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Do not ignore these exclusions in health insurance policies 17th December 2019

Health insurance in India is a necessity in contemporary times as it takes care of your finances in case of any health emergency with the help of a single policy. That being said, even the most comprehensive plans come with some exclusions. These are mentioned in your policy document and are often standard for all insurance providers.

You can make the best of your policy only if you know its coverage as well as exclusions. So, here are some you should definitely know of before you sign up for a new plan:

Waiting period

The only risks your health insurance covers from day one are injury/ hospitalisation claims due to an accident. Other than that, all other medical conditions have a waiting period after which you can make a claim. For common ailments, the waiting period is between one to three months from the inception of the policy, whereas the more serious diseases are excluded from coverage for as long as the first year.

Pre-existing conditions

You must have been told repeatedly that making a full disclosure of your health status is essential to get the right coverage. The reason behind this is a standard exclusion which says that all pre-existing diseases have an exclusion period stated in the policy wordings. Falsifying or hiding critical information can render your policy void and will inevitably leave you hanging in the future.

Lifestyle diseases

While these have not always been a concern, the drastic change in our environment and daily routines have made this a necessary part of healthcare. Unless specified at the time of availing the policy, all lifestyle-related diseases arising from smoking, alcohol consumption or drug abuse are excluded from a health plan. You would either have to pay a higher premium or be denied coverage in cases involving such ailments.

Alternative remedies

Most insurance companies are only slowly warming up to the idea of alternative treatment options. Treatment systems such as Ayurveda, Naturopathy and Unani have conventionally been excluded from health covers due to a lack of support from the medical community, which makes it difficult for insurance companies to accommodate.

However, some insurance providers are beginning to recognise these treatments now and are providing optional benefits which you can opt for to get coverage for them.

Maternity and childbirth

Maternity benefits are an integral part of any family health plan. This includes the medical expenses incurred for childbirth, infertility treatment or even abortion. In most cases, you would have to opt for a specialised maternity plan which is subject to a waiting period. Hence, it is a great idea to keep your family's future in mind while picking your policy.

Cosmetic treatments

While your health insurance policy may mention coverage for all hospitalisation, treatments such as plastic surgery, laser treatments, weight loss programmes, liposuction, eye and dental procedures are excluded from this cover. The exception to this rule is cosmetic procedures after an accident as they are critical to the functioning and well-being of a person.

To conclude, when looking for the best health insurance policy in india , remember to get details of all exclusions and waiting periods from your insurance agent or the policy wordings available to you. After all, the unpleasantness of reading that massive policy document sure beats being caught in a lurch while making a claim.

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