Health insurance An Introduction

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What is Health Insurance?

Health insurance covers expenses towards treatment of diseases and / or injury. A health insurance policy could be either on an indemnity basis which involves reimbursement of expenses up to a specified limit or on a fixed benefit basis where the insurer pays a fixed amount of benefit irrespective of what the expenses are.

A health insurance policy (on indemnity basis) would normally cover expenses reasonably and necessarily incurred under the following heads in respect of insured person subject to overall ceiling of sum insured (for all claims during one policy period):

i. Room, boarding expenses

ii. Nursing expenses

iii. Fees of surgeon, anaesthetist, physician, consultants, specialists,

Anaesthesia, blood, oxygen, operation theatre charges, surgical appliances, medicines, drugs, diagnostic materials, X-ray, dialysis, chemotherapy, radio therapy, cost of pace maker, artificial limbs, cost of organs and similar expenses.

Normally, health insurance policies are not issued for less than one year period.

A Personal Accident cover is also available for protection. In the event of death or disability, permanent or temporary, of the insured, arising as a result of an accident, it provides for compensation, which is either the whole or a percentage of the sum insured depending on the kind of loss.

*Courtesy: Insurance Regulatory and Development Authority of India.