Best health insurance plans for you

How do you buy a health insurance plan? If you just settle with the plan your agent sells or are happy knowing you have bought the cheapest plan, there is a bit of unlearning and a lot of learning in store for you. To help you understand the important features of a health insurance plan and give you a ready comparison, we designed Mint Mediclaim Ratings (MMR), which was developed by SecureNow Insurance Broker Pvt. Ltd. The full ratings along with the methodology can be seen here:http://www.livemint.com/mintmediratings.

In the ratings, for family floater plans, we have considered two sum insured amounts (Rs.10 lakh and Rs.20 lakh) and three age categories in each—eldest insured member is 35, 45 or 65 years old. For individual plans, the age categories are the same but the sum assured is Rs.5 lakh.

In this section, we pick a few plans from a particular age group of one category of sum insured, and give you the details of the ratings of each. Every week we also pick one parameter of the rating and explain its importance. Let’s start with claims not settled. A key piece of buying any insurance policy is how good the company is in paying up its claims. Unfortunately, in India, in the best health insurance in india space, this data is difficult to get in a user-friendly and comparable format. Claims settlement data, as it appears in the public disclosure documents of insurance companies, is a consolidated set of numbers that include claims from group as well as individual policies. But only a small number of group policies are rejected as these don’t come with waiting period on pre-existing ailments and other specified ailments. So, if an insurer has a sizeable group portfolio, its claims settlement data may look healthier.

Therefore, it is important to segregate this data for better analysis. But the Insurance Regulatory and Development Authority has not asked for it, nor have insurers done so.

The second issue is in the nomenclature. Under claims settlement, insurers state number of claims reported, settled, repudiated, closed and outstanding. It’s important to track the claims payment of an insurer--claims paid over claim decisions taken (settled, repudiated and closed). The inverse of this measures the claims not settled. While claims repudiated and settled are self-explanatory, closed claims need some detailing. According to insurers, closed claims are those unpaid claims that are closed either due to lack of more documents from the insured or where the policyholder hasn’t pursued the claim further. Closed claims should ideally form a very small portion, but if it’s sizeable, there is reason to worry.

In our ratings, we have put claims repudiated along with claims closed in the claims not settled basket. This is a start and perhaps will encourage the industry to publicly disclose data in a more transparent fashion.

Source from: http://www.livemint.com/Money/f68DDNqiUFzqnnZ19u3YbM/Best-health-insurance-plans-for-you.html