How health insurance policies are now being customised to fit varied lifestyles

Buying health insurance today feels more like visiting a restaurant with a menu full of choices, where you can pick and choose add-ons to create a plan that suits your unique needs. It’s no longer a dull, rigid process. With rising lifestyle-related risks and medical inflation, it is important that health insurance seekers have the option to choose from what they want and control what they pay for. Hence, insurance providers have moved away from the one-size-fits-all approach of the past. From unlimited sum insured to locking in your premium, new-age health insurance plans are transforming how Indians perceive and purchase medical coverage. “Customers are no longer limited to predefined plans,” says Anand Roy, Managing Director &amp; Chief Executive Officer, Star Health &amp; Allied Insurance Co Ltd, which has a 33% market share in retail health insurance and 91% of total health gross written premium (GWP) for retail businesses. “With new-age products, buyers can build a policy that truly mirrors their health needs and lifestyle. The control now rests with the policyholder,” says Roy. Amit Chhabra, Chief Business Officer—General Insurance at the online insurance provider PolicyBazaar, agrees. “One of the biggest trends in health insurance is customisation. These products are now highly modular. Every policy comes with a range of optional riders that allow customers to tailor their policy to their specific needs,” he says. Here are some of the popular riders available with today’s health insurance policy: Combatting Medical Inflation One of the most popular features in modern health plans is the Loyalty or Cumulative Bonus, a built-in way to tackle rising healthcare costs. With this feature, your sum insured automatically increases year after year, even if you have made a claim. “Some policies allow the coverage to grow up to 10 to 25 times over time—at no additional annual cost. Once you opt for this feature, your coverage increases automatically every year and you don’t need to pay anything extra,” says Chhabra. For example, ICICI Lombard’s Elevate offers a 100% loyalty bonus every year regardless of claims with the Power Booster rider. Manipal Cigna’s Sarvah-Uttam policy, with its Gullak Rider, provides 100% additional sum insured annually, up to a cumulative 1,000% of the base sum insured. Unlimited Claims Benefit With double-digit medical inflation and advanced treatments costing a lot, the unlimited claim benefit has emerged as a powerful safeguard for policyholders. This optional rider acts as a financial shield during critical illnesses or major medical emergencies requiring prolonged hospitalisation or expensive procedures. For example, Manipal Cigna’s Sarvah Uttam with the Anant Rider offers no limit on claims for conditions like cancer, heart disease, stroke, or organbone marrow transplants every year. This is how it works: Even if your base sum insured is Rs 30 lakh, and you face a treatment bill of Rs 1 crore or more, this rider ensures the entire amount is covered—with no upper limit. Some insurers allow this benefit once in a lifetime, while others offer it annually. Customers are no longer limited to predefined plans. With new-age products, buyers can build a policy that truly mirrors their health needs and lifestyle. The control now rests with the policyholder -ANAND ROY, MD &amp; CEO, STAR HEALTH &amp; ALLIED INSURANCE Make the Most of What You Don’t Use Another customer-centric feature is the ability to carry forward unused sum insured, tackling a common consumer frustration—why pay for something you don’t use? “Many young people feel they’re paying for insurance they may never claim. Niva Bupa Aspire policy addresses that by rolling over any unutilised sum insured to the next policy year,” explains Bhabatosh Mishra, Director of Product, Claims, and Underwriting at Niva Bupa. For example, you have a Rs 10 lakh policy and use only Rs 5 lakh in one year, the remaining Rs 5 lakh is added to the next year’s sum insured. Over 10 years, this can accumulate up to Rs 1 crore, creating a safety net as you age. The good part is that when you make a claim, it does not reset to the base, but only that amount is reduced which is used. New-age insurance policies are generally more expensive because they offer broader coverage and additional features -PRIYA DESHMUKH, HEAD HEALTH PRODUCTS, OPERATIONS &amp; SERVICES, ICICI LOMBARD Lock Your Premium Traditionally, health insurance premiums increase as policyholders age. But with the new Age Freeze feature, insurers are now rewarding early buyers with long-term savings. This option allows customers to lock in their premium at the age they buy the policy—and continue paying the same rate until they either make a claim or reach a defined age cap. Galaxy Health Insurance’s Premium Promise allows customers to pay the same premium until they make a claim or turn 55—whichever comes first. So, if a 30-year-old purchases a policy and remains claim-free, they can pay the same premium for up to 25 years, despite growing older. That said, premiums may still rise to account for medical inflation. This feature not only ensures huge savings over time but also nudges younger individuals to invest in health insurance early, when premiums are at their lowest and health risks minimal. No More Hidden Costs Hospitalisation bills are not just limited to room rent or doctor consultations. A substantial chunk often comes from non-medical or consumable items such as gloves, syringes, and PPE kits. While these items are essential for treatment, they were traditionally excluded from insurance coverage, leaving patients with significant out-of-pocket expenses—even if they had a robust health policy. Recognising this gap, several insurers have introduced policies that explicitly cover consumables and non-payable items. For instance, Galaxy Health Insurance offers coverage for 68 different consumables, including admission and insurance processing charges. “We cover 68 consumables, plus admission, record, and insurance processing charges,” says G. Srinivasan, MD &amp; CEO of Galaxy Health Insurance. The inclusion of such expenses is a game-changer, especially in times like the Covid-19 pandemic, when PPE kits and disposable items became a recurring and costly part of every hospital visit. Day-One Cover for Pre-Existing Diseases Individuals with pre-existing conditions like diabetes, asthma, hypertension, or obesity usually have to wait for two years before they could claim treatment costs. This long waiting period was a major deterrent, especially for older customers or those living with chronic conditions. But that’s rapidly changing with new-age plans. For instance, ICICI Lombard’s Elevate Plan, when bundled with the Infinite Assurance rider, allows customers to claim for certain pre-existing diseases from the 31st day of the policy. Chhabra agrees that this is a major relief for policyholders. “Any complication arising out of the covered condition is also included from day one. This is a huge relief for customers with lifestyle diseases,” he says. This rider generally adds around 20% to the base premium, but the benefit of instant protection far outweighs the additional cost, especially for individuals already managing chronic conditions, he adds. Cumulative bonuses in most policies allow unlimited coverage growth, often without paying extra, making them ideal for handling medical inflation -AMIT CHHABRA, CHIEF BUSINESS OFFICER— GENERAL INSURANCE, POLICYBAZAAR Just two hours Health insurance policies require a minimum of 24 hours of hospitalisation in order for a claim to be valid. This rule excluded a wide range of essential day care procedures like chemotherapy and dialysis that could be completed in a few hours. However, now many insurers are now redefining this norm through their advanced health plans. Customers can now get covered even with just two hours of hospitalisation, eliminating the 24-hour requirement. Such innovations bring significant relief to policyholders, especially senior citizens or working professionals who opt for same-day surgeries or procedures. Pre-Authorisation Made Simple To simplify and accelerate the claim process further, insurers have launched several unique offers. “There is a feature which leverages a General Practitioner (GP)-led approach for pre-authorisation, reducing the stress and paper work usually associated with health insurance claims,” says Chabbra. Here’s how it works: If a policyholder anticipates the need for hospitalisation, they can first consult a GP from the insurer’s network, either through teleconsultation or in person. If the GP confirms that admission is medically necessary, the insurer pre-approves the claim upfront. This approach is inspired by global models, such as the NHS in the UK, where primary care physicians act as gatekeepers to specialised medical services. It enhances the overall customer experience and ensures the claim is processed quickly. Geography not a limit As mobility increases across the globe, many Indian policyholders are now seeking health insurance plans that also cover them overseas. Responding to this demand, insurers have introduced the global coverage rider, which allows policyholders to seek medical treatment abroad by paying an additional premium. This feature is particularly valuable for critical illnesses such as cancer, advanced neurological disorders, or organ transplants, where treatment abroad might offer better outcomes or shorter wait times. It also appeals to non-resident Indians (NRIs), high-net-worth individuals (HNIs), and frequent travellers who want to ensure that their insurance isn’t geographically limited. However, coverage terms vary. Some plans offer worldwide coverage, excluding or including the US and Canada, depending on the chosen rider. Others have tiered pricing, where adding the USCanada—due to higher healthcare costs—raises the premium more than other countries. Global coverage riders are typically offered on high-value policies with sum insured ranging from Rs 1 crore to Rs 6 crore, giving customers ample financial buffer for international treatments. Basic vs Comprehensive For young, healthy individuals, a simple hospitalisation policy might still be adequate. But as health risks grow, it becomes more prudent to upgrade to a comprehensive plan with relevant riders. Rakesh Kaul, the Chief Business Officer of SBI General Insurance, believes that new-age lifestyle disorders and rising medical inflation are leading to increased healthcare costs. He says a modern cover ensures extended protection at an affordable premium and provides a safety net for your savings. “New-age health insurance policies such as Elevate offering features like 30-day waiting period for select pre-existing conditions, one-time infinite claim amount, unlimited cumulative bonus, and more have competitive premium in comparison to products offering similar features. Such policies offer a customisable feature bouquet with a simple base coverage allowing customers flexibility to modify premiums,” says Priya Deshmukh—Head Health Products, Operations &amp; Services, ICICI Lombard. This brings us to a critical question: Are new-age policies more expensive? The answer is yes. Premium for a rider can be 10–25% higher than a basic policy, depending on the rider selected. With customisation, customers can control what they want to pay for. “If you pick everything—unlimited sum insured, day-one cover, OPD, wellness benefits—your premium will naturally be higher. But most policies let you add features as you go. You only pay for what you need,” explains Chhabra. The message is clear. Health insurance is no longer just about protecting against hospital bills. It’s also about managing long-term health risks and protecting yourself across different stages of life. @teena_kaushal

COMPANIES

NEWS

How health insurance policies are now being customised to fit varied lifestyles

Health insurance policies are now customisable to fit varied lifestyles— from metro millennials to small-town seniors. Choose wisely