Sum Assured In Health Insurance
Sum Assured In Health Insurance
When you buy a life insurance plan, you need to duly sign a contract with your respective insurance provider to ensure offering financial protection to your beneficiary(ies) after your demise. This implies that you will maintain secure financial protection for your loved ones even in your absence.
However, the financial requirements of every family vary from each other. So, the insurance companies offer the opportunity to pick up a fixed amount of your choice to be payable to your beneficiary(ies) after your demise.
A life insurance policy is made up of several components including death benefit, maturity benefit, riders, etc. One such component is the sum assured amount.
This article will highlight all the significant aspects of sum assured in life insurance.
What is the sum assured in insurance?
In the context of life insurance, the sum assured amount implies the pre-fixed guaranteed amount that the respective insurance provider agrees with the policyholder to pay on his/her demise to the beneficiary(ies) during the course of the plan term. It acts as a protective cushion that your beloved family members can enjoy even after your demise.
What is the sum assured in health insurance?
Although sum assured is an aspect of life insurance, under certain circumstances, it is also relevant for health insurance too.
We all now know that the sum assured is a pre-fixed amount mutually agreed upon by both the policyholder and the insurance provider. The insurer pays the entire amount on the occasion of any particular insured medical event.
We can use an example to understand the scenario better.
A 50-year-old individual carries cancer in his family health history. In his 47th year, he bought a Critical Illness Cover and in the same year, he was diagnosed with intestinal cancer.
The sum assured of his plan amounts to INR 25 lakhs. The insurance provider approves his claim after verifying all the supporting documents. This financial support helped him to attain proper medical treatment and other facilities making him a cancer survivor.
Considering the following example, you must have noted that the sum assured amount in health insurance is a lumpsum benefit. You are free to utilise this amount to manage any financial contingency due to any major health issue. You can even save a part of it if possible for your dependents.
Why is it important to choose the right sum assured in health insurance?
While purchasing a life insurance plan, choosing the right amount of sum assured is very crucial. It is the basis for your dependents to rest upon after your demise. Considering all the relevant aspects like the current financial status of the family, the average health conditions of all the dependents, lifestyle, age, etc. everything must be considered, before deciding upon this critical factor.
How to calculate the sum assured?
You must be critical and wise enough to clearly understand the future requirements of your family and then decide the sum assured amount for your insurance so that the amount does not fall short during needs.
1. Critical evaluation: You must consider the future requirements for your family and their probable necessities essential for maintaining a basic standard lifestyle during your absence.
2. Debt assessment: If you have any outstanding loans or debts, calculate all of them to understand your total amount of liability in the market.
3. Education cost factor: Critically estimate the future educational costs of your dependent children including the higher education charges on an average.
4. Daily expenses account: Considering your current lifestyle, you can assess the daily account expenses cost to proceed accordingly.
5. Emergency fund allocation: For deft financial portfolio management, it is always advisable to set aside a part of your savings and earnings for emergencies. This is very crucial for the immediate handling of such unforeseen circumstances.
6. Seek professional guidance: Calculating the sufficient amount of sum assured might be overwhelming. You can always seek professional guidance for the best solution.
Difference between sum assured and sum insured
| ASPECT | SUM INSURED | SUM ASSURED |
| DEFINITION | The optimum amount selected by the policyholder is to be paid by the insurance provider during claim settlement. | The pre-fixed amount that the insurance provider guarantees to pay to the policyholder after the completion of existing life insurance or to the beneficiaries on his/her demise during the plan term. |
| USAGE | Usually used in non-life insurance products like home insurance, health insurance, motor insurance, etc. | Usually used in life insurance plans |
| FLEXIBILITY | This amount can be selected according to the convenience of the concerned policyholder and can be different from the actual claim amount | This amount is determined beforehand and mutually agreed upon by both parties during the plan purchase; it is a fixed amount. |
| RENEWAL | During the time of plan renewal, the amount of the sum insured can be enhanced depending on the altering situations. | This amount remains constant and fixed throughout the policy term and can be altered exclusively under special circumstances using specific endorsements and riders. |
| CLAIM PAYOUT | The real-time claim payout may be based on the real-time damage or loss incurred considering the amount of the sum insured. | During the death of the policyholder, the sum assured amount is committedly paid to the beneficiaries. |
| EXAMPLES | In the case of a health plan, the sum insured amount can be INR 5 lakhs, and the insurance provider is liable to cover up to this amount excluding the deductibles during claim settlement during the policy term. | You can select the sum assured to be INR 50 lakhs, which will be received by your family members, on your demise during the policy term. This is a single-time payout event. |
| NUMBER OF CLAIMS | As long as the sum insured amount lasts, an unlimited number of claims can be raised during a particular policy term. | The claim can be settled only once |
Understanding the concepts of sum insured and sum assured is essential for making an informed decision during policy purchase.
Relation between the sum assured and the insurance premium
The amount of sum insured directly impacts and eventually determines the premium that you need to pay for the concerned life insurance plan. The plain and simple concept is that the more the amount of sum assured, the higher the premium is supposed to be.
The basic working strategy of the insurance providers is to charge such a premium amount that is dependent on the level of risk that is associated with insuring you. Therefore, when the sum assured level remains high, it implies that they might have to pay a higher payout sum. This is the reason they charge comparatively more to ensure enhanced protection.
On the other hand, if you tend to select a comparatively lower amount of sum assured, the premium payout amount tends to be comparatively lower. This is because the risk associated with the concerned insurance provider also remains low. Here, the coverage span remains low, so the price is also lower.
Therefore, while choosing the correct sum assured amount, you have to critically consider the current as well as the future requirements of your family and plan accordingly. Moreover, your current financial status and income level must also be taken into consideration, so that the premium amount does not become too burdensome.
Maintaining a proper and comfortable balance between the amount sum assured and the premium amount is the foundation for getting the right insurance coverage without putting any strain on your savings and finances. Ensure that this calculation is done critically showcasing your wise decision-making capacity so that the final payout amount offers sufficient coverage to your family at the end.
Importance of choosing the correct sum assured amount
Choosing the correct amount of sum assured is highly essential since it is the financial basis to secure your beloved family members, especially in your absence. Some of the most significant reasons to choose the right sum assured amount include the following:
1. Ensuring financial security: Life insurance coverage acts as a financial safety net for your near and dear ones, especially in your absence. It is a sign of care and concern that you ensure beforehand for your family. They will receive the amount of the sum assured during any unfortunate event with you.
2. Cover for debts and expenses: The correct amount of sum assured showcases your level of responsibility towards your beloved family members. The amount can be utilised to pay off debts, loans, mortgages, and expenses without much financial burden.
3. Future planning and higher education: Both medical and education inflation are skyrocketing and reaching new heights every day. The sufficient amount of sum assured may aid you in securing the educational future of your child along with any other future financial targets.
4. Inflation-proofing: You cannot deny the effects of inflation in our daily lives. So, while planning for the long term, you need to consider this crucial factor and proceed accordingly. A wisely calculated sum assured cannot exclude inflation, ensuring it does not lose its relevance in the long run.
5. Peace of mind: Since there is no guarantee of life, it is very unpredictable. Therefore, it is vital to secure your future along with your loved ones to handle such uncertainties.
Things to keep in mind while choosing the right sum assured
While selecting the correct amount sum assured, you need to consider certain critical factors to enjoy the complete benefit of your insurance. Some such critical factors include:
1. Familial financial requirements: Critically consider the current financial requirements of your family, as well as the future proceedings, including the inflation factor. Apart from these, you must also consider the education costs of your children, daily expenses, outstanding loans, debts, etc. The correct amount of sum assured must sufficiently cover all these expenses comfortably.
2. Replacement of income: If as a policyholder, you are the sole breadwinner in the family, you must consider the total financial income your family requires to sustain and maintain a basic lifestyle. Your life insurance benefit amount must be enough to replace your entire income in your absence by the sum assured amount.
3. Future expenses and inflation: Always note that the cost of living never decreases; it is always rising because of the inflation factor. Be wise enough to consider inflation in your calculation so that your sum assured amount can competently managed it well.
4. Outstanding debts: Any outstanding loans, credit card debts, mortgages, etc. must be deftly handled by the sum assured amount, securing the needs of your family.
5. Healthcare expenses: The inflation is quite steep in the medical sector too. If you have dependents, you must consider the future healthcare costs, especially if any one of them requires any particular type of medical requirements. The sum assured must be competent enough to handle such medical emergencies. However, it is best to keep a part of your income invested in health insurance to ensure enhanced health coverage and enjoy tax benefits on the course.
6. Education and marriage of your children: Plan your children’s educational progress well beforehand to ensure a smooth move. Wisely calculate the essential funds and ensure that the sum assured amount is competent enough to meet all these needs. The sum assured amount is supportive enough to handle the financial necessities of your family despite your absence.
7. Age and health status: Your current age and health status during the time of buying the insurance policy will play a significant role in determining the premium amount of the plan concerned. It is best to opt for a comparatively higher sum assured at a relatively young age to enjoy competitive and affordable premium rates.
8. Current financial portfolio: Consider your current savings, investments, and insurance plans you maintain. Your chosen sum assured amount must deftly complement your currently existing financial portfolio without any hitch.
9. Financial targets: Your sum assured amount must be in sync and properly aligned with your future financial targets and competent enough to fulfil them in future. The targets can be varied like buying a new home, starting a new business, completing any particular course of education for yourself or any of your dependents, etc. You have to ensure that your aum assured coverage is in sync to fulfil these targets in the long run.
10. Reasonability: Consider your income status and then proceed to set a sum assured amount so that the premium payment does not seem to be too burdensome. Ensure that you strike the correct balance between your level of affordability and the coverage span to ensure a sustainable life insurance policy.
By considering all these essential factors, you can ensure to calculate the right amount of sum assured. If you find it overwhelming and challenging, you can always seek professional guidance from financial experts. But never be inconsiderate towards your beloved family members and proceed to make a wrong decision while purchasing a life insurance plan with insufficient coverage.
When can you increase the sum assured?
The amount of the sum assured is pre-fixed and mutually agreed between the insurer and the insured during the policy purchase. It remains constant throughout the term and cannot be increased or decreased.
Frequently Asked Questions
Yes, you may enhance the amount of the sum assured of your existing plan after intimating your respective insurance provider. However, you must remember that this facility varies from plan to plan. Therefore, you must read the terms and conditions of your respective plan well before proceeding.
There is no ideal sum assured amount. It varies from person to person. Several factors like lifestyle, number of dependents, income, liabilities, and assets everything play a role in determining this sum.
Usually sum assured is not available for non-life insurance plans. However, you must check the specific details for the concerned plan.
After considering several factors like lifestyle, income, age, health status, liabilities, financial obligations, etc. of the policyholder, the sum assured is calculated by the insurance providers using actuarial calculations. It aids in determining the sufficient coverage amount.
No, neither it is essential nor it is compulsory, but adding them enhances the scope of policy coverage. Be wise, careful, and critical to assess your actual real-time needs and risks and add only the befitting riders if necessary.
If the sum assured amount remains insufficient, the beneficiaries tend to receive a lower payout amount and inadequate financial support. Therefore, critically assessing the financial goals and requirements of the family is crucial to determining the correct amount of sum assured to ensure sufficient coverage.
Considering the specific terms and conditions of the plan concerned, certain policies offer a sum assured amount in instalments rather than a single lump sum amount. This can ensure a regular income source for the family after the death of the policyholder.
Usually, the sum assured amount is non-taxable. However, the interest earned through the sum assured is subjected to taxability as per the existing IT laws.
The Indian insurance market is loaded with several varieties of life insurance policies like Unit-Linked Insurance Plans, Whole Life Insurance, Term Insurance, Pension Plans, Endowment Plans, and Money-back plans.
Yes, several life insurance policies allow to cover of several family members under a single plan, ensuring convenient coverage.
Yes, life insurance policies possess the eligibility to accommodate insured members of different ages and different health statuses. The coverage and premium of every member may depend on individual circumstances, ensuring inclusivity and flexibility.
No, never the budget can be the only determinant while choosing the correct sum assured amount. Apart from budget, you must consider your financial targets, and responsibilities, ensuring sufficient coverage for your dependents.
The pre-fixed specific duration after the premium due date that the insurance provider offers for paying the premium and continuing with the existing plan. It usually ranges between 15 and 30 days. However, it may vary from one insurer to another. It is best to clarify it beforehand.
Leading Health Insurance Companies
Latest Blogs
