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Your health is the most valuable possession you have, which is why you must take adequate steps to safeguard it from harm. Still, illnesses or accidents are rather common and may send you to the emergency room at any time.
With the current state and expense of healthcare in India, such unplanned visits to the hospital can leave your finances exhausted. Thankfully, individuals securing their health with medical insurance do not need to incur such unplanned expenses. A health insurance policy can help individuals finance their treatment, along with hospitalisation charges.
In some cases, policyholders may be able to avoid spending any money from their own pockets, while seeking medical care from network hospitals and clinics. Additional benefits of health insurance plans include, pre and post hospitalisation expenses cover, daycare expenses reimbursement and attractive annual tax benefits.
Take a look at the list of health insurance companies in India.
Now that you have seen the list of health insurance companies in India, understanding the difference between Insurance company, Insurance broker and Insurance Aggregator is also important.
An insurance aggregator is more of an intermediary that focuses on insurance policies from different insurance companies so that the end-user has an array of choices in as many ways as possible. Intermediaries acquire data from various insurers and organise it to allow consumers to compare product features, advantages, and premiums.
On the other hand, a health insurer can be described as an entity that issues health insurance policies, bears the risk and processes claims. They cater to exigent factors like compensation for harm and other occurrences, including emergencies and other risks related to medical circumstances.
To sum it up, an insurance aggregator allows you to see the differences in various insurance plans of different insurance companies. In contrast, a health insurer provides health insurance and is directly in charge of the insurance policies.
The market segment of health insurance, in India especially, has been seen growing and evolving rapidly in a relatively short period. Let’s see how:
Nonetheless, issues persist, including low penetration and the need for enhanced awareness and training, particularly in rural areas. Furthermore, India’s health insurance sector is expected to grow significantly shortly due to various factors such as economic liberalisation, rising income levels, the predominance of diseases, and technological advancement.
The legal framework governing health insurance in India involves several key regulations and authorities. The primary legal environment of the sector is determined by the Insurance Act of 1938.
The Insurance Regulatory and Development Authority Act of 1999 established the IRDAI, which oversees the insurance sector, protects policyholders' interests, and ensures market stability. Below are a few legal things to remember:
However, ow penetration remains one of the main challenges, and much still needs to be done through awareness, especially in rural areas. Technological advancements like telemedicine are expected to drive growth.
Here are some of the new rules introduced by the Insurance Regulatory and Development Authority of India (IRDAI) for health insurance in 2024:
If you keep the following things in mind, the health insurance plan you end up purchasing will likely provide sufficient financial coverage to you.
You need to be able to rely on your health insurance provider during medical emergencies. Thus, checking a company’s ratings on social media and other places online is an essential part before selecting it as your insurance provider. Keep your eyes peeled for negative comments or problems, which existing customers of the company faced with its products or service.
The Insurance Regulatory and Development Authority of India is a government entity, which is responsible for the regulation of insurance companies in India. Companies registered under it must abide by its guidelines, maintaining sufficient transparency in their activities. Thus, it is always wiser to stick to such IRDAI approved companies when availing medical insurance for yourself or your family.
During a medical emergency, you may have extremely limited scope or time to arrange funds for treatment. At such a time, you require an insurance company that is quick to approve claim requests, providing the necessary financial assistance to ensure that proper care is not delayed. Before picking your insurance company, check its claim settlement ratio. It should give you a fair idea about the percentage of claims the company settles out of the ones it receives. Needless to say, higher ratios are desirable.
Policyholders can avail cashless treatment at an insurance company’s network hospitals and clinics. In these cases, one does not need to file an insurance claim or follow a reimbursement procedure to acquire financial compensation. Instead, medical bills accrued are directly settled between the insurer and the hospital in question. Look for companies with a maximum number of network outlets, so that you can avail cashless treatment every time.
A complicated claim filing procedure can leave you bogged down with formalities during an emergency. When a medical emergency strikes, you cannot afford to fill piles of paperwork to acquire the financial assistance you deserve. Therefore, before picking your health insurance company, always ensure that the provider follows a simple and hassle-free claims procedure, which is not time-consuming or confusing.
The amount of money you pay to afford medical coverage is another important factor to consider before purchasing a plan. Nevertheless, do not go by price alone. Instead, look for the policy with the best value for money. Compare prices while also considering the policy inclusions and exclusions. Doing so should help you pick an economic plan without compromising financial security during medical emergencies.
Perhaps the most important bit of advice for a potential health insurance buyer is to stick to purchasing such policies directly from the insurance company.
Many prefer to go through agents when buying medical insurance as they have their own trusted resources helping them with crucial financial decisions.
However, many don't prefer to buy through agents.
Let’s learn why!
The following are some of the benefits of buying health coverage from a company, as opposed to from sources or brokers:
Brokers or agents often do not reveal all of the health insurance products available from a particular company. They try to limit your knowledge to just the costlier options since they can secure a greater commission from such options. Direct purchase from insurers prevents such limitations.
Insurance companies offer a range of customisation options to its policyholders, using which you can modify health insurance policies to suit your specific needs. A broker, selling you a plan, may not disclose such customisations due to which you would be stuck with a basic policy.
Agents or brokers act as mediating parties between you and the company offering medical coverage. When you decide to buy from such a broker, you are paying an additional fee as part of your policy premium, which is pocketed by this agent as commission. Thankfully, no such fee is necessary when you deal directly with the insurance company.
Brokers will scarcely offer you a chance to look at all your options. Instead, they will hurry you along to purchase the insurance policy they have to offer. When you approach companies directly, you can take your time to compare and research the various plans available to you. Only after you make an informed selection do you need to sign the policy documents.
A health insurance policy can be the difference between life and death. Therefore, do not take decisions related to such coverage lightly.
Read all terms and conditions in your policy documents to understand what it covers and what it does not. Doing so will help you maximise its benefits in the long term.
Understand the difference between insurance companies, aggregators and brokers.
Insurance Company |
Aggregators |
Brokers |
Insurance companies are businesses responsible for creating insurance products and selling them to customers. |
Aggregators are third party entities who list all available insurance options, along with relevant data for potential customers to compare. |
Brokers are mediating parties between an insurance company and its customers. |
Role - Produce various insurance products for customers and offer adequate financial support to individuals who purchase these products. |
Role - Offers a platform to potential insurance buyers to compare the various plans available so that they can pick the most suitable option. |
Role - Sell or market insurance products to customers on behalf of the insurance company to earn a commission. |
Employed By - None |
Aggregators are third parties with no affiliations to any insurance companies operating in the market. |
Brokers are often employed by the insurance company. Alternatively, they may be affiliated to such companies through a commission programme. |
An insurance company is responsible for settling all credible claims from its policyholders. |
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