Unlimited health insurance is now a reality. But can insurers make it work?

So when a friend mentioned Acko General Insurance’s unlimited sum insured (SI) plan last year, Mahajan took notice.

“I was looking for decent health coverage for my 70-year-old mother,” he said. “When I enquired with Acko about unlimited SI, I figured I needed to buy the policy in my name adding my mother as another insured person. It cost me ₹57,400. The policy document mentioned that the base sum insured is unlimited. The delta (premium differential) between the sum insured of ₹1 crore and unlimited was too less so I went with the unlimited option.”

What does ‘unlimited’ really mean?

An unlimited sum insured means there’s no predefined ceiling on the amount a policyholder can claim for medical treatment, unlike traditional plans that cap coverage at ₹10 lakh, ₹20 lakh or ₹50 lakh.

According to data from beshak.org, only two plans currently offer this option: Acko Platinum and ICICI Lombard Elevate.

However, the Insurance Regulatory and Development Authority of India (Irdai) does not disclose product-level sales data, and insurers typically don’t share it either. Mint reached out to Acko for figures on how many such policies have been sold but received no response. ICICI Lombard is currently in a silent period.

These comprehensive plans come without room rent limits, modern treatment caps or exclusions for organ donation. Waiting periods for pre-existing conditions vary.

Mahajan said both he and his mother underwent full-body health checks as required by the insurer. The standard 30-day initial waiting period was waived for both. However, while no further exclusions applied to his mother, Mahajan was diagnosed with fatty liver and a gall bladder polyp, which drew a three-year waiting period as pre-existing conditions.

ICICI Lombard Elevate, meanwhile, allows policyholders to reduce the waiting period by paying a higher premium.

Should consumers opt in?

Unlimited cover might sound reassuring, but not everyone is convinced.

“To be honest, it sounded too good to be true,” said Mahajan. “My family insurance advisor suggested not to go ahead with Acko Platinum because it was a new product with not much of a claims history.” Mahajan still went ahead, but no claims have been filed yet.

That lack of a track record raises concerns.

In a worst-case scenario, if claim volumes exceed a certain threshold, the insurer may choose to withdraw the product, leaving policyholders to shift to another offering from the company, as per experts.

Specifically addressing Acko’s plan, Nikhil Jha, co-founder of Hercules Insurance Advisory, pointed out that because Acko operates on a no-advisor model, policyholders must handle the claims process on their own. “In case of claim rejection, no trusted advisor will be there to help them out,” he said.

For ICICI Lombard’s Elevate plan, Jha said, the calculus is more straightforward: “A sum insured of ₹50 lakh to ₹1 crore is more than enough, but if one really wants unlimited protection and can afford it, they can go for it.”

Unlimited restoration vs unlimited sum insured

Don’t confuse an unlimited sum insured with unlimited restoration. Experts say that in many cases, a health plan with a solid base cover and unlimited restoration may be enough to meet the need for higher or even unlimited protection.

To break it down: if your base cover is ₹20 lakh and it gets exhausted during your first hospitalization, the same amount is reinstated each time you’re hospitalized within the same policy year.

However, it’s important to check whether restoration applies only to different illnesses or to the same illness as well. Also verify whether the benefit applies to different insured members or just the same one. Some policies offer this feature by default, while others include it as an optional rider.

“Restoration benefits come under various names—recharge, reinstatement, or reload—and may vary in terms of applicability: same illness, different illness, same or different members, limited or unlimited reinstatements,” said Manju Dhake, Head – Insurance Advisory Practice at 1 Finance, a financial advisory firm registered with the Securities and Exchange Board of India.

Some policies also include conditional triggers—for instance, restoration may only apply once both the base cover and cumulative bonus are fully exhausted. Whether one should opt for such benefits depends on individual health profiles, such as age, pre-existing conditions, or an anticipated high frequency of claims. “These add-ons can increase the base premium by 12.5% to 17.5%, so buyers must evaluate the value they derive,” Dhake added.

The bottom line

Unlimited sum insured remains a niche offering with limited availability and mixed levels of trust among advisors. Acko Platinum is relatively cheaper but comes with a risk of unsettled claims experiences due to its short track record and direct-to-consumer model. ICICI Lombard Elevate is more expensive but backed by a traditional distribution network.

Consumers seeking peace of mind may find a high base cover— ₹50 lakh to ₹1 crore—with an unconditional unlimited restoration rider a more dependable route, experts say. But for those willing to pay for absolute worst-case protection, unlimited SI could be worth exploring—with caution.