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These key restrictions in your policy can affect health insurance claims

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Waiting period: When you buy a health insurance policy, your coverage doesn’t start immediately. This restriction protects insurers from misuse of such policies to cover pre-existing ailments and pre-anticipated immediate medical costs.

However, even during this period, medical expenses due to accidents are covered. Coverage against most other illnesses largely starts after a waiting period of 30 days.

Moreover, coverage of some pre-existing ailments, like diabetes, hypertension or heart diseases, can come with a waiting period of up to three years, depending on policy chosen. Sub-limits: A restriction that often catches policyholders unawares is the sub-limits clause in their policies.

A sub-limit clause in health insurance caps benefits for specified conditions. For instance, while your sum insured as per the policy could be ₹5 lakh, there may be a sub-limit on the room rent in case of hospitalisation, say 1% of the sum assured.

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