The Kerala High Court has stated that the mere presence of alcohol in a person’s system does not necessarily imply that they were intoxicated, and therefore, should not be a grounds for denying health insurance claims. When selecting a suitable health policy, consider the following factors:

  1. Coverage and Benefits: Assess the extent of coverage, including the types of medical expenses covered, and any additional benefits such as critical illness coverage or maternity benefits.
  2. Premium Costs: Evaluate the cost of premiums in relation to the coverage provided, considering both the amount and the frequency of payments.
  3. Deductibles and Copays: Understand the out-of-pocket expenses you’ll need to pay before insurance coverage kicks in, including deductibles, copays, and coinsurance.
  4. Network Providers: Check if your preferred healthcare providers are part of the insurer’s network to avoid out-of-network costs.
  5. Pre-existing Conditions: If you have any pre-existing medical conditions, look for policies that offer coverage with minimal waiting periods.
  6. Claim Process: Research the ease and efficiency of the claim filing and settlement process.
  7. Policy Flexibility: Consider policies that offer flexibility in terms of coverage options, premium payment modes, and the ability to make changes as your health needs evolve.
  8. Insurer Reputation: Evaluate the insurance company’s reputation for customer service, claim settlement ratio, and overall reliability.
  9. Riders and Add-ons: Assess any additional riders or add-ons that can enhance your policy, such as accidental death benefit or waiver of premium.
  10. Renewal and Lifelong Coverage: Check the policy’s renewal terms and whether it offers lifelong coverage without any upper age limit for renewal.

The Kerala High Court has made a significant ruling that insurance companies cannot reject accident-related claims solely because the driver had alcohol in their system at the time of the incident. The court stated that insurers must prove actual intoxication or...