Health Insurance in Kolkata

Known as the City of Joy, Kolkata hosts multiple tourists annually. The city offers a wide range of cultural spots - from geographical diversity (forests, seas, and mountains) to being a heaven for the foodies! In essence, the city is usually affordable if you are looking to eat, shop for food, or look around in its old markets selling books. However, the city has its own challenges. 

While Kolkata is home to some of the best government-sponsored medical facilities, the services provided might not match up to the expected standards. On the other hand, if you are looking at private hospitals or nursing homes, you might as well expect a lengthy bill that can easily take a toll on your savings. Moreover, the city’s pollution level, accompanied by its extreme weather conditions, might encourage a variety of ailments and allergies that can lead you to get hospitalised or treated for chronic conditions. 

Under such circumstances, it is only natural that you turn towards purchasing plans for health insurance in Kolkata that would offer comprehensive coverage during medical emergencies. Now, when you purchase a health insurance policy, the least you would expect is a plan that has minimum exclusions and restrictions and is yet affordable. So, here’s a quick look at the details of health insurance in Kolkata, the best plans, ways to choose it, and reasons why you shouldn’t delay the purchase. 

Pro tip: The health insurance market can be a labyrinth. Instead of spending hours navigating through the hundreds of policies out there, why not book a 30-minute call with our expert IRDAI-certified advisors? We don’t spam or pressure you to buy. Just honest insurance advice

Kolkata and Health Insurance 

Kolkata, the cultural capital of East India, is known for its historical buildings, extensive literary heritage, and vibrant festivals. However, it also faces unique healthcare challenges that necessitate specific health insurance considerations:

• Dense Population: The high population density increases the risk of communicable diseases and puts pressure on the city’s healthcare infrastructure.
• Environmental Factors: Kolkata deals with significant pollution and seasonal flooding, which can lead to various health issues, including respiratory problems and waterborne diseases.
• Economic Diversity: With a wide economic spectrum among its residents, there is a varied ability to afford healthcare, making health insurance a critical buffer for many families.

Why do you need health insurance policies in Kolkata? 

Health insurance in Kolkata is essential for several reasons:

• Protection Against High Healthcare Costs: The cost of medical treatment in Kolkata's private healthcare sector is rising. Health insurance helps mitigate these costs, making healthcare more accessible and affordable.
• Coverage for Prevalent Health Issues: Given the environmental and lifestyle-related health issues prevalent in Kolkata, such as respiratory ailments and infectious diseases, comprehensive health insurance is vital.
• Support During Health Emergencies: With the city’s propensity for natural calamities like cyclones and flooding, having health insurance ensures that medical emergencies are managed without depleting savings.

Things to remember when choosing health insurance plans in Kolkata 

When choosing a health insurance plan in Kolkata, consider the following factors:

• Wide Coverage: Ensure the plan covers a broad range of medical issues, particularly those prevalent in Kolkata, including monsoon-related health issues.
• Network Hospitals: Opt for a health insurance plan with a wide network of hospitals across Kolkata to ensure accessibility to cashless hospitalisation.
• Affordability vs. Coverage: Evaluate whether the plan is affordable while providing extensive coverage. It's crucial to strike a balance that doesn't compromise essential health benefits.
• Policy Terms: Understand all terms and conditions, especially the waiting periods for pre-existing diseases and specific exclusions that might affect you.

How to choose the best health insurance plans in Kolkata? 

To choose the most appropriate health insurance plan in Kolkata, follow these guidelines:

• Evaluate Your Health Needs: Consider your family's health history and lifestyle to assess your specific health insurance needs.
• Compare Policies: Use online tools to compare different health insurance plans based on their features, benefits, limitations, and premiums.
• Insurer Reliability: Research the insurer's claim settlement ratio and customer reviews to gauge their reliability and service quality.

1. Claim Settlement Ratio: Calculated as the number of health insurance claims settled in a year against the number of claims raised to the insurer in the year, the Claim Settlement Ratio, or CSR, is one of the crucial metrics used to determine an insurer's credibility. It sheds some light on the insurer's claim settlement track record. 

Here is a quick look at the CSR of some of the top health insurance providers (average of data from 2021 to 2024) - 

However, it would be good to remember that CSR numbers can easily be misleading since they do not reflect whether the claim has been settled entirely or partially. A CSR of 90 or above is the best way forward for a credible health insurer. On the other hand, if an insurer’s CSR is less than 80, you might start looking around for other providers. 

2. Incurred Claim Ratio: An insurer's Incurred Claim Ratio (ICR) indicates the provider's future sustainability and, hence, its claim settlement potential. The ICR metric is measured by dividing the total amount spent settling claims against the total amount collected as premiums across the year. 

Here is a quick look at the ICR of some of the top health insurance providers (average of data from 2021 to 2024) - 

The ideal ICR of a health insurer lies between 50 and 70. An ICR of less than 50 suggests that the insurer is too focused on building its business profits, and an ICR of more than 80 means that the insurer is too focused on settling claims (which might seem great in the short term, but in the long run, the insurer might face a financial crunch). 

3. Complaint Volume: When choosing a health insurance provider, it's important to consider the number of complaints the insurer receives (per 10,000 claims filed). This metric offers valuable insight into the claim settlement experience of current policyholders. As most complaints arise from delayed or denied claims, the complaint volume strongly indicates the insurer's approach to handling claims and their ability to settle them efficiently.

Here is a quick look at the complaint volume of some of the top health insurance providers (average of data from 2021 to 2024) - 

4. Annual Average Business Income: While this may not be an exact measure of an insurer’s credibility, understanding their annual business volume helps you gauge the scale of the insurer’s operations and the potential size of its client base. Since you are entrusting a significant coverage amount to the insurer, choosing a medium- or large-sized provider with a strong client base is advisable, as this often reflects their reliability and established track record in the insurance industry.

Here is a quick look at the average annual business income of some of the top health insurance providers (average of data from 2021 to 2024) - 

• Seek Expert Advice: If uncertain, consult with health insurance experts or financial advisors who can provide insights tailored to your needs and the specifics of Kolkata.

What are the Best Health Insurance Plans in Kolkata for 2025? 

Considering the healthcare needs of Kolkata, the following plans are recommended for 2025:

Each of these plans is structured to address the unique challenges and healthcare requirements of residents in Kolkata, ensuring that individuals and families can navigate health concerns effectively and affordably.