Health insurance is no longer a luxury – it has become a necessity. A single hospitalization can wipe out your savings with medical inflation rising at 15-20% annually in India. However, not all policies are the same. Choosing the wrong plan can lead to claim rejections, hidden costs, or inadequate coverage.
To help you make the best decision in 2025, here are 10 important questions every Indian should ask before buying health insurance.
2. What’s the Claim Settlement Ratio (CSR)?
A high CSR (above 90%) means fewer claim rejections.
🔹 Check IRDAI’s latest report (e.g., 2024 data shows HDFC Ergo at 98%, while some PSU insurers are below 85%).
🔹 Also, check claim settlement time—some insurers delay for months.
3. Are There Sub-Limits or Co-Pay Clauses?
Many policies have hidden caps, like:
- Room rent limit (e.g., only ₹5,000/day in a ₹10,000 hospital room).
- Disease-wise sub-limits (e.g., only ₹50,000 for cataract surgery).
- Co-pay (you pay 20%, and the insurer pays 80%).
💡 Pro Tip: Zero sub-limit policies (like Niva Bupa ReAssure) are better but costlier.
4. Does It Offer Cashless Hospitalization?
✅ Cashless = No upfront payment in-network hospitals.
✅ Check if your preferred hospitals (Apollo, Fortis, etc.) are in their network.
⚠️ Warning: Some insurers deny cashless last minute, forcing reimbursement claims.
5. What’s the Waiting Period for Pre-Existing Diseases?
Most insurers impose a 2-4-year waiting period for diabetes, hypertension, etc.
🔹 Look for: Policies with reduced waiting periods (e.g., 1 year in Care Health Insurance).
6. Does It Cover Critical Illnesses?
Critical illness cover (cancer, heart attack, etc.) gives a lump sum payout.
✅ Check if it covers new-age diseases (e.g., post-COVID complications).
✅ Standalone critical illness plans (like ICICI Pru Heart/Cancer Protect) can supplement your base policy.
7. Is There a No-Claim Bonus (NCB)?
NCB = Reward for not claiming (e.g., 10-50% increase in sum insured).
🔹 Best in 2025: HDFC Ergo & Star Health offer lifetime NCB accumulation.
8. What’s the Renewability Policy?
✅ Lifetime renewability is a must (especially after age 60).
🚫 Avoid policies with age-based renewal restrictions.
9. Are Maternity & Newborn Benefits Included?
🔹 Waiting period: Usually 2-4 years.
🔹 Coverage: Normal/C-section delivery, newborn baby cover (for 90 days).
💡 Best for 2025: Aditya Birla Activ Health & Manipal Cigna offer good maternity riders.
10. How Much Will Premiums Increase Over Time?
⚠️ Many insurers hike premiums drastically after claims or age 50+.
✅ Ask: “What’s the maximum premium increase per year?”
✅ Compare long-term costs using IRDAI’s premium calculator.
Final Verdict: Best Health Insurance Picks for 2025
| Best For | Top Policy | Why? |
|---|---|---|
| Comprehensive Cover | HDFC Ergo Optima Restore | High CSR, restoration benefit |
| Senior Citizens | Star Health Red Carpet | No age limit, good renewal |
| Maternity Cover | Aditya Birla Activ Health | Low waiting period |
| Critical Illness | ICICI Pru Cancer Protect | Lump-sum payout |
🚀 Pro Tip: Use PolicyBazaar/InsureMile to compare policies in 2 minutes!
💬 Your Turn!
Which health insurance policy do you use? Share your experience in the comments!
📢 Found this helpful? Share with family — health insurance mistakes can cost lakhs!
