How to suggest the best health insurance plan for your client?

best health insurance

Health insurance is an essential buy for every customer today. Few people are aware of the benefits that come along with health insurance plans. However, there are many who still enroll in health plans just to save tax.


With so many variants available, hunting for the right plan could get challenging for many. You can guide them rightly with the best suitable health insurance plan by understanding their individual need.


Which plan is best for whom and why?


Educate your clients on how each plan works in layman terms. Let them understand the suitability of each plan- individual plan, family floater or senior citizen health plan. Then, give your recommendations. Let them know why a particular plan is suitable for them, what features and riders are offered and how it can help them.


Family floater or Individual?


While recommending your clients whether to buy family floater or an individual plan, first consider the number of family members, their age, and health history and coverage requirement.


For example, your client wants health cover for himself and his wife (aged 35 and 31), two children (7 years and 4 years) and his elderly parents aged 65 years and 58 years. Now, covering everyone under one floater plan may seem inexpensive but not really be suitable considering the age of parents. Suggesting separate floater for parents and a floater to cover him, his wife and two kids would be an ideal option, provided your client is not prone to any serious illness. If any member is susceptible or prone to illness, it’s good to suggest a separate individual plan for that member.


Choose the type of plan smartly:


While suggesting a plan to your client, consider various parameters to get the most suitable plan.


  • Cashless V/S Reimbursement: A direct mode of claim settlement i.e. cashless facility is the best one to suggest as it spares your clients from sudden financial burden.


  • Amount of Cover: listen to your clients carefully on their requirement. Leave some open questions to them such as what would be their average expenses on hospitalization, a number of dependants and how much they can afford to pay each month etc to arrive at the right coverage amount.


  • Choose the coverage according to requirement: Suggest them the coverage that is most required such as- Maternity coverage for a young family/single individual who is yet to plan a family, Pre-existing disease cover for an older family member with pre-existing illnesses, Critical illness cover if there is a family history of any serious illness.


  • Check co-pay for parental coverage: If you are recommending a plan for your client’s elderly parents mention about co-pay. Suggest them a plan that can give better coverage at a lesser percentage of co-pay.


  • Check sub-limit for hospitalization expenses: understand the cap on sub-limit for various medical procedures such as cataract operation, plastic surgery or any other pre-planned procedures. Also, consider sub-limits on room rent, ICU charges, and other treatments before you suggest a plan.


Top #6 Things to check before choosing the best plan:


Check key elements while shortlisting the best plans for your clients.


  1. A network of hospitals: learn from your clients on their most preferred hospitals and suggest them the plans that have them in their network. Else, you can suggest a plan with wider networks.
  2. Incurred claim ratio of the insurer: suggest suitable plans from the insurers having high incurred claim ratios so that your client experiences smooth claim settlement whenever needed.
  3. Claim process: guide your clients on the claim process and suggest plans with the excellent and simple claim process.
  4. Exclusions: Knowing what is not covered under the plan is important. Ensure your client’s important needs are not excluded.
  5. Reviews of the plan: Evaluate and compare plans based on their reviews.
  6. Compare premium V/S benefits: when you shortlist plans for your clients, make a cost-benefit analysis of each plan to offer them the best as per their affordability and need.


Top #4 Things to understand:


  1. NCB: make your clients understand how no claim bonus works and can help them boost the sum insured from 50% to 100%.
  2. Renewability age: Go for plans with lifelong renewability.
  3. The waiting period for pre-existing illness: Understand your clients’ health conditions and suggest them with the plans having a lesser waiting period for illnesses like diabetes, heart diseases, and any other pre-existing illnesses.
  4. Coverage geography and policy limitations: Insurers rate and coverage availability may vary depending on the area. Hence, consider such things while recommending plans to clients.


You can also read: Things that you need to highlight your clients before selling health insurance


Focus on educating your clients. Your valuable recommendations and great insights can get you more business in return. You can set a stage for a valuable relationship just by uncovering your clients’ needs and guiding them right.


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