Personal health insurance companies

Whether you are buying health insurance for the first time or looking for additional cover on top of a family floater plan, you should consider the plans offered by personal health insurance companies with a high claim settlement ratio (CSR). You can find a list of insurance providers that offer flexible policies to the customers and provide adequate coverage on this page. Many of these insurance companies also offer insurance for families, corporate groups, vehicles, and more, in addition to individual health insurance.

Before diving in the list of best personal health insurance companies, let’s first understand the need of buying health insurance.

Why should you buy health insurance?

Health insurance is an effective tool that can help you navigate any medical crisis in the future without exhausting all of your finances. Following are the reasons you should invest in personal health insurance:

1. Beat rising medical expenses

In 2021, India reported medical inflation at about 14%, highest in the Asian region. Healthcare costs are on a steady rise, investing in an individual policy from a reputed health insurance company should be your priority, especially if you are the sole source of income for your family.

2. Safeguard and maximise savings

A health insurance policy provides coverage for your medical expenses, which can be extremely helpful in a case of an unexpected medical crisis. You don’t have to worry about exhausting your savings for availing medical care and, therefore, can focus on building wealth. You can also avail of tax deductions on the policy premium under the Section 80D of the Income Tax Act.

3. Protect yourself against mental health problems, lifestyle diseases, and chronic ailments

Conditions, such as diabetes, obesity, PCOS (polycystic ovarian syndrome), depression, and anxiety, can be debilitating for people. In addition, medical expense for all these conditions can be burdensome on an individual without a health insurance cover. Although the government is taking initiatives for improving mental health situation in India by offering dedicated insurance policies, coverage for these treatments may or may not be provided under your regular policy.

4. Avail quality treatment for critical Illnesses

Critical diseases, including cancer, have hefty treatment costs, and some people may not be able to get appropriate medical attention due to the lack of funds. Investing in a medical insurance policy can help you minimise financial lead.

Some of the personal health insurance companies in India

Today, it is easy to buy a health insurance plan with the numerous policy options offered by insurance providers online through their website. You can compare different policies and make your decision. Here’s a list of leading insurance providers in India:

1. HDFC Ergo

Well renowned in the industry for its excellent customer service and swift claim settlement process, HDFC Ergo has emerged as one of the best personal health insurance companies in the past 20 years since its inception. Many people find 24 × 7 support received from HDFC Ergo’s claim support team quite convenient. HDFC Ergo is tied up with more than 13,000 network hospitals, where policyholders can avail cashless treatment. It is evident that HDFC Ergo places great importance in maintaining the privacy of their customer and in keeping their data safe since it is ISO 9001:2008 certified. In addition, HDFC Ergo has a 97% claim settlement ratio (CSR), which means they have successfully settled about 97 claims out of every 100 claim requests.

Optima Restore Individual Health Insurance plan by HDFC Ergo is a suitable choice for individuals. Here’s a list of key features of this plan:

1. Restoration of the entire basic sum after an individual raises their first claim
2. An increase of 50% in the basic sum insured every claim-free year (up to a max of 100% increment)
3. Available sum insured ranges from INR 3 to 20 lakhs
4. Coverage for medical expenses including pre and post hospitalisation, in-patient department (IPD), organ donor, day care, and stem cell therapy.

2. Care Health Insurance

Formerly known as Religare Health Insurance Company Ltd., Care Health Insurance is a leading insurance company in the private sector that is tied up with 19,000+ network hospitals. Care Health Insurance has settled over 30 lakhs claims and have a 95.2% CSR; Care Health Insurance is known to settle cashless claims in about 2 hours. Additionally, its convenient app enables policyholders to check their claim status, access and download policy documents, and locate network hospitals nearby among other things.

One of Care’s best health insurance plans for individuals is Care Advantage that provides the maximum coverage of 1 crore. Following are the highlights of this policy:

1. Three options for sum insured—25 lakhs, 50 lakhs, or 1 crore
2. Lifetime renewability
3. No-claim bonus (50% of the sum insured) for every claim free year
4. Available for children from the age of 5 and lifelong eligibility for adults
5. Coverage for treatment expenses for IPD, day care, organ donor, and pre and post hospitalisation, etc.
6. Automatic coverage recharge in case the sum insured is exhausted once during a policy year
7. Optional top-up to enjoy unlimited automatic recharge
8. Option to top-up the policy to waive off 20% co-payment charges
9. Air ambulance cover up to 5 lakhs
10. Free annual health check ups

3. TAGIC 

TAGIC, short for Tata AIG General Insurance Company, has been providing health insurance to people since past 20+ years and is one of the best personal health insurance companies in India. Over 5 crore customers have purchased health insurance from TAGIC. TAGIC has a 97% CSR, and one of their individual policies (Medicare Premier) is available at about INR 800/month. People can avail cashless claim facility by availing treatment at any of the 7500+ network hospitals pan India.

Let’s look at the features of Tata Medicare plan:

1. Global cover that gives people freedom to get treatment outside the country if the diagnosis is made in India
2. Wellness services to maintain good health including 8 consultations over the phone with qualified medical professionals in a year
3. Coverage for the vaccination-related expenses of diseases such as hepatitis B, human papilloma virus (HPV) after 2 years of continued coverage and typhoid and rabies without any waiting period
4. Coverage for AYUSH (Ayurveda, Yoga & Naturopathy, Unani, Siddha, and Homeopathy) treatment, bariatric surgery, and domiciliary treatment
5. No medical checks before buying insurance for people who are 45 years old or younger
6. Coverage for the travel expenses of up to INR 20,000 for an immediate family member’s round trip to join the patient in hospital 

4. ManipalCigna

As one of the largest personal health insurance companies in India, ManipalCigna has more than 8,000 network hospitals where people can avail cashless facility. ManipalCigna has settled over 12.88 lakh claims till date. With a user-friendly website, you can easily navigate through multiple plans, renew your policy, or raise claim requests. To help the customers live a healthy lifestyle, ManipalCigna runs wellness programs for lifestyle habits including quitting smoking.

ProHealth Protect is one of the individual health insurance plans offered by ManipalCigna with the following features among others:

1. Sum insured ranges from INR 2.5 to 50 lakhs
2. Waiting period of 4 years for claiming coverage for pre-existing diseases
3. Free health check-up once every 3rd policy year
4. Optional covers such as hospital cash benefits and booster for cumulative bonus
5. Coverage for IPD hospitalisation, day care, and ambulance
6. Coverage for health maintenance expenses including consultation fees, diagnostic tests, drugs, and dental treatments 
7. 100% restoration of the sum insured in a policy year any number of times
8. Boost of 25% for coverage irrespective of number of claims with an optional cumulative bonus booster
9. Super top-up at additional charges to remove limitations on choosing the type of room and coverage for all day care treatment expenses

5. Aditya Birla Capital

Aditya Birla Capital, a part of the Aditya Birla group of companies, offers various health insurance options for individuals, families, and people with chronic or critical ailments. Aditya Birla Capital offers excellent services to the customers; as a policyholder, you get a care manager, who helps you throughout the process of reviewing the policy all the way to settling claims. People are rewarded for maintaining good health and staying active through their HealthReturns™.

Aditya Birla Capital’s Activ Health Platinum Enhanced Insurance Plan comes with the following features:

1. Premium starting at approximately INR 660/month (or INR 7,900/annum)
2. Coverage for listed dental treatments at network hospitals and modern treatment methods, including oral chemotherapy and robotic surgery
3. Over-the-phone consultation from experts on medical treatments, homeopathy, nutrition, and medical counselling
4. Coverage for hospitalisation expenses including costs for pre and post hospitalisation, day care, organ donor, domiciliary, obesity, and AYUSH treatment
5. Convenient claim settlement process with 24 × 7 support
6. 100% recharge of the sum insured if the policyholder undergoes treatment for an unrelated illness in the same policy year
7. Sum insured range of 2 lakhs to 2 crores
8. Minimum age of 5 years to get individual health insurance 
9. Three-year waiting period for pre-existing diseases

6. ICICI Lombard

ICICI Lombard is one of the best personal health insurance companies with a network of 6,700+ hospitals. ICICI Lombard also has a mobile app—IL Take Care—through which you can access your policy documents and raise a claim request among other things. ICICI Lombard’s 24 × 7 customer support is also quite convenience as you can reach out to the insurance providers in case of any emergency.

Following are some of the key features of an individual health insurance plan by ICICI Lombard—Health Shield (ICICI Lombard Complete Health Insurance):

1. Sum insured coverage options from INR 3 lakhs to 50 lakhs
2. Coverage for expenses for AYUSH, IPD, day care, pre- and post-hospitalisation expenses, and domiciliary treatment along with donor expenses
3. Optional add-on covers for critical illness, personal accident, nursing at home, hospital daily cash, and worldwide policy cover
4. Wellness program for people to maintain good health
5. Option to consult another doctor after diagnosis for second option
6. Free annual health check-ups for every policy year
7. Online consultation with experts on diet and nutrition

7. Star Health

As a health insurance company with more than 13,000 network hospitals, Star Health has a hassle-free claim settlement process. You can reach out to Star Health's representatives 24 × 7 if you have doubts related to the health insurance policy. Star health has only been around for 16 years and has already settled over 75 lakh claims. Star Health provides health, travel, and accidental insurance for individuals, families, senior citizens, and corporates.

One of their personal health insurance policies—MediClassic Insurance Policy—has the following features:

1. No medical screening for people who are under 50 before purchasing the plan
2. Sum insured ranges from 1.5 lakhs to 15 lakhs
3. People who are in the age group of 5–65 years can purchase this policy and enjoy lifelong renewal
4. Coverage for expenses for all day care procedures along with IPD, pre- and post-hospitalisation, and modern treatment expenses
5. One-time restoration of 200% for the basic sum insured during the policy period

8. SBI General

SBI General Insurance Company Ltd. is a 13-year-old company, which provides customisable insurance policies to its customers as per their eligibility. Known to be agile and transparent in their service, SBI General has more than 20,000 network hospitals pan India. You can choose health and/or life insurance from their list of products. SBI General has a 24 × 7 customer care helpline so that you can avail support in case of emergencies.

SBI General offers Arogya Plus Health Insurance policy for individuals with the following features:

1. No pre-acceptance health check-ups before the age of 55
2. Policy tenure has 3 options—1/2/3 years
3. Flat policy premium (fixed for all ages) starting from INR 750/month
4. Minimum entry age of 18 years for an individual, and maximum entry age of 65 years
5. Lifelong renewability
6. Coverage for 141 day care treatments and out-patient department (OPD) treatments including doctors’ consultation and diagnostic tests
7. Maternity cover of up to the OPD limit along with domiciliary hospitalisation and nursing expenses
8. Optional top-up covers for hospital cash
9. Sum insured range from INR 1 to 3 lakhs

Points to remember while considering individual health insurance

Make sure you invest some time in research to figure out your requirements and current budget to choose the best available plan. Ponder over the following factors before finalising your ideal plan:

1. Current health status and scope of coverage

Book a general-physician consultation for a regular health check and discuss about existing and potential health conditions that may arise in the future. This way you can gauge approximate coverage required and choose a plan accordingly. Think about expenses for treatment and consultation fees for the conditions to shortlist the policies that suit your needs.

2. Sum insured

Medical expenses are rising consistently and will continue to rise in the future as well. Factor this in while choosing a plan as the coverage appropriate for today may not suffice coverage for treatments tomorrow.

3. Pre-existing diseases and waiting period

Sum insurance companies may not cover expenses for re-existing conditions but most of them have a waiting period clause. People can claim expenses for treatment of diseases, such as diabetes, thyroid, and cardiovascular ailments, after the specified amount of time. You will find details about this in your policy documents.

4. Premiums, deductibles, and co-payment

Compare multiple policy options online for coverage against premium rates and choose the lowest possible premium without compromising on other important factors (including sum insured and CSR). You can also look for policies that have deductible or co-payment clauses that can reduce the financial burden of high premium rates without reducing the sum insured.

5. Sub-limits

Watch out for any sub-limiters in your insurance plan, as these imply a maximum cap on specified expenses and significantly impact the claim later on. For example, some insurance providers have limits on room rent, which may necessitate you to spend money from your pocket if you want to upgrade to a better room during hospitalisation.

In the end

While deciding the best insurance plan from personal health insurance companies, consider your requirements, do some research, and read all policy documents for inclusions and exclusions before finalising anything. Look out for adequate coverage and invest in an additional top-up if it saves you money in the long run.

For the ease of claim settlement, going to a network hospital and availing the cashless facility whenever possible can be beneficial. However, you should never compromise on the quality of medical treatment. Although most network hospitals shared by your insurance provider will provide optimum care, approach a different hospital if you feel the need and don’t fret over additional paperwork.