What is Health Insurance?
Health insurance is a contract that can help pay eligible costs when an insured person needs medical care for an illness or injury. The policy may settle eligible hospital expenses or pay a stated benefit, depending on the type of plan. The insurer’s payment is always subject to the policy wording, chosen cover, and applicable limits.
With an indemnity-based policy, eligible medical expenses are covered up to the available sum insured and policy limits. A benefit-based policy pays a fixed amount when the covered event or condition is met. Some plans offer cashless treatment at listed hospitals; reimbursement may apply in other situations. These options and procedures vary by policy.
What to understand
- Sum insured
- The maximum cover available under the policy, subject to its terms.
- Waiting periods
- Some illnesses or treatments may be covered only after a stated period.
- Your share of costs
- Co-payments, deductibles, room limits, or sub-limits can affect what you pay.
- Before buying
- Disclose health information accurately and check exclusions, network hospitals, claim steps, and renewal conditions.
