If you’ve just attended our webinar, welcome back! This piece is your next step. At Ditto, we believe that buying health insurance is one of the smartest decisions you can make to protect everything you’re building: your savings, your investments, and your long-term plans.

Most people tend to focus on growing wealth such as salaries, SIPs, and side hustles, but few give serious thought to protecting that wealth. And that’s where health insurance plays a major role. It’s about making sure your financial goals stay intact, even when life throws a curveball.

In case you’re wondering why this matters so much, let’s look at a real example:

A Real Story: How Health Insurance Saved Rahul’s Finances

Rahul, 30, had a basic health insurance policy costing around ₹10,000 a year. A few years in, he was hospitalized for pancreatitis, and the bill ran up to ₹5 lakhs. But thanks to his policy, he didn’t have to dip into his savings or investments. Everything was covered.

It’s a reminder that one health emergency can derail your financial plans — unless you're protected. And the best time to buy a plan is when you're young and healthy, with fewer chances of rejection or added costs.

A lot of us have active investments such as SIPs, stock portfolios, and long-term goals. But one big medical emergency can knock it all off course. This is why having a health insurance policy means you won’t have to make that difficult choice between health and wealth.

If you’ve been postponing your decision to buy a plan, now is a great time to evaluate your needs and lock in a good policy while you're young and healthy, because that’s when it’s easiest to get accepted.

Disclaimer: Name changed to protect identity.

Why Young Adults Shouldn’t Ignore Health Insurance

There’s a common misconception that you don’t need health insurance until you hit your 40s. But the best time to buy it is when you’re young, healthy, and unlikely to face rejections or high premiums.

Plans are more affordable when you’re fit, and insurers are more welcoming. What’s more, you get to finish waiting periods, which are part of every policy, without much risk of hospitalization during that time.

If you wait until a health issue crops up, insurers might increase your premium, exclude conditions, or deny your application. It’s smarter to lock in coverage early, and if you need help finding the right plan, our advisors are just a call away.

Choosing the Right Plan: What to Avoid

In the webinar, we touched on a few common traps people fall into while picking a health insurance policy. This article picks up right from there to help you understand not just what to look for but also what to avoid.

There are thousands of policies out there, but not all are built the same. In fact, some might offer low premiums by cutting corners in crucial areas. During the webinar, we discussed a few things to steer clear of:

    • Co-payment clauses: These require you to pay a percentage of every claim from your own pocket. That means even with insurance, you’ll still feel a financial pinch at the hospital.
    • Restoration benefit: If you use up your entire sum insured , this benefit reinstates it for future claims in the same year. Very helpful for family floater plans where multiple hospitalisations are possible in a given year.
    • Room rent limits: This clause puts a cap on the type of hospital room you’re eligible for, usually based on a fixed amount (like ₹5,000 per day) or a room category (like a shared room). Now, if you choose a room that exceeds this limit, say, a private room when your policy allows only a shared one, it doesn’t just affect the room rent. Everything from doctor fees to surgery charges may be higher in a more premium room. As a result, the insurer may apply a proportionate deduction, where they reduce a portion of the entire bill because you stayed in a higher category room.

      It’s one of the most frustrating surprises during claims, especially when you assumed you were covered. That’s why it’s always better to go for a policy with no room rent limit or at least one that covers private single rooms.
    • Disease-specific sub-limits: For example, a ₹5 lakh plan might cover only ₹1 lakh for cataract surgery. These hidden caps can really hurt during treatment.

You don’t want to be caught off guard by fine print during a medical emergency. So, look out for policies that skip the usual traps like co-pay, room rent limits, or disease caps. And while you're at it, make sure the plan includes useful perks like unlimited restoration and shorter waiting periods for pre-existing conditions.

Not sure if your current plan checks all these boxes? Don’t worry, we’ve read more brochures and policy wordings than we care to admit. Book a call and we’ll help you make sense of it all (minus the insurance headaches). Feel free to book a call here 😄

Features in Health Insurance That Add Real Value

Beyond avoiding the bad stuff, some features are genuinely worth seeking out. These might cost a bit more, but they offer significantly better protection.

    • Bonus: Sometimes, this increases your coverage every claim-free year, often up to 100% or more over time without a matching increase in premium. At other times, the insurer will give you a loyalty bonus just for renewing the policy, regardless of the claims made. Either way, this is an extremely useful benefit.
    • Pre and post-hospitalization coverage: Illnesses don’t begin or end in the hospital. Good policies cover diagnostic tests, doctor consultation charges, and medicines both before and after admission.
    • Daycare and domiciliary treatment: Many procedures now happen without 24-hour hospitalization, think cataract, dialysis, chemotherapy.. A good plan should cover these too, along with treatment at home when hospitalization isn't possible due to the condition of the patient or non-availability of beds..
    • Free annual health checkups: Preventive care matters. Several insurers now offer free checkups as part of the policy.

These features can make your policy genuinely useful when you need it most. But keep in mind, not all plans offer them in the same way. Some come with limits on when or how often they apply. If you’d like help breaking this down, our advisors are always up for a detailed walkthrough.

What About the Insurer? Do They Matter?

Absolutely. Even the best plan is only as good as the company backing it.

During the session, we recommended choosing insurers who have:

    • Claim Settlement Ratio (CSR) above 90% over the last 3 years, consistently not just in one good year.
    • A wide network of hospitals, especially in your area. Because the last thing you want is to travel far in an emergency just to get treatment on a cashless basis.
    • A strong reputation in the industry also matters. Look for insurers with a solid track record of honoring claims, especially during emergencies. However, also pay attention to the volume of complaints. A high number of unresolved issues can be a red flag, regardless of the company's reputation.

It also helps to check their average annual business (i.e., the amount of premium they collect each year) and Incurred Claim Ratio (ICR), which indicates how much they pay out in claims compared to what they earn. A healthy ICR typically shows that the insurer is balancing claims and business effectively, neither rejecting too many nor bleeding money unsustainably.

If you've already shortlisted a few insurers but aren't sure how they stack up, we can help with a side-by-side comparison, no jargon, no bias.

CTA

I Already Have Corporate Health Insurance. Do I Still Need a Personal Plan?

This is a question we get asked all the time, and the answer is a resounding yes.

We don’t deny that corporate health insurance is a great perk, especially because it usually has no waiting periods. But beyond that, it comes with serious limitations. Corporate plans often have limited coverage, can be revoked if you change jobs, and rarely cover family members in full. Think of them as useful additions, but never substitutes for your own individual policy. Even portability isn't easy. Transferring your corporate cover to a personal plan involves paperwork, approvals, and often doesn’t carry over all benefits.

By investing in your own plan now, you not only get lifelong coverage but also safeguard yourself against any gaps in employer-provided coverage, retirement, or starting up.

If you’d like help choosing a personal plan that complements your existing corporate cover, our team can walk you through the options step by step.

Avoiding Claim Rejections: Common Mistakes to Watch For

A lot of people assume that once they have insurance, claims are guaranteed. But that’s not entirely true. Some of the most common claim rejections are completely avoidable.

For instance:

    • Submitting incorrect information on claim forms
    • Forgetting to include important documents like prescriptions or test reports
    • Trying to claim for treatments during the waiting period
    • Not raising the claim within 30 days of discharge for reimbursement claims.
    • Trying to claim exclusions  like cosmetic procedures, unproven treatments, or specific permanent exclusions

If you’ve had claims rejected before or you want to make sure your documentation is airtight, we’re happy to guide you through the process and even help out during the claims stage, if you’ve bought your policy through us.

A Quick Recap Before You Go

Health insurance is an essential part of protecting your finances and securing your future. It ensures your long-term goals, investments, and peace of mind stay intact even if life takes an unexpected turn.

Whether you’re buying your first policy, reviewing an existing one, or trying to understand the fine print, we're here to help. So, feel free to book a call with us for honest, spam-free insurance advice.

Last updated on