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Insurance is necessary but why is that people are running away from buying insurance. Forty-three per cent of India’s total population does not have health insurance. One reason for not buying insurance is the expensive premium. Along with this, complex insurance products have left consumers more confused. Insurance aggregator and broker, Policy Bazaar has conducted a consumer survey called How India Buys Insurance. According to the survey, 19% of people in the country did not take health insurance because they found it complicated. Twenty-four percent considered it was hassle to buy health insurance policies. Whereas, 26% of people got confused by availability of so many insurance products in the market.

New policies are being launched every day in the health insurance market. Each policy has so many features. So, it is not easy to choose the right policy. If you have a checklist of all these features , it will help you shortlist the right insurance policy for yourself. Let’s see what is included in this checklist…

1. OPD Cover
First comes the OPD cover. Check for the feature of Outpatient Department cover in health insurance policy. This includes doctor consultation. There will be no need for admission to the hospital. But in OPD, apart from the doctor’s fee, sometimes there may be a need for consultation with a specialist, so you may have to go to the hospital two or three times. Many times it includes tests that are done in the hospital. Health policies with less than one or two lakh cover do not include the cost of checkups in the hospital under OPD. In such a case, people think that if the cost of OPD is not being covered, then why buy an insurance policy? There are also many other confusions due to which people have difficulty in buying health insurance plans.

2. Pre and Post Hospitalisation
Before buying health insurance, it is important to know whether it will cover the the cost of pre and post hospitalisation or not.

3. Room Rent Cap
Do not ignore the third feature. When admitted to a hospital, room rent is a big expense. In basic health policy, room rent is insured at one percent. If there is a policy with a cover of three lakh rupees, then room rent will be available at the rate of 3000 rupees on daily basis. If the actual room rent is 6,000 rupees, then 3000 rupees will have to be paid from your own pocket that too on a daily basis. The terms related to room rent create confusion due to which people back away from buying the policy.

4. Day Care Treatment
The next important feature is day care treatment. In most policies, claims are only available after patient gets admitted to the hospital for 24 hours. For operations like cataract and cysts, there is only a need to be admitted to the hospital for two to four hours. Some policies do not provide claims for undergoing such operations. Similarly, there is no need for admission for fever etc. Many insurance policies do not cover such treatment. Most people spend more on such cases. So, while taking the policy, one must make sure that health policy includes day care treatment feature also.

5. Co-payment
If you have not read the co-payment clause properly, then, despite having a health insurance policy, you may have to pay a part of the claim from your own pocket. Health insurance companies add a co-payment clause to reduce the premium. Under this, the policyholder has to pay a part of the bill after treatment. For example, if your policy has a 10% co-payment clause, and a bill of 3 lakh rupees is generated after being admitted to the hospital, then, you will have to pay 30 thousand rupees from your own pocket. The co-payment clause is quite an annoying thing for the policyholder.

6. Restoration Facility
The last but one important feature that can be added at the beginning w is the restoration facility. If health insurance cover is 5 lakh rupees and during treatment 6 lakh rupees are spent, then, in such a situation, insurance companies provide restoration facility. Under this, if the entire cover of five lakh rupees is spent on treatment, then, the insurance company will give another cover of 5 lakh rupees. This facility is called restoring. Most companies provide restoration facility up to three times equal to the insured amount in one year. You can increase your insurance cover up to three times by paying a nominal premium.

In India, only 1% of people have any of the types of general insurance policies? General insurance means health, vehicle, accident or home insurance. Out of this 1%, only 0.34% i.e.have health insurance. To increase insurance penetration, insurers need to simplify their products. That’s why on Money 9 our endeavour is to make complex things about insurance easy.