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Who Cannot Be Covered Under A Family Floater Policy?

Family floater policies offer extensive coverage, but there are specific exclusions. In this article, we outline who cannot be covered under a family floater policy, providing clarity on the limitations and exceptions.

  • 03 Nov 2023
  • 3 min read

Family floater health insurance is designed to typically cover your entire family within a single insurance arrangement. With family floater health insurance, you have the option to include your spouse, children, parents, and dependent in-laws and siblings under one unified coverage. This policy comes with a predetermined sum insured and covers various medical expenses like hospitalisation, pre and post-hospitalisation costs, day-care procedures, and ambulance fees. Depending on the policy's terms and conditions, it might also extend its coverage to include your maternity expenses, newborn care, and pre-existing medical conditions. By understanding who cannot be covered under a family floater policy, you can make an informed decision about purchasing this insurance.


People that cannot be covered under family floater plan

Typically, almost every family floater policy defines a family uniquely, and there are specific rules governing who can be included and who cannot be covered under a family floater policy. The definition of family typically includes your spouse, children and parents. Some policies may offer coverage for siblings and parents in law, if they are financially dependent on you. However, uncles, aunts, grandparents, cousins and other relatives cannot be covered under a family floater plan. The specifics differ from insurer to insurer.  

It's also important to note that certain policies impose a restriction on the count of adult family members covered, allowing up to a maximum of two adults in some cases. In contrast, others are more lenient, extending coverage to as many as four adults within a single policy.

Following are some exclusions applicable for the floater across age groups:

  • Family floater health insurance plans generally don't cover pre-existing medical conditions. This means that if any member within your family already has a health issue diagnosed before you acquired the insurance policy, the costs tied to managing that specific condition might not be included in the protective coverage of the policy. However, these costs are usually covered after a fixed period of time such as 24 or 36 months.
  • When considering a family floater plan, remember that expenses related to cosmetic procedures—like plastic surgery or hair transplants—are usually not covered unless these procedures are deemed medically necessary and can be proven as such.
  • It's vital to understand that expenses not directly associated with medical treatments, which typically include administrative fees, service charges, or admission expenses, typically aren't included by these insurance policies.
  • Moreover, family floater health insurance policies often don't account for expenses resulting from self-inflicted injuries or injuries sustained during risky activities or sports engagements.
  • Keep in mind that instances involving health hazards or disorders arising due to nuclear or radioactive incidents in your geographic vicinity aren't part of the coverage provided by family floater health insurance plans.
  • Medical costs that emerge due to the consumption of intoxicating substances are usually excluded from the coverage scope of family health insurance plans.

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In summary, family floater health insurance policies present a holistic approach to include your entire family under one insurance plan. However, it's crucial for you to be mindful of the exclusions inherent in these policies. Prior to finalising your policy, always ensure a thorough review of the terms and conditions within your family floater insurance plan to gain a thorough understanding of its coverage and limitations.

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