Sum Insured in Health Insurance – Get Detailed Information Here


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The sum insured or the coverage offered in an insurance policy is of utmost importance to its holder. Here we learn all about sum insured in health insurance so that you can make an informed decision while buying a mediclaim plan.

Health insurance is one of the most vital necessities in the life of every being today. The post-COVID era is still infested with a number of infections and diseases, some of which can still be deadly. It only makes sense in such uncertain times then to be fully prepared for all eventualities. This is where the need for health insurance plans is the most felt.

A health insurance policy contains a number of important elements, each of which has its own significance for the policyholder. One such component is sum insured. Here we will discuss all about this component and why it is of prime importance to a potential buyer of health insurance plans.

What is Sum Insured in Health Insurance?

Let’s begin by understanding a little bit about the sum insured meaning in terms of a mediclaim policy. It simply refers to the total amount payable by the insurance company to the policyholder in case the latter bears huge expenses incurred on the treatment of a medical condition. It is also sometimes referred to as the maximum coverage in terms of health insurance.

This basically means that in case the policyholder needs to be hospitalized for some reason in a medical emergency, under the health insurance plan purchased, he/she would be entitled to be compensated by the insurer up to the total amount specified as sum insured.

This also means that in case the hospital bills or healthcare costs involved in the treatment are higher than the sum insured amount, the remaining excess needs to be borne by the policyholder from their own pocket.

It therefore makes sense to check the sum insured carefully in the policy document before purchasing a health insurance plan. Always try and buy a mediclaim policy that offers a higher sum insured so that you needn’t burn a hole in your pocket in case of any hospitalization emergency.

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Why is Sum Insured  in Health Insurance So Important?

As stated earlier, it is very important to ensure that you choose an adequate amount of sum insured or coverage as part of your health insurance policy. This is because in case of any emergency requirement, it is not wise to use up all your life savings over medical treatment. In such cases, health insurance comes to your rescue but if the sum insured provided is not appropriate or in line with your healthcare needs, then it really does not serve the purpose.

Hence, make sure that you determine your exact requirements in terms of expenditure on healthcare, both in the present and the future. Based on your needs, it would then make sense to choose a health insurance plan that offers just the right amount of coverage for you and your family.

Moreover, sum insured is particularly important in case of family floater plans. This is because these plans are designed to provide financial coverage for the entire family. In case multiple family members need insurance protection at the same time, it would be vital that the sum insured in the healthcare policy takes care of all expenses that need to be incurred.

3 Tips to Choose the Right Sum Insured

So we discussed all about sum insured and why it is so important in health insurance. But how to ensure that we choose just the right amount of coverage for our policy? Keep the following points in mind to make an informed decision for you and your loved ones:

  1. Keep in mind your current state of wellbeing: When deciding how much sum insured to opt for as part of your mediclaim plan, make sure to keep in mind the current state of health, not just your own but also that of your family. This would greatly help you decide the amount of sum insured to choose for the health insurance plan, since any pre-existing health conditions would need larger financial protection in future.
  2. Bear in mind your age: Age plays a very critical part in determining the coverage factor in health insurance. As you age, you are at a higher risk of contracting infections/diseases with reduced immunity; hence, it directly impacts the sum insured required. Most insurance companies are reluctant to even offer health insurance plans to prospects who are older simply because it means higher sum insured. It is therefore better to buy a mediclaim policy earlier on in life.
  3. Your lifestyle plays a role too: It is not just about the age and pre-existing health conditions; your current lifestyle also determines how likely you are to fall sick or become in need of medical treatments in life. The poorer lifestyle you follow, the higher it puts you at risk healthwise and this directly impacts the sum insured decided for your plan.

Read More: What is the Cost of 10 Lakh Health Insurance for a Family of Four Members?

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Is Sum Insured the Same As Sum Assured?

Both these terms are used in the context of health insurance; however, it is important to note that they cannot be used interchangeably. Even though sum insured and sum assured sound similar, the two terms are different in meaning.

Sum assured refers to the fixed amount payable by the insurer, regardless of whether an event has happened or not. Sum insured is the total amount payable by the insurance company only when a particular claim is raised by the insured. Also, sum assured is generally a part of life insurance policies, whereas sum insured is a part of most insurance plans except life insurance.

Wrapping Up

Sum insured is one of the most important considerations when it comes to buying health insurance for  your family. Make an informed choice based on the information shared in this blog. If you’re looking for the best health insurance, visit PayBima to find answers to all your healthcare needs.

Also Read: What is the Free Look Period in Health Insurance Policy?  |  Is Health Insurance Premium Payment in Installments Possible?

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Oct 04, 2022
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PayBima is an Indian insurance aggregator on a mission to make insurance simple for people. PayBima is the Digital arm of the already established and trusted Mahindra Insurance Brokers Ltd., a reputed name in the insurance broking industry with 17 years of experience. PayBima promises you the easy-to-access online platform to buy insurance policies, and also extend their unrelented assistance with all your policy related queries and services.

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