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Sub-limits on health insurance can make your policy benefits insignificant

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₹10 lakh around five years ago. He had even paid a premium of ₹61,000 ( ₹12,200 per annum) thereafter. But, after his wife Neeshu Tripathi was admitted to a hospital for the delivery of their first child, Shukla found that he was only eligible for a reimbursement of ₹50,000 towards maternity benefits.

The policy had a sub-limit on the overall sum insured for maternity benefits. There are many subscribers like Shukla who are ignorant of the sub-limits and have had to shell out money for treatment costs when their insurance claims go beyond the sub-limits. “Several insurers often impose a mandatory co-payment and sub-limits clause on the health cover when you buy a policy to reduce the premium.

While this may reduce your premium to some extent, it will cost you dearly when you file a claim," said Venkatesh Naidu, CEO of Bajaj Capital Insurance Broking Ltd. Sub-limit: This is the term used by insurers for a monetary limit on expenses for disease/illness treatment, room rent, post-hospitalisation, and pre-planned medical procedures.

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