Pick a Health Insurance Plan That's Right for You

Buying the right health insurance is important, but with a great number of health insurance plans available in the market, it can become a daunting task. This is because not always the health insurance companies highlight those features which the customers must keep in mind while purchasing a particular plan. Also, because the customers’ focus revolves more around the inclusions and exclusions that the plan offers. And in such a pursuit, some important points like claim settlement go missing, while persuading the customer for a particular plan.

To solve this, LiveMint has partnered with SecureNow Insurance Broker Pvt. Ltd to plan the Mint SecureNow Mediclaim Ratings (MSMR) 6 years earlier. MSMR ratings help understand the parameters of rating a health insurance better.

Across three sections such as features, price, and claims, LiveMint has rated 24 insurers and 112 insurance policies this year. These rating help to pick up the right plan and also help understand the important aspects that one must look upon while purchasing one.

What has been rated?

MSMR rates various health insurance plans that cover hospitalisation bills of the insured, i.e. indemnity plans. LiveMint has made three sections to divide the ratings that is sum insured, age of the customer, and cover type, viz. Individual or family basis. The categories for sum insured are Rs. 5 Lakh, Rs. 10 Lakh, Rs. 20 Lakh, Rs. 50 Lakh for the age groups of 30 years, 45 years, 60 years, and 75 years.

Premiums:

Premiums have been given 20% of weightage for the senior citizens category and 25% for the non-senior citizen category. Health insurance plans come with many additional features to pull ones attention but LiveMint has kept only the essential features included in the parameters; all of which affect the pricing of a policy.

Also, premiums are calculated slightly differently. For people aged between 30 to 45 years, the average premium is calculated including higher age groups. The policies are rated on the basis of this average premium amount where the cheapest one gets the maximum score.

Features:

Some features of insurance plans can make a customer super satisfied, whereas some can come as a rude surprise to them. The latter comprises of exclusions including sub-limits on room rents, the initial waiting period on a pre-existing disease, etc. These features get scored 15% each and policies with these exclusions get scored down.

However, the features that add value to the policy, thereby enhancing the sum insured, include No Claim Bonus (NCB), scoring a total of 5%, and the restore feature gets a total score of 2.5%.

For the senior citizen's category, the scoring rate for features is kept high at 45%, as some exclusions have been taken into major consideration. These include disease-wise capping or waiting period for specific diseases and co-payment.

Claims:

Unlike previous years, where the number of settled claims was considered with 25% of total weightage and the number of complaints for every claim at 5%, this year aging of claims have also been taken into consideration into MSMR rating. This will show how many insurers are able to settle their claims in a month. Claims can be made in two ways, cashless or reimbursement, of which cashless is the more preferred one. So, ‘ageing of claims’ is rated at 5%.

The insurers getting the high rating include the insurers who have settled a minimum of 10,000 claims, thereby leaving aside Kotak General Insurance, Edelweiss General, Magma HDI General Insurance, Reliance Health, and Raheja QBE.

How to use MSMR?

For all the points discussed above, the ratings for policies have been given A if their scores lie between 65% to 100%. Then the policies between 45% to 65% score B rating and the rest get C category.

It is understood that plans with ‘A’ rating have done broadly well on all the 3 parameters i.e. price, features and claims. LiveMint has taken into consideration 24 combinations of the sum insured, age, and individual and floater metrics.

At the end for at least 15 of these combinations, 6 insurers were rated A, namely-Bajaj Allianz General Insurance Co. Ltd, ICICI Lombard General Insurance Co. Ltd., Royal Sundaram General Insurance Co. Ltd, Manipal Cigna Health Insurance Co. Ltd, Religare Health Insurance Co. Ltd, and Apollo Munich Health Insurance Co. Ltd.

But a thing to understand here is that you should not just restrict yourself only to the top-rated, 'A' products for say. Even a plan that is not rated so well may offer you utmost satisfaction. But yes one thing is for sure that what not to buy is a plan that is restrictive as far as exclusions are concerned and is offered by an insurer with bad claim record. Thus, you should definitely use your discretion while making the final choice.