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Fine Print Points Of Your Health Insurance Policy Document Which Can Fall You In Trap

Fine Print Points Of Your Health Insurance Policy Document Which Can Fall You In Trap

The worst practice which we Indians follow while buying financial products is that we don’t even look beyond the application form where all the terms and conditions are written. The bad thing happening due to this practice is that we end up cursing the provider for not keep up with the promise. In fact, lot of customer complaints regarding miss-sales of financial products are because of this particular reason.

Take an example Mr. Ganguly who recently bought a health insurance policy following the same practice but after five months when we went get himself operated for cataract his health insurance provider cancelled his claims. For quite obvious reasons Mr. Ganguly filed a complaint and the Insurance company came with an answer that as per the insurance contract cataract was supposedly not to be covered in the first year so the claim was rejected. All these things were actually mentioned in the insurance contract document which Mr. Ganguly never took a pain to study otherwise he might planned the operation for next year and the financial loss he had wouldn’t be there.


This is a common phenomenon even while buying health insurance plans too. Though we try to use online websites to compare plans but we just do it on the basis of the amount of premium but you don’t actually go back of the policy contract to see the fine prints of the policy which are like detailed terms and conditions of the contract.

There are some important points which you should actually look every time before you buy a health policy are listed below. The foremost caution after reading all these points is don’t forget from next time.

  1. Condition regarding pre and post hospitalization expense: if you take a health insurance plans for family other than the cost of hospitalization your policy generally cover the costs involved in various medical test and doctoral visits and advice which you might have taken before hospitalization or post hospitalization. Though the number of days for which coverage would be there depend on the insurance company but it is a good benefit which people generally miss out. Also make sure you should know while raising claim for expenses happening during this period about the sub-limits.
  2. Waiting period in your policy for specific treatments:  The case of Mr. Ganguly is a classic example of waiting period. Most of the health insurance plans do have waiting period for specific ailments and for pre-existing medical conditions before you make a claim for expenses happening for their treatments. If you know this before you have chosen a policy to buy you can plan certain things well in advance and if you don’t, you will end up paying heavy amount of money out of your pocket just like Mr. Ganguly.
  3. Room rent limits: When we buy a health policy we generally have an impression that all the cost related to any type of medical emergency would be covered but if you try reading the important point of your policy contract you might find a lot of limits on many categories of medical expense which give a right to the insurance company to honour your claim to certain limit and deny the rest. This phenomenon is exactly similar in case of Hospital room rent related expense. Insurance companies generally have a benchmark in terms of a percentage of sum assured or a fixed amount which can limit your daily spending on room rent. In fact, the worst part of this sub-limit is the percentage of uncleaned amount out of the total claim raised will also decide the fortune of what has to paid in case of other expenses
  4. Maximum renewal ceasing age and the maximum age till you can carry your policy:  The insurance company generally sets a limits on different age bracket till the time you can pay your premium and time till which the policy will keep on covering you. This is an important point on your policy contract which you need to read to do an effective planning for any type of medical emergency at any age.

So if you still feel like not reading the policy contract points in detail it can really act a back burner and you always be spending money out of your pocket even though you have a policy in place.