Experts warn that comparing policies solely on premiums can be misleading, as hidden clauses like room rent caps and co-payment requirements may significantly reduce payout during claims. Buyers are advised to scrutinise the fine print to ensure comprehensive coverage.
Choosing a health insurance policy on price alone can be a costly mistake, because the fine print often matters more than the premium. According to Business Today, Hercules Advisors founder Aditya Shah told the channel that buyers should look well beyond the headline sum insured and examine the conditions that can reduce a claim when treatment is needed.
One of the most important checks is the room rent cap. Shah said policies with no room rent sub-limit are preferable, because a cap on the hospital room can trigger proportionate deductions across the wider bill, not just the accommodation charge. Industry explainers from Trustner Insure, Ely and LiveMint say that this clause can sharply cut the amount paid out, even when the cover amount itself looks generous.
Shah also cautioned against policies with co-payment clauses, which require the customer to bear part of the bill at claim time. Moneycontrol and other personal-finance guides have made the same point, noting that such terms can leave policyholders facing significant out-of-pocket costs during a major hospital stay, even if the policy appears comprehensive at first glance.
Beyond those headline traps, Shah highlighted the value of no-claim bonuses and the effect of medical inflation, which he said is running at about 14 per cent. That makes automatic increases in cover more useful than a fixed benefit that can quickly lose value. He also warned buyers to check disease-specific sub-limits, since some plans advertise large overall cover but place strict ceilings on treatment for serious illnesses such as cancer.
The checklist does not stop there. Shah said consumers should examine consumables cover, since items such as PPE kits and syringes can account for a sizeable share of hospital bills, and they should also review waiting periods for pre-existing conditions. Cashless access at nearby hospitals matters too, as does reading the policy document itself rather than relying on brochure language. The broader message from the insurance guides is simple: a policy that looks cheap or large on paper may still provide weak protection when a claim is filed.
Disclaimer: This article is intended to inform and educate, not to recommend or endorse any financial product, investment or strategy. Please consider your own financial circumstances and seek professional advice where appropriate before making financial decisions.
