Unlimited Coverage in Health Insurance 2026

Q: Does unlimited coverage apply to maternity and newborn claims?

No. Maternity and newborn benefits usually have separate waiting periods and sub-limits. As a result, unlimited coverage rarely applies to these claims in the way policyholders expect.

Q: In a family floater, who can use the one unlimited claim?

In a family floater policy, any insured family member can use the unlimited claim benefit. However, it is allowed only once during the entire policy lifetime. If one member uses it even once, it cannot be used again by any other member.

Q: Will unlimited claims face more scrutiny or take longer?

Yes, high-value unlimited claims may take longer to process because they are reviewed more carefully. This does not mean the claim will be rejected, but additional documents and follow-ups may be required compared to routine claims.

Q: Is unlimited available only for family floaters?

No. Unlimited coverage can also be offered on individual health insurance plans. Availability depends on the insurer and the specific product variant, so it is important to check the policy brochure.

Quick Overview

Unlimited coverage in health insurance sounds like “no limits”, but it usually has conditions. It typically means either an add-on that covers one (sometimes two) large hospital bills in your policy lifetime, or a newer “Unlimited Sum Insured” plan option with no fixed rupee cap.

In both cases, policy rules still matter, like room eligibility, co-pay, deductibles, waiting periods, exclusions, and sub-limits. For most people, a strong base plan with good bonus and restoration is often more predictable and future-proof than paying for an unlimited base cover.

“Unlimited coverage” in health insurance sounds like a dream: no more worrying about whether ₹10L or ₹25L will be enough. However, “unlimited” doesn’t always mean “no limits”. In a few cases, it may cover just one big claim, and after that, the benefit stops.

In this article, we’ll break down what “unlimited” means in simple terms, the types of unlimited coverage, and the key terms you must check before buying.

What Does “Unlimited Coverage” Actually Mean?

Unlimited For One/Two Claims

The insurer will cover one or two very large hospitalization bills, even if your base sum insured is much lower. In most cases, this is a paid add-on and can be used only once or twice in the policy lifetime.

Example: You have a ₹10L policy with one unlimited claim add-on, and a ₹70L hospitalization bill. The base ₹10L gets used first, and the “unlimited” benefit can cover the remaining ₹60L.

Unlimited Sum Insured

There is no fixed annual cap like ₹10L or ₹25L on the plan if you have opted for an unlimited sum insured. But the final payout can be reduced due to room rent restrictions, co-payments, deductibles, or disease-wise sub-limits, depending on the policy terms.

Example: You have an unlimited sum insured plan and a ₹1 Cr hospital bill. The claim would be payable up to ₹1 Cr, given the expenses are admissible.

Did You Know?

Some plans offer unlimited restoration as a built-in feature. This means your base sum insured gets refilled repeatedly during the year, for multiple hospitalizations.

Example: Aditya Birla’s Activ One Max offers unlimited restoration. So, if you buy a ₹15L policy, for each new hospitalization, you still have ₹15L available.

Which Plans Offer Unlimited Claims Once in a Policy Lifetime?

Insurer	Plan	Unlimited Coverage	Add-on for unlimited claims	Premiums
HDFC ERGO	Optima Secure	If base SI is ₹10-25L, you get 1 lifetime infinite claim; if base SI is ₹50L or more, you get 2 lifetime infinite claims	Limitless - ₹2,216	₹24,488
Care Health	Care Supreme	One infinite claim	Unlimited Care - ₹1,821	₹21,527
TATA AIG	Medicare Select	One infinite claim	Infinite Advantage - ₹284	₹18,802

Note: Premiums are for a ₹15L sum insured, for a family floater (ages 32 and 31), residing in Delhi - 110001, with unlimited claim add-on and other necessary and mandatory add-ons.

Which Plans Offer Unlimited Sum Insured?

Insurer	Plan	Premiums
ICICI Lombard	Elevate	₹35,177
Acko	Platinum	₹30,048
Niva Bupa	Reassure 3.0	₹26,428

Note: Premiums are for an unlimited sum insured, for a family floater (ages 32 and 31), residing in Delhi - 110001, with necessary and mandatory add-ons.

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Pros of Unlimited Coverage

Covers That “One Scary Bill”

If a single hospitalization shoots past your maximum cover amount, “unlimited” features can reduce the chance of you paying a huge chunk from your pocket.

Less Mental Math

You’re not constantly wondering, “Will my cover last if things get worse?”

Useful For High-risk Profiles

For families with known risks like complicated medical history, living in a metro city, or aged parents, it can be a peaceful choice.

Things to Keep in Mind Before Opting for Unlimited Coverage

It’s Not A Blank Check

Room rules, co-pays, waiting periods, and exclusions can still impact how much a bill is payable.

Premium Unpredictability Is Real

Unlimited SI options are newer, and premiums in health insurance rise with age anyway.

You Still Need A Strong Base Plan

If your base plan has weak room rules/sub-limits, an “unlimited” tag will not save you from surprise deductions.

Continuity Rules Can Lock You

Many unlimited add-ons have strict opt-in rules and require continuous renewal to stay active. If you drop it, you may not be allowed to opt back in later.

Why Insurers Offer Unlimited Coverage

Most health claims are small, and truly catastrophic bills are rare. IRDAI’s Annual Report 2023–24 shows an average payout of ₹31,086 per settled health claim.

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Ditto’s Take on Unlimited Coverage

If you specifically want “unlimited coverage”, the add-on route is usually the more sensible way to get it.

Unlimited sum insured plans can look attractive, but this is still a relatively new feature in India. We do not yet know how insurers will price it long-term, how sharply premiums may rise with age, or whether the same unlimited option will remain as easily available in future renewals.

For most people, a more future-proof setup is picking a solid plan with a practical sum insured like ₹15-25L, strong cumulative bonus, restoration, and minimal hidden limits.

This combination tends to handle real-life claims more predictably than an “unlimited” label that can come with expensive and uncertain premium growth.

Quick Note

Ditto currently partners with HDFC ERGO, Care Health, Aditya Birla Health, Niva Bupa, and ICICI Lombard. For a detailed explanation of our process, partnership policy, and disclaimers, please see our Editorial Policy & Disclaimers document.

This article is based on publicly available information and should not be treated as personalized advice. Always read the policy brochure carefully and consult a licensed advisor before purchase.

Frequently Asked Questions

Do unlimited plans cover pre- and post-hospitalization, too?

Yes. If your base plan covers pre- and post-hospitalization, the unlimited benefit follows the same rules. The number of days and what’s payable will still be as per the policy terms.

Does unlimited coverage apply to maternity and newborn claims?

No. Maternity and newborn benefits typically have their own waiting periods and limits, so ‘unlimited’ rarely applies in the way people expect.

In a family floater, who can use the one unlimited claim?

In a family floater, anyone covered under the policy can use this benefit. But it is allowed only once for the entire life of the policy. So if one family member uses it even once, no one else can use it again later.

Will unlimited claims face more scrutiny or take longer?

Yes, delays can happen because high-value claims are checked more carefully. This does not automatically mean your claim will be rejected. It just means you may need to share more documents, and there may be extra follow-ups compared to a smaller, routine claim.

Is unlimited available only for family floaters?

No, insurers offer it on individual plans, too. Availability depends on the insurer and product variant, so you should check the brochure for your exact plan.

Last updated on: 29 Dec, 2025