Health & Family Insurance

Yes. We evaluate your family's age distribution, medical history, budget, and local hospital preferences. We explain the trade-offs between individual sum insured vs family floater plans, room rent sub-limits, OPD add-ons, and critical illness riders before you make any commitment.

Under current IRDAI regulations, the maximum waiting period for declared pre-existing diseases is capped between 24 to 36 months (reduced from the historical 48 months). Specific ailments such as cataract, hernia, or joint replacements typically have a standard 2-year waiting period, while initial coverage for accidental hospitalization starts from day 1.

During an emergency or planned admission at a network hospital, the hospital's TPA desk transmits pre-authorization documents to the insurer. The insurer issues an initial sanction letter within 1 to 2 hours. At discharge, the final medical bills are settled directly by the insurer, requiring the patient to pay only non-medical expenses (like gloves, registration fees, and syringes).

A Family Floater provides a shared sum insured (e.g., ₹10 Lakhs) accessible by any covered family member in a single policy year. An Individual policy assigns a dedicated sum insured (e.g., ₹10 Lakhs each) to every member separately. For families with senior citizens or chronic health issues, separate individual policies are usually recommended to prevent one member from exhausting the shared pool.

A room rent cap limits insurer payout to a specific percentage (typically 1% of Sum Insured per day). If you choose a room exceeding this cap, insurers apply proportionate deductions to all associated medical charges — including doctor fees, nursing charges, and surgery costs. We always advise selecting policies with 'No Room Rent Capping' to avoid surprise out-of-pocket bills.