Question 1

What is the difference between individual and family floater health plans?

Accepted Answer

An individual plan covers one person with a dedicated sum insured. A family floater shares one sum insured across all insured members — usually spouse and children. Floaters can be cost-effective for young families, but a single large claim can exhaust the shared limit for everyone.

Question 2

What is a room rent limit in health insurance?

Accepted Answer

Many policies cap room rent to a percentage of sum insured (for example, 1% per day for a ₹5 lakh plan). Choosing a room above the limit can reduce claim payouts proportionally. Compare plans with single private room or no sub-limits if you prefer predictable hospital bills.

Question 3

Does health insurance cover pre-existing diseases?

Accepted Answer

IRDAI allows insurers to apply waiting periods for pre-existing conditions — typically 2–4 years depending on the product. Disclose all medical history at purchase. After the waiting period, eligible hospitalisation for declared conditions is covered as per policy terms.

Question 4

What is claim settlement ratio for health insurers?

Accepted Answer

Health claim settlement ratio shows what share of claims an insurer settled in a financial year. It is a useful starting point, but also check average claim processing time, cashless hospital network in your city, and exclusions for specific treatments.

Question 5

Is GST applicable on health insurance premiums?

Accepted Answer

Yes. Health insurance premiums attract 18% GST in India. The tax is added to your premium invoice. Section 80D deduction applies on the premium paid (within limits) — consult a tax adviser on how GST fits your overall tax planning.

Question 6

Can I port my health insurance to another insurer?

Accepted Answer

Yes, under IRDAI portability rules you can switch insurers at renewal while carrying forward waiting periods already served, subject to underwriting. Porting is useful if you find better coverage or service — initiate the process 45–60 days before renewal.

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