Mrs. Khan got done her Cataract operation last week but is upset with the insurance company. The reason for Mr. Khan’s dismal condition is that insurance company is not ready to reimburse her for the operation. But why is the insurance company rejecting her plea?
The answer is very simple and easy to understand, in the policy wording it is clearly stated that cataract is not covered in the first year of the policy.
That means, here Mrs. Khan didn’t read the policy wording properly and was wrong to ask for claim from the insurance company. If Mrs. Khan would have delayed the operation for a year then she would have easily got the reimbursement without causing a hole in her pocket.
There are many people who bear wrong conceptions in their minds and many clauses which they don’t read properly in the policy wording of the health insurance policy. It is very important to know the policy fine print along with hidden fine prints before buying health insurance.
6 Hidden Fine Prints You Must Know Before Buying a Health Policy:
Following are hidden fine prints which people often don’t understand or ignore while buying health insurance policy.
1) Waiting Period & Other Diseases
Most people often don’t understand the term ‘waiting period ‘in the policy. It is very important to understand that you are not going to get cover from the first day after buying a policy. You cannot ask for any claim settlements from insurance company for a period 30 days from the first date of commencement of the policy. But only in case of accident you will get cover from your health insurance company.
Other Diseases
Many people like Mrs. Khan ask for claim settlement for various diseases but not all the diseases are reimbursed. Reason for this is that, Insurance Company clearly states which all diseases will be covered after first year, second year and so on. People often ignore the policy clauses and then tend to blame Insurance Company for their mistake. Before buying health policy it is always advisable to check what diseases are covered and how and when are they covered to avoid unnecessary troubles.
2) Pre Existing Diseases
What exactly are pre exiting diseases according to the health insurance company? Any disease which a person is suffering before buying of health policy is termed as pre existing diseases. It becomes necessary to disclose any diseases before buying a health policy. All the pre existing diseases are covered after a period of 4 years by Health Insurance Company. So it is always advisable not to ask for claim reimbursement for which you won’t get any help from Health Insurance Company result in empting your pocket.
3) Renewal Ceasing Age and Age Brackets
Renewal ceasing age is the maximum age until which you can renew the existing policy. But there is no indication of renewal ceasing age in the policy wording. It is very important to clarify this point with your agent/broker while buying a policy.
Premium increases as you grow older. There are age brackets in the policy through which the premium is charged. You pay a constant premium in one bracket but as you move to the next age bracket you find the premium also increases. So don’t be surprised if you pay more premiums with increasing age.
4) Renewal of the Policy
Health insurance policy is to be renewed every year. What many people don’t know is that Insurance Company is not bound to remind you for policy renewal. It is better to renew the policy before the date of expiry. Unless you renew your policy on time you wouldnt enjoy the benefits of the policy and the discounts that you are entitled to.
Set Health Insurance Policy Renewal Reminder on your Mobile
5) Room Rent Limit
Many people assume that insurance company will pay the entire room rent charges for all the days. But it is clearly mentioned in the policy wording that only 1% of sum insured per day and 2% of sum insured for ICU/ICCU will be covered. Before buying a policy check the room rent terms to avoid further dissatisfaction from the insurance company.
6) Pre and Post Hospitalization Expenses
Many people don’t know about this benefit which Insurance Company offers to the insurer. Pre hospitalization expenses mean that insurance company will reimburse all the relevant medical expenses prior to and after hospitalization. Pre hospitalization expenses cover all the relevant medical expenses prior to hospitalization which varies from 30 to 60 days according to different insurance companies. Post hospitalization expenses covers all the expenses incurred towards the treatment of the illness which required hospitalization. The period may vary from company to company because some company give reimbursement up to 60 days while others give up to 30 days. You can use this facility and claim for reimbursement if you undergo any hospitalization.
It is very important to read and understand all the clauses at the time of buying the health insurance policy to avoid unnecessary goof ups. And if one has doubts even after reading the policy fine print then you can always seek advice from whom you are taking the policy.
