What is Sum insured in Health Insurance?

Health Insurance Plans starting at Rs.15/day*

Health Insurance Plans starting at Rs.15/day*


If you are one of those first-time policy buyers certain terms could be completely new to you. It’s important to understand the insurance jargon to make the right decisions. As a policy buyer, you should know what sum insured means and its overall impact on buying the right policy.

What is sum insured?

The maximum amount that the insurance company will agree to pay the policyholder in the case of a medical emergency or expenses incurred due to hospitalisation is known as the “Sum Insured”.Under health insurance, it refers to the maximum coverage. It is important to note that if the actual costs are greater than the SumInsured, the policyholder is responsible for paying the exceeded amount.

For instance, your health insurance coverage has a 3 lakh sum insured,you got hospitalised twice during a specific year. Your hospital cost for the first time hospitalisation was 2 lakh rupees, and for the second time, it was 3 lakh rupees. Your total hospital bill was 5 lakhs, but the maximum amount covered by your health insurance is only 3 lakhs. In this case, your insurance provider will cover 3 lakhs of your hospital expenses, leaving 2 lakh for you to pay from your pocket.

How is sum insured determined?

Lifestyle habits: 

Today’s lifestyle, such as sedentary living, unhealthy food habits, etc., has increased health risks. It is advisable to have a a higher sum insured to ensure you have adequate protection in case of certain unexpected circumstances.


Early twenties and thirties could choose a bigger sum insured as they can more easily opt for a higher sum insured at reasonable prices. Because your medical bills might rise as you become older, this higher sum insured can be helpful later in life.

Health History:

Sum insured varies based on the person’s health condition. The sum insured may be higher for people with health issues like diabetes, heart diseases, blood pressure, etc. However, it is advisable to opt for a higher sum insured as it will provide necessary financial back-up in times of need.

Members covered:

Sum insured will vary based on the number of people covered under the policy.

This will give you some flexibility to use the sum insured for any medical emergencies that may arise during the term of the policy.

Choosing the policy with adequate sum insured will secure you and your family from medical expenses.

Tips for determining the right sum insured

Researching and comparing quotes from different insurance providers give you the benefit of understanding and choosing the right policy that works for you.

It might be essential to choose a high sum insured in particular, if you are choosing a family health insurance plan that can cover the needs of an insured family members. It is advised to have a suitable sum insured on all policies, even for individual health insurance policies.


Understanding the relevance of certain essential insurance terms, such as the sum insured, and ensuring you choose an amount as per your family’s needs have become very important. Understanding that each member has unique requirements, Star health insurance offers various plans with wide sum insured options at affordable premiums.


The Information including but not limited to text, graphics, images and other material contained on this blog are intended for education and awareness only. No material on this blog is intended to be a substitute for professional medical help including diagnosis or treatment. It is always advisable to consult medical professional before relying on the content. Neither the Author nor Star Health and Allied Insurance Co. Ltd accepts any responsibility for any potential risk to any visitor/reader.

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