Important things to consider before buying a health insurance policy
With health problems and medical costs on the rise, many people are purchasing health insurance to protect themselves and their families. However, policyholders often discover too late that their plan does not cover what they expected. Experts and social media posts have repeatedly warned buyers to study policies carefully before committing. Here are the key points every buyer should check before purchasing health insurance.
Key considerations
1. Coverage
Check exactly what the policy pays for, including: hospitalization, surgery, daycare treatments, pre- and post-hospitalization expenses, and ambulance charges. Confirm any limits or sub-limits.
2. Sum insured
Choose a sum insured large enough to meet your family’s likely needs. Medical costs are higher in metro cities, so consider a higher sum insured if you live in or near large urban centres.
3. Waiting period
Some conditions - such as pregnancy and pre-existing diseases - have waiting periods. These can typically range from 2 to 4 years, during which claims for those conditions are not covered.
4. Network hospitals (cashless facilities)
Check the insurer’s hospital network and whether the hospitals near you provide cashless treatment. A wide network reduces out-of-pocket payments at the time of treatment.
5. Premium
Premiums vary with coverage level and the sum insured. A low premium may mean limited coverage or more exclusions - read the policy schedule and inclusions carefully before deciding.
6. Coverage exclusions
Policies exclude certain conditions (cosmetic surgery, some injuries, etc.). Read the exclusions section of the policy document thoroughly.
7. Room-rent limits
Many policies cap room rent. If you opt for a room category above the limit, you may have to pay the difference yourself or face deductions in claim settlement.
8. Renewal and lifetime coverage
Verify whether the policy offers lifetime renewability. Continuous coverage is important, especially as health risks increase with age.
9. No Claim Bonus (NCB)
Some plans increase the sum insured or reduce premium if you have a claim-free year. Check how NCB is applied and whether it’s retained after a claim.
10. Co-payment clause
Some policies require the insured to pay a fixed percentage of the claim. Understand any co-payment obligations before buying.
Buyers are advised to read the entire policy document, compare plans, and ask questions. For personalised guidance, consnsult authorised health insurance advisors or contact insurance companies directly to clarify doubts and avoid unpleasant surprises later.
