Sum Insured
What it means, and what it does to a claim.
The maximum the insurer will pay in a policy year. Once it is used up, further claims that year come out of your pocket unless the policy restores it.
Why it matters
Most people buy too little of it. The figure that matters is not last year's hospital bill but what the same treatment costs in a decent hospital in your city in ten years, with medical inflation running well ahead of general inflation. A floater shared across a family is also one shared limit, not one each.
The legal definition
Sum Insured means the aggregate limit of indemnity consisting of the Base Sum Insured, Super Reload, Super Credit (if applicable), Cancer Booster (if applicable) and any other benefit or section (if applicable) whose Sum Insured is over and above Base Sum Insured for the Insured Person. It represents the maximum, total and cumulative liability of the Company for any and all claims made under the Policy (under any and all Benefits), in respect of that Insured Person (on Individual basis) or all Insured Persons (on Floater basis) during the Policy Year, as specified against an Insured Person or all Insured Persons in the Policy Schedule. Sum Insured will be utilized as per the following sequence in event of any claim: a. Base Sum Insured followed by; b. Super Credit (if inbuilt / opted and applicable) followed by; c. Super Reload followed by; d. Cancer Booster (if opted and applicable)
Quoted verbatim from an IRDAI-filed policy wording. Definitions are standardised across insurers, but the limits attached to them are not — always read your own policy schedule.
Plans where sum insured matters
- HDFC ERGO Optima Secure+ — No limit — any room category
- SBI General Super Health Platinum Infinite — No limit — any room category
- Care Health Care Supreme — No limit on ₹10 L and above
Related terms
- Base Sum Insured — The core annual limit on your policy, before any bonus, restoration or top-up is added on.
- Co-Payment — A share of every approved claim that you pay yourself, as a fixed percentage.
- Deductible — An amount you cover yourself before the policy starts paying at all.
- Room Rent — What the hospital charges per day for your room and board.
Disclaimer: Figures shown here are compiled from IRDAI annual reports and public grievance disclosures, and from insurer public disclosures and policy wordings. Claim settlement ratios and complaint volumes are three-year averages for FY 2024–26. Premiums are indicative illustrations for the stated profile, not quotes — your actual premium depends on your age, health, city, habits and underwriting. Scores are Myinsurancebro's own assessment. Always read the official policy document and speak to an advisor before buying. Myinsurancebro is an IRDAI-licensed insurance advisor — we do not manufacture or underwrite any insurance product.