What factors should I consider while choosing a health insurance policy?

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I am 43 years old with two kids and currently posted in Mumbai. My spouse is 39 years old. I want to buy a health insurance policy for my family of three dependents. Please suggest suitable health insurance policy options. Also, suggest how much insurance cover would be enough in Mumbai and what factors I should look into while choosing the right health insurance policy?


One should have at least 10 -15 lakh of base plan in combination with a low-cost super top-up plan from the same insurance company. We recommend the below-mentioned options with premiums :

1. 10 Lakh of Reassure Plan from Niva Bupa + 40 lakh of Recharge super top-up from Niva Bupa – Rs. 24788(Base)+ 2079(Super Top-up)= 26867

2. 10 lakh of Prohealth Protect Plan from Manipal Cigna + 30 Lakh of Super top-up plan – 28524 (Base) + 2490 (Super Top-up) = 31014

3. 50 Lakh of Lifetime Health Plan – Domestic from Manipal Cigna Health insurance Co. – 32214

Factors to consider before choosing the right health insurance:

1. Selecting the right insurance amount/Sum insured: At the time of selecting a health insurance plan, one should select the amount wisely as it covers the medical expenses for a year. One should also take a look at his or her income levels to analyze the premium affordable. One should have a Sum insured which is 1.5 times of your annual income (Self + Spouse put together).

2. No Claim Bonus: NCB refers to the incentive offered by the insurance company for all the years that you have not filed a claim. Typically it varies from 5 to 50% p.a depending on the insurance company and plan. Your coverage amount is increased at the time of subsequent policy renewals for all claim-free years. This factor ensures that the policy is future-ready to get a sizable sum insured enhancement every year. It will ensure that ever so increasing medical inflation doesn’t eat into your sum insured over a period of time.

3. No disease-wise capping: This refers to a capping put on various illnesses irrespective of the sum insured in the policy. There shouldn’t be any capping of diseases.

4. Cappings on room & ICU charges in a hospital: This refers to the limit on Room rent and ICU charges on a per-day basis. One must look at buying a policy that covers rooms on a single occupancy basis with actual charges covered for ICU admission.

5. Additional features: There are features like Refill/Annual Free health check-up every year/Wellness features /OPD etc which makes a health insurance policy a “New Age health insurance Plan.”

Query answered by Sanjiv Bajaj, joint chairman and MD, Bajaj Capital. 

(Send your queries and views to [email protected])

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