What it is
Health insurance is a contract in which an insurer promises to compensate you for covered medical costs, on the terms written in the policy. For senior citizens, the same buying rules apply as for anyone else, but the cost of getting a choice wrong can be higher, so the checks matter more.
The insurance regulator, the Insurance Regulatory and Development Authority of India (IRDAI), publishes general advice for buyers on its policyholder portal. This guide turns that advice into a checklist. It does not recommend any company or plan.
How it works
Most policies are sold through an intermediary, meaning an insurance agent (an individual or a company) or a broker. IRDAI describes them as a bridge between buyers and insurers. You can also buy directly from the insurer.
Brokers are registered by IRDAI under the Insurance Regulatory and Development Authority of India (Insurance Brokers) Regulations, 2018. Individual and corporate agents are licensed by IRDAI under separate regulations, which include a code of conduct.
IRDAI says an intermediary should give you all material information about a proposed cover and advise you with full disclosure. After the sale, the intermediary must coordinate between you and the insurer on servicing and claims.
What it means for you
Before you buy
- Check that the insurer is registered with IRDAI.
- Ask the agent or broker for an identity card or licence. Check that it covers the right business: life, general (which includes health) or both under a composite licence.
- Read the brochure or prospectus to understand what is covered and what is not. Ask for the exclusions to be explained.
- Consider only what you can afford. IRDAI warns against tall promises and over-selling.
Know your commitments
Understand what you have to pay when you take the policy, when you surrender it and when you make a claim. Ask the intermediary to explain any term you do not follow.
Filling the form and paying
- Fill in the proposal form yourself and never sign a blank one.
- If you pay through an intermediary, check that the person is authorised by the insurer to collect premium, and insist on a signed receipt straight away.
After you receive the policy
Read it thoroughly. For health policies with a term of three years or more, IRDAI notes there is a free-look period, a window in which you can return the policy if you disagree with its terms. The sources do not state the length of that window, so check it in your policy document.
Also ask about the documents and steps needed to make a claim. IRDAI notes that in some cases you may have to inform agencies other than the insurer, so get the full details early.
Common mistakes to avoid
- Buying from someone whose licence you have not seen.
- Skipping the brochure and learning about exclusions only at claim time.
- Signing a form with blank fields, or one with terms you do not understand.
- Paying cash or cheques to an intermediary without confirming authority and getting a receipt.
- Choosing a cover because of aggressive sales talk rather than what you can afford.
A family member helping with the purchase can be useful, as IRDAI also notes that a referral helps when choosing an intermediary.
