It only makes sense to protect oneself in every way by acquiring comprehensive health insurance, given the hefty costs of hospitalisation, treatments, and medication. To ensure that you get the best value for your money and get the right coverage, it is imperative that you comprehend the most important terms and conditions of health insurance.
- Waiting time
The time frame that you are prohibited from submitting a claim under your health insurance is known by this term in the insurance industry. The waiting period varies in length depending on the insurance policy. In general, there are three different sorts of waiting times. The first waiting period is when, barring an accident, your claim will be rejected if you need hospitalisation within the first 30-90 days of acquiring the insurance. However, this time frame might be variable for other insurance firms. The waiting period for existing illnesses is the second. You must disclose any illnesses for which you have previously had treatment or are still receiving it prior to acquiring a health insurance policy.
Certain plans include a co-payment clause. When referring to health insurance, it is implied that you will be responsible for a share of the claim’s cost. A proportion of the claim’s total cost is typically used to reflect your out-of-pocket expenses. For instance, if the co-payment requirement is 10% and your claim is for Rs. 20,000, you will be required to pay Rs. 2,000 out of pocket. When the risk is substantial, such as in a senior citizen’s health insurance coverage, insurers frequently incorporate a co-payment clause.
Only claims that exceed the deductible will be required to be paid for. The deductible is a predetermined sum that may be subtracted from the claim amount. The portion of your claim that is not covered by insurance is, to put it simply, the deductible. Prior to your insurer covering losses, as a policyholder, you are required to pay this amount.
- Cumulative bonus
According to these rules for health insurance, if you don’t file any claims, your insurer will give you a cumulative bonus. For every year you go without making a claim, your health insurance coverage in India, or the sum insured, typically grows by 5%, up to a maximum of 50%. Each insurer offers a different type of cumulative bonus and concession rate. *
- Free look period
On the recommendation of a friend, someone may have purchased health insurance, only to discover later that the benefits and conditions do not meet their requirements. The free-look period is helpful in this situation. Within a predetermined period of time after acquiring your insurance, the free-look period enables you to assess it and return it if it doesn’t fit your needs.
Pick a health plan that covers a variety of medical disorders, and carefully review the terms and conditions of your health insurance. Make sure the coverage meets the needs of each family member when you buy health insurance plans for the family.
* Standard T&C Apply
Insurance is the subject matter of solicitation. For more details on benefits, exclusions, limitations, terms, and conditions, please read the sales brochure/policy wording carefully before concluding a sale.