List of Health Insurance Companies in India in 2024
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.
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.
List of Health Insurance Aggregators in India
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.
How is the Health Insurance Market in India?
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:
- Valued at approximately USD 12.86 billion in 2022, the market is expected to grow at a compound annual growth rate (CAGR) of 11.55% from 2023 to 2030, projecting a market size of USD 82.5 billion by 2030.
- The significant factors for this growth include rising healthcare expenses, people’s awareness and income, large-scale government interventions such as the Ayushman Bharat Scheme, and, due to the influence of COVID-19, the issue of health insurance.
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.
Legal Frameworks Governing Health Insurance in India
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:
- The IRDAI's Health Insurance Regulations of 2013 standardise terms, conditions, policy wordings, and claims procedures for transparency and fairness. Moreover, the 2013 Guidelines on Standardisation in Health Insurance make policies more understandable and comparable.
- The chief regulating authority for insurance in India is the Insurance Regulatory and Development Authority of India (IRDAI), responsible for granting insurance firms licences, establishing regulatory measures, and overseeing compliance with these measures. It also helps safeguard customer interests and facilitate markets.
- Ayushman Bharat – PM Jan Arogya Yojana and Rashtriya Swasthya Bima Yojana are significant policies in India. PM-JAY is a free healthcare scheme adapted for low-wage earners and includes hospitalisation, while RSBY is health insurance for families in the lower income bracket.
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.
IRDAI New Rules for Health Insurance
Here are some of the new rules introduced by the Insurance Regulatory and Development Authority of India (IRDAI) for health insurance in 2024:
- Cashless Claims Processing: Insurers must accept or reject cashless claims within one hour and settle them within three hours of discharge.
- Age Limit Removal: Health insurance policies can now be offered to individuals of all age groups, including those above 65 years.
- Reduced Waiting Periods: The waiting period for pre-existing diseases (PEDs) has been reduced from four years to three years. The waiting period in health insurance for specific diseases or treatments has also been reduced from four to three years.
- Coverage for Severe Medical Conditions: Insurers cannot refuse health policies for individuals with severe medical conditions such as heart disease, renal failure, or AIDS.
- No Sub-Limits on AYUSH Treatments: Sub-limits on AYUSH (Ayurveda, Yoga, Unani, Siddha, Homeopathy, and Naturopathy) treatments have been removed, allowing policyholders to claim expenses up to their maximum sum insured.
- Policyholder Rewards: Insurers are required to reward policyholders with no claims during the policy period by offering either an increased sum insured or discounted premium amounts.
- Premium Refunds: Policyholders can receive a premium refund for the unexpired policy period if they cancel it mid-way.
- Renewability: All individual health policies are renewable and cannot be denied based on previous claims, except in cases of fraud, non-disclosures, or misrepresentation.
- Portability Requests: Stricter timelines have been imposed on portability requests via the Insurance Information Bureau of India portal.
- Customer Information Sheet: Insurers must include a customer information sheet in the policy document, explaining all customer-facing details such as policy type, sum assured, coverage details, exclusions, deductibles, and waiting periods.
Things to Check Before Choosing Health Insurance Policy
If you keep the following things in mind, the health insurance plan you end up purchasing will likely provide sufficient financial coverage to you.
The Reputation of the Brand
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.
IRDAI Approval is Must
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.
Track Record of Claim Settlement
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.
Network Hospitals
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.
Hassle-free Claims Process
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.
Health Insurance Premiums
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!
Benefits of Purchasing Health Insurance Directly from Insurance Company
The following are some of the benefits of buying health coverage from a company, as opposed to from sources or brokers:
Choose from Various Options
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.
Customising Insurance Plans As Per Your Needs
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.
No Commission Payments
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.
Compare Various Products
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.
Why Should You Choose Digit for Health Insurance?
Simplified Process
- Easy Online Access: Seamless is an online platform for purchasing and managing policies.
- Minimal Paperwork: Reduced paperwork for a more efficient experience.
Customer-Centric Approach
- Transparent Policies: Clear terms and conditions for better understanding.
- Customer Support: Robust support to assist with queries and issues.
Innovative Products
- Diverse Offerings: Range of products, including term insurance and group credit protection.
- Customisable Plans: Policies tailored to individual needs for flexibility.
Competitive Pricing
- Affordable Premiums: Competitive pricing for broader accessibility.
- Value for Money: Affordable premiums with comprehensive coverage.
Technological Integration
- Digital Tools: Technology for monitoring policies, making claims, and receiving updates.
- User-Friendly Interface: Intuitive platform for easy navigation.
Insurance Company vs Insurance Aggregators vs Insurance Brokers
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. | NA | NA |
FAQs about Health Insurance Companies in India
What factors should be taken into account when purchasing medical coverage from insurance companies?
- Coverage and Benefits: Ensure the policy covers various medical expenses, including hospitalisation, pre and post-hospitalization, and critical illnesses.
- Network Hospitals: Review the roster of network hospitals for cashless treatment.
- Premiums and Deductibles: Compare premiums and understand the deductible amounts.
- Waiting Periods: Look at the waiting periods for preexisting conditions and specific treatments.
- Claim Settlement Ratio: Consider the insurer's claim settlement ratio to gauge reliability.
Why is IRDAI approval critical when choosing insurance companies?
IRDAI approval ensures that the insurance company operates under strict regulations and guidelines, protecting policyholders' interests and ensuring financial stability and transparency.
What is the reason for the lower cost of health insurance policies when bought directly from the insurance provider?
Health insurance policies are often cheaper when purchased directly from the insurance provider because no intermediary commissions or fees are involved, reducing the overall cost.
Which insurance providers extend health insurance coverage in India?
In India, health insurance is available from all life, general, and health insurance companies registered with IRDAI. General and health insurers offer indemnity and benefit-based policies, while life insurers adhere to benefit-based policies under Health Insurance Regulations. Additionally, these companies provide personal accident, domestic travel, and overseas travel insurance.
Are there guidelines or principles governing how health insurance coverage premiums are determined?
The Health Insurance Regulations, 2016 outlines specific principles for pricing health insurance products offered by life, general, and health insurers. These principles include:
- Insurers must base the premium of health insurance policies on factors such as age for individual and group policies and other relevant risk factors.
- When providing coverage under a family floater policy, insurers must consider the impact of the multiple rates applicable to all family members covered.
- Premium rates filed for approval should generally remain unchanged for at least three years after a product has been cleared, per the guidelines specified by the regulatory authority. After this period, insurers may revise premiums based on their experience, subject to further regulatory conditions ensuring stability in pricing adjustments.
What does health insurance policy portability entail?
Health insurance "portability" allows policyholders to transfer credits for preexisting conditions and exclusions between insurers. The new insurer assesses the proposal and communicates its decision. Portability applies to the sum insured from the previous policy and may include an increased sum insured upon the insured's request.
What is the Grace Period of a health insurance?
The grace period in health insurance is a specific time frame immediately after the premium due date. During this period, policyholders can renew or continue their policy without losing continuity benefits, such as waiting periods and coverage for preexisting conditions. No coverage is provided for periods when premiums are not received.
What is a premium in health insurance?
A premium is the amount you pay periodically (monthly, quarterly, or annually) to keep your health insurance policy active. It is the cost of purchasing the insurance coverage.
Can I switch my health insurance plan?
Yes, you can switch your health insurance plan during the renewal period or through the portability option provided by the IRDAI. Portability allows you to transfer your existing benefits and waiting periods to a new insurer without losing coverage.