Amid the rise of various health insurance coverage plans and careful monitoring of the same, it has perhaps never been easy to acquire a safe and sound medical backup policy. But what remains a headache
for the insured is the claim procedure at the point of need.
The claim procedure is often delayed due to certain common errors in paperwork, which makes it harder to access your coverage plan upon being hospitalised. These mistakes hurt you badly, leading to delays, reduction and even derailment of claims. Here are a few common but critical mistakes you must avoid with your insurance coverage plans.
Do Not Underinsure
Underinsuring because the premiums of a policy seem too expensive to you can be an error that kicks you in the gut when the medical bill rises and you don’t have sufficient coverage at hand. A policy costing you around Rs 3-5 lakh may seem fine today when you’re young and healthy, but that would barely suffice when age catches up with you and the medical inflation goes through its own course.
Not Learning Waiting Periods, Exclusions
At the point of purchasing a health insurance policy, individuals must carefully read the waiting periods. In most health insurance plans, waiting periods for claims are attached to cases concerning a pre-existing health condition and certain types of surgeries. While not hidden, this clause is often ignored by policyholders in the rush to buy. If a condition falls within a waiting period or exclusion, the claim may be partially or fully denied.
Low Premium – Not The Win You Think It Is
Don’t fall for a low-premium plan. A cheaper policy may feel like a saviour initially due to benefits on room rent limits, co-pay clauses or restricted hospital networks. But these also lead to transactions that ultimately cause deductions. An insured may believe they have a designated room or medical treatment covered with their plan, not realising that only a partial reimbursement is possible.
Incorrect Disclosure Of Medical History
While you may skip certain health-related issues, thinking they’re now resolved and don’t really matter that much now, your insurer would end up evaluating risks based on limited and incorrect information. At the time of the claim, hospitals often require a submission of detailed medical history. The insurer may scrutinise or deny the claim if a prevailing condition is not present on paper.
Delaying Intimation
Don’t delay the intimation and ensure proper paperwork without missing any documents before hospitalisation. It helps avoid unforeseen disputes and settlement issues.
Employer Insurance Is Enough
No, it isn’t. A policy provided by your employer might feel reassuring, but it wouldn’t likely suffice. Especially for non-government employees. Also, the coverage often ends at the point of job switch or retirement.
