Tick off the clauses that decide what a health policy pays before you buy, renew or port.
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Use this checklist with the policy wording, the Customer Information Sheet (CIS) the insurer must give you, and the quote. It is grouped in the order you meet each decision: what the policy covers, when cover starts for existing conditions, what you declare, how claims work and what you pay.
How to use it. Tick an item only when you have found the answer in a document, not on a sales call. If an answer is missing, ask the insurer to confirm it in writing by email; that email can matter later at claim time.
Worked example. A buyer comparing two ₹10 lakh plans ticks every line for Plan A, but finds Plan B has a 1% room-rent limit (₹10,000 a day) and a two-year wait for named conditions. Using the room-rent guide, she estimates that a ₹4 lakh stay in a ₹15,000 room would cost her about ₹1 lakh extra under Plan B, which outweighs its lower premium.
Limits. A checklist cannot judge your medical needs. If you have a chronic condition, ask your doctor which treatments you are likely to need and then check them against the wording. See the full buying checklist guide.
Claim Pitfalls, Complaints and Official Sources
The common reasons Indian health insurance claims are rejected or cut, what the policy wording says about each, how to prevent them and what to do after a rejection.
Worked Examples and Buying Checklists
A step-by-step checklist for buying or renewing health insurance in India, covering cover size, clauses, disclosures, network hospitals, premium, tax and the 30-day free look.
Claim Pitfalls, Complaints and Official Sources
The escalation route for a rejected or underpaid health insurance claim in India, with time limits, the ₹50 lakh Ombudsman limit, consumer commission tiers and a complaint letter structure.
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How to port a health insurance policy to another insurer in India, what credit carries over, timelines, documents, a worked example and the mistakes that break continuity.
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How non-disclosure of pre-existing conditions affects health claims in India, what the 60-month moratorium protects, what it does not, and how to correct a proposal form.
Claim Pitfalls, Complaints and Official Sources
Check that an insurer, agent or web aggregator is IRDAI-registered, that your health policy is genuine, and which official portals to use for rules, tax, GST, PM-JAY and complaints.
