Health insurance basics

Start with the sum insured

The sum insured is the maximum amount available under the policy, subject to its terms. In a family floater, one shared limit may be used by eligible family members.

Choose a level that matches your city, family profile, existing employer cover, and ability to pay costs that the policy does not cover.

Waiting periods and disclosures

A waiting period is a period during which specified conditions or treatments may not be covered. Different policies can have initial, pre-existing-condition, and condition-specific waiting periods.

Answer health questions completely and accurately. Missing or incorrect disclosures can create problems when a claim is assessed.

• Check the initial and pre-existing-condition waiting periods.
• Ask which conditions or treatments have their own waiting period.
• Keep your policy schedule and customer information sheet accessible.

Look beyond the headline cover

Cashless access depends on the insurer’s network and the hospital’s process. Reimbursement claims may require you to pay first and submit documents later.

Co-payments, deductibles, room-rent limits, and sub-limits can affect what you pay in an eligible claim.

Before renewal

Review the cover amount, network hospitals, claims experience, and any life changes. Renew on time to protect continuity benefits available under your policy.

• Read the customer information sheet.
• Confirm the hospital network you are likely to use.
• Check exclusions, co-payments, and sub-limits before renewing.