Comparing Health Insurance Companies in India

Take the time to compare not only the prices of medical insurance in India but also the policy documents — and read the fine print. Otherwise, you may be disappointed when it comes time to get paid by your medical insurance company.

Here is an example.

Example: ICICI Lombard medical insurance

ICICI Lombard is one of the companies offering medical insurance in India, and of course actively advertising to NRIs to buy policies for their families in India. I decided to check their medical insurance policy.

Policy coverage (as shown on the ICICI Lombard website)

The policy covers medical expenses:

• Incurred as an inpatient during hospitalisation for more than 24 hours, including room charges, doctor's/surgeon's fees, medicines, diagnostic tests, etc.
• 30 days prior to hospitalisation
• 60 days post-hospitalisation
• Pre-existing disease can be covered after the 4th year, provided the policy is renewed for four consecutive years

Technologically advanced treatments that do not need 24-hour hospitalisation but are covered under this policy:

• Cataract
• Lithotripsy (kidney stone removal)
• Tonsillectomy
• Eye surgery
• Dialysis
• Dilatation & curettage
• Chemotherapy
• Radiotherapy
• Coronary angiography
• Cardiac catheterisation

So — are all of the above covered? Without reading the full policy, one would think so. However, when you check, many items mentioned above are not covered for the first two years.

Check policy exclusions – reading the fine print

Reading the above, one would believe all the listed items (provided they were not pre-existing) would be covered by the policy. However, if you bother to check the details before signing up, you'll find that some of these are not covered for two years.

When you actually read the policy wording in Section 3.4, you will find the following clarification:

3.4 Expenses incurred on treatment of the following diseases within the first two years from the commencement of the Policy will not be payable:

• Cataract
• Benign Prostatic Hypertrophy
• Hernia, Hydrocele
• Fistula in anus, Piles
• Arthritis, gout, rheumatism
• Joint replacements unless due to accident
• Sinusitis and related disorders
• Stones in the urinary and biliary systems
• Dilatation and curettage
• Skin and all internal tumours/cysts/nodules/polyps of any kind, including breast lumps unless malignant; adenoids and haemorrhoids
• Dialysis required for chronic renal failure
• Surgery on tonsils and sinuses
• Gastric and duodenal ulcers

Takeaway

With the above example, I am not trying to pass the impression that ICICI Lombard medical policies are inferior in any way compared to other insurance companies operating in India. I am just trying to impress upon readers the necessity of finding a company whose policy suits their needs and offers no surprises when — God forbid — you or your loved ones need medical help.

• Don't make assumptions. If in doubt, get it in writing.
• Spend a few minutes when buying a policy rather than face problems when you are ill and need help.
• Always check the fine print for exclusions in the policy wording, which may be written deep inside the policy.