Finance · Uncategorized

Health insurance policy: All you need to know about sub – limits

You can never take your health for granted. At some time in your life, your health can take a turn for the worse. This can be due to genetic conditions or acquired ones. But no matter the risk and eventuality of you falling sick, you need to stay protected, regarding finance.

This is where the health insurance comes into the picture. A health insurance plan will help you ensure that you are financially taken care of when you fall sick, without putting a burden on your current savings. But when you are selecting any health insurance plans, you must look out for certain factors, namely sub – limits.

By definition in the legal sense of insurance, the limitations in an insurance policy apply to the amount of coverage available to cover a specific type of loss. The sub – limit is a part of the limits which would otherwise be applied to the loss.

How do sub – limits work?

We can take it through an example. Mrs Saini needed to undergo treatment to get rid of kidney stones, which would have amounted to Rs. 25,000. She already had a health insurance cover of Rs. 2 lakh, and hence was covered for the treatment. She got the acknowledgement from her insurance provider and underwent the required surgery. However, due to a few complications, she needed to undergo an additional kidney stone removal surgery which would have amount to Rs. 75,000. However, as per her policy conditions under the sublimit condition, there were limitations in terms of treatment costs for specific illnesses. She was viable only for 25% of the sum assured in her health insurance cover. Since she had already claimed Rs. 25,000 in her previous she was only viable for an additional Rs. 25,000. The remaining Rs. 50,000 she had to pay from her own funds.

What is the solution to such policies?

In order to avoid such sub – limits on any of your healthinsurance plans, you will need to first check if your health insurance is under the category of the old policies or under the new one. If it is under the old plan, switch to a new generation healthinsurance plan. In the old health plan, look out for the sub-limits policies, which you can compare to the new plan. In the same way, look out for sub – limits in the new plan. If you can avoid eradicating the sub – limits, ensure it is at a minimum level. While you may end up paying anextra premium for this sake, at least you will avoid the situation where you will be forced to compromise on your treatment if the situation ever arises.

In most cases, if you claim your insurance at least once in your life, you will recover the major part of your premium paid over the decades. While you may feel that you would lose several benefits by moving to a new generation plan, you can be well assured that you will still get the best of your tenure benefits.



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