மருத்துவக் காப்பீட்டில் காப்பீடு செய்யப்பட்ட தொகை பற்றி நீங்கள் தெரிந்து கொள்ள வேண்டிய அனைத்தும்

Medical emergencies often arise without warning. In this situation, even if you have a health insurance policy, without adequate coverage, you cannot achieve proper financial security.

This is why understanding the base sum insured meaning is essential. It is generally the maximum amount your insurer will pay for covered medical expenses during a policy year. From hospitalisation costs and treatment expenses to policy benefits and claim settlements, the sum insured plays a crucial role in determining your coverage.

In this guide, we will explain what is the base sum insured in health insurance and why it matters.

Understanding the Base Sum Insured Meaning with Example

In health insurance, the base sum insured means the maximum amount an insurance company agrees to pay for covered medical expenses during a policy year. It represents the financial protection available under your health insurance policy, which is used to cover expenses related to hospitalisation, doctor consultations, diagnostic tests, and other eligible medical expenses as per the policy terms.

Let's understand how it works with an example.

Mr. Ghosh has a health insurance policy with a sum insured of ₹10 lakh. This means the insurer will cover eligible medical expenses up to ₹10 lakh during the policy period. However, during a hospitalisation for heart surgery, he had a hospital bill of ₹15 lakh. It means his family has to cover the additional 5 lakh out of pocket.

This is why choosing an adequate sum insured will help you ensure that rising healthcare costs do not create a significant financial burden during medical emergencies.

What are the Features of Base Sum Insured in a Medical Insurance Policy?

Here are some key features of the base sum insured.

1. Applicability: The term is widely used in the general insurance category, such as critical illness insurance and health insurance. For life insurance, this term is not applicable.

2. Principle of Indemnity: According to the principles of insurance, the sum insured amount is not for your monetary benefit. Instead, it acts like a reimbursement, which the insurer will only pay in case of actual loss.

3. Based on Risk: Insurance companies assess factors such as age, medical history, lifestyle habits, and health risks while underwriting a policy. These factors may affect policy eligibility, premium rates, or coverage limits.

4. Impact on Premium: If you choose a high sum-insured amount, then you have to pay higher premiums. Even if you do not use the sum-insured amount, you cannot get the balance as a monetary benefit.

மேலும் படிக்க: மருத்துவக் காப்பீட்டின் எதிர்காலம்: டிரெண்டுகள் மற்றும் கணிப்புகள்

What is the Importance of Understanding the Base Sum Insured Meaning?

Now that we know what sum insured in health insurance is about, we must understand why choosing the right amount is necessary. According to an Economic Times article, India’s insurance penetration remains low at 40-42%.

Understanding the importance of the sum insured will help bridge the information gap.

Helps Protect Your Savings

Every year, medical costs shoot to a new high, making healthcare inaccessible for many Indians. Currently, the inflation rate is at 12-15% every year.

With adequate health insurance and a sum insured amount, you can ensure that your insurance pays your hospital bills without draining your bank account.

Sufficient Coverage

Did you know that a kidney transplant surgery, which used to cost ₹10.8 lakh in 2020, now costs almost ₹18.2 lakh.

Globally, India’s health inflation is the highest! In this scenario, having sufficient sum insured ensures that you focus on recovering rather than thinking about high bills.

மன அமைதி

Lastly, during an emergency, the last thing you want to think about is how you will pay the hospital bill. Therefore, if you have a proper understanding of your base sum insured meaning, you will know the extent of your health insurance coverage. Therefore, you can estimate any out-of-pocket expenses that may arise if treatment costs exceed your coverage limit.

Don't let rising healthcare costs compromise your financial security. With the Health Guard Policy from Bajaj General Insurance, you can choose a suitable sum insured to safeguard yourself and your loved ones against unexpected medical expenses. Visit our website to compare plans, get quotes, and explore the benefits in detail.

How to Determine the Right Base Sum Insured?

When we think about protecting our families from medical emergencies, choosing the highest sum insured amount comes naturally to mind. However, arbitrarily choosing the sum insured amount may create a liability.

Let's discuss the pointers that you must keep in mind while choosing a sum insured amount:

வயது காரணி

Age plays a significant role in deciding the sum insured. With ageing comes a higher probability of getting a disease, which in turn increases the need for a higher sum insured. Hence, we can say that the earlier we start, the better it is.

Assess Your Health Care Needs

When purchasing a medical insurance policy with an adequate base sum insured, you must assess your and your family's healthcare needs. For instance, if a policyholder has a pre-existing disease or high health risks, it is ideal to purchase individual health insurance with a high sum insured. Since the family floater plan shares the sum insured among all insured members, the coverage can quickly be exhausted.

லைஃப்ஸ்டைல்

Something we are now familiar with is that stress causes a lot more harm than anything else. Apart from that, many jobs involve high-stress work, while others might put you at risk of getting a specific disease. All these considerations are taken into account while deciding on the sum insured.

Income Level

You should choose a sum insured amount that matches your income level. If you choose a high sum insured amount that you cannot afford, then it will pose a significant problem during a claim. As a rule of thumb, choose a sum insured that is 50% above your income level.

Your Location

Lastly, healthcare costs vary according to different cities. For example, if a heart transplant costs ₹10 lakh in Kolkata, it can cost ₹15 lakh in Mumbai. Therefore, when choosing an amount, make sure that it aligns with the city or state you live in.

மேலும் படிக்க: What is Cumulative Bonus in Health Insurance and Why You Should Know

What is the Difference Between the Sum Insured and the Sum Assured?

Another very common term in the insurance sector is sum assured. Although they sound similar, the base sum assured and base sum insured mean quite different things. Let’s understand the differences below:

இறுதி வார்த்தைகள்

Understanding the base sum insured meaning is your key to selecting a health insurance coverage that matches your healthcare needs and financial goals.

With an adequate sum insured, you can manage the rising medical expenses and reduce the burden of unexpected healthcare costs. This is why, before purchasing a medical insurance policy, explore multiple options and select the right plan that suits your needs.

With the Health Guard policy of Bajaj General Insurance, you can select a sum insured amount ranging from ₹1.5 Lakhs to ₹1 Crore, based on your budget and coverage requirements.

மேலும் படிக்க: Difference Between Sum Insured vs. Sum Assured

பொதுவான கேள்விகள்

How do insurance companies calculate the sum insured amount?

Insurance companies calculate the sum insured amount according to the amount of risk the person carries. They will evaluate your age, health profile, and location to determine the best amount and the premiums that you have to pay.

Can I make multiple claims against my base sum insured?

Yes, you can certainly make multiple claims during the policy year. However, you must ensure the total claim amount does not exceed the available sum insured.

Is it possible to increase my base sum insured later?

Yes, you can increase your base sum insured at your annual policy renewal. However, it can be subject to the insurer's underwriting guidelines, your health status, and any past claims.

Does a restoration benefit increase the base sum insured?

No, a restoration benefit does not increase your original base sum insured. Instead, it adds additional coverage, often equal to your base coverage.

Do pre-existing diseases affect the required base sum insured?

Yes, individuals with pre-existing illnesses are more prone to make frequent claims due to their high health risks. As a result, their sum insured can get exhausted quickly.

*Standard T&C apply. Insurance is the subject matter of solicitation. For more details on benefits, exclusions, limitations, terms, and conditions, please read the sales brochure/policy wording carefully before concluding a sale.

பொறுப்புத்துறப்பு: இந்த பக்கத்தில் உள்ள உள்ளடக்கம் பொதுவானது மற்றும் தகவல் மற்றும் விளக்க நோக்கங்களுக்காக மட்டுமே பகிரப்படுகிறது. இது இணையத்தில் உள்ள பல இரண்டாம் நிலை ஆதாரங்களை அடிப்படையாகக் கொண்டது மற்றும் மாற்றங்களுக்கு உட்பட்டது. எந்தவொரு தொடர்புடைய முடிவுகளையும் எடுப்பதற்கு முன்னர் ஒரு நிபுணரை கலந்தாலோசிக்கவும்.

காப்பீடு என்பது தேவையின் பொருள். நன்மைகள், விலக்குகள், வரம்புகள், விதிமுறைகள் மற்றும் நிபந்தனைகள் பற்றிய மேலும் விவரங்களுக்கு, விற்பனையை முடிப்பதற்கு முன்னர் விற்பனை சிற்றேடு/பாலிசி விதிமுறைகளை கவனமாக படிக்கவும்.