Frequently Asked Questions
What is claim settlement ratio and why does it matter?
CSR is the percentage of claims an insurer pays out of total claims received. Higher CSR (>95%) means the insurer is reliable. We track this data for every insurer.
How much health insurance cover do I need?
Minimum ₹10L for individuals, ₹25L+ for families in metros. Medical inflation runs at 14% annually — what costs ₹5L today will cost ₹20L in 10 years.
What is the waiting period for pre-existing conditions?
Most health insurance plans have a 2-4 year waiting period for pre-existing conditions. Some plans offer lower waiting periods at higher premiums.
Is the premium tax deductible?
Yes. Health insurance premiums qualify for deduction under Section 80D — up to ₹25,000 for self (₹50,000 for senior citizens), plus ₹25,000-₹50,000 for parents.
Can I switch my insurance provider?
Yes, health insurance is portable from the 2nd year. Your waiting periods carry over to the new insurer. File portability request 45 days before renewal.
What documents are needed to file a claim?
Typically: hospital bills, discharge summary, doctor prescriptions, policy copy, ID proof. Cashless claims need pre-authorization from the TPA/insurer.
What's Covered
- Death Benefit
- Terminal Illness
- Accidental Death
Key Features
- Same-illness restoration
- No room-rent cap
- Covers AYUSH treatments
What's Not Covered
- Suicide within 1 year
- Pre-existing conditions
Pros
- Same-illness restoration
- No room-rent cap
- Covers AYUSH treatments
Cons
- Premium 10% higher than budget options
- Pre-existing waiting 36 months
Optima Secure
Optima Secure by HDFC ERGO offers ₹1 Crore coverage with a 98% claim settlement ratio. Reliable protection for you and your family.
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