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What is Health Insurance: Health Insurance's Meaning Explained
Mar 30, 2023

What is Health Insurance Policy?

Health is one of the most important facets of your life, and it is in your best interest to have insurance that can cover you in case you face any health-related issues. Health insurance is one such financial product that can take care of the finances if you or your family members have a medical emergency. Health insurance is a crucial investment in today's world, where medical costs are on the rise, and healthcare has become expensive.

What is Health Insurance?

Health insurance is a type of insurance that provides financial coverage for medical expenses and treatments. It is a contract between the insured person and the insurance company, where the insured pays a premium in exchange for the promise of the insurance company to cover the medical expenses incurred by the insured person/persons. Having a health insurance policy gives you peace of mind in times of crisis and provides you access to quality healthcare services. Now that you may know what health insurance is , check out the features and coverages of health insurance offered by Bajaj Allianz: *
  • Coverage for pre- and post-hospitalisation charges
  • Coverage for in-hospital expenses, room rent and boarding expenses
  • Doctor's consultation fees
  • Ambulance charges
  • Cashless claim facility available at 6000 + network hospitals
Multiple customised health insurance plans are available to suit different sets of requirements, such as for individuals, family members, senior people, pregnant women, critical illness patients, and so on.

Types of Health Insurance

Are you wondering what the different types of health insurance policies are and what each health insurance policy is like? Here is a brief overview of the several types of health insurance policies available in the market, each with its features and benefits, so that you can choose which suits you the best.
  1. Individual Health Insurance

    This type of health insurance policy covers a single person and provides coverage for hospitalisation, medical expenses, and treatments. * It covers individuals who are 18 years of age and above. It offers sum insured options ranging from INR 1.5 lakhs to INR 50 lakhs and comes with a lifelong renewal facility. The premium for an individual health insurance policy is based on the age, health condition, and medical history of the insured person.
  2. Health Guard Family Floater Plan

    This family floater health insurance covers the entire family under a single policy. The SI (Sum Insured) options range from INR 1.5 lakhs to 50 lakhs with these plans for families. Policy term options offer extended coverage for up to 3 years. The premium for a family floater health insurance policy is based on the age, health condition, and medical history of the family members covered under the policy.
  3. Critical Illness Insurance

    Critical illness insurance is a type of health insurance policy that covers specific critical illnesses such as cancer, heart attacks, strokes, and kidney failure. * The policy pays a lump sum amount on the diagnosis of the critical illness, which can be used to cover medical expenses and loss of income.
  4. Silver Health Insurance plan

    This insurance plan is specifically designed to cater to the needs of the elderly. The entry age for this insurance plan is 46 years to 70 years with a lifelong renewal option. This plan provides the financial security you need in your later years by covering you for the medical treatments you require in your old age. *
  5. Extra Care Plus Policy

    It is an additional cover available to you, over and above your existing cover. This is a top-up plan that can prove beneficial in case you exhaust your SI during the treatment.* While these are a few of the plans that have been elaborated on here, there are many more plans and top-up covers, which you can check on our website. All the plans come with a fixed set of features, inclusions, and exclusions. It is best advised that you should thoroughly go through the policy wording to avoid any confusion while filing the claim.
Now that you may know what health insurance is and the different types of plans offered, let us look at the benefits one can gain from health insurance.

Benefits of Health Insurance

The following are the benefits of the health insurance plan offered by Bajaj Allianz:
  1. Financial Coverage

    Health insurance provides financial coverage for medical expenses and treatments, which can help you manage your expenses and reduce your financial burden. Our health insurance policies provide maximum coverage at very reasonable premium rates.
  2. Quality Medical Care

    With our health insurance, you have access to quality medical care and treatment, which can ensure that you receive the best possible medical care.
  3. Peace of Mind

    Health insurance provides peace of mind, knowing that you and your family are protected against the financial implications of medical emergencies.
  4. Hassle-free claim settlement

    We offer 24/7 call assistance for claims settlement. Additionally, we have an in-house Health Administration Team (HAT) for faster and more efficient claim settlement.
  5. Tax Benefits

    The premium paid for health insurance is eligible for tax benefits under Section 80D of the Income Tax Act.
Note that tax benefits are subject to changes in tax laws. Furthermore, you can buy and renew health insurance online, which can save you a lot of time and the troubles of substantial paperwork. You also get the benefit of health CDC, which allows you to register a claim through our app - Insurance Wallet

What Is Long-Term Health Insurance?

There is another type of health insurance which you should know about. However, what differentiates this policy from other types is not the scope of coverage but the tenure. Are you wondering what like? Let us help. The shortest term offered for health insurance in India is one year. However, there is an option to get a health insurance policy for more than 1 year. You can extend the tenure of your insurance plan for up to 3 years, which offers you coverage for a long time and saves you from the task of yearly policy renewal. You might also earn some savings on your premium if you opt for a long-term policy. You can also take advantage of the cumulative bonus for each claim-free year. Most health insurance policies also provide cover for pre- and post-hospitalisation expenses, which have occurred 60 days prior to hospitalisation or 90 days after hospitalisation respectively. **

How Does Health Insurance Work?

By now, you may be clear on what health insurance is, its features and benefits, as well as various other aspects. Now, let us understand how the concept of health insurance works. Health insurance works on the principle of risk-sharing. When you purchase health insurance, you are expected to make premium payments on a regular basis to the insurance company. In exchange, the insurance company agrees to cover your medical expenses and treatments up to the sum assured. When you need medical care or treatment, you can approach any of the network hospitals associated with your health insurance plan. The hospital will send the bills to the insurance company, which will verify the bills and approve the claim. If the claim is approved, the insurance company will settle the bills directly with the hospital, and you do not have to pay anything out of pocket. If the claim is rejected, you will have to pay the medical expenses yourself.

Why Do You Need Health Insurance Now?

Simply knowing what health insurance is, may not be enough; one must also know its importance and significance in today’s world. Having health insurance is not mandatory in India as per the law, but it is a must-have for availing hassle-free medical treatment and handling your health care expenses. Here are some reasons why you need health insurance now:
  1. Rising Medical Costs

A health insurance plan helps you deal with the finances when you or your loved ones undergo medical treatment. The costs of medical procedures and medicines are sharply rising, making even basic treatments out-of-reach for common people. Health insurance provides financial coverage for medical expenses and treatments, which can help you manage your expenses and reduce your financial burden.
  1. Protects Your Savings

In the absence of health insurance, medical expenses can be a significant drain on your savings. Health insurance provides financial coverage for medical expenses, which can help you protect your savings and investments. Thus, health insurance becomes the best tool to minimise your out-of-pocket expenses, helping you keep your savings in reserve.
  1. Cashless Hospitalisation

You may have heard the term ‘cashless health insurance’ and may be wondering cashless health insurance. It is a feature within health insurance wherein the hospital bills are directly paid for by the insurer. This feature can be accessed via network hospitals only. * With a large number of network hospitals spread throughout the country, we ensure that no matter where you are, you and your loved ones receive the best medical care without you having to pay hefty medical bills.

How to Choose a Good Health Insurance Plan?

Choosing the right health insurance plan can be a daunting task, given the number of options available in the market. Here are some factors to consider while choosing a good health insurance plan:
  1. Coverage:

    The coverage offered by the health insurance plan is an essential factor to consider. Make sure that the plan provides comprehensive coverage for medical expenses and treatments, including pre and post-hospitalisation expenses.
  2. Network hospitals:

    Check if the health insurance plan has tie-ups with a network of hospitals in your area. This can ensure that you have easy access to quality medical care and treatment.
  3. Premium:

    The premium for the health insurance plan is an important factor to consider. Make sure that the premium is affordable and fits your budget.
  4. Claim Settlement Ratio:

    * Check the claim settlement ratio of the insurance company before choosing the health insurance plan. A high claim settlement ratio indicates that the company has a good track record of settling claims and provides timely and hassle-free claim settlement.
  5. Exclusions:

    Check the exclusions in the health insurance plan to understand what is not covered under the policy. Make sure that you are aware of the exclusions before signing up for the policy.
  6. Co-payment and Deductibles:

    Co-payment and deductibles are the amounts that you need to pay out of pocket before the insurance company starts covering medical expenses. Check the co-payment and deductibles of the health insurance plan before choosing it.

Which Plan to Buy - a Mediclaim Plan or a Critical Illness Insurance Plan?

While both mediclaim and critical illness Insurance plans provide financial coverage for medical expenses, they are designed to meet different needs. Here are the major differences between the two:
  1. Coverage:

    Mediclaim plans cover hospitalisation expenses, medical expenses, and treatments, while critical illness insurance plans cover specific critical illnesses such as cancer, heart attack, stroke, and kidney failure. *
  2. Payout:

    Mediclaim plans pay out the actual expenses incurred, while critical illness insurance plans pay a lump sum amount on the diagnosis of the critical illness.
  3. Premium:

    The premium for critical illness insurance plans is generally higher than mediclaim plans, as the coverage is for specific critical illnesses.
  4. Exclusions:

    The exclusions in the two plans differ, and it is essential to understand what is not covered under each plan before choosing them.
Please note that mediclaim and health insurance are not to be used interchangeably. It is important to explore each of these & understand the difference between mediclaim and health insurance, so you do not make an uninformed purchase in haste.

What Is the Claim Process For Health Insurance?

Health insurance claims can be registered either offline or online. For offline claim registration, you can call on our toll-free number - 1800-209-5858, where our executive will guide you through the complete claim registration process. For online claim registration, you can follow the steps mentioned below:
  • Cashless claims

For cashless claims, you need to approach the network hospital with your policy details. The hospital will verify your details and send the pre-authorisation form to the insurance company. This form is scrutinised by the insurance company, and it conveys the policy coverage and details to the hospital if the claim is approved. The insurer might also send a query letter asking for more details from the hospital.
  • Reimbursement claims

If you do not go to a network hospital, then you will need to file a reimbursement claim. In this case, you need to collect all the required documents from the hospital and submit the same to the insurance company. The insurance company will then verify these documents and then decide to either approve or reject the claim. In case it finds that some of the documents are missing, it will intimate the same to you and begin the claim process after you send all the remaining documents. You can also opt for more than one health insurance plan and register the claim under multiple health insurance policies.


We hope this article has helped you understand what health insurance is and explained its importance. We recommend that you get yourself and your family members a suitable policy post thorough research and comparison to stay covered in the event of any medical emergency.   * Standard T&C apply. ** All savings are provided by the insurer as per the IRDAI-approved insurance plan. Insurance is the subject matter of solicitation. For more details on benefits, exclusions, limitations, terms, and conditions, please read the sales brochure/policy wording carefully before concluding a sale.

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