Individual Health Insurance: Meaning, Benefits & How to Choose the Best Plan
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Home / Health Insurance / Individual Health Insurance: Meaning, Benefits & How to Choose the Best Plan
Individual health insurance plan is your best choice when it comes to protecting yourself from unexpected medical expenses. Whether you are single, a working professional, or simply want dedicated coverage, these plans ensure your income is safe while providing comprehensive medical care. With ACKO’s individual health insurance plans, you can enjoy cashless claims at network hospitals, affordable premiums, and instant digital policy issuance, making health protection simple and stress-free.
What is Individual Health Insurance?
Individual health insurance, also known as personal health insurance, is a policy designed to cover the medical expenses of a single person. Unlike group or family health plans, which share the sum insured among multiple members, individual health insurance provides dedicated coverage for the policyholder. This ensures that the full sum insured is available whenever you need treatment.
How It Differs from Group or Family Plans
Dedicated Coverage: Individual plans are meant for one person, whereas family floater plans share coverage among family members.
Customisation: You can choose your sum insured, add-on covers, and deductibles according to your needs, unlike group plans which may have standard benefits.
Portability: Your coverage is independent of your employer or family, so you retain the same benefits even if you change jobs or move cities.
Key Components of Individual Health Insurance
Premium: The amount you pay for coverage, influenced by factors like age, health status, sum insured, and optional riders.
Coverage: Includes hospitalization costs, surgeries, doctor fees, medications, and diagnostic tests. Many plans also cover pre- and post-hospitalization expenses, ambulance charges, and optional add-ons like critical illness or maternity coverage.
Benefits: Access to cashless treatment at network hospitals, tax deductions under Section 80D, and flexibility to customise your plan according to your health needs.
Choosing the right individual health insurance plan ensures you are financially protected against unexpected medical expenses while giving you the freedom to tailor coverage to your personal requirements.
Why Choose Individual Health Insurance?
Choosing the best individual health insurance plans ensures you have dedicated, personalised coverage tailored to your unique healthcare needs and financial situation. Unlike family or group plans, the sum insured is exclusively yours, offering complete financial protection during medical emergencies. Here’s why individual health insurance is a great choice:
Dedicated Coverage
With an individual health insurance plan, you don’t share your sum insured with others. This means full protection is available for you whenever you need it, providing peace of mind in case of medical emergencies.
Seamless Claims
Get cashless treatment at 11,500+ network hospitals with ACKO. The streamlined claim process ensures minimal paperwork, faster approvals, and less stress during hospitalisation.
Paperless Convenience
Buy, renew, and manage your policy entirely online. ACKO’s digital platform offers a hassle-free experience, allowing you to take control of your health insurance anytime, anywhere.
Affordable Premiums
Pay only for what you need. Individual plans allow you to customise your coverage, avoiding unnecessary extra costs while ensuring comprehensive protection.
Flexibility to Suit Your Needs
Individual health insurance offers the freedom to tailor your policy according to your requirements:
Customised Coverage: Adjust coverage limits, deductibles, and policy details to match your health needs and budget.
Choice of Providers: Select hospitals, doctors, and specialists you trust, ensuring access to quality care without compromise.
Optional Add-ons: Include riders for critical illness, maternity, dental, or vision care to enhance protection.
Portability & Employment Independence
Your coverage is not tied to your employer, so you can maintain your health insurance even if you switch jobs, are self-employed, or currently between roles.
Family Coverage Options
Many individual plans allow you to include family members such as your spouse or children under the same policy. This simplifies management and can be more cost-effective than separate plans.
Early Start Advantage
Purchasing health insurance early, even as a young adult, reduces premiums and helps you build a continuous coverage history, potentially offering better terms in the future.
Control Over Coverage
Focus on the healthcare areas that matter most to you. Individual plans let you prioritise protection for treatments or conditions that are financially or medically significant.
Access to Specialized Care
Need specialised treatments or advanced procedures? Individual health insurance ensures coverage for specialised care (subject to policy terms), critical for those with specific health needs.
Peace of Mind
Above all, individual health insurance provides confidence and security, knowing that unexpected medical expenses, accidents, or illnesses won’t derail your financial stability.
With ACKO, you get instant policy issuance, hassle-free renewals, and 24x7 support, making it one of the best individual health insurance plans in India.
Benefits of Buying an Individual Health Insurance Policy Online
Buying individual health insurance plans online makes the process faster, convenient, and efficient, giving you complete control over your policy. Here are the key benefits of choosing health insurance for individual coverage online:
Ease of Comparison
Online platforms allow you to compare multiple plans from different providers. Review coverage options, premiums, deductibles and benefits side by side, helping you make an informed choice.
Convenience and Flexibility
Purchase your health insurance policy from the comfort of your home or office at any time that suits you, even late at night. No need to visit offices or deal with agents in person.
Instant Policy Issuance
Get your policy issued instantly after payment, so you are covered immediately without waiting for paperwork.
Time Saving
Complete the entire purchase process quickly, avoiding lengthy documentation and office visits. Online platforms streamline applications and approvals.
Access to Information
Online platforms provide detailed information about policies, including coverage, exclusions, network hospitals and add-ons. This transparency empowers you to choose a plan tailored to your healthcare needs.
Instant Quotes and Customisation
Receive instant quotes based on your details, and customise your policy by adjusting coverage limits, deductibles and optional riders according to your preferences.
Secure and Paperless Process
Reputable online platforms use secure payment gateways to protect your personal and financial information. Most transactions are paperless, reducing document management hassles.
24x7 Customer Support
Access assistance anytime via chat, email or phone. Online purchasing ensures continuous support, helping you manage your policy effortlessly.
No Pressure Sales
Avoid high-pressure tactics often experienced with in-person agents. You can make a calm, informed decision while comparing plans online.
Digital Access
Manage your policy digitally, with access to claims history, policy details and renewals anytime, ensuring smooth post-purchase management.
Buying individual health insurance online with ACKO combines speed, convenience and transparency, making it an easy, hassle-free way to secure your health coverage.
What is Covered in Individual Health Insurance Plans?
Individual health insurance coverage in India protects you against a wide range of medical expenses. The exact inclusions may vary depending on the insurer and specific policy, but most plans offer the following.
Hospitalisation Expenses: Covers in-patient hospitalisation costs, including room charges, nursing, doctor’s fees, surgery, anaesthesia, and other related expenses.
Pre-Hospitalisation Expenses: Medical expenses incurred before hospitalisation, usually up to 30 or 60 days, are covered.
Post-Hospitalisation Expenses: Costs for treatment, tests, and medications after discharge are included for a specified period.
Day Care Procedures: Covers treatments and procedures that do not require an overnight hospital stay but require specialised care.
Ambulance Charges: Reimbursement or direct payment for ambulance services needed for hospitalisation.
Emergency Care: Coverage for medical emergencies, including accidents and sudden illnesses.
Domiciliary Treatment: Medical treatment taken at home when hospitalisation is not possible or required.
Organ Transplants: Includes the cost of organ, surgery, and post-operative care for approved transplant procedures.
AYUSH Treatment: Covers treatments under Ayurveda, Yoga & Naturopathy, Unani, Siddha, and Homeopathy systems of medicine.
ICU Charges: Covers intensive care unit expenses, including specialised monitoring and critical care.
Note: Individual health insurance coverage may include exclusions, waiting periods, sub-limits, and specific terms and conditions. Always review your policy document carefully to understand what is and isn’t covered.
What is Not Covered Under Individual Health Insurance Plans?
While individual health insurance plans provide comprehensive medical coverage, there are certain exclusions in individual health insurance that you should be aware of. These are treatments or situations that the policy generally does not cover. Common exclusions include the following.
Cosmetic and Plastic Surgery: Elective or cosmetic procedures, unless medically necessary, are usually not covered.
Dental and Vision Care: Routine dental check-ups, eyeglasses, and contact lenses are often excluded. Some policies may offer these as optional add-ons.
Regular Health Check-ups: General health screenings are usually not covered unless specified in the policy.
Experimental or Unproven Treatments: Procedures that are considered experimental may not be included.
Injuries from Hazardous Activities: Accidents occurring during extreme sports or adventure activities might be excluded.
Substance Abuse-Related Illnesses: Health issues arising from alcohol, drugs, or other substance abuse are generally not covered.
War or Terrorism-Related Injuries: Injuries caused by acts of war or terrorism are usually excluded.
HIV/AIDS and Certain STDs: Some policies may exclude treatment for HIV/AIDS and other sexually transmitted diseases.
Self-Inflicted Injuries: Injuries intentionally caused by the insured person are not covered.
Criminal Activities: Injuries or illnesses resulting from participation in unlawful acts are excluded.
Pre-Existing Conditions Waiting Period: Most plans have a waiting period before covering pre-existing conditions, so these expenses may not be reimbursed initially.
Note: Understanding these exclusions in individual health insurance helps you make informed decisions and avoid surprises when filing a claim. Always check your policy document carefully before purchase.
Eligibility Criteria for Individual Health Insurance
Before buying personal health insurance, it’s important to understand who can buy individual health insurance and the common eligibility requirements. While criteria may vary depending on the insurer and the specific plan, the following are generally considered:
Age: Most individual health insurance plans have minimum and maximum age limits. Typically, applicants need to be between 18 and 65 years old. Some policies also provide coverage for children and senior citizens with specific terms.
Nationality and Residency: You must be an Indian citizen or resident of India to be eligible for a personal health insurance policy.
Medical History: Insurers usually ask for details about your medical history, including pre-existing conditions, past illnesses, surgeries, and ongoing treatments. This helps them assess your risk and determine coverage.
Medical Examination: Depending on your age and the sum insured, some policies may require a medical examination before approval. This ensures your health condition is properly evaluated.
Premium Payment: Eligibility also depends on your ability and willingness to pay premiums. Policies are typically approved once the first premium is successfully paid.
Accurate Disclosure: It is crucial to provide complete and accurate information about your health, lifestyle, and medical history when applying. Any discrepancies could affect claim approvals later.
Renewal Criteria: Some plans have renewal conditions, such as age limits or claim history, which may influence your ability to continue coverage in future years.
Note: Understanding these personal health insurance eligibility requirements ensures you select the right plan and avoid surprises during purchase or renewal. Always review the policy documents carefully and clarify any doubts with your insurer.
How much individual health insurance coverage should you have?
The ideal individual health insurance coverage should be at least twice your annual income. For example, if you earn ₹10 lakh a year, a ₹20 lakh cover is a good choice. In metro cities, ₹15–25 lakh coverage is ideal due to higher healthcare costs, while ₹10–20 lakh works well for smaller cities. This balance ensures adequate protection without overspending on premiums. Here are key factors to consider:
Ideal sum insured based on income
Your income and budget can be one of the most important factors while choosing a health plan. While there are ways in which you can reduce the premium or opt for payment methods that help in decreasing the burden of lump sum payments, you need to buy a plan that does not cause a large financial gap.
Annual Income (₹) | Recommended Sum Insured (₹) | Estimated Annual Premium (₹) | Approx. Monthly Cost (₹) |
|---|---|---|---|
Up to 5 lakh | 10 lakh | 8,000 – 12,000 | 650 – 1,000 |
5 – 10 lakh | 20 lakh | 15,000 – 20,000 | 1,250 – 1,700 |
10 – 15 lakh | 30 lakh | 20,000 – 30,000 | 1,700 – 2,500 |
15 – 25 lakh | 50 lakh | 30,000 – 45,000 | 2,500 – 3,800 |
Above 25 lakh | 1 crore or higher | 50,000+ | 4,200+ |
For example: Miss Priya’s annual income is ₹10 lakh so ideally her sum insured should be around twice her income i.e. ₹20 lakhs. This plan can cost around ₹15 to ₹20 thousand per year. This comes down to approximately ₹1.5 to ₹2 thousand per month.
Ideal sum insured based on location
Your ideal sum insured for Individual Health Insurance Plans can differ as per your location. This is because the cost of healthcare is different in various Indian states. Take a look at this table to know the recommended sum insured as per your location.
City Tier | Recommended Sum Insured | Estimated Annual Premium | Approx. Monthly Premium | Notes |
|---|---|---|---|---|
Tier 1 (Metro Cities) | ₹15–25 lakh | ₹15,000–₹25,000 | ₹1,250–₹2,100 | Higher healthcare costs; consider ₹20 lakh for comprehensive coverage. |
Tier 2 (Large Cities) | ₹10–20 lakh | ₹12,000–₹20,000 | ₹1,000–₹1,700 | Moderate healthcare costs; ₹15 lakh is often sufficient. |
Tier 3 (Small Cities/Towns) | ₹5–10 lakh | ₹8,000–₹15,000 | ₹650–₹1,250 | Lower healthcare costs; ₹10 lakh offers ample coverage. |
Ideal sum insured based on family size
Your ideal sum insured for Family Health Insurance Plans can vary depending on the size of your family. As the number of family members increases, so do the potential healthcare costs. Check out this table to see the recommended sum insured based on your family size.
Family Size | Recommended Sum Insured (₹) | Estimated Annual Premium (₹) | Approx. Monthly Premium (₹) | Notes |
|---|---|---|---|---|
Individual (1 adult) | 10–20 lakh | 8,000–20,000 | 650–1,700 | Suitable for a single person; consider higher coverage if in Tier 1 city. |
Couple (2 adults) | 20–30 lakh | 15,000–30,000 | 1,250–2,500 | Covers both adults adequately; ideal for Tier 2–Tier 1 cities. |
Couple + 1 child | 25–35 lakh | 18,000–35,000 | 1,500–2,900 | Child coverage increases sum insured slightly; ensure maternity or newborn benefits if needed. |
Couple + 2 children | 30–40 lakh | 22,000–40,000 | 1,800–3,300 | Adequate coverage for the whole family; includes hospitalisation and daycare procedures. |
Extended Family (3+ members) | 40–50 lakh | 30,000–50,000 | 2,500–4,200 | Suitable for larger families or parents living together; opt for family floater plans for better cost efficiency. |
Individual vs. Family Floater vs. Group Health Insurance
Choosing the right health insurance plan depends on your personal needs, family size, and financial situation. Here’s a comparison of health insurance for individual vs family floater vs group health insurance to help you decide.
Feature | Individual Health Insurance | Family Floater Plan | Group Health Insurance |
|---|---|---|---|
Coverage | Dedicated sum insured for the individual policyholder | Shared sum insured among all family members | Coverage for employees under an employer-sponsored plan |
Premium | Based on individual’s age, health, and sum insured | Usually lower than individual plans per person; premium depends on total family coverage | Paid by employer; sometimes partially contributed by employees |
Flexibility | Customisable coverage, riders, and deductibles | Limited customisation; same coverage for all members | Limited to employer-defined benefits and coverage |
Portability | Policy is independent of employer, can be renewed regardless of job | Tied to the family, can continue after changes in employment | Coverage may end when you leave the company |
Cashless Hospitals | Network hospitals with cashless facility | Network hospitals, depends on insurer | Network hospitals; restricted to group policy network |
Best For | Individuals seeking dedicated coverage and customisation | Families wanting shared coverage and convenience | Employees looking for employer-provided health benefits |
Looking for family coverage? Explore ACKO’s Family Health Insurance Plans for comprehensive protection for your loved ones with easy online purchase and cashless claims.
Add-ons and Riders Available with Individual Health Insurance
Many individual health insurance plans allow you to enhance your coverage through add-on covers in health insurance or optional riders in individual plans. These extras let you tailor your policy to suit your unique healthcare needs.
Here are some of the most popular add-ons and riders:
Critical Illness Rider: Provides a lump sum payout in case you are diagnosed with a critical illness such as cancer, heart attack, or kidney failure. This helps cover treatment costs that go beyond standard hospitalisation coverage.
Maternity Cover: Covers expenses related to pregnancy, delivery, and newborn care. Some plans also include pre- and post-natal care.
Room Rent Waiver / Upgrade: Lets you choose a higher room category or removes limits on room rent charges, ensuring comfort during hospital stays.
Personal Accident Cover: Offers financial protection in case of accidental injuries, disability, or death. Read more on personal accident cover.
AYUSH Treatment Rider: Covers alternative treatments such as Ayurveda, Yoga & Naturopathy, Unani, Siddha, and Homeopathy.
Health Check-up Add-on: Provides coverage for routine health screenings and preventive check-ups.
Hospital Daily Cash: Offers a fixed daily allowance for each day of hospitalisation to cover incidental expenses. Read more on hospital daily cash.
Adding the right riders can enhance your individual health insurance coverage, giving you more flexibility and financial protection against specific health risks.
Things to Keep in Mind While Buying an Individual Health Insurance Plan
When choosing from the many best individual health insurance plans, it’s important to consider various factors to ensure your policy meets your healthcare needs and financial goals. Here’s what you should keep in mind:
Coverage Needs
Consider your age, pre-existing conditions, anticipated medical expenses, and lifestyle. Think about how your health may change over time and how factors like fitness routines, diet, or high-risk activities might affect your future health needs.
Policy Coverage
Review what the policy covers, including hospitalisation, pre- and post-hospitalisation, day-care procedures, critical illnesses, and maternity benefits if applicable. Ensure the plan addresses the medical treatments and procedures you are likely to require.
Sum Insured (Coverage Limit)
Choose a sum insured that can cover potential medical expenses today and in the future. Factor in healthcare inflation to ensure your coverage remains sufficient as medical costs rise over time.
Network Hospitals
Check the insurer’s network hospitals for cashless treatment. Ensure the network includes reputable hospitals that are conveniently located and have the specialists you may need.
Exclusions and Waiting Periods
Understand the policy’s exclusions, waiting periods, and limitations. Be aware of waiting periods for pre-existing conditions and specific treatments to avoid surprises during claims.
Renewal Age and Lifetime Renewability
Opt for a policy that offers lifetime renewability. This guarantees continued coverage even as you age and face higher health risks. Check the maximum renewal age to avoid losing protection later in life.
Premium Costs
Compare premiums across insurers to find a balance between affordability and coverage. Don’t compromise essential coverage for lower premiums.
Add-On Riders
Consider optional riders like critical illness, maternity, or accidental cover to customise your policy according to your specific health risks and financial needs.
Network Hospital Availability
Ensure there are network hospitals in your city or region for easy access to cashless treatment, especially during emergencies.
Customer Support and Reviews
Check the insurer’s customer support quality and read reviews from existing policyholders. Good support can make a significant difference when filing claims or seeking guidance.
Free-Look Period
Understand the free-look period, which allows you to review the policy after purchase. If unsatisfied, you can cancel the policy and get a refund, ensuring you make an informed decision without pressure.
Policy Renewal
Be aware of the renewal process and renew your policy on time to avoid lapses in coverage. Timely renewal ensures continued protection, including for conditions covered after waiting periods.
Disclosure and Honesty
Provide accurate and complete information in your application. Non-disclosure of pre-existing conditions can lead to claim rejection. Transparency ensures smooth claim processing and appropriate coverage.
Read the Policy Document
Finally, thoroughly read the policy document before purchasing. Clarify any terms or clauses you do not understand to avoid surprises later.
Keeping these points in mind will help you choose one of the best individual health insurance plans that is reliable, comprehensive, and tailored to your personal healthcare needs.
Save Tax with Individual Health Insurance (Section 80D)
Buying individual health insurance not only protects your health but can also help you save on taxes under Section 80D of the Income Tax Act. Understanding these health insurance tax benefits can make your investment in healthcare even more rewarding.
Tax Deduction for Individuals
If you purchase an individual health insurance policy for yourself, your premium payments are eligible for tax deduction up to ₹25,000 per financial year. If you or your spouse are above 60 years old, this limit increases to ₹50,000.
Deduction for Parents
You can also claim tax benefits on premiums paid for your parents’ health insurance. If your parents are below 60, the deduction is up to ₹25,000; if they are senior citizens (above 60), it rises to ₹50,000.
Preventive Health Check-Up
Section 80D also allows a deduction for preventive health check-ups, up to ₹5,000 within the existing limits, giving you an added incentive to monitor your health regularly.
How ACKO Helps
ACKO makes it easy to claim tax benefits. When you buy a health insurance plan online, you receive instant e-statements that you can use while filing your taxes. This digital documentation ensures a hassle-free experience, saving you time and effort.
By choosing an ACKO individual health insurance plan, you not only secure your health but also enjoy Section 80D tax benefits, making your coverage cost-effective and smart for your finances.
How to Buy an Individual Health Insurance Policy Online
Buying individual health insurance online in India is quick, convenient, and paperless. With ACKO, you can complete the entire process digitally and get your policy instantly. Here’s a step-by-step guide.
Research and Compare: Start by exploring different insurance providers and health insurance for individual plans. Compare coverage, benefits, premium costs, and exclusions to find the policy that best fits your healthcare needs.
Choose a Reputable Provider: Select a reliable and IRDAI-approved insurance company. A well-established provider ensures faster claim settlement and trustworthy customer support.
Visit the Provider’s Website: Go to the official website of your chosen insurer and navigate to the health insurance section.
Use Online Tools: Many websites, including ACKO, offer premium calculators to estimate your policy cost based on your age, coverage preferences, and add-ons.
Select and Customise Your Plan: Choose the individual health insurance plan that suits your budget and requirements. You can often customise coverage limits, add riders, or select deductibles according to your preferences.
Fill Out the Application Form: Complete the online form with accurate personal and medical information. Transparency ensures smooth claim processing later.
Upload Documents: Some insurers may require ID proof, address proof, or medical records. ACKO keeps this process simple and mostly digital.
Review and Confirm Premium: The system will calculate your premium based on your inputs. Review it carefully and confirm before proceeding.
Make Payment: Pay securely using credit/debit cards, net banking, or digital wallets.
Receive Policy Documents: Once payment is successful, your digital policy documents are sent via email instantly. These include your policy number, coverage details, and terms and conditions.
Policy Servicing: Set up an online account to manage your policy, track claims, and access documents anytime.
Customer Support: If you need help during or after purchase, ACKO offers 24x7 customer support through chat, call, or email.
Buying from ACKO is quick and easy! Just click the link, fill in your details, and get your quote instantly.
Individual Health Insurance Premium Calculator
An Individual Health Insurance Premium Calculator is an online tool that helps you estimate how much premium you’ll need to pay for your personal health insurance plan. It uses a few basic details to give you an approximate premium amount so you can compare, plan, and budget better before buying.Here’s how it works and what factors influence your premium.
Age: Younger individuals usually pay lower premiums as the health risk is lower.
Sum Insured: Higher coverage offers more protection but comes with a higher premium.
Coverage Type: Basic, comprehensive, or enhanced plans with add-ons can impact the overall cost.
Pre-existing Conditions: Some calculators may ask about your medical history, as existing health conditions can increase the premium.
Location: Premiums may vary depending on your city or region due to differences in healthcare costs.
Policy Tenure: Longer policy durations can slightly affect the premium amount.
Lifestyle Habits: Factors such as smoking, alcohol consumption, or a high-risk occupation can increase your premium.
Add-ons or Riders: Adding extra covers like critical illness or maternity cover will increase the total premium.
You can use ACKO’s Health Insurance Premium Calculator to instantly check your premium, customise your plan, and get a policy that fits your needs and budget, all online, without any paperwork.
How to File an Individual Health Insurance Claim (with Types Explained)
Filing an individual health insurance claim ensures that you get financial support for your medical expenses as per your policy coverage. Depending on your situation, you can choose between a cashless claim or a reimbursement claim. Here’s how both processes work.
1. Cashless Health Insurance Claim Process
You don’t have to pay hospital bills upfront when you visit a network hospital under your policy. ACKO settles the bills directly with the hospital.
Steps:
Visit a network hospital: Choose one from ACKO’s 10,500+ network hospitals.
Inform at the insurance desk: Share your policy details or ACKO e-card.
Pre-authorisation: The hospital sends your treatment details to ACKO for approval.
Claim approval: Once verified, ACKO approves the cashless treatment.
Discharge and settlement: After discharge, ACKO pays the hospital directly for all covered expenses.
Documents Required:
Pre-authorisation form
ACKO Health ID or policy number
Doctor’s prescription and medical reports
Hospital bills and discharge summary
2. Reimbursement Health Insurance Claim Process
If you receive treatment at a non-network hospital, you can file a reimbursement claim after paying your bills.
Steps:
Pay hospital bills: Settle your medical expenses directly with the hospital.
Collect all documents: Keep all original bills, prescriptions, and diagnostic reports.
Submit your claim: Upload the claim form and documents on the ACKO app or website.
Claim verification: ACKO reviews the details and may contact you or the hospital for clarification.
Reimbursement: Once approved, ACKO transfers the claim amount directly to your bank account.
Documents Required
Original hospital and pharmacy bills
Doctor’s prescription
Discharge summary and diagnostic reports
Filled claim form
Bank account details
Quick Claim Filing Tips
Always inform ACKO within 24 hours of hospitalisation (for planned admissions) or as soon as possible for emergencies.
Ensure that your name, policy number, and treatment details match your policy records.
Keep digital copies of all documents for faster uploads and claim tracking.
Why File with ACKO?
With ACKO’s digital-first claim process, you can file and track claims effortlessly via the app, no paperwork, no follow-ups, and instant updates at every step.
Claim Settlement Ratio and Process at ACKO
When it comes to choosing the right health insurance provider, claim settlement performance is one of the most important factors to consider. At ACKO, we take pride in offering a fast, transparent, and hassle-free claim settlement process, designed to make your healthcare journey smoother.
High Claim Settlement Ratio: ACKO maintains an impressive claim settlement ratio of over 95%, reflecting our strong commitment to customer satisfaction and reliability. This means that out of every 100 claims received, more than 95 are successfully settled, a clear indicator of trust and efficiency.
Quick Turnaround Time: Speed is key during medical emergencies. ACKO’s average claim settlement time is under 2 hours for cashless claims, ensuring you or your family members receive timely medical care without worrying about finances. Reimbursement claims are typically processed within 3–5 working days, provided all documents are in order.
Simple, Digital Claim Process: With ACKO, you can raise and track your claims completely online through the ACKO app or website. You don’t need to deal with lengthy paperwork or physical visits. Just upload the required documents, and our claims team takes care of the rest.
Why It Matters
A strong claim settlement ratio, backed by speed and transparency, shows that ACKO values its customers’ trust. Our digital-first approach ensures that every claim is handled quickly, fairly, and with empathy.
Customer Support and Assistance for Individual Policyholders
At ACKO, we understand that health emergencies and insurance queries can arise anytime. That’s why our customer support team is available 24x7 to ensure that you always have help when you need it most. Whether you need assistance with your individual health insurance policy, help with claims, or clarification on coverage details, our support channels are designed for convenience and speed.
Multiple Contact Channels:
You can reach ACKO Customer Care through several easy-to-access options:
In-App Chat: Use the ACKO app to connect instantly with our customer support team via the in-app chat feature.
Email Support: Write to us at [email protected] for policy-related queries, claim assistance, or feedback.
Help Centre: Visit the Contact Us page for self-service options.
Social Media Support: ACKO’s verified handles on platforms like Twitter (X) and Instagram also assist with general queries.
24x7 Assistance: ACKO’s digital-first approach ensures round-the-clock support for individual policyholders. Whether it’s a cashless claim query at midnight or a renewal reminder on a Sunday, our team is just a few taps away.
Seamless Experience: Policyholders can also track claim status, update policy details, or renew policies directly through the ACKO app or website. The intuitive interface and guided assistance make it simple to manage everything without needing to call or visit an office.
At ACKO, we believe that great insurance goes hand in hand with great support, quick responses, transparent communication, and reliable help every time.
FAQs about Health Insurance for Individuals
The following are questions and answers related to Individual health insurance policy
Do individual health insurance plans cover mental health treatment?
Yes, as per the IRDAI mandate, most modern health insurance plans in India now include mental health coverage. This includes psychiatric consultations, therapy, and hospitalisation for mental illnesses, subject to policy terms and limits.
How does individual health insurance differ from a critical illness plan?
Individual health insurance covers hospitalisation expenses due to illness or injury, while a critical illness plan pays a lump sum if you’re diagnosed with a listed severe condition such as cancer or a heart attack. You can buy both for wider protection.
Can I get coverage immediately after buying an individual health plan?
Yes, coverage for accidental hospitalisation usually starts immediately, while coverage for illnesses begins after an initial waiting period (typically 30 days). This period may vary depending on the insurer and policy terms.
Does an individual health insurance plan come at a lower price?
The cost of an individual health insurance policy depends upon the list of inclusions and terms & conditions of a health insurance company. One can reduce this cost to an extent by renewing the policy on time and avoiding claiming for minor incidents.
Are there any waiting periods under Individual Health Insurance Plans?
Yes, there are waiting periods under individual health insurance plans. These waiting periods are specific periods during which certain coverage benefits, such as coverage for pre-existing conditions or specific treatments, are not immediately available after purchasing the policy. The duration of waiting periods varies between policies and insurance providers.
Is cashless treatment available under Individual Health Insurance Policy?
Yes, cashless treatment is available under many individual health insurance policies. Policyholders can receive medical treatment at network hospitals without having to make upfront payments, as the insurance company settles the bills directly with the hospital. It's important to ensure that you choose a policy that offers a wide network of hospitals in your area for convenient access to cashless treatment.
Can an individual have more than one personal insurance policy?
Yes, an individual can have more than one health personal insurance policy from different insurance providers to enhance coverage and manage healthcare expenses. This is known as "dual insurance" or "multiple policies." However, coordination between the policies and adherence to terms and conditions are important to avoid potential issues during claims settlement.
How to save on health insurance for a single person?
One can consider doing a couple of things while trying to save money on an individual health insurance policy. For example, you can improve your lifestyle to reduce the number of claims. Consider quitting smoking if you are a smoker. Secondly, you can compare various similar health insurance plans to understand the lowest priced policy and its inclusions.
Which plan is best for a health insurance plan for an individual?
A policy that offers an all-round coverage is considered to be the best health insurance plan. One can buy such a plan by taking into account the current lifestyle, medical history, and financial status. Then choose a plan that suits your requirements.
What is meant by an individual health insurance plan?
An individual health insurance plan offers health insurance coverage to a single person. The sum insured of the policy is not shared among other people and can be used by the policyholder. The policyholder can enjoy certain discounts if a claim is not raised during the policy period.
What is the eligibility for an individual health insurance plan?
The eligibility for health insurance for individual includes being an Indian citizen or resident, within a certain age range (usually 18 to 65 years), and meeting the insurer's underwriting criteria. Pre-existing conditions and medical history may also affect eligibility and coverage terms.
How can I buy individual health insurance online?
You need to select a digital-first insurance company like Acko to buy health insurance online. Visit the insurance company's website and search for Individual health insurance plans. Enter your details and review coverages. Next, take a look at the exclusions and other terms & conditions. Also, read the fine print thoroughly before making the final payment. Don't hesitate to get in touch with the insurance company if you have any doubts related to their insurance policy. If not medical tests are required, then you might get your health insurance policy instantly at the registered email address.
Does individual health insurance come with maternity coverage?
All individual health insurance plans do not come with maternity coverages. You need to buy a separate cover with the base plan. Remember that there could be a waiting period for availing maternity benefits. Some insurance companies may enforce a waiting period of a few months to a few years of these benefits. Contact the insurance company to know more about maternity coverage.
How to find the best health insurance companies for individuals?
You can easily search for the best health insurance plan when you intend to buy it online. This way you can compare policies and take a look at the social media handles of insurance companies for understanding the credibility of the company. Choose a plan that is most suitable for your requirements. Next comes the premium amount. Select a plan that has all the benefits and is priced lower than other plans with similar coverage.
How are individual health insurance rates decided?
The premium rate for buying an individual health insurance policy is decided based on the medical history of the applicant, claim history (if applicable), the scope of coverage, the insurance company, etc.
Is group health insurance cheaper than individual health insurance?
A group health insurance policy is usually offered by an organization to a group of people. For example, Employee health insurance benefits. Here usually the employer pays the premium. On the other hand, an Individual Health insurance policy is purchased by a person, and he/she pays the premium. So yes, a Group Health Insurance plan can be cheaper compared to an Individual policy.
Is it a good idea to buy multiple healthcare insurance plans for individuals?
Absolutely yes. As per the new rules, a policyholder will be allowed to raise a claim with multiple insurance companies for one claimable event for example cost of treatment arising out of an accident. This is how it works. Suppose Mr A has bought two separate health insurance plans, and he met with an accident. The first insurance company paid 80% of the total cost of treatment. Mr A can approach the second health insurance company to make a claim for the remaining 20% of the expenses. Thus, it is a good idea to build a solid health insurance portfolio by buying multiple plans.
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