Now everyone knows — one hospital bill is enough to make you poor, very poor. But the fact is, even one health insurance policy can also make you poor, because either the premium will be too high or your claim will get rejected. Why is the premium high? Thanks to the government for 18% GST, and thanks to the companies that keep adding new features — ₹1 Crore plans, Infinite Sum Assured, Fancy Riders — which you might not even require. Yet, you’ll still have to pay the premium and might not even be able to utilise it. My name is Money Minded Mandeep, and this is the ultimate guide to buying the best health insurance policy — one where the premium shouldn’t be so high that it makes us poor today.
Finding the Best Insurer
In India, there are approximately 30 to 35 health insurance companies. But not all of them are good. So, how do you find a good one?
The first step is to check the Incurred Claims Ratio (ICR).
ICR simply means: the total amount of claims paid by a company divided by the total amount of premiums collected in a year. That’s how the insurance business works — companies collect premiums from a large number of people, assuming that not everyone will file claims at the same time.
ICR tells you how much of that collected money is actually paid back as claims.
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If the percentage is very low, it means the company is not passing claims easily — and this will reflect in their complaint data.
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If the ICR is more than 100%, it means the company is paying more in claims than it is earning.
So where is this extra money coming from? Who is funding a loss-making company, and how long will that last?
A healthy incurred claims ratio is around 80–85%. There are several companies I’ve marked green based on this, and their ICR and average over the past three years are shown. If you look closely, you’ll notice that most companies with ICR above 100% are public insurance companies.
If you want to explore ICR in depth, the IRDAI Handbook has segment-wise data from the last 10 years.
You don’t need to dig through all that, but you can find some interesting patterns. I’ve highlighted only the latest data (2014–2024), ignoring the past nine years.
This data breaks down ICR into four segments, along with totals. But note:
Your total ICR won’t match with the IRDAI’s Annual Report because the handbook provides granular data specific to health insurance, excluding personal accident and travel insurance.
How to Read the ICR
Start by checking which companies are close to the ideal range of 80–85%.
For example:
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Chola Mandalam shows 81% total ICR — looks good, right?
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But when you check individual policies, the ICR shoots up to 360% — meaning they pay out 3.6 times what they earn in premiums. That’s a loss-making business.
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However, their family floater policy shows an ICR of just 14%, meaning they’re not passing claims in this segment.
This inconsistency is a red flag.
Complaints Data
Next, let’s check the complaints per 10,000 claims.
The industry average is 22 complaints per 10,000.
If a company is above this, it's a sign of customer dissatisfaction.
Companies above 22 complaints:
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Care Health
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ManipalCigna
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Niva Bupa
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Star Health
Most people wouldn’t be surprised by Star Health’s complaint figures.
Now, look at the best-performing private companies with single-digit complaints:
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Bajaj Allianz
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ICICI Lombard
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HDFC Ergo
Among public insurers, United India has just 8 complaints, but their ICR is too high to recommend.
Let’s Revisit Bajaj Allianz
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Reported ICR: 83% — decent.
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In IRDAI Handbook data (health only): 89% — slightly high.
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Individual policy ICR: 67% — decent.
But again, this is just one year’s data. Numbers may change next year. So, I wouldn’t be too harsh on Bajaj Allianz yet.
Who Stands Out?
Based on this ICR and complaints data, only two private companies clearly meet both benchmarks:
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HDFC Ergo
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ICICI Lombard
Already Have Care or Star Health? Don’t Panic
If you already have a policy from Care or Star Health, don’t worry.
It’s not guaranteed that your next claim will be rejected.
But here's what might happen:
You may not realise you’ve been scammed by hidden terms and conditions. You might have those features in your policy, but you won’t be able to claim them properly.
That’s why it’s important to understand what those hidden clauses look like.
In this post (or video), I’ll explain how good and bad policies hide conditions — so you can evaluate your current plan properly.
What If You Find Your Policy is Bad?
If you realise your current policy isn’t good, you must port it to a better one.
Why?
Because when you port your health policy:
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You don’t have to serve the waiting period again (for the previously covered sum insured).
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But if you increase your sum insured while porting, the additional amount will have a fresh waiting period.
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Your original covered amount remains safe and waiting-period-free.
How to Find Bad Policies
After shortlisting the insurance company, we must also know how to identify a good plan. And for that, there’s an elimination technique. You need to avoid policies that come with three evil features:
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Room Rent Limit
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Disease-wise Sublimit
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Copay
Let’s break them down one by one.
In most policies, you'll find a room rent limit — such as 1% of the sum insured, or a restriction like “Single AC Private Room.” This sounds fine until you realize what it means in practice.
Say your base sum insured is ₹10 lakhs, and you’re only allowed a Single AC Private Room — the cheapest in the hospital, priced at ₹3,000 per night. But instead, you choose a ₹5,000 room for better comfort and get admitted for 5 days. Your total room rent becomes ₹25,000.
Let’s say your total eligible surgery cost is ₹5 lakhs, making your total bill ₹5.25 lakhs. You assume — “I’ll just pay the ₹10,000 extra for the room rent from my pocket, and the remaining ₹5.15 lakhs will be covered by the insurer.”
Wrong.
The insurance company will say — your room rent exceeds the allowed limit. Since your room cost is 60% more than the eligible one, only 60% of your entire hospital bill will be paid. So, instead of ₹5 lakhs, they’ll only cover ₹3 lakhs. You end up paying ₹2 lakhs from your pocket.
Now what’s the point of such a policy?
Next is Disease-wise Sublimit — a major scam.
A company may offer you a policy with ₹50 lakhs sum insured. Sounds amazing, right? But hidden in the policy is a disease cap — meaning no matter how high your cover is, each disease has a predefined claim limit.
You might never even get the chance to claim ₹50 lakhs, because for every illness, there’s a ceiling — and often it’s too low for quality treatment. The worst part? Many advanced and modern treatments available in top hospitals won’t even be an option for you.
So, there must be no disease-wise sublimit.
The third trap is Copay.
Copay means that even on the admissible claim amount (not your full bill), you have to pay a fixed percentage — like 20% or 30% — from your own pocket.
Let’s take a real-world example.
Imagine you have a ₹15 lakh policy. You make a claim of ₹10 lakhs.
Now, due to the expensive room you opted for, ₹2 lakhs are deducted. So the admissible claim becomes ₹8 lakhs.
Then, because your policy has a 20% copay, you’re required to pay ₹1.6 lakhs yourself — leaving you with ₹6.4 lakhs reimbursed.
But here comes another shocker: your policy also has a ₹5 lakh disease sublimit.
The company now compares ₹6.4 lakhs (admissible claim after copay) and ₹5 lakhs (sublimit) — and chooses the lower amount. So, finally, you get only ₹5 lakhs, and end up paying ₹5 lakhs from your own pocket out of a ₹10 lakh bill.
If your health insurance policy includes room rent limits, disease-wise sublimits, and copay — then your ₹15 lakh sum insured may be completely useless when you actually need it.
Filtering Out Good Policies
Now, let’s learn how to find good policies from good companies.
To search and compare policies side by side, I highly recommend using PolicyBazaar.
Full Disclosure:
This video is not sponsored by PolicyBazaar or any other brand. However, the link to PolicyBazaar (shared in the description and top comment) is an affiliate link.
That means if someone doesn’t buy a policy through that link, then we — i.e., LLA — don’t earn anything from this video.
Why is this important?
Because when we accept sponsorships from brands, we’re being paid to create content. But in the case of insurance videos, I want to speak freely and call out bad practices in the industry. That’s only possible when I’m not bound to a sponsor.
So, if you’re planning to buy a policy anyway — and feel that this video has provided real value — you can purchase through our link.
👉 Important Note:
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Using our link won’t increase the price of the policy.
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In fact, you may even get a 10–15% discount.
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And no, we’re not sending you to an inferior platform to support us.
PolicyBazaar is a large and reputable name.
They don’t spam like before, and in some cities, their claim department directly assists you at the hospital. They support you through the entire process.
That said, if you already have a trusted agent, feel free to go with them. I respect your peace of mind. But in my opinion, PolicyBazaar is that agent who doesn’t forget you after collecting the money — they actually provide service.
In fact, my team and I use PolicyBazaar for our own policies.
You’ll find the link in the description and top comment. Click it — and you’ll be redirected to the PolicyBazaar website.
How to Use PolicyBazaar
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Click on Health Insurance.
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Choose whether the policy is for you or a family floater.
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If you have any existing disease, disclose it honestly.
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You’ll be asked to undergo medical tests.
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If something is discovered later, your claim might be rejected.
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You’ll need to submit a doctor’s prescription during hospitalization too.
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If you’re not tech-savvy, PolicyBazaar’s executives can visit your home and guide you — free of charge.
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Just confirm “Yes” if you want a home visit.
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Choosing the Right Cover
Your ideal coverage depends on where you live.
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If you’re in a metro city, medical expenses are higher.
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If you’re in a tier 2, tier 3, or rural area, healthcare is slightly cheaper (and the air is better too!).
My recommendation:
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₹15–20 lakhs for adults
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At least ₹10 lakhs for kids
But for now, I’m selecting a cover range of ₹25 lakhs to ₹1 crore.
Now apply filters:
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Room rent type
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Policy benefits like pre & post-hospitalization
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Daycare treatments (very important)
✨ Fun fact about Daycare Treatments:
In March 2023, the Vadodara Consumer Court ruled that daycare treatments must be covered.
Companies cannot deny these claims anymore.
Even though many insurers market this as a feature, they are legally obligated to provide it.
Types of Waiting Periods
Understanding waiting periods is crucial when selecting a policy:
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Standard Waiting Period
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You cannot file a claim within the first 30 days of buying the policy (except for accidents).
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Pre-existing Disease Waiting Period
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Usually 3 years.
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You can reduce it by adding a rider, depending on the policy.
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But you must disclose your pre-existing diseases — or your claim may get rejected later.
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Specific Diseases Waiting Period
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Covers slow-growing conditions like:
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Kidney stones
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Cataract
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Anal fissure
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[Other examples can be listed from the chart you show in your video]
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Even if you don’t currently have these diseases, your policy won’t cover them for the first 2 years.
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These are mandatory waiting periods you’ll need to survive.
Types of Waiting Periods
When buying a health insurance policy, you must be aware of the different types of waiting periods. These are conditions where you cannot raise a claim, even though your policy is active.
1. Standard Waiting Period
There is a standard waiting period of 30 days from the date of purchasing your policy.
During this time, you cannot file any claim, except in case of an accident.
2. Pre-Existing Disease (PED) Waiting Period
Next comes the waiting period for pre-existing diseases, which is usually 3 years.
However, you can reduce this period by adding a rider to your policy.
Exactly how and on which policies this can be done — we’ll cover that in detail later.
But one thing is very important:
You must disclose all your pre-existing diseases honestly.
Failing to do so can lead to a claim rejection in the future, and you’ll still have to complete the full 3-year waiting period by default.
3. Specific Disease Waiting Period
There is also a waiting period for certain specific or slow-growing diseases, even if you don’t have them at the time of purchase.
Some examples include:
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Kidney stones
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Cataract
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Anal fissure
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(And other similar conditions shown in the list on screen)
Even if you’re healthy at the time of buying the policy, these conditions are usually not covered for the first 2 years.
This is another form of waiting period you must survive.
Pre and Post Hospitalization
Almost all health insurance policies include Pre and Post Hospitalization coverage. But very few people understand what this actually means — and even fewer take full advantage of it.
What is Covered?
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Pre-hospitalization refers to the expenses incurred before your main treatment or surgery, typically for a period of 60 to 90 days.
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Post-hospitalization includes expenses after your surgery or hospital stay, and some policies cover this for up to 180 days.
But what kind of expenses are included?
Anything directly related to your main treatment.
For example:
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If you had 10–12 diagnostic tests done before the surgery — and those tests were required to proceed with treatment — their costs will be reimbursed.
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If, after surgery, your doctor prescribes physiotherapy, follow-up consultations, or medications essential for your recovery, those expenses are also covered.
The Common Mistake
The catch?
Most people don’t even know this benefit exists in their policy — so they never claim it.
To make sure you don’t miss out:
🔸 Keep all your bills and prescriptions safe.
🔸 Submit them within the allowed post-hospitalization period (up to 180 days).
No Claim Bonus (NCB)
This one’s quite self-explanatory — No Claim Bonus means:
If you don’t raise a claim during the policy year, your coverage amount increases as a reward.
But the details vary from policy to policy.
How It Works
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Some policies offer a 20% bonus every year you don’t claim.
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Others offer up to 50%, depending on the company.
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Over time, this can significantly boost your sum insured — without increasing your premium (in most cases).
Fancy Names, Same Feature
Some companies have now rebranded No Claim Bonus with names like just "Bonus" or other catchy terms.
They present it like a special feature — but it’s essentially the same thing.
Even more interesting, some companies now advertise:
“Whether you raise a claim or not, we’ll still give you a bonus of 20%–50% every year. Don’t worry, it won’t be removed!”
Sounds great, right?
But... There's a Catch
There will be conditions behind this too. So make sure to read the fine print carefully.
And don’t worry — I’ll also show you exactly where it’s written and how to check it.
Restoration Benefits
One of the most popular features promoted by health insurance companies is Restoration. Every insurer loves to highlight it — claiming that when your sum insured gets exhausted, your base sum insured will be restored.
This feature is especially useful in family floater policies.
When Restoration Is Useful
Imagine you have a family floater policy of ₹20 lakhs for a family of 4.
This ₹20 lakh is shared among all members — not ₹20 lakh per person.
Now, if one member undergoes an expensive treatment and uses up the full ₹20 lakh in a year,
the remaining members will have no coverage left for that year.
👉 If your policy has a restoration benefit, the base sum insured can be restored, protecting others too.
One-Time vs Unlimited Restoration
Some insurers allow restoration only once a year.
Others offer unlimited restorations.
You might think — great! I'll just take a basic ₹5–10 lakh policy and keep restoring it every time it's used.
But here's where the catch lies...
Claim Utilization Sequence
Every insurer follows a claim sequence, usually found in the policy wordings:
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Base Sum Insured
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No Claim Bonus (NCB)
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Additional Cover or Riders
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Restoration
Now depending on how much the insurer wants you to benefit, they draft terms and conditions accordingly.
Example: Policy A — Restoration That Exists Only on Paper
Let's assume:
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Base Sum Insured: ₹10 lakhs
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No Claim Bonus: ₹5 lakhs
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Additional Cover: ₹10 crores (hypothetical)
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Restoration Benefit: ₹10 lakhs
First Claim: ₹20 lakhs
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₹10 lakhs → Base sum insured
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₹5 lakhs → No claim bonus
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₹5 lakhs → Additional cover
✅ ₹5 lakhs of additional cover still remains
Second Claim: ₹10 lakhs
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Base sum insured = 0
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NCB = 0
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Additional cover remaining = ₹5 lakhs
✅ Only ₹5 lakhs claim settled, you pay the rest ₹5 lakhs yourself
You’ll ask — what about restoration?
❌ It stayed on paper.
Why?
Because the policy says:
Restoration activates only if Base + NCB + Additional Cover = ZERO at the time of the next claim.
Since ₹5 lakhs were still left in the additional cover, restoration didn’t trigger.
Example: Policy B — A More Practical Restoration Policy
Let’s assume the same benefits:
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Base: ₹10 lakhs
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NCB: ₹5 lakhs
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Additional Cover: ₹10 lakhs
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Restoration: ₹10 lakhs
First Claim: ₹20 lakhs
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₹10 lakhs from base
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₹5 lakhs from NCB
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₹5 lakhs from additional cover
✅ ₹5 lakhs additional cover remains
But here’s the key difference in Policy B’s wording:
“If the base sum insured is fully or partially used in the first claim, restoration will be triggered in the next claim, regardless of remaining NCB or rider.”
Second Claim: ₹10 lakhs
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₹5 lakhs from additional cover
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₹5 lakhs from restoration benefit
🎉 Full claim settled!
You don’t pay anything from your pocket.
👉 The restored sum insured matched your actual need (₹5 lakhs)
That’s a practical, useful restoration feature.
Moral of the Story
Not all restoration policies are created equal.
✅ Some allow unlimited restoration
❌ Others limit to only unrelated illnesses
Hidden Conditions in Restoration Benefits
Some policies have conditions like:
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Restoration applies only to unrelated illnesses.
For example:-
First hospitalization: heart condition
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Second hospitalization: another heart condition
👉 Restoration won’t apply
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Restoration allowed for related illnesses — but only if there’s a 45-day gap between hospitalizations
That’s hard to control, right?
💡 It’s better to go for policies without such conditions, or at least understand them fully before buying.
Comparing Multiple Policies in One Place
Now let’s compare HDFC Ergo Optima Secure and ICICI Lombard Elevate — two flagship health insurance plans from well-performing companies.
We’ve picked these two insurers because:
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Their incurred claims ratio is healthy
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Their complaint data is relatively low
And we chose these specific plans because they are flagship offerings.
Feature-by-Feature Comparison
Let’s go step by step.
We will:
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Open the official policy documents
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Learn how to read between the lines
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Understand hidden terms & conditions
This will help you analyse your own current policy and see whether the “fancy” features actually work in reality.
Premium Comparison
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HDFC Ergo Optima Secure: ₹22,308
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ICICI Lombard Elevate: ₹14,285
These premiums are for a 30-year-old healthy male.
So why is HDFC more expensive?
Let’s find out...
Sum Insured
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ICICI Elevate gives a base sum insured of ₹50 lakhs.
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HDFC Optima Secure gives ₹50 lakhs + an extra ₹50 lakhs from Day 1.
✅ This is called Secure Benefit (unique to HDFC Ergo).
That’s already a major value add for HDFC — and explains some of the price difference.
Room Rent Limit
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HDFC: ✅ No room rent limit
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ICICI: ❌ Only a “Single Private AC Room” allowed
In ICICI’s policy document, it’s clearly mentioned that only the cheapest room in this category is allowed.
If you opt for anything higher — you’ll face proportionate deductions on your entire claim.
You might be wondering — how can a flagship plan have this limitation?
Answer: The Elevate Plan is cheaper — and doesn’t include important features by default.
👉 Instead, they offer essential features as paid riders.
Riders and Real Cost
So what happens if you add all necessary riders to make ICICI Elevate a usable plan?
You’ll likely notice the premium coming closer to HDFC's Optima Secure, or maybe even matching it.
So yes, ICICI is cheaper upfront — but not necessarily in the long run if you want all-round protection.
Understanding Policy Wordings
To truly compare features, don’t just rely on brochures or comparison tables.
You need to read the policy wordings. This is where all the hidden clauses, exclusions, and limitations are mentioned.
Here’s how you can access it:
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Go to Policy Bazaar
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Search for either plan
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Click on “All Features”
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Scroll down — you’ll see the downloadable “Policy Wording” document
Reading these wordings helps you answer key questions like:
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Are features like No Claim Bonus, Restoration, and Pre/Post Hospitalization genuinely usable?
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Are there room rent sub-limits or copays buried inside?
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Are the waiting periods practical?
Summary
| Feature | HDFC Optima Secure | ICICI Lombard Elevate |
|---|---|---|
| Base Sum Insured | ₹50 lakhs + ₹50L (Day 1) | ₹50 lakhs |
| Premium (Age 30, Male) | ₹22,308 | ₹14,285 |
| Room Rent Limit | No limit | Single Private AC Room only |
| Riders Required | Most included | Essential features via riders |
| Best For | High coverage, less hassle | Budget buyers with time to customize |
Tip: Always compare real-life claim usability, not just fancy numbers
Understanding Hidden Terms and Conditions
Firstly, sum assured, as I mentioned before... In HDFC, with the base sum assured, you get the same amount in secure benefit, which is applicable from Day 1. You can claim it from first hospitalization itself. Is there any hidden condition in it? Let's find out.
This is the secure benefit. It's written: "The additional amount as specified in the policy schedule will be available to the insured person as sum insured for all claims admissible under Section B and Section B.2.3," which is called 'Protect Benefit'. Section B covers all policy features, and Section B.2.3 is the consumables cover. Yes, you also get consumables cover in Optima Secure. It's clearly stated that secure benefit can be used for both standard and consumable claims.
Any unutilized amount in whole or in part will not be carried forward to the subsequent policy year. You will keep getting a similar additional amount of base sum insured every year, but it can’t be accumulated. It’s also mentioned that secure benefit can be used for one or multiple claims in a year. So, if it’s a 50 lakh policy, it’s technically a Rs 1 Crore policy in a year. There is no secure benefit in ICICI Elevate.
Now we compare the no claim bonus, termed 'Plus benefit' in HDFC. Point A: you can accumulate this up to 100% of the base sum assured. Point B: you get this after completing a policy year. You can carry it forward if there's no policy break. Point C: whether you claim or not, you will still receive the plus benefit. So, with Optima Secure, your cover is doubled from Day 1 (Secure Benefit), and becomes 2.5x at the start of year two (assuming 50% plus benefit), and 3x in the third year (with 100% plus benefit).
Read Points 5 and 6 in the notes: If you reduce your cover during renewal from 50 lakhs to 25 lakhs, your plus benefit will also drop accordingly. If you increase it to 1 Crore, the plus benefit still applies only on the original 50 lakhs. Newly added members will not get Plus benefit from Day 1; they will earn it in subsequent renewals.
ICICI Elevate calls its no claim bonus 'Loyalty Bonus'. It provides a 20% bonus annually regardless of claims, provided the policy is renewed without a break. This loyalty bonus can be accumulated up to the base sum insured.
Next is 'Restoration'. HDFC calls it 'Automatic Restore Benefit'; ICICI calls it 'Reset Benefit'.
ICICI’s reset benefit says it will reset up to 100% of the annual (i.e., base) sum insured for any illness, disease, or injury—related or unrelated. A previous condition that required a 45-day gap for related illness has been removed.
The restoration is triggered only when your base sum insured and loyalty bonus are insufficient. For example:
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Base Sum Insured: Rs 50 lakhs
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Loyalty Bonus: Rs 10 lakhs
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Restoration: Rs 50 lakhs (inactive initially)
If your first claim is Rs 25 lakhs: it's paid from base.
If your second claim is Rs 45 lakhs:
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Rs 25 lakhs from remaining base,
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Rs 10 lakhs from loyalty bonus,
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Rs 10 lakhs from restoration.
So, Rs 10 lakhs from restoration is activated. Your base sum insured is now topped back up by Rs 10 lakhs.
Important: You won’t get restoration in the first claim or first policy year. The restored amount can’t exceed your base sum insured in total across all claims. Even if it says "unlimited times," it's only up to 100% of your base sum insured. Day care and inpatient claims are covered for restoration, but not Ayush day care.
Now, HDFC’s restore benefit:
It restores up to your base sum insured upon partial or full use of base. Unlike ICICI, it doesn’t require other coverages to be depleted first. Even partial utilization of base triggers restore for next claim.
Claim order:
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Base Sum Insured
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Plus Benefit
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Secure Benefit
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Restore Benefit
Restore can be used in base and protect benefit (consumables) too. Restoration applies only once per policy year. But if you restore Rs 25 lakhs after using Rs 25 lakhs from base, and later claim Rs 40 lakhs, the next Rs 25 lakhs from restoration + Rs 15 lakhs from remaining secure/plus will be used. So restoration is available across multiple claims but limited to base sum insured amount per year.
Both policies offer restoration only up to the base sum insured per year and allow multiple uses in subsequent claims. Promotional materials may say ICICI offers unlimited restoration, but the fine print reveals limits. HDFC too offers similar usage, and with a rider (like 70/80), it can offer truly unlimited restoration.
In conclusion:
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HDFC offers secure, plus, and protect benefits upfront.
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ICICI offers lower premiums but requires riders for similar utility.
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Restoration in both is functional but must be understood beyond the "unlimited" tag.
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Always check policy wordings to decode actual usability of each benefit.
Zone Based Policies
One more thing you need to remember is, ICICI's policy is zone based policy. It means if you take it in metro cities, then its premium will be higher, because the treatment cost is higher as well. And if you purchase it in tier 3 city, then its cost will be lower. So it's divided into zones A, B, C and D.
You are punished based on zone based policy in certain policies. It means that maybe you added your native's address, but you live in a city. If you visit to take treatment in a city, in this case, the company can suggest opting for the treatment at your native for you to get a 100% claim. But if you opt for it in the city, then 20% copay will be levied.
Thankfully, there is no punishment in ICICI. However, there is definitely a condition that your address must be accurate at all times. If you have changed the address, that changed address must be updated in the policy, or else your claim will get rejected. As long as your address is accurate, whether you get treated in tier 1 or 2, there is no problem with it.
The next feature is consumables, which is under the name 'Protect Benefits' in HDFC. Consumables means gloves, PPE kit, and other expenses after the treatment, which are not usually covered. You will also get that covered in the HDFC plan.
But in ICICI's case, you won't get that cover inbuilt — you'll have to get a separate rider.
There is another feature as annual health check-up. You get that in HDFC, but not in ICICI. You will have to get a separate rider for that.
You can compare all these features easily. And you have Policy Bazaar's link in the description.
Riders, Are They Useful?
Now since we are talking about riders, then we have to see that... If ICICI is affordable, and you have to add a lot of riders to it, to make it usable. So which are those riders, which combined together makes a useable plan.
I kept both the plans side by side. HDFC's base cover is kept at Rs 25 lakhs... and the base cover in ICICI is Rs 50 lakhs. This is because... In HDFC, along with the base cover of Rs 25 lakhs, you get Rs 25 lakhs extra from Day 1, in the form of secure benefit. It doesn't have a lot of hidden conditions.
This is not a fair comparison by the way. If we keep HDFC's base sum insured as Rs 25 lakhs. Then their cover will become triple, i.e. Rs 75 lakhs, in the third year. Whereas, ICICI's 25 lakhs base sum insured, will double in the fifth year to 1 Crore. Just something to keep in mind. Even then HDFC is quite expensive.
Now the premium is Rs 19,300 and Rs 12,882. I have added a rider in HDFC, in the name of 'unlimited restore'. Because, in their policy, I will get the restoration only once a year. But If you want that you get unlimited restoration, then you add a very affordable premium. Hence, I have not added another rider in HDFC.
But in ICICI, there are a lot of riders.
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Infinite Care – It means, in one single claim, you can claim for an infinite amount. In your entire lifetime, instead of once a year. Once the entire year. It means it's usable for the most serious illnesses. The rider is formed keeping in mind that very few people will claim it.
So it could be possible that, you keep paying Rs 189/year as loading as the premium keeps increasing on it. But you won't be able to claim this benefit. And if you are highly paranoid like me, even then opt for the terms and conditions before purchasing it. It has a total of nine terms and conditions.
There are limitations like co-payment, room category limits, and sequence of cover utilization (base sum insured → loyalty bonus → power booster → inflation protector → infinite care). You must exhaust all others first before using Infinite Care.
So in my opinion, I must skip this rider, you must learn how to increase your base sum insured. If you are taking adequate base cover, then you are sorted. Because at the same time, you are also getting a renewal bonus in both policies. So after some years, your cover will get doubled anyway. If you are opting for HDFC, then your cover will be tripled.
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Power Booster – 100% sum insured every year, regardless of claims. i.e. Rs 50 lakhs becomes 1 Cr next year, 1.5 Cr the year after. No upper limit. Technically infinite policy. No hidden terms. But if you opt out during renewal, all bonus will reset to zero. And premium keeps increasing with age, so future affordability could be an issue.
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Jump Start – Reduces waiting period for pre-existing diseases from 3 years to 30 days. Expensive (Rs 3800). Comes with many conditions. You can only opt it at the beginning or with new members. Must be continued for 3 years. Diseases must be both declared and accepted. And includes only certain diseases with specific conditions (e.g. PTCA done more than 1 year ago).
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Claim Protector – Consumables cover (PPE kits, gloves, etc.). Needed if you want full claim value.
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Pre-Existing Disease Rider – Reduces PED waiting period from 3 to 1 or 2 years. High premium. Not as useful unless you really need it immediately.
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Inflation Protect – Adjusts base sum insured based on CPI inflation. Cheap (Rs 150), worth adding.
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Room Rent Modifier – Removes single private room limit. Important to avoid proportionate deduction in bills.
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Annual Health Check-up – Included in HDFC base. Needs to be added in ICICI. Not always comprehensive.
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BeFit C – Offers limited OPD benefits like 4 doctor consults, Rs 1000 pharmacy, physio, e-consult, etc. Most don’t use these features. Optional.
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Specific Disease Waiting Period Rider – Reduces waiting period from 2 to 1 year. Expensive and not very useful. Not like Jump Start.
There are more like:
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Dependent Accommodation
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Durable Medical Cover
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And two more ICICI riders you can explore further.
If I add a rider in ICICI, I will do:
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Room modifier (important)
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Inflation protect (cheap, helpful)
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Claim protector (for consumables)
I won’t take power booster now to keep premiums low.
Premium Summary:
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ICICI: ₹14,315 (after adding above riders)
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HDFC: ₹19,300
Key Differences:
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HDFC: Triple cover by 3rd year with base + secure + plus benefit (50%)
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ICICI: Base only, no secure benefit, only 20% bonus per year (doubles in 5 years)
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Maternity: Present in both, not financially useful
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Bariatric Surgery: ICICI covers it (only for highly obese)
Conclusion:
If you want maximum cover at low premium and need PED cover via JumpStart, go with ICICI.
If you want no compromise policy, triple cover, simple terms — then go with HDFC, even if premium is high.
How to Lower the Premium?
Now how can premiums be lowered further from here, you've two tricks on that too.
You have an option in HDFC of 'aggregate deductible'. You can choose an aggregate deductible amount as per your wish. For example, you chose ₹50,000. It means the bill formed in a year, in one claim or in multiple claims — you've to provide first ₹50,000 of that medical bill.
Not per hospitalization, but per year.
It doesn't mean that you visited the hospital 10 times a year, then you'll have to provide ₹5 lakhs for it. You only have to provide ₹50,000. You can claim the remaining from HDFC.
If you chose this deductible, which is actually not a bad deal compared to co-pay, in which 20% of the admissible claim amount is levied. You'll have to provide 20%, if you receive a ₹50 lakh claim.
Here your upside is capped on ₹50,000. By choosing this, your premium drastically reduces.
And If you notice here, then the premium discount you receive on the deductible of ₹50,000 —
You won't get double discount on ₹1 lakh.
It really doesn't make sense that you choose the deductible of ₹1 lakh.
Mathematically speaking, you have a higher benefit on ₹50,000.
You choose this at the time, when:
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You decide not to claim in the next 10 years, and you save ₹50,000 before paying it for the first time.
OR -
You have a different policy, and the first claim could be fulfilled from there too.
Super Top Up
Taking a huge cover while keeping the premium lower is a super top-up policy.
And this comes at an affordable rate than the normal health insurance policy.
And it's affordable because the first 5 or 10 lakhs — any deductible limit that you choose —
you will get a claim only higher than that.
For example:
You got a super top-up policy of ₹50 lakhs.
Aggregate deductible is of ₹10 lakhs.
So it means that year, you will have to accumulate the first ₹10 lakhs from somewhere else.
And if your claim is more than ₹10 lakhs, then any claims in excess of that —
you will get that from super top-up.
The trick is:
Whichever deductible you choose,
-
The insurance from there till now should be sorted with your main policy
-
The insurance above that must be sorted with your super top-up
There is a top-up policy, which you have to simply ignore.
You must take a super top-up.
Because you only get one hit to claim the deductible in top-up.
Whereas, the deductible in super top-up,
it will still be counted even after multiple claims.
So the practical usage of super top-up increases,
and it could happen that you might not get claim in the case of top-up.
I Have a Corporate Policy. Should I Get a Separate Health Policy?
Now a commonly asked question, a lot of people ask me is —
I have received a great plan from a corporate.
Should I opt for an individual or personal health insurance policy?
The answer to that is — absolutely you must.
Because if you left the job,
there is no guarantee whether the company will let you convert it into an individual plan.
A fresh underwriting will be done on that.
It’s company’s decision, they can even deny it.
It is denied in most cases.
It is not possible to port in most cases.
And if you don’t have the policy in the future,
then you will have to take a new policy.
You will have to survive all the waiting periods again.
And maybe, you might have to pay an extra premium —
because your age will be more in the future date.
There will be a new pre-existing disease too.
You might have to give extra loading on that too.
There are a lot of these complications.
You must have your own policy,
in which you have your entire control.
Individual vs Family Floater Plans
The next question is whether to take an individual plan or a family floater.
You can combine people of the similar age group in one floater plan.
But if you are combining with your parents in one plan,
so it's not a good decision.
Because the plan's premium will be kept as per the eldest member's age.
And your premium which could have been reduced,
that will increase.
You and your spouse could be in one plan,
and both your parents in a different plan.
If you don't have a spouse,
then consider individual.
When you get married,
then add the spouse later.
So this was 2025 — 'The Ultimate Guide to Buying the Best Health Insurance' from the best company in India.
If I've left anything, then please mention in the comments.
And if you think that you've got great value from this video,
which I have made sure that you do —
then please go to the Policy Bazaar link available in the description or top comment,
get your policy's research done,
download the policy wordings too,
and purchase the policy if you consider to.
I will meet you in a new video.
Until then, bye!
This is the editor, who comes home and edits.
We have such a service too.
So I was editing this video.
And I opted for the policy while watching.
I bought the policy 1–2 hours before.
I purchased a policy a while ago and received an email
that my policy has been issued, too.
Conclusion
Health insurance lena aaj ke zamane mein sirf ek financial decision nahi, balki ek responsible decision hai. Chahe aap HDFC Optima Secure jaise all-in-one cover choose karein ya ICICI Lombard Elevate jaise flexible riders ke saath ek tailored plan, har option ka apna role hai. Sabse zaroori baat yeh hai ki aap policy kharidne se pehle uski terms & conditions achhi tarah samjhein, waiting periods, restoration benefits, aur riders ka comparison karein.Agar aapko lagta hai ki yeh guide aapke liye helpful rahi, toh Policy Bazaar ka link description mein diya gaya hai — wahan se apna final decision lekar policy purchase kar sakte hain.
📌 Aapka koi sawal ho ya apna experience share karna ho, toh comment karna na bhoolen. Is post ko apne doston ke saath zaroor share karein — health insurance sabke paas hona chahiye!
