keep waiting for dream policies that cover everything for next to nothing.
  • Focus on important aspects mentioned above, don't worry about very rarely used features (for e.g. - an ambulance would run you a minimal one time charge and is not a factor for your insurance plan)

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.  

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