Finding the BEST Health Insurance | Ultimate Guide 2025
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Summary
In the quest to find the best health insurance, Mandeep, or Money Minded Mandeep, delves into the intricacies of premiums and claims. He emphasizes understanding key metrics like the incurred claims ratio, common pitfalls in policy terms, and tactics to select the best policy without overpaying or under-protecting oneself. Mandeep compares policies from various companies, highlighting features and loopholes in commonly promoted 'unlimited' benefits, riders, and conditions that can cost policyholders more without proper understanding. He also provides practical advice on using aggregators like Policy Bazaar for transparent purchasing decisions while maintaining a clear stand on unbiased recommendations.
Highlights
Mandeep decodes insurance jargon to save you from hidden costs. π΅οΈββοΈ
Learn to identify shady insurance practices and poor policy features. π
Discover the importance of the incurred claims ratio in selecting your insurer. π
Find out how to port to a better policy without losing benefits. π
Understand why combining corporate plans with personal ones is vital for long-term coverage. π€
Key Takeaways
Always check the 'incurred claims ratio' of insurance companies for reliability insights. π
Avoid policies with room rent limits, disease-wise sublimits, and copayments. π«
Use Policy Bazaar for comparing policies, but make your decision based on features, not just price. π·οΈ
Consider both individual and family floater plans based on age and relationship dynamics. πͺ
Never solely rely on corporate health plans; maintain a personal policy for security. π
Overview
Mandeep kicks off with a reality check about hospital bills and insurance premiums, explaining how both can lead to financial strain if not navigated wisely. He underlines that flashy features like '1 Crore plans' often come with high premiums where the real value may be skewed. To arm viewers with knowledge, he introduces the concept of incurred claims ratio (ICR) as a vital measure for assessing an insurer's reliability and how complaints ratios offer transparency into service quality.
Unveiling the mystery of policies, Mandeep stresses on avoiding policies with room rent limits, disease-wise sublimits, and copays to prevent unforeseen expenses. His advice is rooted in eliminating surprises at the claim stage, stressing that hidden conditions might void policyholder expectations. By illustrating through real-world examples and data, he teaches how to thoroughly scrutinize a policyβs terms, comprehend the implications of riders, and be wary of misleading βunlimitedβ claims benefits.
He rounds off by detailing how to make informed choices through sites like Policy Bazaar without getting swayed solely by sponsorships. Emphasizing policy management, Mandeep suggests a blend of personal and corporate plans ensures uninterrupted coverage without loopholes harming one's interests. His conversational tone combined with detailed policy breakdowns aims to empower viewers to buy health insurance with clarity and confidence.
Chapters
00:00 - 00:30: Introduction The introduction discusses the financial burden of hospital bills and health insurance policies, emphasizing that high premiums or claim rejections can also lead to financial strain. It attributes the high premiums to government-imposed GST and unnecessary additional features in insurance plans offered by companies. The speaker, Money Minded Mandeep, critiques these aspects of the insurance industry.
00:30 - 02:00: Understanding Incurred Claims Ratio This chapter provides a guide to selecting the best health insurance policy. It discusses the importance of not choosing a policy with such high premiums that it leads to financial strain. A key metric for determining a good insurer is the 'incurred claims ratio,' which is the total claims paid out divided by the premiums earned in a year. There are about 30 to 35 health insurance companies in India, but not all offer quality services, making it crucial to evaluate them carefully.
02:00 - 05:30: Analyzing Companies and Complaints Data Insurance companies collect premiums with the aim that not everyone will claim at once. The incurred claims ratio reveals the percentage of premiums paid out versus earned. A low percentage indicates possible reluctance to pay claims, affecting complaint data. A percentage over 100% shows the company is paying out more in claims than it earns.
05:30 - 15:30: Hidden Terms and Conditions in Policies The chapter discusses the source of funds for loss-making companies, particularly focusing on public insurance companies that have incurred claims ratios (ICR) exceeding 100%. The ICR is a measure used to assess the company's ability to pay claims against premiums collected. The healthy ICR is generally between 80% to 85%. The chapter references data from the Insurance Regulatory and Development Authority (IRDA) handbook for a more in-depth segment-wise analysis over the past decade.
15:30 - 31:00: Comparing HDFC and ICICI Policies The chapter titled 'Comparing HDFC and ICICI Policies' focuses on data analysis from the years 2014 to 2024. The emphasis is on the latest data rather than past trends. The Incurred Claims Ratio (ICR) is broken down into four segments and a total is provided at the end. There is a discrepancy noted between the total incurred claims ratio and the Insurance Regulatory and Development Authority of India's (IRDAI) annual report due to the nature of the IRDAI's granular data, which only includes health insurance data without personal accident and travel. The chapter seeks to interpret and make sense of this data discrepancy.
31:00 - 43:00: Selecting and Understanding Riders The chapter discusses how to select and understand riders in insurance policies. It begins by evaluating companies' Incurred Claim Ratio (ICR). An example given is Chola Mandalam, which has an overall ICR of 81%. However, its individual policies have an ICR of 360%, indicating they are not profitable as they result in larger payouts than premiums received. In contrast, the company's family floater policies have a much lower ICR of 14%, suggesting a lower payout of claims. The chapter also points out abnormalities in these figures and transitions into discussing complaints data, noting the industry average of complaints per 10,000 claims is 22. This data helps to assess the reliability and satisfaction level with the insurance providers' handling of claims.
43:00 - 48:00: Lowering Premiums In the chapter titled 'Lowering Premiums,' an analysis is presented on insurance companies with a focus on complaint data and incurred claims ratio (ICR). Companies such as Care, ManipalCigna, Niva Bupa, and Star Health are mentioned, the latter noted for its high complaint data. Only three companies, namely Bajaj Allianz, ICICI Lombard, and HDFC Ergo, have the lowest numbers of complaints in the private insurance sector, while United India has eight complaints in the public sector. Despite the rejection of some companies due to a high ICR, Bajaj Allianz emerges with a decent total incurred claims ratio of 83%.
48:00 - 49:00: Corporate vs Personal Health Insurance The chapter compares corporate and personal health insurance with a focus on their incurred claims ratio (ICR). It highlights that in corporate insurance, the ICR is 89%, which is relatively high, while in individual policies, it's 67%. The data is for one year, and it suggests that these figures may change over time, so judgments about companies like Bajaj Allianz should be tempered with time. The text also notes that few companies, including HDFC and ICICI Lombard, fit this criteria well, and mentions other insurance providers like Care and Star Health.
49:00 - 50:00: Individual vs Family Floater Plans This chapter discusses the nuances of Individual vs Family Floater insurance plans. It highlights common issues policyholders face, such as claim rejections due to hidden terms and conditions. The chapter aims to educate readers on how to identify and understand these terms to make informed decisions about their policies. By understanding the structure of good versus bad policies, individuals can evaluate their current insurance plan and decide whether it meets their needs.
50:00 - 50:50: Conclusion and Call to Action The conclusion stresses the importance of porting policies to ensure they are beneficial. Porting a policy allows you to maintain your waiting periods already endured, making it a strategic move. However, if you opt to increase the sum insured when porting, be prepared for additional waiting periods on the extra amount. The already insured amount will remain as is without any extra delay.
The chapter also provides insight into identifying poor insurance policies. After selecting a company, it's crucial to scrutinize plans effectively. This includes recognizing policies with unfavorable features using a specific elimination technique that avoids policies exhibiting three negative traits.
Finding the BEST Health Insurance | Ultimate Guide 2025 Transcription
00:00 - 00:30 Now everyone knows. One hospital bill is enough to make you poor, very poor. But the fact is that one health insurance policy can also make you poor. Because either the premium will be too high or your claim will get rejected. Why is the premium high? Thanks to the government, 18% GST. And thanks to companies, because they keep bringing new features. 1 Crore plans, Infinite Sum Assured, Fancy Riders... which you might not even require. But you will still have to pay the premium and won't be able to utilise it. My name is Money Minded Mandeep, ..
00:30 - 01:00 and this is the ultimate guide to buying the best health insurance policy. And the premium should not be so high that it makes us poor today. FINDING THE BEST INSURER In India, there are approximately 30 or 35 health insurance companies. Not all of them are good. But we need to know how to find a good one. For that, first we will have to find the 'incurred claims ratio'. This means amount of claims paid... divided by total amount of premiums earned in one year.
01:00 - 01:30 That's how Insurance businesses work. The companies collects premiums from a lot of people. Hoping that everyone doesn't claim it together in a single year. So the companies incurred claims ratio states that. How much money did the company earn through premiums and... how much percentage of the money was distributed through claims? If the percentage is very low... that means the company is not passing the claims easily. And it will further be reflected on it's complaints data. And If this percentage is more than 100%. That means, the company is spending more on claims than it earns.
01:30 - 02:00 So where is this extra money coming from? Who will fund a loss-making company, and when will it be funded? The healthy incurred claims ratio is somewhere around 80-85%. And there are several companies which I have marked green. The ICR and its average for the past three years have been mentioned here. And If you look at it carefully, then such companies whose incurred claims ratio is more than 100%. All of those are public insurance companies. If you want to study ICR further. There is a segment-wise data of the past 10 years in the IRDA's handbook.
02:00 - 02:30 You won't have to do so much. But you can find certain interesting things here. This data is from 2014 - 2024. I have only highlighted the last data. I haven't focused on the past 9 years. In this, the ICR is shown in four segments. And the total is also mentioned in the end. Your total incurred claims ratio will not match with your IRDAI's annual report. And it won't because... The granular data of the IRDAI's handbook... you will only get the health insurance data without personal accident and travel. How do we make sense of this data?
02:30 - 03:00 Firstly we will see, which company is close to 80-85%. For example, Chola Mandalam is at 81% in total. But as soon as I check the individual policies, then this is 360%. i.e. the premium they earn from individual policies, they pay 360% in claims. And that's a loss-making business. If you look at the family floater of this company ICR, then it's only 14%. It means, they are not passing the claim here. There is something weird happening here. Next we will head to the complaints data. This is the number of complaints per 10,000 claims & industry average is 22.
03:00 - 03:30 And If you check who is above 22. then you will find Care, ManipalCigna, Niva Bupa and Star health. Most people won't be surprised by Star Health's complaint data. Only three companies have the lowest and single-digit complaints. Bajaj Allianz, ICICI Lombard and HDFC Ergo, in terms of private insurance. There are eight complaints of United India, with respect to public insurance. But, they got rejected because their ICR is higher. You will find the total incurred claims ratio of 83% in terms of Bajaj Allianz decent.
03:30 - 04:00 But in the handbook data, where there is only health insurance. Their total ICR is 89%, which is on the higher side. In individual policies, their incurred claims ratio is 67%. But then again, this data is only for one year. All of this data will change for all the companies in the following year. So, I wouldn't be too harsh on Bajaj Allianz. According to this criteria, there aren't many companies in the market. There are two: HDFC and ICICI Lombard. Before that, If you worry stating I have Care or Star Health policy.
04:00 - 04:30 You don't have to worry. It's not as If your next claim will get rejected. It could be possible. Most of the claims get legally rejected. You find out later that you've been scammed. You have the features in your policy, but you are not able to claim them. Hence, you must know the hidden terms and conditions in your policy. And I will teach you that in this video. How do the hidden terms and conditions of better policies appear like? How do hidden terms & conditions of bad or slightly bad policies appear like? You evaluate your current policy after understanding that. If you think this is a wrong policy,
04:30 - 05:00 then you must definitely port the policy into a good policy. The benefit of porting would be... you won't have to endure the waiting periods that you've already been through. But if you've increased the sum insured during the porting time. then additional waiting period will be levied on the additional sum insured. The continued sum insured will remain untouched. HOW TO FIND BAD POLICIES After shortlisting the company, we must also know how to shortlist a good plan. There is an elimination technique for that too. You have to avoid policies with three evil features.
05:00 - 05:30 Room rent limit, disease-wise sublimit, and Copay. In most policies, you'll get a room rent limit, such as 1% of the sum insured. Or else the room type will be written as 'Single AC private room'. This means If you get treated by opting for a larger or a higher priced room. For example, your base sum assured is Rs 10 lakhs. And you are only allowed a single AC private room... which is the cheapest room in a hospital and it's price is Rs 3,000. But, you opted for a Rs 5000 per night room. And you were admitted for five days. then your room rent costed Rs 25,000. The total eligible surgery expense was Rs 5 lakhs.
05:30 - 06:00 then your total bill was Rs 5,25,000. Now you assumed that instead of Rs 3,000; I opted for Rs 5000 room. I spent an additional of Rs 2000 every day. And you were admitted for five days. That means you have to pay Rs 10,000 from your own pocket. And you will get the remaining Rs 5,15,000 expense in the form of a claim from policy. Eventually, the insurance company will tell you... The room rent limit in your policy is only 60% of your actual room rent. You will only get 60% on your claim of Rs 5 lakhs.
06:00 - 06:30 i.e. Rs 3,00,000. You will have to pay Rs 2,00,000 from your pocket. And there is no use of such a policy. Disease wise sublimit is also a very big scam. Maybe the company will tell you that you've a sum insured of Rs 50 lakhs. But you won't find a treatment for you to claim Rs 50 lakhs on, because... The treatment of every type is predefined... and there is a maximum limit defined on how much you can claim on it. And the worst thing I find is... It could be possible in today's times for several diseases that... cutting-edge, technologically advanced treatments are available in good hospitals.
06:30 - 07:00 But I won't be able to do that. So there must not be a disease wise sub-limit. 3. Copay. This means the admissible claim amount, not the total claim. which the company considers as worth paying... A certain percentage of it, i.e. 20% or 30%, you pay from your pocket. I will share one real example... If you have all three features mentioned in the policy, then how your Rs 15 lakhs policy is useless? Sum insured is Rs 15 lakhs. You claimed Rs 10 lakhs. And firstly we will consider the admissible claim amount, which comes to Rs 8 lakhs. Where are the 2 lakh rupees?
07:00 - 07:30 2 lakhs have been deducted from the expensive room you opted for. The admissible claim amount is Rs 8 lakhs, but you've to give 20%. i.e. it's confirmed that you have to pay Rs 2,40,000. But what do you get to know after that? There is a 5 lakh sub limit on disease. What's happening is. Admissible claim amount and sub limit, whichever is lower, is been checked. The company is holding onto the lower amount and stating... we will only provide the lower amount. So half of the amount from the claim of Rs 10 lakhs, or sometimes more... needs to be paid from your end. If you've room rent, disease-wise sub limit and copay, all in one policy.
07:30 - 08:00 FILTERING OUT GOOD POLICIES Now we will learn how to find good policies of good companies. And to search the policy and to compare it side by side... I will highly recommend using Policy Bazaar. Full Disclosure. I'll mention the link to Policy Bazaar in the description and top comment. This video is not sponsored by Policy Bazaar or any other brand. The link I am providing in the description and comment is an Affiliate link. It means If someone doesn't buy a policy through that link. Then we, i.e. LLA won't get any money for creating this video.
08:00 - 08:30 Whereas, when we accept sponsorship from a brand. It would mean that we are getting paid to create the video. But in terms of insurance videos, I want to be able to speak my mind, expose bad things in the industry. It's best If I am more transparently able to help my Jagruk Janta. Hence, If you want to purchase a policy anyway. And If you think that you've received a lot of value from this video. then you can purchase the policy through the link given by us. It won't mean that you'll get a higher priced policy through Policy Bazaar. In fact, you might get a 10-15% discount.
08:30 - 09:00 This also doesn't mean that we are encouraging you to support us, by sending you to an inferior aggregator. Policy Bazaar is a very big and reputable name. They don't spam much these days. The claim department of Policy Bazaar in certain cities, visits your hospital and facilitate your claims. And it offers you support in all the end-to-end cases. And I also respect your peace of mind. So, If you have an agent whom you trust better, then you can take it from them. In my opinion, Policy Bazaar is that agent... who doesn't forget after collecting money, but does provide you service. Hence, mine and my team's policies have been taken from Policy Bazaar itself.
09:00 - 09:30 With that being said, you'll get the link to Policy Bazaar in the description and top comment. Click on it. By clicking on it, you will be redirected to Policy Bazaar's website. You need to click here, i.e. on Health Insurance. Then you have to decide whether you want to buy it for yourself or a family floater. If you have any existing disease, then you have to disclose it honestly here. You'll have to undergo certain medical tests, you might get caught there too. And If hospitalization happens, then you have to give doctor's prescription pad too. If you get diagnosed with anything, your claim will get rejected.
09:30 - 10:00 If you are not that tech-savvy, then Policy Bazaar's executives will come to your house and guide you. and they won't charge you for anything. If you need a free home visit, then you can confirm 'Yes'. Now you have to select a cover. How much cover is ideal for you will depend upon where you live. Because you could be living in a metro city, and the health care might be expensive. And If you are staying in tier 2 or 3 cities or even in rural India, then the medical expenses are a bit cheaper. Air quality is also cheaper. Uh! It's better. In my opinion, you must have a cover of 15 - 20 lakhs for adults, and atleast a 10 lakh cover for kids.
10:00 - 10:30 But for now I will select the cover range of 25 lakh - 1 Crore. And I have filters here. I will narrow down the policies I need with the filters. Cover, room rent type, policy benefits such as pre and post hospitalization, day care treatments. It's a very interesting story about day care treatments. In March 2023, Vadodara Consumer Court issued a judgement. Day care treatments must be allowed. Companies cannot reject a day care claim. Even today, it's sold primarily as a feature.
10:30 - 11:00 Companies promote stating that we provide daycare claims. But now the thing is, they will have to provide it anyhow. It's the court's order. TYPES OF WAITING PERIODS There is a standard waiting period, which you must be aware of. You cannot claim within 30 days of purchasing the policy, expect for accidents. After that comes the waiting period of pre existing disease, which usually is for 3 years. But you can reduce this by adding a rider. How can you do it? On which policy? We will see that. But you will have to disclose the pre existing diseases. Or else you will face a major issue. The claim might get rejected in the future.
11:00 - 11:30 And you will have to by default survive the waiting period of three years. The next thing you need to remember is the specific diseases waiting period. Or else slow growing diseases. Such as kidney stones, cataract, anal fissure, etc. The list is on the screen, you can refer to the type of diseases mentioned. If you don't have diseases while purchasing the policy, then you won't get the cover for the first two years. This is a waiting period, which you have to survive. PRE AND POST HOSPITALIZATION You will get pre and post hospitalization cover in almost all the policies.
11:30 - 12:00 It means that before the main treatment or surgery, i.e. your expenses of 60 or 90 days get covered. And after surgery, i.e. post-hospitalisation expenses... are covered up to 180 days in certain policies. Which expenses? All the expenses that are related to your main treatment. It means If you had done 10-12 tests. You got it done because you had to undergo surgery based on the results. You will get the test expense reimbursed. After surgery, If the doctor has prescribed that you need to take physiotherapy, or more medications, related to the surgery, for recovery.
12:00 - 12:30 That expense will also be covered. The catch is most people aren't aware of such a feature in their policy, hence they don't claim it. You need to keep all the bills carefully and submit after 180 days. NO CLAIM BONUS It's self-explanatory, 'No Claim Bonus'. It means If you don't claim it this year, then you will get a little cover in the additional no claims bucket. The cover will vary from policy to policy. Certain policies offer 20%, certain offer 50%, every year. Certain companies have changed the name of 'No claim bonus' to 'Bonus'.
12:30 - 13:00 It means they have given fancy names from policy to policy. And now companies are stating whether you claim it or not. We will keep giving you bonus of 20% - 50% every year, please don't deny it. And even If you claim the no claim bonus or bonus won't be deleted. There will still be some conditions, which you'll have to read... and I'll tell you where it's written. RESTORATION BENEFITS The next benefit is restoration. It's every company's favourite feature and is promoted a lot.
13:00 - 13:30 They like to say that when your sum insured ends, your base sum insured will be restored again. It's quite useful in the family floater policy. Assume that it's a 4-member family and the policy is for Rs 20 lakhs. So it's not like the 20 lakh cover will be given to each individual. It's a 20 lakh shared cover, which will be beneficial for everyone. And If within a year, one family member has to undergo an expensive treatment. And the Rs 20 lakhs are used up for it. Then, no cover will be left for the remaining three members for that year. And If in that case, the cover is restored.
13:30 - 14:00 It will be beneficial for the other members too. Some companies will restore your base sum assured only once per year. And some will restore unlimited times in a year. Here is where the gimmick starts. If you are restoring it unlimited times, then there is no issue at all. I will opt for a 5 - 10 lakh basic policy. When the 5 - 10 lakhs is used up, I will restore it again. What's the tension? There is tension, but for that you need to know about 'Claim Utilization Sequence'. You will get this in the policy wording of every company. Every company has a sequence and mostly the sequence is similar.
14:00 - 14:30 1. Base Sum Assured. 2. No claim bonus. 3. After that additional cover or rider which you've opted for. 4. And restoration comes towards the end. Now depending on how easily... the company wants you to have restoration benefit. The terms and conditions are drafted accordingly. First example, Policy A - We are claiming it for the first time. The base sum assured is of Rs 10 lakhs. We have received the no claim bonus of Rs 5 lakhs. If we have opted for an additional cover, then it's for Rs 10 Crores. Let's assume we have it. And finally the restoration would be Rs 10 lakhs.
14:30 - 15:00 Which is equal to the base sum insured, that benefit is on paper now. We claimed for Rs 20 lakhs. Firstly, Rs 10 lakhs will be deducted from your base sum insured, and that will be entirely emptied. After that the no claim bonus is of Rs 5 lakhs. So the next Rs 5 lakh will be taken from 'No Claim Bonus'. It will be used up too. After that you had an additional cover of Rs 10 lakhs. Rs 5 lakh would be claimed from that. And Rs 5 lakh additional cover would still remain. Now, in the same year, we will claim Rs 10 lakhs for the second time. The base sum assured is zero.
15:00 - 15:30 The no-claim bonus is zero. Rs 5 lakh is remaining in the additional cover. Your claim will be settled for Rs 5 lakhs. And you will have to pay the remaining Rs 5 lakhs from your pocket. Now you will ask where is the restoration? Restoration remained on paper itself. Because it's written in the terms and conditions of the policy, In one single hospitalization of yours, Base Sum Assured, No Claim Bonus, Additional Cover (if any). The calculation after adding everything must be zero. Your base sum assured will be restored only after that. Because while claiming for the second time,
15:30 - 16:00 you had Rs 5 lakhs in your additional cover. So the base sum assured won't be restored. And you will have to pay the remaining Rs 5 lakhs from your pocket. Now when you claim for the third time, your base sum assured of Rs 10 lakhs will certainly be restored. But the thing is, whether you get hospitalized for the third time, or whether the year gets completed and the policy renews next year. Anyways your base sum assured, no claim bonus, additional cover will be restored. That means your fault or your hospital's fault would be... Why was your hospital bill invoiced Rs 5 lakhs lesser?
16:00 - 16:30 The first claim must have been of Rs 20 lakhs. Make it zero there itself. So that you get the restoration benefit in the next claim. You will find a different type of restoration in several policies. Let's consider Policy B's example. We have a base sum insured in this too. No claim bonus of Rs 5 lakhs, additional cover of Rs 10 lakhs. The restoration benefit which is available of Rs 10 lakhs, still on paper... and your claim is of Rs 20 lakhs. So, Rs 10 lakhs will be deducted based on base sum insured. Rs 5 lakhs on no claim bonus. And Rs 5 lakhs will be deducted on additional cover as well. And now you have an additional cover remaining of Rs 5 lakhs.
16:30 - 17:00 But it's written in the terms and conditions of this policy that.. If your base sum insured in the first claim... It's either fully or gets partially utilized, then you can restore it in another claim. Regardless of any cover available on no claim bonus or additional rider. Here when you claim for Rs 10 lakhs for the second time. Rs 5 lakhs will be deducted from your additional cover. The remaining Rs 5 lakhs will be deducted from your restoration. The restoration benefit will be maximum as per your base sum assured. Here in your base sum assured, your requirement was only of Rs 5 lakhs.
17:00 - 17:30 It will be restored by Rs 5 lakhs. Now this is very practical. You will get a chance to claim restoration during the second hospitalization. And you won't have to pay those Rs 5 lakhs from your own pocket. Moral of the story: You will get unlimited restoration option in certain policies. You need to check the conditions of it. Will they help you utilize it or is just on paper? Some more hidden terms of restoration. In certain policies, you will find unlimited restoration, but there will be a catch... They will do unlimited times for unrelated illnesses.
17:30 - 18:00 Won't do it for related illness. Related illness means you get hospitalized owing to a heart condition. And you are getting hospitalized again due to the heart condition. That's a related illness. Maybe you won't get the benefit of restoration. If you are going for a knee operation, then you might get it. In certain policies, there is an additional condition, You will get it for a related illness. But there must be a 45-day gap after your next hospitalisation. We can try to manage it somehow. But it's well and good If this condition didn't exist. COMPARING MULTIPLE POLICIES IN
ONE PLACE Now we will compare HDFC Ergo Optima Secure & ICICI Lombard Elevate plan.
18:00 - 18:30 Now these two companies, because... their incurred claims ratio and complaints data is good. And these two plans because... Both of these are flagship plans of the respective companies. Firstly, we will start the feature wise comparison. I will take you further in depth. I will open the policy documents of both policies side by side. I will teach you how to find the hidden terms and conditions. By learning this exercise, you can analyse your existing policy and derive that... Can you claim the fancy features of your policy?
18:30 - 19:00 So the HDFCs Optima Secure plan... And I will compare ICICI's Elevate. Firstly, you will notice that HDFC's premium is more. Rs 22,308. Whereas, ICICI Elevate's premium is Rs 14,285. This premium is for a 30 year old man who is fit and fine. That is because you get a base sum insured of Rs 50 lakhs in ICICI. Whereas in HDFC, along with a base sum insured of Rs 50 lakhs... You get an extra of Rs 50 lakhs from Day 1. This is called HDFC Ergo's Secure Benefit. After that you will notice, there is no limit on HDFC's room rent limit.
19:00 - 19:30 But there is a single private AC room limit in ICICI. If you look at the policy wordings, then it's written that the cheapest room is allowed. If you even go one step above, then you will have a proportionate deduction. Now you might be wondering how can it happen in the flagship plan? It's because the elevate plan is quite cheap. And it's cheap because instead of including it's important features here... It is sold with additional riders. Then it's something to talk about that If you add useful riders in this. To make this a useable policy.
19:30 - 20:00 So will it's premium come close to Optima Secure? In it's detailed comparison, you can compare rest of the features easily. This will give you an overview. Which policy has which types of features? But how useful are those features? To understand that, let us understand the police wordings of both the policies. You will get the policy wordings on Policy Bazaar itself. Wherein you are watching all the premium and riders calculation. And If you click on 'All Features' and then scroll down, then that policy's 'policy wording document' is available for download.
20:00 - 20:30 UNDERSTANDING HIDDEN TERMS AND CONDITIONS Firstly, sum assured, as I mentioned before... In HDFC, with the base sum assured, you get the same amount in secure benefit. which is applicable from Day 1. And you can claim it from first hospitalization itself. Is there any hidden condition in it, let's find out. This is the secure benefit. It's written here, 'the additional amount as specified in the policy schedule... will be available to the insured person as sum insured... for all claims admissable under Section B and Section B.2.3
20:30 - 21:00 which is called 'Protect Benefit'. All the coverage is written in Section B. And the section B.2.3 protect benefit is the consumables cover. Yes, you also get consumables cover in Optima Secure. And it's a good thing, that it's written in secure benefit... you can avail secure benefit in both types of covers. Any unutilized amount, in whole or in part will not be carried forward... to the subsequent policy year. It states that, you will keep getting a similar additional amount of base sum insured every year.
21:00 - 21:30 But you can't add that each year. It's also written in the next point that, you can use secure benefit for one claim or multiple claims in a year. So If it's a 50 lakh policy. So it's technically a Rs 1 Crore policy. I can use it anyhow. There is no secure benefit in ICICI Elevate. Now we will compare no claim bonus, which is termed as 'Plus benefit' in HDFC. It's written in Point A that, you can accumulate this as 100% base sum assured. It's written in Policy B that you will be given this after completing a year.
21:30 - 22:00 You can carry it forward which I've told you. There must not be a break in your policy. In Point C, it's written, whether you claim it or not, you will get the plus benefit. It's a great thing. It means Optima Secure is such a policy, whose cover is doubled from day one. i.e. you are getting the secure benefit. The cover is 2.5x in the initial part of second year. You might have got a plus benefit of 50%. And in the start of third year, your total cover has now become 3x, i.e. your cover will become 1.5 crores. If you opt for a 50 lakh policy.
22:00 - 22:30 After this, the scenarios have been further explained in notes. For example, read point 5 and 6. It's written that If you deduct the cover during the policy renewal next year. You reduced it from 50 lakhs to 25 lakhs. You will get the plus benefit for Rs 25 lakhs. But in point 6, it's written If you increase the cover during renewal next year. You increased it from Rs 50 lakhs to 1 Crore. You won't get the plus benefit on Rs 1 crore but on Rs 50 lakhs. And the last point is also important for you. New insured person added to the policy during subsequent renewal...
22:30 - 23:00 will be eligible for the plus benefit as per the renewal terms. Now it's written as per their renewal terms. If the new person's renewal terms are different. It means they will get base sum assured, secured benefit, But they won't get plus benefit from Day 1. They will also have to go through a year. They will get 50% + benefit on the next renewal. And on the next renewal after that, they will get 50% plus benefit. Now this plus benefit, which is the new term for no claim bonus. Let's search that in ICICI Elevate.
23:00 - 23:30 They have stated their annual renewal bonus as... Loyalty Bonus. It's written here that they will provide a 20% loyalty bonus. Every year. Irrespective of our claim. That means even If you claim or don't, you will still get it. Provided that the policy has been continuously renewed with the company... It means that there should not be a break between your policy. You can add 100% of the annual sum insured as the loyalty bonus. i.e. you can do it until base sum insured, you can't go above that. And you can carry it forward in the coming years. The next feature is 'restoration', which is the most interesting in my opinion...
23:30 - 24:00 because you'll find a lot of loopholes in this condition. Let's open it on both sides. HDFC states 'Automatic Restore Benefit' and ICICI states 'Reset Benefit'. So let's look at ICICI's Evelate's reset benefit. It's written that we will reset upto 100% of the annual sum insured. Wherever you find annual sum insured in this policy, understand that they are talking about base sum insured. Because, they have written 'annual' instead of 'base'... After that they have also written, for any illness, disease or injury.
24:00 - 24:30 Which means, related or unrelated. For all types of treatments, you will get this restoration benefit. They had a written a condition previously, which they have now removed. And it's a good thing. The condition was that If you have a related illness, and you get hospitalized for it, for the second time. That hospitalization should happen minimum 45 days later. If it doesn't happen like that, then you won't get restoration. But the condition is not the same now. Now we have to understand these points better. The entire story is here. Firstly, it's written the benefit will be triggered unlimited times.
24:30 - 25:00 Nothing won't happen so easily. Read ahead. In the third point it's written, the annual sum insured including loyalty bonus. Inflation protector, power booster. should be insufficient as a result of previous claims paid in that policy year. There are two things mentioned in this. Firstly, claim utilization sequence has been taught to you. And secondly it's also mentioned that. If you want to claim the benefit of restoration. So all these types of covers must be insufficient for you to pay the claim. Only then will you get it. Let's understand this with an example. Assume you have a base sum insured of Rs 50 lakhs.
25:00 - 25:30 'Annual sum insured' in their language. And you have a loyalty bonus of Rs 10 lakhs. Because, your policy completed a year, and you received a 20% loyalty bonus. And assume you don't have an inflation rider, and power booster rider. And you have a restoration benefit of Rs 50 lakhs together, which is not activated now and is on the side. And now your first claim comes as Rs 25 lakhs. It will be quite easily claimed from the base sum insured. For the next claim, in the same year, you have Rs 25 lakh in base sum insured.
25:30 - 26:00 10 lakh rupees in no claim bonus or loyalty bonus. And restoration is left, but it's not activated. If you get hospitalized the same year for the second time... and your bill is lower than Rs 35 lakhs. So it will be very easily... it will be paid from the base sum insured and loyalty bonus. But let's say your claim comes to Rs 45 lakhs. So Rs 25 lakhs will be deducted from base sum insured. Rs 10 lakh will be deducted from loyalty bonus. And the remaining Rs 10 lakh will be deducted from the restoration benefit.
26:00 - 26:30 So the restoration benefit of Rs 50 lakhs which is available with you. Rs 10 lakhs will be added to your base sum insured and restored. And later the claim will be deducted. This is because, it's written in the third point, your existing coverage... i.e. base sum assured, loyalty bonus or any rider. All of it was insufficient to pay your Rs 25 lakhs bill. Hence, restoration was applied. In most of the policies, instead of the sufficient word, it's written as... it's necessary that all your covers must be zero.
26:30 - 27:00 I had explained that restoration to you before... it's useless. This is atleast usable. 4. You won't get the restoration benefit in the first claim. You won't get it in the first year of your claim. In the 5th point it's written that the total amount of reset... will not exceed the annual sum insured for that policy year. If the case is that my total reset cannot be more than the annual sum insured, So how can I claim that thing unlimited times. Because it's written that it will be triggered unlimited times.
27:00 - 27:30 Turns out, unlimited times doesn't mean unlimited restoration. Let's continue this example. Your second claim also got easily done. For the third claim, you are left with zero base sum assured. There is zero loyalty bonus left. And you are left with Rs 40 lakhs restoration. And now your third claim drops down to Rs 40 lakhs. This 40 lakhs amount will be restored in the base sum insured. And it will be paid. And similarly for this year, third claim onwards... The total cover is only Rs 40 lakhs. Now you use it for one claim or for multiple claims...
27:30 - 28:00 or whether you use it for unlimited claims. You can use this Rs 40 lakhs the way you want to. So unlimited means... Your limited restoration which is 100% of your annual sum insured. In this case, for Rs 50 lakhs, by leaving the first claim, you can use it for the upcoming infinite unlimited claims. which becomes like a marketing gimmick. Because how many times do you get hospitalized in a year, But I am not saying that their reset benefit is not usable.
28:00 - 28:30 It is usable. But this word unlimited is a little misleading. After that in my point six, it's written as... Day care or inpatient. You can get restoration in both types of treatments. But in the case of Ayush treatment, you need to get admitted. You won't get restoration in the day care. It's also written that unutilized reset benefit will not be carried forward, which is standard. If you are claiming outside India, even then you won't get it. Now let's see what does HDFC's automatic restore benefit states, In the event of complete or partial utilization of the base sum insured, the company shall restore sum insured upto base sum insured.
28:30 - 29:00 Irrespective of the utilization of cumulative bonus, Plus benefit; Secure benefit. It means that claim utilization sequence will be followed. You will claim it from the base sum insured firstly. After that from the plus benefit and then from the secure benefit. And after that restore amount will be utilized. But to trigger restoration, all these types of coverage. It's not necessary to be zero or insufficient. If you've claimed even a little from the base sum insured. In the next claim, your base sum insured will become full again...
29:00 - 29:30 because you have restoration. And you will get this restoration benefit in the base coverage, and in the protect benefit too. Protect benefit means you also get consumables cover in this HDFC policy, which is not available in ICICI. One more thing that you've to note is... Company shall restore sum insured upto base sum insured. It means that your base sum insured is equal to restoration benefit for one year. The same thing is for ICICI. It's written in Point A,
29:30 - 30:00 restoration benefit shall be applied only once during each policy year. It will be written in Point B, restoration benefit would be triggered... only upon complete or partial utilization of base sum insured. By way of first claim admitted. And be available for subsequent claims thereafter in the policy year. Now it's important to combine these points and interpret it. Let's understand with an example. You've a base sum insured of Rs 50 lakhs. Plus benefit is of Rs 25 lakhs. Because this policy completed a year... & you've received a plus benefit of Rs 50 lakhs.
30:00 - 30:30 And you've a secure benefit of Rs 50 lakhs. And there is restoration benefit on the side, up to base sum assured, i.e. 50 lakhs. And now your first claim will be up to Rs 25 lakhs. You can easily claim it from the base sum insured. In the next claim, you'll have Rs 25 lakhs in base sum insured... Rs 25 lakhs in plus benefit and Rs 50 lakhs in secure benefit. But before claiming this second claim. your base sum insured has been restored from Rs 25 lakhs to 50 lakhs. It's written here that If your base sum insured gets partially utilized.
30:30 - 31:00 It will top it up. Now, you think about it. If it's written in Point A. Restoration policy shall be applied only once, during each policy year. Does that mean If I claim it next time. So this remaining restoration benefit of Rs 25 lakhs... I won't get this because I've claimed it once this year. If you only listen to Point A, then you will assume it like that. But it's written in Point B, that... If it gets triggered once, then it will be available for subsequent claims... in that policy year. The restoration benefit which you receive equal to the maximum base sum insured.
31:00 - 31:30 It is Rs 50 lakhs in our case. If you claim Rs 25 lakhs once. Then remaining Rs 25 lakhs will be beneficial for your future claims in the same policy year. So what does Point A mean, that you will only get it for a year. The total restoration benefit, i.e. Rs 50 lakhs. You will get that once a year. Rs 50 lakhs won't be restored either. It means this feature is providing similar type of restoration. The total restoration that you will get in both policies, in one year. It cannot be more than your base sum insured.
31:30 - 32:00 In both the policies, second claim onwards. You can take the restoration benefit. And the total restoration in both policies, you can utilize them in multiple claims. But If you only look at the promotional material, then you will realize you only get one restoration benefit in HDFC. And you get unlimited time in ICICI. And fun fact, If you truly need unlimited restoration in HDFC, So it has a 70 or 80 rider. If you add that, then you will get truly unlimited restoration.
32:00 - 32:30 It means after Rs 50 lakhs entirely. You can get an additional restoration of Rs 50 lakhs. The next feature is 'Domiciliary Hospitalization'. There are certain exclusions in ICICI. From A to K. Hence, If you have a requirement of hospitalization at home, then whether the company will pay for it's expenses? In ICICI's case, company will provide it. But you must have hospitalization of minimum three days. You must have a written advice of a medical practitioner. And even after that,
32:30 - 33:00 you won't get cover for diseases listed from A to K. Whereas it's written in HDFC that, you must get it in writing from the medical practitioner, similar to ICICI. The patient's condition must be that he should not be able to move... Or not being able to take to the hospital, they will get it then. Or else he is admitted at home, because he didn't get a room in the hospital. Now this doesn't mean that ICICI is not good and HDFC is better. This means that ICICI's plan is quite affordable. And If we consider all the terms and conditions, then we are buying this plan with our eyes open.
33:00 - 33:30 This comparison is done to empower you. If you keep your premiums low and opt for a policy that has a useful feature, then our objective is fulfilled. ZONE BASED POLICIES One more thing you need to remember is, ICICI's policy is zone based policy. It means If you take it in metro cities, then it's premium will be higher. because the treatment cost is higher as well. And If you purchase it in tier 3 city, then it's cost will be lower. So it's divided into zones A, B, C and D. You are punished based on zone based policy, in certain policies. It means that maybe you added your native's address, but you live in a city...
33:30 - 34:00 If you visit to take treatment in a city. In this case, the company can suggest opting for the treatment at your native, for you to get a 100% claim. But If you opt for it in the city, then 20% copay will be levied. Thankfully there is no punishment in ICICI. However, there is definitely a condition, that your address must be accurate at all times. If you have changed the address, that changed address must be updated in the policy. Or else your claim will get rejected. As long as your address is accurate, whether you get treated in tier 1 or 2.
34:00 - 34:30 There is no problem with it. The next feature is consumables, which is under the name 'Protect benefits' in HDFC. Consumables means gloves, PPE kit, and other expenses. After the treatment, which are not usually covered. You will also get that covered in the HDFC plan. But in ICICI's case, you won't get that cover inbuilt, you'll have to get a separate rider. There is another feature as annual health check up. You get that in HDFC, but not in ICICI. You will have to get a separate rider for that. You can compare all these features easily.
34:30 - 35:00 And you have policy bazaar's link in the description. RIDERS, ARE THEY USEFUL? Now since we are talking about riders, then we have to see that... If ICICI is affordable, and you have to add a lot of riders to it, to make it usable. So which are those riders, which combined together makes a useable plan. I kept both the plans side by side. HDFC's base cover is kept at Rs 25 lakhs... and the base cover in ICICI is Rs 50 lakhs. This is because... In HDFC, along with the base cover of Rs 25 lakhs, you get Rs 25 lakhs extra from Day 1, in the form of secure benefit.
35:00 - 35:30 It doesn't have a lot of hidden conditions. This is not a fair comparison by the way. If we keep HDFCs base sum insured as Rs 25 lakhs. Then their cover will become triple, i.e. Rs 75 lakhs, in the third year. Whereas, ICICI's 25 lakhs base sum insured, will double in the fifth year to 1 Crore. Just something to keep in mind. Even then HDFC is quite expensive. Now the premium is Rs 19,300 and Rs 12, 882. I have added a rider in HDFC, in the name of 'unlimited restore'. Because, in their policy, I will get the restoration only once a year. But If you want that you get unlimited restoration,
35:30 - 36:00 then you add a very affordable premium. Hence, I have not added another rider in HDFC. But in ICICI, there are a lot of riders. 1. Infinite Care. It means, in one single claim, you can claim for an infinite amount. In your entire lifetime, instead of once a year. Once the entire year. It means it's usable for the most serious illnesses. The rider is formed keeping in mind that very few people will claim it. So it could be possible that, you keep paying Rs 189/ year as loading as the premium keeps increasing on it.
36:00 - 36:30 But you won't be able to claim this benefit. And if you are highly paranoid like me, even then opt for the terms and conditions before purchasing it. It has a total of nine terms and conditions. It is written quite nicely that without any limits on the annual sum insured, you will be given to claim once in your lifetime. Apart from Ayush Day Care treatments, you will get the cover in other types. If you don't take the other while purchasing the policy, you can take it in the next two years. You won't get it after that. If you opt for it once, then...
36:30 - 37:00 you won't be able to opt out until you claim once in your policy lifetime. 5. Total sum assured, i.e. Annual sum insured. Loyalty bonus, If accrued. Power booster if opted and approved. Inflation protector shall be utilized as per the following sequence. It means firstly annual sum insured will be considered. After that, loyalty bonus will be considered. After that power booster and then inflation protector. After that your inflinite claim will be applicable. In the next point, it's written... after utilization of all the above-mentioned sum insured. The total sum insured shall be reduced to zero.
37:00 - 37:30 It means that your last coverage which is the inflation protector. If 1-2 lakh remains. And you get admitted in a hospital and the time of infinite claim occurs. Because the medical bill has become huge, then you won't be able to claim. Because little money remained in the inflation protector. Firstly, use it, make it zero, and once you go to the next claim. Only then will you get infinite. Next point is If you take voluntary co-payment. then a copayment will also be levied on this infinite cover.
37:30 - 38:00 Don't do this, that you've taken the co-payment as well. And If you have also taken an infinite rider. There are certain other aspects wherein you can't take claim. And lastly it's written that your room category will also be applied. So if you are taking the rider, then you should not opt for co-pay. You must opt for modifying room rent rider, so that your room rent limit gets removed. Otherwise this will become an infinite percentage bill of an infinite claim, and you will have to incur it. And the point number six states that, If I want to turn these four types of covers into zero, then for one particular case this infinite cover will be denied.
38:00 - 38:30 So in my opinion, I must skip this rider, you must learn how to increase your base sum insured. If you are taking adequate base cover, then you are sorted. Because at the same time, you are also getting a renewal bonus in both policies. So after some years, your cover will get doubled anyway. If you are opting for HDFC, then your cover will be tripled. The next rider in ICICI is power booster. Power booster means you will get 100% sum insured every year, regardless of claims. This is quite amazing. i.e. This policy is for Rs 50 lakhs, and will become Rs 1 Crore next year.
38:30 - 39:00 After that it will be 1.5 Crore. In the next 10 years, it will become Rs 5 Crore 50 lakhs. There is no upper limit. You can keep adding unlimited. Technically you are buying an infinite cover policy. There are no hidden terms and conditions in power booster, which is a good thing. But in point number 3, it's written... In case the insured person opts out of this cover at any time of the renewal. All the bonus accumulated under power booster will be reduced to zero. Now you will say why should I opt out of this amazing rider. It will become a 10 crore policy after 20 years.
39:00 - 39:30 And 20 crore policy after 40 years. You will opt out because... because this plan is cheaper today, it won't be tomorrow. Premiums of health insurance keeps increasing with age. They are not fixed like term insurance. Your total premium could increase so much in the future, you will think that... You must remove this rider. If you remove it, then the added sum insured will be removed. After that the next rider is jump start. In jump start, it states that the waiting period in your pre existing diseases. Usually of 3 years, you can make it up 30 days.
39:30 - 40:00 That is you can treat pre existing disease from the 31st day. The rider's price is the most expensive in this case, which is Rs 3,800. You must only consider when you have any pre existing diseases. If you are plannig a surgery or a treatment. But not without knowing the terms and conditions. And as you can see, one of the longest list of terms and conditions is of jumpstart. So it's written the diseases that you declare. and the diseases that we (the company) accepts, that will be covered. This cover will be available only during inception of the policy...
40:00 - 40:30 or upon addition of a new member. Once chosen, this optional cover will have to be opted for... a period of three continuous policy years. What will happen after three years, this rider will be removed from the policy. But it's not written that, your normal premium will increase after three years. Your money won't be saved. You might think that you need to pay upto three years. After that premium will reduce. No, it won't happen like that. There is a term as loading. Loading states by looking at your pre-existing conditions, your premium is increased. Assume that and it will happen with you.
40:30 - 41:00 Don't presume that your premium will decrease after three years. After that it's written list of diseases covered. Asthma, diabetes, Hypertension i.e. high BP, Hyperlipidemia i.e. high cholesterol. Obesity, coronary artery disease. These six diseases have been further explained. What are these? and when will you get a cover on it? For eg: Coronary artery disease, PTCA done prior to one year. PTCA means coronary angioplasty, i.e. the procedure to insert a stent in the artery. Further it's also written that, Angioplasty with or without stenting for treatment of narrowing or blockage...
41:00 - 41:30 of a minimum of 50% of one or more major coronary arteries. It's not that you have a blockage and it's appeared in the test. There is a coronary CT angiography, in which you have to... It's a non-invasive test, a CT scan is conducted to show the blockage. and when you get to know about it, then it's not considered a pre existing disease. As far as this policy or jumpstart rider is confirmed... Your operation is confirmed and should be done.. More than one stent should be added. There must be 50% blockage, only then will you be able to cover it. This is the claim protector.
41:30 - 42:00 This is the consumables cover, i.e. gloves, PPE kit, etc. All the out of pocket expenses. You will have to take an additional rider to cover that. Amounting to Rs 652. The next rider is of pre-existing disease. If you want instead of three, you only have two years of waiting period. Or it should only be for a year, then you can pay the premium immediately. You also need to think If you need the cover immediately. Or If you don't want to wait for three years, then you will have to add. The next rider is inflation protect, which we have repeatedly come across. It's also known as sum insured. It's for Rs 150. It states that as per the previous year's inflation rate,
42:00 - 42:30 your base sum assured will be increased. Since this rider is very cheap. So it's not bad to opt for this. After that is room modifier, which you have to purchase. Now you need to opt for select and click on 'any room'. And you will have to add this. The next rider is annual health check up. It's included in HDFC, in the base plan. You have to take it separately in ICICI. Maybe all types of tests might not be covered in this. Next is 'BeFit C'. This BeFit C states that upto four out patient consultations... i.e. you'll get doctor consultations, routine diagnostic and minor procedure cover of Rs 1000.
42:30 - 43:00 Pharmacy 1000, six sections of physiotherapy, e counselling, diet and nutrition, e consultation each. This is something to create a package and then form a rider. I won't opt for it. And in HDFC, you will get an OPD cover in built. There is a separate render in this. And this physiotherapy, e counselling, etc. Most people don't use this. It's ok even If you don't take it. But you only have to manage the OPD expense. The next is 'specific disease waiting period' which is of 2 years, I told you.
43:00 - 43:30 You can give a premium and change it from 2 to 1 year. I think the premium is too high... and it's not like jumpstart that it's waiting period could go reach 30 days. It will only be for a year. So as per me, this must not be added. After that, dependent accomodation, durable medical cover, After that, there are two riders which I haven't seen... you can read them. If I add a rider in ICICI. So I will do the room modifier thing because it must be done. I could also make inflation, because it's only for Rs 150. And if because of inflation, my cover keeps increasing...
43:30 - 44:00 then there is no major issue. However, it won't increase due to medical inflation. It will increase because of CPI inflation. I can also take claim protector and If you want to get it equal to HDFC. I can also take claim protector. Because this is consumables cover. And as I told you about power booster. There are no hidden terms and conditions in terms of usability. But If we opted out in the future, then all the added power booster will disappear. And for this, I believe the premium will become so unaffordable... and I might have to leave it and it will be removed.
44:00 - 44:30 I won't add it today. I want to keep my premium slow. By doing this, my premium in ICICI comes to Rs 14,315. Whereas, in HDFC, it comes to Rs 19,300. In ICICI, the premium is less, but there are some key differences. In HDFC, you get base sum assured... and you also get a secured benefit along with that. and you will also get 50% plus benefit, which is also called as no claim bonus. Irrespective of claims. It means my total cover will triple in the third year. If you look at it that way, then the premium will be justified. Whereas in ICICI,
44:30 - 45:00 you won't get any secured benefit, you will only get the base sum assured. After that you will get a no-claim bonus, which is 20% instead of 50%. i.e. your cover will double in the fifth year. Whereas, in HDFC, the cover triples in the third year. You also get maternity cover in ICICI and it must've been added in HDFC too. But the terms for both are not good. If the annual premium you give and the waiting period. It turns out you will pay your entire delivery expense in premiums and get it back. So calculate that once. You also get a bariatric surgery in ICICI.
45:00 - 45:30 But understand this fancy name once. Bariatric surgery is done on highly obese people, by cutting their organs. Their weight loss surgery is done, so that they survive in the future. So If you don't come in the category, then there is no requirement for you. The conclusion is... If now you've understood when do you get claims in ICICI plan. When do you get it, when you don't. And which features are helpful for you. You can take it with open eyes, and you can save the premium too. So If you want more cover in a lower premium. If you also need jumpstart rider for pre existing diseases,
45:30 - 46:00 then you can consider ICICI for it. But If you need a no compromise policy with triple coverage. And simple to understand terms and conditions. Then you can opt for HDFC with high premium. HOW TO LOWER THE PREMIUM? Now how can premiums be lowered further from here, you've two tricks on that too. You have an option in HDFC of 'aggregate deductible'. You can choose an aggregate deductible amount as per your wish. For example, you chose Rs 50,000. It means the bill formed in a year.
46:00 - 46:30 in one claim or in multiple claims. You've to provide first Rs 50,000 of that medical bill. Not per hospitalization, but per year. It doesn't mean that you visited the hospital 10 times a year, then you'll have to provide Rs 5 lakhs for it. You only have to provide Rs 50,000. You can claim the remaining from HDFC. If you chose this deductible, which is actually not a bad deal compared to co-pay. In which, 20% of the admissable claim amount is levied. You'll have to provide 20%, if you receive a Rs 50 lakh claim. Here your upside is capped on Rs 50,000.
46:30 - 47:00 By choosing this, your premium drastically reduces. And If you notice here. Then the premium discount you receive on the deductible of Rs 50,000. You won't get the double discount on Rs 1 lakh. It really doesn't make sense that you choose the deductible of Rs 1 lakh. Mathematically speaking, you have a higher benefit on Rs 50,000. You choose this at the time, when you decide not to claim in the next 10 years, and you save Rs 50,000. Before paying it for the first time. Or else you have a policy, i.e. a different policy.
47:00 - 47:30 And the first claim could be fulfilled from there too. SUPER TOP UP 2. Taking a huge cover while keeping the premium lower is a super top-up policy. And this comes at an affforable rate than the normal health insurance policy. And it's affordable because the first 5 or 10 lakhs, Any deductible limit that you choose. You will get a claim higher than that. For eg: You got a super top-up policy of Rs 50 lakhs. Aggregate deductible is of Rs 10 lakhs. So it means that year, you will have to accumulate the first Rs 10 lakhs from somewhere else. And if your claim is more than 10 lakhs, then any claims in excess of that.
47:30 - 48:00 You will get that from super top up. The trick is whichever deductible you choose. The insurance from there until now. It should be sorted with the main policy. And the insurance above that must be sorted with your super top up. There is a top up policy, which you have to simply ignore. You must take a super top up. Because, you only get one hit to claim the deductible in top up. Whereas, the deductible in super top, it will still be counted even after hitting multiple claims. So the practical usage of super top up increases,
48:00 - 48:30 and it could happen that you might not get claim in the case of top up. I HAVE A CORPORATE POLICY. SHOULD I GET A SEPARATE HEALTH POLICY? Now a commonly asked question, a lot of people ask me is... I have received a great plan from a corporate. or whether I should opt for an individual or personal health insurance policy. The answer to that is, absolutely you must. Because If you left the job. So there is no guarantee... whether the company will let you convert it into an individual plan. A fresh underwriting will be done on that. It's company's decision, they can even deny it. It is denied in most cases. It is not possible to port in most cases.
48:30 - 49:00 And If you don't have the policy in the future, then you will have to take a new policy. You will have to survive all the waiting periods again. And maybe you might have to pay an extra premium. Because your age will be more in the future date. There will be a new pre existing disease too. You might have to give an extra loading on that too. There are a lot of these complications too. You must have your own policy, in which you have your entire control. INDIVIDUAL V/S FAMILY FLOATER PLANS The next question is whether to take an individual plan or a family floater. You can combine people of the similar age group, in one floater plan.
49:00 - 49:30 But If you are combining with your parents in one plan. So it's not a good decision. Because the plan's premium will be kept as per the eldest member's age. And your premium which could have been reduced. That will increase. You and your spouse could be in one plan, and both your parents in a different plan. If you don't have a spouse, then consider individual. When you get married, then add the spouse later. So this was 2025, 'The Ultimate Guide to buying the best Health Insurance'... from the best company in India. If I've left anything, then please mention in the comments.
49:30 - 50:00 And If you think that you've got great value from this video, which I have made sure that you do. Then please go to the Policy Bazaar link available in the description or top comment... get your policy's research done. Download the policy wordings too. And purchase the policy If you consider to. I will meet you in a new video. Until then, bye! This is the editor, who comes home and edits. We have such a service too. So I was editing this video.
50:00 - 50:30 And I opted for the policy while watching. I bought the policy 1-2 hours before. I purchased a policy a while ago and received an email... that my policy has been issued, too.