ET - PlanCover.Com Ranking

Health insurance we believe is the key to your being at peace with regards to unforeseen healthcare costs. This protects your savings from being eroded in case you were to get hospitalised for treatment, especially those which can be high cost ones. In this era of rapid advancement in medical technology and new drug discoveries, the cost of healthcare is fast becoming out of reach for many. Absence of a good health plan and the high anticipated out of pocket expenditure, has seen to be one of the reasons why many people either do not go in for treatment or proper treatment. Health Insurance is expected to be the tool to allow you access and coverage for the best possible treatment for you and your family.

India’s liberalisation of the insurance sector has resulted in many private insurers coming up. As the market evolves, new products are being introduced. Each innovation in this field results in added benefits being offered and marketed aggressively. Price & product competitiveness has resulted in variations in the legal terms & conditions accompanying of the benefits being offered. What a customer appears to be buying versus what actually is covered, can at times, be largely different. While some customers may not at all know what the insurance plan covers, some others may be misled into thinking what the coverages are. To simplify this process, we decided to launch ranking of health insurance plans currently available.

Best Health Insurance Policy In India

This is a question often asked but not as frequently answered accurately. What makes a health insurance cover best is answered by taking into account many variables. Some of them being -

  • What is your family composition and age band - This determines the morbidity profile typically associated with a certain age group. Children have different set of reasons for getting hospitalised as compared to elderly. Similarly a young couple who have recently got married may have different needs than an Established Family. One needs to ensure that typical ailments associated with certain age categories are well covered under the policy so that in case there was a hospitalization, least amount of out-of-pocket expense accrues to the policyholder.
  • What is your geographical location - Where you stay largely determines what is the cost of healthcare in general. A person / family living in a Metro city may need higher sum insured as well as a policy which allows for higher coverage of room rent, certain typical surgical ailments etc
  • What is your premium paying capacity and priorities in planning for future goals - This particularly since the cost of healthcare is rising and the choice of health cover needs to take into account which policy you choose and for how much sum insured.
  • What are the terms of the policy and their acceptable interpretations - Many terms can be confusing if not downright incomprehensible by a customer. For example, those health insurance covers which pay for rateable proportion of a claim in case you exceed the room rent eligibility, can result in extraordinarily high out of pocket payment by the policyholder if there be a claim. There are about 50 broad terms in a policy that may have an impact on what you will be paid or if you will be paid, each having its own subset of what, when and how.
  • What is the long term financial implication of being with a plan. What is the rate at which their premiums increase and what is the maximum that you will be charged as per current premiums. Do note that this is not set in stone. Every 5 years or so, an insurer has an option to readjust their premium charts overall as well as policy term albeit only when they can convince the regulator of the changes and to what extent.
  • Beyond the above, there are a bunch of other parameters that impact which could be the best health insurance cover including the claims settlement record of the insurer, the financial strength of the insurer to ensure speedy settlement of claims, the degree of prudency in their underwriting ( the mechanism by which they access the risk and decide on extending the cover and at what price ) and hence the nature of the risk pool that they have created / they are creating by extending insurance contracts, historical nature of the risk pool, vintage of the insurer any many more.

PlanCover.com is a part of HII Insurance Broking Services Private Limited, an enterprise established to make people win by minimising risk in their lives and businesses. We have over the years handled lacs of claims and served hundreds of thousands of customers. We have been passionate practitioners of health insurance and claims management. Our commitment goes beyond selling a policy. It truly is to provide unbiased solutions to customers and protect whats dear to them. We tell what you can expect and what you won’t get in a cover. Beyond this, we put ourselves on the line when you have a claim to ensure that on your behalf, we navigate this system for you and ensure that your policy delivers as per the contract and claims get paid. That’s been our Promise !

Our Rankings are based on PlanCover.com Ranking Model which classifies almost all parameters in typical health insurance policy in 5 categories -

  • Critical - These set of factors are decided and chosen based on their maximum cost implication for an insured. If any of these factors were not considered, the potential of a claim being denied or partially paid to a significant degree, results in huge out of pocket expenses for the policyholder. The probability of these factors getting invoked and their cost implication, are both high.
  • Motivation - These features with low probability of occurrence for the segment, but high cost implication. It is mostly where innovation occurs for targeted marketing of products, say, restore benefits, which work specifically for family floaters. Given the wording, the probability of it being used is extremely low, but it offers peace of mind for consumers.
  • Standard - The features with high probability of occurrence, but low/minimal cost implication in overall health care. These are seen as standard features that are needed, and are part of most covers typically due to the IRDAI directives. These include free-look period, claim intimation/submission, portability, etc.
  • Luxury - These are features that don’t have a high cost implication and have low probability of occurrence. For instance, second medical opinion with another specialist, health check-up benefits, etc.
  • Does Not Matter (DNM ) - Those features that are not needed and can be ignored, such as maternity benefits for senior citizens.

Apart from these categories for classifying policy features, we segment the customers based on a variation of the Sagacity Segmentation. This allows for a focussed need identification of each segment. We have then analysed the claims data from our own experience and other data sets available publicly through IRDAI and IIB to find out the importance of any variable for any segment based on disease patterns and subsequently given it due weightage in our calculations.

The segments we chose are -

  • Young Single - Male (Age Range 18 to 40 years) - Needs and Assumptions - This profile caters to young to middle-aged singles males, no dependents and no immediate plans for children. While with age young single males tend to start thinking about benefits of health cover especially if they have had personal / family experiences with hospitlisation and / or need tax deductions, they are often found to be price conscious and need only a basic cover. Typical risk sensitivity includes hospitalisations arising out of accidents, water borne diseases and other infections. Not uncommon are ailments arising from stones, appendix etc but completely not bothered about joint replacements, cataracts and other age related disorders.
  • Young Single - Female (Age Range 18 to 40 years) - Needs and Assumptions - This profile caters to young to middle-aged singles females no dependents and no immediate plans for children but has been factored in to include Maternity coverage in a few years by when the waiting periods will be over.Typical risk sensitivity includes hospitalisations arising out of accidents, water borne diseases and other infections. Not uncommon are ailments arising from stones, appendix etc but completely not bothered about joint replacements, cataracts and other age related disorders.
  • Young Couple - Wanting Children (Age Range 18 to 40 years) - Needs and Assumptions - This profile includes those who may or may not already have children but want a child in near future. This profile of individuals starts getting conscious of having a financial risk cover to meet healthcare costs for the family. Important is a cover to meet Maternity related costs and a cover for the new born child. Click Here for Ranking
  • Young Couple - Not Wanting Children (Age Range 18 to 40 years) - Needs and Assumptions - This profile includes those who may or may not already have children but definitely don’t want a child in future. This profile of individuals starts getting conscious of having a financial risk cover to meet healthcare costs for the family.
  • Established Families (Age Range 41 to 60 years) - Needs and Assumptions - This profile covers mostly middle-aged to mature couples with an older but still dependent child or children. These families have stopped growing so no longer need cover for maternity. The parents are starting to think about cover they might need for growing kids such infections related hospitalization. This age has also started seeing trends of lifestyle ailments and its ensuing complications leading to admissions in hospital.Click Here for Ranking.
  • Mature Singles (Age Range 41 to 60 years) - Needs and Assumptions - This profile ( Males and Females ) now has seen the unpredictability of health over the years and need a sense of safety cover which is robust and delivers when needed. Larger concerns now start on covering costs related Cardiac and Oncology related episodes.
  • Mature Couples (Age Range 41 to 60 years) - Needs and Assumptions - This profile now has seen the unpredictability of health over the years and need a sense of safety cover which is robust and delivers when needed. Larger concerns now start on covering costs related Cardiac and Oncology related episodes.
  • Senior Citizen - Singles (Age Range 60 years +) - Needs and Assumptions - This profile caters to mature singles (both male and female) that no longer have or never had dependent children. We did not wish to draw a finite line as far as the age where maturity begins but this profile is now more concerned with areas of cover such as cardio-thoracic surgery, hip replacements or multi-focal lenses. Due to the natural processes of aging, their health insurance requirements differ from that of young singles.
  • Senior Citizen - Couple (Age Range 60 years +) - Needs and Assumptions - This profile caters to mature singles (both male and female) that no longer have or never had dependent children. We did not wish to draw a finite line as far as the age where maturity begins but this profile is now more concerned with areas of cover such as cardio-thoracic surgery, hip replacements or multi-focal lenses. Due to the natural processes of aging, their health insurance requirements differ from that of young singles.Click Here for Ranking.
  • Tax Saving Plans (Age Range 18 to 40 years) - Needs and Assumptions -This profile includes those in younger to middle age category who want to have a basic cover but want to take benefit of tax deductions. They are not much concerned about the finer prints and additional benefits / features in a health insurance cover.

For PlanCover.com Health Insurance Ranking Methodology, Click Here

For Participating Insurer's Product List Click Here

Insurance is the subject matter of solicitation | HII Insurance Broking Services Private Limited [ HIBS ] IRDA Registration No. DB 459/09. Direct Broker (Life & General), Date of licence - 14th February 2016, Licence valid till 13th February 2019. For more details on terms and conditions, exclusions and waiting period, please read sales brochure before concluding a sale. Any Tax Benefits available on purchase of an insurance cover is subject to changes in tax by the Government of India The trademark(s) PlanCover" and "PlanCover.com" logo are owned by HII Insurance Broking Services Pvt. Ltd. Corporate office: 87 B, 2nd and 3rd Floor, Shahpurjat, New Delhi-110049.
Principal Officer - Mr. R K Sethi Contact - +91 9650066422