Insured India

Introduction: The Vague Clause That Gets Your Claim Denied Picture this: you or a loved one are finally home from the hospital. The worst is over, and you feel a sense of relief. You have health insurance for moments just like this. You file the claim, expecting your insurance to cover the bills you've paid premiums for. But instead, you get a letter. Your claim has been denied. The reason? "Treatment not medically necessary." This is a frustratingly common experience for people all over India. The "medically necessary" clause is a powerful tool for insurance companies, and they use it to reject a large number of claims. The wording is so vague that it gives the insurer an unfair advantage, leaving you feeling helpless and worried about the cost. The insurance company, a big corporation, has made a one-sided decision about a treatment your own doctor said you needed. I will explain in simple terms what "medically necessary" means, break down ...

You’ve secured a health insurance policy with a ₹10 lakh sum insured, believing you've built a financial fortress around your family's health. You pay your premiums on time, confident in this safety net. Then, a doctor recommends a knee replacement for an elderly parent. The estimated cost at a good city hospital is ₹3.5 lakhs—a significant amount, but well within your policy limit. You initiate the cashless claim, only to receive a staggering blow from your insurer: they will only approve ₹50,000. The remaining ₹3 lakhs must come from your pocket. This scenario isn't a hypothetical nightmare; it's the harsh reality for countless policyholders who fall into the sub-limit trap . It’s the fine print in your policy that can render your high-value cover tragically inadequate, a fact often upheld in the very consumer courts designed to protect you. What is a Sub-Limit and Why is it Legally Binding? A sub-limit is a cap placed by an insurer on a specifi...

For millions of salaried professionals across India, the corporate health insurance plan provided by their employer feels like a warm blanket of security. It’s a fantastic perk, a line item in the benefits package that brings peace of mind. But what if this comfort is actually a gilded cage, creating a false sense of security that could leave you and your family vulnerable when you need protection the most? Your employer's group health policy is an excellent starting point, but relying on it solely is one of the riskiest financial decisions you can make. Here’s a detailed breakdown of why that company policy isn't the foolproof shield you think it is. 1. The Coverage is Tied to Your Job, Not to You This is the single most critical point. Your corporate health cover is valid only as long as you are an employee of the company. The moment you leave—whether you resign for a better opportunity, face a layoff, or decide to start your own venture—that safety net van...

It’s September 2025, and the way we interact with healthcare in India is changing faster than ever. If you have health insurance, there's a new tool in your arsenal that you absolutely need to know about: your ABHA ID. You might have heard of the Ayushman Bharat Digital Mission, but many people still see ABHA as something separate from their private health insurance. Think again. The integration of ABHA with private insurance is no longer a distant concept—it’s happening now, and it’s designed to make your life significantly easier. What is an ABHA ID? Think of your ABHA (Ayushman Bharat Health Account) ID as a unique health identifier, like an Aadhaar for your medical history. It's a 14-digit number that allows you to securely and digitally access and share your health records with doctors, hospitals, and, crucially, your insurance provider. You can store everything from prescriptions and lab reports to hospital discharge summaries in one secure, accessible p...

Big news! The recent GST cut to 0% on health and life insurance premiums could be a major turning point for insurance adoption in India. Current Penetration Levels According to the IRDAI Annual Report for FY 2023-24, India’s overall insurance penetration is around 4% of GDP —down from 4.2% the year before. Life insurance accounts for 2.8%, while general insurance remains stagnant at ~1%. This is significantly lower than the global average of ~7%. Why Removing GST Makes a Big Difference Previously, premiums were taxed at 18%. That extra cost deterred many, especially middle-class families, from buying policies. Industry experts now believe the GST move can make insurance significantly more affordable. Rakesh Jain, CEO of Reliance General Insurance , stated that cutting GST will encourage more people to protect themselves financially without worrying about stretching their budget. Projected Uptake in Insurance Penetration Analysts estimate that making insurance tax-free co...

Breaking News: The Government of India has officially reduced the Goods and Services Tax (GST) on health insurance policies to 0% . This is a historic move that will directly benefit millions of Indians, making health insurance more affordable, accessible, and practical for everyone—from salaried professionals to farmers in villages. Why Was This Move Necessary? Earlier, health insurance premiums carried a 18% GST . This meant that if you were paying ₹20,000 as premium, you had to pay an additional ₹3,600 as tax. For families already struggling with medical expenses, this extra cost acted as a barrier. The removal of GST now makes insurance more affordable and encourages more households to protect themselves financially. The Burden of Rising Healthcare Costs India’s healthcare expenses have been rising steadily, especially after the pandemic. A single hospitalization for a major illness can cost anywhere between ₹3 to ₹10 lakh in private hospitals. Without ...