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While Happy family floater diamond policy offers a decent cover and extends protection for maternity related complications (upto a certain limit), it is still a lot more expensive than other polices in its class. And it makes you wait 4 years before covering complications arising out of pre-existing diseases (like diabetes).

What's good here?

You most likely don't have to split the bill

The insurer will bear the entire cost of treatment (up to the sum insured) unless you explicitly opted to pay a portion of the bill. And if you’ve opted to co-pay a part of the bill, have you thought through it completely?

You always have full cover irrespective of the disease

No funny business here. If your insurer hasn’t explicitly stated they won’t cover a certain illness, you can claim the full amount up to the sum insured, irrespective of the disease you’re dealing with. Meaning this policy doesn't impose the dreaded disease wise sub-limits.

Pre & post hospitalization expenses covered

No worries if the doctor had to run a host of diagnostic tests before or after hospitalizing you. The insurer has your back. They will cover this amount in full for a pretty reasonable duration - 30 days before you are hospitalized and 60 days after discharge. This includes the cost of medication by the way.

Day Care treatments covered

If you’re hospitalized for less than 24 hours in lieu of a minor procedure, then the insurer will cover these costs too. Think dialysis, chemotherapy or minor surgeries.

Full coverage even if you are forced to hospitalize at home

The insurer will bear the costs even if you are hospitalized at home due to a condition or the hospital running out of beds. In insurance lingo, they call this a policy with domiciliary cover.

Covers Alternative Medicine

Think of getting Ayurvedic, Homeopathic or other alternative treatments to cure an illness? Your insurer will cover you fully, up to the sum insured.

What's bad here?

Restrictions on the rooms you can pick and much more

Your insurer won’t let you stay in a room whose rent exceeds 10,000 + 0.5% of the sum insured. If it’s an ICU they’ll bump it to 20,000 + 1% of the sum insured. And in the event you breach these limits, then you’ll have to pay a lot more - Read more here

Long waiting period for pre-existing diseases

If you’re already dealing with diabetes, cardiovascular problems or any such illnesses, the insurer will cover all costs arising out of these pre-existing problems only after 4 long years. It could be much shorter you know? Like 2 years perhaps!

What's lacking here?

No Restoration Benefit

Some policies will tell you - Even after you claim part of the cover on one occasion, you will have the full cover restored, if you are hospitalized another time during the same year. So if you have a family cover and multiple members of the family are hospitalized in the same year, this feature will come in handy. Unfortunately, this policy offers no such benefit.

No Bonus for being healthy and not claiming insurance

Some policies offer you extra cover if you go an entire year without claiming your insurance. This policy, however, offers no such benefit.

Your insurer doesn’t provide free health check-ups

If you want to get a full-body checkup just to make sure you’re in fine working condition, be ready to pay for it yourself.

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