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How Health Insurance Works

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Health Insurance

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​Buying a health insurance plan is one of the smartest decisions you can make today. It saves you on the day your medical bill shows up if you ever get hospitalised. Simply put, health insurance ensures that you receive the necessary healthcare support when required without worrying about the resulting financial burden.

If you are still wondering whether to buy one, this post is for you. We will discuss what is health insurance, how health insurance works and other important things to help you make an informed decision.

What is Health Insurance and ​​How Does it Work in India?

Health insurance is an agreement between two parties: the policyholder (you) and the insurer (or the insurance company). In this agreement, the insurer agrees to pay your medical expenses mentioned in the policy if you ever get hospitalised. In return, you are expected to pay a premium, which is the amount to buy the policy.

Moreover, health insurance policies in India are monitored by a regulatory body - the Insurance Regulatory and Development Authority of India (IRDAI). This helps ensure a standard practice is maintained across the country and maintains protection for policyholders fairly.

How Health Insura​​nce Works?

  • Buy a Plan and Pay the Premium

    First step to purchase a health insurance policy based on your specific coverage requirements. You are required to pay a certain amount, known as premium, to maintain your coverage for the given period.

  • Enjoy Medical Coverage and Benefits

    Once you have a plan, you can enjoy the coverage and a range of benefits including cashless hospitalisation, annual check-ups and more.

  • File a Claim

    In the event of a covered medical emergency, you can file a claim by filling a claims form and submitting it along with other supporting documents.

  • Avail Cashless Treatment or Get Reimbursed

    Once your claim is registered and approved, you can either receive cashless hospitalisation or get reimbursed for your medical expenses via our reimbursement claim facility.

Also Read: Understanding How Health Insurance Works

Types of Health Insurance with Re​​liance General Insurance

Individual Health Insurance

An individual health insurance policy covers a single person's medical expenses. Our Health Infinity Insurance provides various coverage options to ensure that you receive comprehensive benefits.

These include pre- and post-hospitalisation, higher sum insured, special treatment cover, AYUSH benefits and various add-on options.

Family Health Insurance

Family health insurance covers multiple family members under a single policy. Since all family members are covered under one policy, the premium is generally lower, making it a cost-effective solution.

We offer family insurance under the Reliance Health Gain Insurance policy, which offers three sub-categories with varied sum insured, in-patient care with no sub-limits, ambulance cover and cover for a maximum of six adults and six children in your family.

Senior Citizens Health Insurance

Since the healthcare needs of senior citizens vary greatly from those of young adults and children, we offer a separate plan catering to their needs.

Under these plans, we offer coverage against many age-related health conditions, cashless hospitalisation, ambulance cover, pre- and post-hospitalisation, lifetime renewability and a higher entry age.

Group Health Insurance

This type of health insurance is designed specifically for companies or organisations to provide healthcare for their employees. It ensures that the maximum number of people in this country can have access to healthcare services without financial burden.

Our Group Mediclaim Insurance Policy provides coverage to up to 1,000 employees and offers them the perks of having a health insurance policy.

International Health Insurance

International health insurance is designed to provide adequate coverage if you have a planned treatment or surgery outside of India as part of the treatment.

Our Reliance Health Global Insurance offers comprehensive coverage for individuals and families for a wide range of treatments and a lifetime limit of twice the sum insured.

Additionally, we also offer global + India coverage with sub-categories to choose from based on your requirements.

Top-Up Health Insurance

This feature is available when you have exhausted your existing coverage and need to add more to it.

With Reliance Super Top-Up insurance, you can be assured of securing your financial protection at all times, along with benefits like worldwide coverage, maternity cover, discounts and a high sum insured.

Accidental Health Insurance

This plan is designed to provide immediate medical care for injuries or conditions caused by an accident.

Our Personal Accident Insurance plan offers hospitalisation coverage, worldwide coverage, quick claim settlement, family security, a low premium and no waiting period.

Critical Health Insurance

This type of health insurance is created to provide financial protection for the treatment of life-threatening critical illnesses, such as cancer, kidney problems, cardiac surgeries, etc.

With Reliance Critical Illness Insurance, you get coverage for a broad range of life-threatening conditions and can receive benefits upon diagnosis.

Note: Please read the policy wordings carefully to understand each type of health insurance plan and its coverage details.

How Does the Reliance Health In​surance Claim Process Work?

Understanding how health insurance works is important. But learning about the claims settlement process of your plan is even more crucial. There are two types of claims settlement options available at Reliance General Insurance:

  • Cashless Claims: Cashless claims mean you do not have to pay anything from your pocket toward your medical bills (except for applicable deductibles and co-payment). All payments are handled between us and the hospital. Also, cashless services are available at any hospital in India, as per the IRDAI’s mandate.
  • Reimbursement Claims: A reimbursement claim is the opposite of a cashless claim. In a reimbursement claim, you're required to settle hospital bills before raising a claim. After our claims department verifies your claim, you get reimbursed for the bills you paid.

How to File Cashless Claims?

  1. Register your claim by calling our claims helplineor logging into the Reliance Self-i mobile app. Make sure to intimate your claim within 24 hours facing the emergency.
  2. Fill a claims formand submit it alongside all documents required by our claims team.
  3. Once your claim is accepted, you can avail cashless hospitalisation at any authorised hospital of your choice. For a speedy claims settlement, it is strongly advised to avail cashless treatment at our network hospitals.
  4. Once your treatment is done, our claims team will settle your covered expenses directly with the hospital.

How to File a Reimbursement Claim?

  1. Register your claim by calling our claims helplineor logging into the Reliance Self-i mobile app. Make sure to intimate your claim within 24 hours facing the emergency.
  2. Update the claims team regarding the type of treatment you're getting, the start date, etc.
  3. Receive treatment at any hospital of your choice and pay your medical bills with the hospital. Make sure to collect all the invoices and discharge papers.
  4. Submit all the original documents to our claims team within 7 days of being discharged from the hospital to claim your reimbursement.

How Does Health Insurance Re​newal ​​Work?

Health insurance renewal is a crucial aspect of maintaining continuous coverage without interruptions and carrying forward the accumulated bonuses and discounts.

During the renewal process, you also get an opportunity to opt for any add-on covers, revise your sum insured, add or remove members and adjust the coverage if required.

Renewing your health insurance policies with Reliance General Insurance is a hassle-free process. Here is how you can renew your plan:

How to Renew Your Health Insurance Policy Online?

  1. Visit our official website.
  2. Navigate through the menu bar and go to the “Renewals” tab.
  3. Click on the “Renew Health Insurance” tab and enter your details, such as your policy number or registered mobile number and the expiry date.
  4. Verify your details and select any add-ons or coverage requirements if required.
  5. Complete the payment using your preferred mode of payment.

Alternatively, you can also complete the renewal process via our Reliance Self-i App. Our existing customers can benefit from the seamless on-the-go renewal process by simply logging into their account, comparing plans and add-ons and completing the payment.

Also Read: How To Renew Expired Health Insurance Policy Online?

Benefits of Purchasing Health Insur​​​ance from Reliance General Insurance

Access to Quality Healthcare

When you have health insurance, you can access quality healthcare services without worrying about paying the bills out of your pocket. Our health insurance policies offer cashless treatment facilities at any hospital, including our network of 10,000+ hospitals.

Financial Protection

Our health insurance offers coverage for pre- and post-hospitalisation expenses, affordable premiums, a high sum insured, alternative treatments, preventive treatment, room rent and much more. These reduce your financial burden and out-of-pocket expenses during the billing procedure in the hospital.

100% Claims Settlement

We offer a swift and stress-free claims settlement process to help you protect your finances. With our 100% claims settlement ratio, you can stay assured of an efficient resolution of your claims in a timely manner.

Coverage for Pre-Existing Conditions

After a waiting period, most of our health insurance plans cover pre-existing conditions, providing financial relief for managing chronic illnesses.

Tax Benefits

Annual premiums paid for health insurance are eligible for tax deductions under Section 80D of the Income Tax Act, reducing your overall tax liability. Simply put, you can maximise your tax savings by purchasing health insurance for yourself and your family.

Preventive Healthcare Services

We offer coverage for preventive care, such as annual health check-ups, vaccinations, screenings, etc., to promote overall well-being.

Low Premiums

Buying health insurance is critical but it should not bring any additional burden on your income. Hence, we offer super affordable health insurance premiums starting from just ₹243 per month. In addition, we also offer up to 80% exclusive discounts if you buy our plan online.

Cumulative Bonuses

We offer bonuses for every no-claim year in the form of premium discounts, additional discounts or an extra sum insured.

Peace of Mind

Knowing that unforeseen medical expenses are covered provides peace of mind; you can focus on recovery or taking care of your loved ones without financial stress.

Factors to Consider Before Pur​chasing Health Insurance

Assess Your Healthcare Requirements

Understanding health insurance and how it works, as well as your healthcare requirements, is important before choosing a health insurance policy.

Thus, consider factors such as age, family medical history, lifestyle and pre-existing diseases to choose the right policy with adequate coverage for you.

Premium

Premium is the amount you pay to your insurer on a monthly, quarterly or yearly basis to maintain the insurance policy. Choose a policy that has affordable premiums while also providing adequate coverage.

Compare our health insurance plans and their premiums and choose the one that fits all your needs.

Additionally, you can use our health insurance calculator to derive an estimate of the premium you are supposed to pay with your choice of insurance plans and make an informed decision.

Wide Network of Hospitals

Treatments at network hospitals facilitate a quick and easy billing procedure in hospitals. We have a network of 10,000+ hospitals spread across the country. You can use our Network Hospital Locator to easily find one near you.

Sum Insured

The sum insured is the maximum amount you receive in a policy year after you claim your insurance. Thus, choose a policy that provides a higher sum insured that covers all your medical expenses during emergencies.

Policy Renewal

Understand the policy terms and choose a policy that offers quick and hassle-free online policy renewal to avoid missing out on accumulated bonuses and policy coverage.

Exclusions and Limitations

Every policy has a different set of exclusions and limitations. Thus, review the policy exclusions and limitations to know what is not covered. By being aware of the exclusions, you can avoid unnecessary claim rejections.

Additional Benefits

Consider additional benefits like maternity coverage, preventive care, critical illness cover, AYUSH benefits, etc., to ensure broader protection against various health-related expenses.

Customer Services

Consider the availability of customer service before choosing your healthcare policy. Since medical emergencies can occur at any time, we offer 24/7 assistance to help you with the claim process and support you through difficult situations.

Also Read: A Guide to Purchase the Perfect Health Insurance

Conclusi​​on

Understanding health insurance, how it works is a matter of knowing the principles on which insurance is based. After all, insurance is a tool that protects you from financial losses that may occur from unforeseen risks like illness or accidents.

Thus, it is crucial that you choose the right health insurance policy with the best health insurance benefits, covering all your healthcare needs.

At Reliance General Insurance, you can not only get all the above-listed benefits but also a broad range of health insurance plans to choose from. Since different types of health conditions require specific types of coverage, we provide a plethora of dedicated services to support your needs.

Using our services, you can be assured of protecting yourself and your loved ones from unprecedented medical expenses.

Frequently Asked Questi​ons

  • What is the ideal age for buying health insurance in India?
  • There is no defined age to buy a health insurance policy, but you are advised to purchase a policy as early as possible to get maximum benefits from your insurance plans.

    However, certain plans, like our insurance plans for senior citizens and Group Health Insurance Mediclaim Policy, have a defined entry age. Thus, go through the policy underwriting carefully to ensure you fit into criteria.

  • How much does a health insurance policy cost?
  • The cost of a health insurance policy depends on various factors, such as age, required coverage, required sum insured, insured members and your current health condition. While our plans start at just ₹243 per month, the price varies depending on these factors.

  • Can you add additional family members to an existing health insurance policy?
  • Yes, you can add another family member to your family health insurance plan at the time of renewal. Our Health Gain Insurance policy allows you to add a maximum of 6 adults and 6 children under one policy.

  • What happens if I do not claim my health insurance?
  • If you do not claim your health insurance within the policy year, you are eligible for a No-Claim Bonus. With this, we reward you for maintaining good health by offering discounts on premiums at the time of renewal.

  • Is it better to take health insurance or mediclaim?

    While health insurance and mediclaim are used interchangeably in this landscape, they mean different things. Health insurance offers extensive coverage that includes ambulance cover, room rent, pre- and post-hospitalisation expenses, etc.

    On the other hand, mediclaim focuses on covering hospitalisation and emergency treatment-related expenses only. Thus, analyse your needs, read the policy terms and choose accordingly.

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