Adequate Sum Insured Matters – How Much Health Coverage Do You Really Need?

💰 Why Adequate Sum Insured Matters?

Having adequate health insurance coverage means your sum insured should cover:

• Rising medical inflation (12-15% annually)

• Advanced treatment costs

• Multiple hospitalizations

• Post-hospitalization expenses

⚠️ Risks of Under-Insurance

• Paying huge amounts from savings

• Compromising on treatment quality

• Claim rejection due to exhaustion of limit

• Stress during medical emergencies

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📊 How to Calculate Your Adequate Sum Insured?

1️⃣ Base Calculation (By City Tier)

2️⃣ Age-Based Adjustment

• Below 30: ₹5-10 Lakh

• 30-45: ₹10-25 Lakh

• 45+: ₹25 Lakh+ (consider top-up)

3️⃣ Special Conditions Add-On

• +₹5L for cardiac history

• +₹10L for cancer coverage

• +₹3L for senior citizens

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🏥 Real Treatment Costs vs Coverage Needs

(Costs as of 2024 in private hospitals)

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💡 5 Ways to Ensure Adequate Coverage

1️⃣ Use the 10X Rule

• Minimum cover = 10X monthly income

• Ideal = 20X income

2️⃣ Add Super Top-Up Plans

• ₹5L base + ₹25L top-up

• More economical than high base premium

3️⃣ Consider Family Medical History

• Allocate extra for hereditary conditions

4️⃣ Account for Future Needs

• Account for 10% annual medical inflation

• Plan for age-related illnesses

5️⃣ Review Every 3 Years

• Adjust for lifestyle changes

• Increase with salary growth

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📈 Adequate Coverage Growth Calculator

Example: 35-year old in Mumbai earning ₹1.5L/month

• Current need: ₹15L (10X income)

• After 5 years: ₹24L (inflation-adjusted)

• After 10 years: ₹38L (with promotions)

(Use our online calculator for personalized estimates)

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❓ Adequate Sum Insured FAQs

Q: Can I increase sum insured later?

✅ Yes – Through porting or buying top-up

Q: What if I can’t afford high coverage?

✔ Start with base + super top-up combo

Q: How does corporate insurance affect this?

🔄 Deduct employer cover from total need

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