Check for Disease Wise Sub-limits

10 lakh cover at a premium of just ₹6,000 a year. That’s the offer in front of you. But instead of jumping for joy, you’re suspecting something already. This guy is offering you a price that nobody else is matching. You are sceptical and you ponder for a while. But you go ahead with his recommendation anyway since he is a family friend of sorts.

And then, one day, your worst fears come true. A slipped disk forces you into the operation theatre. You require extensive treatment. The final bill is hefty. ₹4,36,000 — inclusive of all costs. But despite your 10 lakh cover the insurer tells you they can only cover ₹2,00,000. You are outraged and you press for a clarification.

Eventually, they tell you your policy has disease wise sub-limits. Meaning, they have a cap on the total coverage amount specifically mandated for certain diseases.

For instance, cardiovascular diseases — They only pay ₹2,50,000

For knee replacements —₹2,75,000

For other major operations like the one you just had — ₹2,00,000

And finally, you realize how the company could offer you a ₹10 Lakh cover at such a low premium. They probably never end up paying the full cover amount in most cases.

Don’t fall prey to this devious practice. Make sure you always know there are no disease wise sublimits. Because you don’t know what will hit you. It’s always prudent to pick a policy that has no such stipulations.

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