Twelve questions.
Ask them of anyone.
Including of this site. These are the questions that separate a policy which fits your household from one that simply sold well — and the answers you get will tell you as much about the adviser as about the product.
Most people buying insurance in India are handed a comparison table and asked to pick. The table shows premium, sum insured, and a column of green ticks. Almost everything that decides whether the policy works sits outside that table.
These twelve questions pull it back in. Ask them of a website's chat window, a bank relationship manager, a relative who sells policies, or of him. Good answers are specific and include at least one drawback. Vague answers are their own answer.
-
01
What exactly am I protecting against, in rupees?
Not "health cover" in the abstract. The actual number: what would a serious admission at the hospital you would genuinely use cost today? In Delhi NCR that figure has moved a long way in ten years, and a sum insured chosen in 2016 is not the same protection in 2026. Start from the hospital bill, work backwards to the cover.
-
02
Is there a room-rent limit — and what is it in rupees a day?
Ask for the number, not the percentage. "One percent of sum insured" means ₹10,000 a day on a ₹10 lakh policy, which is below the private room tariff at several NCR hospitals. Then ask the follow-up that matters: if I exceed it, is a proportionate deduction applied to the whole bill? Usually the answer is yes, and it is the most expensive sentence in the document.
-
03
What are the sub-limits and the co-pay?
Disease-wise caps on cataract, knee replacement and hernia are common and rarely mentioned. Co-pay — a fixed share of every claim you bear — is standard on senior citizen plans and appears on cheaper plans generally. Neither is disqualifying. Both should be a decision, not a discovery.
-
04
When does each waiting period end?
Ask for dates, not durations. Initial waiting, pre-existing conditions, specified illnesses, maternity if relevant, and when the moratorium is reached. Write them on the folder. Under current IRDAI norms the pre-existing and specified-illness waits are capped at three years and the moratorium at five, but confirm against your own wording.
-
05
Which hospitals near me are in the network — today?
Name the two or three you would actually go to in East Delhi, Noida, Ghaziabad or wherever you live, and check those specifically. A network list of 12,000 hospitals is meaningless if the one four kilometres away is not on it. Lists change annually, so check at every renewal, not just at purchase.
-
06
What is not covered?
Ask for the exclusions section by name and read it. It is short, it is written plainly, and it is the part nobody opens. Any advisor who cannot walk you through it in five minutes has not read the policy either.
-
07
How is the no-claim bonus earned, and can it be taken away?
Additional sum insured for a claim-free year is genuinely valuable — often 10–50% a year up to a cap. The question is what happens after a claim: some policies reduce the accumulated bonus, some keep it. Over ten years the difference is substantial.
-
08
What will this premium look like at 60, and at 70?
Health premiums rise with age and with medical inflation, and a plan that is comfortable at 35 can become unaffordable at 62 — precisely when you cannot switch, because your conditions are now pre-existing everywhere else. Ask to see the current premium table by age band. It is public information.
-
09
If I already have a policy, should I keep it?
Frequently, yes. Years already served on waiting periods are worth real money, and a fresh policy resets them all. Topping up, porting, or adding a super top-up above an existing plan is often better than replacing it. Be cautious of any advice to surrender and start over — check whose interest that serves.
-
10
What is the free-look period, and when does my copy arrive?
You currently get 30 days from receiving the policy to return it for a refund, net of small charges. That window exists to be used. Ask when the document will arrive, then actually read it — this is the last easy exit.
-
11
Who fills the proposal form, and can I read it before signing?
The answer should be: you fill it, and yes. If a form arrives partly completed, or someone offers to "handle the details", that is the moment to slow down. Everything at claim time traces back to this document. Keep a copy.
-
12
Who do I call when I claim — and will they answer?
The most important question and the least asked. A name and a number, not a helpline. Ask what happens at eleven at night, who talks to the TPA, who follows up a query. The answers tell you whether you are buying a policy or a relationship — and both are legitimate purchases, as long as you know which one you made.
Any plan worth buying survives being questioned. The rest need you not to ask.
What twenty-six years in NCR
actually teaches you.
Some of this is not in any brochure, and it is the part that only comes from working the same catchment for a long time.
NCR pricing outran the old caps
Private room tariffs at well-known hospitals in East Delhi, Noida and Ghaziabad have moved faster than the 1%-of-sum-insured convention that many older policies still carry. A cap that was generous when the policy was written is now a constraint on the whole bill.
Two kilometres changes the answer
Families in Vivek Vihar, Shahdara, Indirapuram or Vaishali usually have three or four realistic hospitals nearby, and they are not in-network for every insurer. Choosing an insurer whose network matches your actual geography quietly removes most claim friction.
Cover them separately, and early
Adding elderly parents to a family floater raises the premium for everyone and exposes the shared sum insured to their claims. A separate senior citizen policy, bought before conditions accumulate, is almost always the better structure — and the window for it closes quietly.
No group cover, no sick pay
Traders and professionals across East Delhi carry two risks at once: the medical bill and the income that stops while they are away from the business. That is the case where hospital cash and critical illness stop being decorative.
The gap nobody plans for
Group cover ends with the job, and serious illness has a habit of arriving alongside a career disruption. A modest personal policy running underneath employer cover keeps waiting periods ticking down while you are healthy and employed.
One folder, one shelf
Policy wording, proposal copy, premium receipts, medical reports, and a page at the front with renewal dates and the claim helpline. Sounds trivial. It is the difference between a two-week claim and a two-month one.
A sensible order of operations
If you are starting from nothing, this sequence has held up across a lot of households:
- Emergency fund first. Three to six months of expenses in cash. Insurance handles catastrophes; this handles everything smaller, and without it you will end up borrowing during the waiting period anyway.
- Health cover for the household. Comprehensive, no room-rent cap, sized to real NCR hospital bills.
- Term cover, if anyone depends on your income. Sized from goals and liabilities, not from a comfortable premium. The estimator does this arithmetic →
- A super top-up above the health policy. The cheapest way to be ready for a genuinely large claim.
- Separate parents' cover, before conditions accumulate.
- Only then, everything else — critical illness, personal accident, and investments judged as investments.
Nobody does all six at once, and nobody needs to. Doing the first three properly puts you ahead of most households.
Read next.
Health cover checklist
Work through your policy point by point, and keep the progress on your own device.
Read →Term cover checklist + estimator
Build a cover figure from goals, liabilities and existing assets — arithmetic shown.
Read →Buy plain. Add three things.
Which extras earn their premium, and which are answers to questions nobody asked.
Read →Bring your questions.
Leave with clarity.
Ask all twelve. If the answers do not satisfy you, that is useful information too — and there is no follow-up call unless you ask for one.