Health insurance plays a crucial role in safeguarding you and your family from the unexpected financial pressure that can arise due to sudden illnesses, injuries, or medical emergencies. Life is unpredictable, and anyone can require medical care at any moment. During such times, access to quality healthcare becomes essential, but the expenses for diagnostic tests, medicines, specialist consultations, and hospitalization can rise quickly and impact your financial stability. A dependable health insurance plan ensures that you receive the treatment you need without compromising your savings or peace of mind.
Although many insurance providers claim to offer comprehensive health coverage, only a few truly support their customers when it matters most. At ELS General Insurance, we are committed to delivering on our promises by providing reliable coverage, smooth claim assistance, and guidance tailored to your needs. Our goal is to stand by you during life’s challenging moments and ensure you and your loved ones receive the care you deserve.
Health insurance, often referred to as medical insurance, covers the expenses that arise due to illnesses or accidental injuries, either by reimbursing the incurred medical bills or by settling them directly with the healthcare provider. A good and comprehensive health plan includes coverage for hospitalisation, day-care treatments, medical care at home (domiciliary care), ambulance services, maternity-related expenses, OPD benefits, and many other essential healthcare needs.
Purchasing a health insurance policy not only secures financial protection against multiple diseases but also provides the additional advantage of tax savings. The premium you pay for your health insurance qualifies for tax deductions under Section 80D of the Income Tax Act, 1961, offering both health security and monetary benefits at the same time.
Medical insurance covers all essential hospitalisation costs, including room charges, surgical procedures, ICU expenses, and fees for doctor consultations.
Health insurance includes coverage for expenses incurred before and after hospitalisation, such as diagnostic tests, biopsies, histopathology reports, physiotherapy sessions, and doctor consultations.
Health insurance covers day-care treatments that can be completed within 24 hours and do not require an overnight stay in the hospital.
Health insurance covers treatments under AYUSH systems — Ayurveda, Yoga, Unani, Siddha, and Homeopathy — provided they are carried out by recognised and accredited healthcare facilities.
Domiciliary hospitalisation allows you to receive medical treatment and care at home under specific circumstances, providing convenience and comfort while ensuring proper healthcare.
In emergency situations, ambulance services may be required to transport you to a hospital. Health insurance covers the costs of such ambulance services when needed.
Most Medical Insurance plans include a lifelong renewability cover, allowing you to get uninterrupted Health Insurance coverage, regardless of your age. You only need to renew your policy on time.
If you require a surgery involving an organ transplant due to organ failure, the medical and surgical expenses related to organ harvesting are covered under the health insurance policy.
Medical insurance plans do not include coverage for treatments arising from self-inflicted harm or injuries caused due to attempted suicide, as these fall outside the scope of policy benefits.
Health insurance does not allow claims for cosmetic or plastic procedures done for aesthetic or personal enhancement purposes. Such treatments are only considered when they become medically necessary due to situations like burns, accidents, or cancer-related reconstruction.
Medical insurance does not cover expenses arising from treatments related to the use or abuse of intoxicants, including drugs and alcohol.
Health insurance does not cover expenses for experimental or unproven treatments. Additionally, claims for medical treatments received abroad are generally not eligible, unless explicitly mentioned in the policy terms.
Medical insurance does not cover treatment expenses for injuries incurred while engaging in adventure sports such as parasailing, paragliding, skiing, skydiving, or similar high-risk activities.
Health insurance does not cover costs related to elective medical procedures, including sterility treatments, infertility treatments, in-vitro fertilization (IVF), or gender reassignment procedures.
Medical insurance does not cover expenses for injuries or treatments resulting from wars, war-like situations, or large-scale communal disturbances affecting the public.
Health insurance does not cover medical expenses resulting from actions that violate the law or policy terms, such as using drugs, driving under the influence, or sustaining injuries during illegal activities.
Your age plays a significant role in determining the coverage you need. As you grow older, the likelihood of certain age-related health conditions increases. Choosing a health insurance plan that aligns with your age ensures you get the protection and benefits that suit your specific healthcare requirements.
Given the impact of medical inflation, it is important to select a health insurance plan with a sufficiently high sum insured to ensure long-term financial protection. This helps you stay secure against rising healthcare costs, so that when you need to make a claim in the future, you are not burdened by escalating medical expenses.
In addition to standard pre- and post-hospitalisation expenses, some health insurance plans provide benefits such as maternity coverage, ambulance services, home healthcare, and OPD coverage. It is important to choose a plan that best meets your individual healthcare needs and requirements.
The quality of customer service, claim settlement ratio, solvency ratio, and the speed of service delivery all impact your overall experience with an insurance provider. It is important to evaluate these factors before choosing a health plan. ELS General Insurance is known for its high claim settlement ratio and prompt, reliable customer support.
If you want to enhance your health insurance policy to cover specific medical conditions and related expenses, add-on riders make it easy to do so. These riders provide extra benefits and extend coverage for the conditions specified in your policy.
All health insurance policies have a defined waiting period, which can range from 30 days up to 4 years. During this time, claims cannot be made even if you are covered by the plan. Most of our health insurance plans, however, offer a minimal waiting period of just 30 days.
Buying health insurance at a younger age typically leads to lower premiums. Insurance providers take into account your youth and overall good health, offering cost benefits that can continue throughout the duration of the policy.
Getting health insurance at an early age provides financial protection against unexpected medical expenses. It serves as a safety net, ensuring that healthcare costs do not place a strain on your finances from the start of your adult life.
Buying health insurance at an early age helps protect against claim denials or higher premiums due to pre-existing conditions. Early coverage ensures that your potential medical needs are met, providing peace of mind and financial stability as you grow older.
Purchasing health insurance early provides long-term advantages. It allows you to enjoy continuous coverage, additional benefits, and financial security as you move through various stages of life.
ELS General Insurance offers the convenience of cashless claims at over 17,000 network hospitals across India. To avail this, you simply need to inform us of your intention to file a claim and provide the name of the network hospital where you plan to receive treatment. Our customer service team will guide you through the pre-authorization process to ensure a smooth and hassle-free experience.
Health insurance plans acknowledge that you may prefer a specific healthcare provider or facility, whether or not it is part of our network. In such cases, you can receive treatment at your chosen hospital or clinic. After discharge, you can submit the original bills and supporting documents to file a reimbursement claim, allowing you to be reimbursed for the covered medical expenses.
Visit a network hospital and present your health card to initiate the cashless claim.
Hospital submits pre-authorization documents to ELS General Insurance for approval.
After approval, proceed with admission and receive treatment as per policy coverage.
Hospital submits documents to ELS General Insurance for settlement post discharge.
Settle bills and collect original treatment records and receipts.
Fill and submit the claim form with all required supporting documents.
Submit original documents to the ELS General Insurance Health Office.
Claim is reviewed and processed as per policy terms and conditions.
Enter your mobile number, name, and pin code, then click ‘Proceed’.
Select the members to be insured, pick a plan, choose the sum insured, and include any additional coverages you need.
Fill in all required details, including proposer information, EIA, nominee details, and other relevant information.
Complete the payment online and receive your health insurance policy instantly in your inbox.
Whether you purchase your health insurance policy online or offline, you need to submit the necessary documents to complete the KYC process. Online applicants can submit scanned and self-attested copies, while offline applicants should carry photocopies when visiting the insurance office.
As per Section 80D of the Income Tax Act, 1961, you can claim deductions up to the following amounts:
| Beneficiaries of ELS General Insurance | Annual Deduction Amount |
|---|---|
| Yourself, your spouse, and your children | ₹25,000 |
| Yourself, your spouse, your children, and parents below 60 years | ₹50,000 |
| Yourself, your spouse, your children, and senior citizen parents | ₹75,000 |
| Yourself (above 60 years), your spouse, children, and parents | ₹1,00,000 |
Section 80DDB allows tax deductions for:
Health insurance and expenses incurred for treatment of specified critical illnesses.
The maximum annual deduction is ₹40,000 or the actual premium paid, whichever is lower.
For senior citizen policies, the maximum deduction is capped at ₹1,00,000.
Section 80DD provides tax benefits for:
Medical expenses incurred for yourself as a disabled individual or for dependents with physical or mental disabilities.
The maximum deduction available under this section is ₹75,000 per annum.
Purchasing health insurance online is easy and hassle-free. Simply select your preferred policy on the ELS General website, complete the application form, and submit the necessary documents — all without needing to visit a branch or office in person.
With the online option, there’s no need to worry about cash or cheque payments. You can conveniently pay your insurance premiums using secure online methods such as internet banking, UPI, debit/credit cards, or digital wallets.
ELS General provides a health insurance premium calculator that instantly generates quotes based on the policies you select.
Buying your policy online removes the need for extensive paperwork. Simply complete the application form and upload soft copies of your KYC documents. Additionally, if you meet the eligibility criteria, medical check-ups may not be required.
After selecting your policy and making the premium payment, ELS General sends your policy instantly to your registered email. You don’t need to wait for postal delivery and can access your policy documents anytime via email.
Specify the number of individuals for whom you want to purchase Health Insurance. Select the ‘Self’ icon if coverage is for you alone. To include your spouse, parents, and/or children, simply click on the respective icons representing them.
Enter the necessary personal details for all members covered under the Medical Insurance policy. Include their name, age, date of birth, and mobile number in this step.
Next, select a health plan that aligns with your coverage requirements. Choose the desired sum insured, policy tenure, and any additional riders for enhanced protection. Keep in mind that each added rider may slightly increase the premium amount.
You need to answer important questions that help determine your insurance premium. This includes details about any pre-existing medical conditions, lifestyle habits (such as smoking or drinking), and responses to other related queries.
You need to answer important questions that influence your insurance premium. This includes details about pre-existing medical conditions, lifestyle habits (such as smoking or drinking), and responses to other similar health-related questions.
Premiums are generally lower for younger and healthier individuals, whereas buying insurance at an older age, such as in the 40s, usually results in higher premiums.
The sum insured plays a crucial role in determining your premium payments. A lower sum insured generally results in lower premiums, and a higher sum insured increases the premiums. It is important to choose a sum insured that adequately covers your potential medical expenses.
The premium rates increase as you opt for higher coverage. Additionally, the type of coverage—whether an individual plan or a family floater plan—also affects the premiums, as each plan has different rates.
A long-term health insurance plan covers all medical expenses incurred during its policy period. Premiums for such plans are generally spread over time, making them more manageable. While the cost of a single hospitalization may run into lakhs, the premiums paid over the term are usually much lower.
A long-term health insurance plan covers all medical expenses incurred during the policy period. The premium for such plans is spread over time, making it more manageable. While a single hospitalization could cost several lakhs, the total premiums paid are generally much lower.
Individuals who smoke, consume alcohol, or engage in similar habits may face higher insurance premiums, provided they meet the eligibility criteria for coverage.
Individuals who regularly smoke, consume alcohol, or engage in similar habits may face higher insurance premiums, provided they meet the eligibility criteria for coverage.
The sum insured is the maximum amount your insurer will cover for a claim during a policy year. Any medical expenses beyond this limit must be paid by you.
Alternative medical treatments, including Ayurveda, Yoga, Unani, Siddha, and Homeopathy, are covered under health insurance as per IRDAI guidelines.
The Insurance Regulatory and Development Authority of India (IRDAI) is the main regulatory body in India that establishes rules and guidelines for all insurance-related activities.
Add-on riders are extra covers that can be bought alongside your main health insurance policy. They provide enhanced protection by covering specific medical expenses not included in the base plan.
Co-payment allows you to lower your insurance premiums by agreeing to pay a fixed percentage of your medical expenses when hospitalised and filing a claim.
In indemnity policies, a deductible is the set amount that you, as the policyholder, must pay for medical treatment before the insurer settles the remaining expenses.
Medical treatments or procedures that need less than 24 hours of hospitalisation, such as dialysis or chemotherapy, but do not include standard outpatient care.
Any medical procedure that needs a hospital stay of at least 24 hours as covered under your health insurance plan.
The time after buying a policy during which claims cannot be made. This period may range from 30 days to 4 years, depending on the policy and treatment type.
Claims cannot be made for certain diseases and treatments, which are clearly listed in your policy document.
A benefit from your insurer that increases your coverage without extra premium if no claims are made during the policy period.
Plans that let you boost your coverage with an easy top-up, giving additional protection beyond your base policy.
Hospitals included in your insurer’s network where you can receive cashless treatment services.
Replenishes your base sum insured once it has been used up during the policy period.
The insurer pays the hospital directly, so you don’t have to make out-of-pocket payments during your treatment.
You pay upfront for treatment at non-network hospitals and later submit the bills to your insurer for repayment.
The minimum time you must survive after being diagnosed with a critical illness for your claim to be eligible, usually a few days.
Lets you switch insurers and transfer your policy benefits without losing any of your accrued advantages.
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