This article is written by Anuj co-founded SureClaim to fix the broken claim experience of insurance customers. He believes technology can play a major role in empowering customers. His understanding is shaped by his decade long stint in healthcare and health-tech companies.

Health insurance is expensive, and that is a major reason why you could be tempted to go without it. But you know what’s more expensive than health insurance. It’s not having one at all. 

When you fall sick or undergo a medical emergency, without health insurance coverage, you find yourself digging into your savings or crippling with medical debt. Health insurance is one of the most important aspects of financial planning, and you must be vigilantly careful when investing in it. And then, you also need to make sure that when the time comes, you claim what you’re paying for. 

There are several mistakes that people make when it comes to choosing and claiming from health insurance. Learn about them here so you can avoid them:   

1. Choosing a Health Insurance Policy with the Lowest Premium 

A premium is an amount you pay each year to ensure that your health insurance kicks in when you need it the most. When you buy health insurance with the lowest premium it may or may not cover the cost of your medical treatment or room rent in full when you are in a medical emergency. And if it does, you may exhaust your cover in no time, leaving you no choice but to dig into your savings or liquidate your assets.

The clever way to go about it is assessing your finances and your family’s medical needs, comparing different health insurance policies, knowing the features they offer, and then finalizing on the one that ensures you will get the maximum possible payout for your medical treatments and hospitalisation.  Moreover, insurance with the lowest premium may come at an additional cost. So, analyse your options and buy a policy that may not be the cheapest but ensures maximum coverage.  

2. Relying Only on Your Corporate Health Insurance Plan 

Relying solely on your employer’s health insurance plan seems like a cost-effective option, but does the policy cover your family including parents? Will it be enough for you and your family? Additionally, the employer has the right to suddenly decide to cut down the benefits leaving you high and dry. So, you must ask yourself other important questions – what if I leave the job? How will I be covered if I start a business? 

You should have your own health insurance policy so you can claim from it if your corporate policy cannot pay for your medical treatments or does not cover certain ailments or if it gets exhausted and another medical emergency strikes you in the same year. The main advantage of an additional policy is that you can continue this policy lifelong even after retirement.

3. Not Reading the Policy’s Fine Print 

Health insurance policy documents are detailed, cover a thousand scenarios and use the industry jargon which can be difficult to understand. So, a lot of people don’t read it assuming their health insurance plan will cover all their medical expenses, only to get a costly surprise later. 

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Reading the fine print is essential as it gives you information on everything you need to know about your health insurance policy. It tells you which medical services will be covered, which treatments are not covered during the waiting period, what percentage of per day hospital charges your plan will cover, how much of the room rent and nursing charges it will cover, how much you will have to pay on your own, and a lot of other things. If you are not able to demystify your policy, then you can consult an online claim advisory portal for clarifications related to your doubts.

4. Letting Your Insurance Lapse

Health insurance policies need to be renewed every year. Don’t wait for it to lapse. Because once it lapses, you will not get any of the continuity benefits. Insurance policies impose a waiting period on pre-existing diseases and certain ailments that have a high occurrence rate. So, if you don’t renew your policy even during the grace period, you lose out on the accrued years and your new policy will impose the waiting period again. Moreover, you also accrue a no claim bonus with every claim-free year but letting your insurance policy lapse means you miss out on a big benefit.   

5. Not Considering Zone-Based Pricing

Most health insurance plans are priced according to the tier of the city and every city falls into a specific zone. The premium outgo will be relatively higher for those living in a metro city or a Tier-I city as compared to those living in Tier-II & III cities. For example, a person living in Bangalore will get a policy at a higher price compared to someone living in Chandigarh who can buy the exact same policy and coverage at a lower price. So, you must buy insurance in tier 2 or tier 3 city if you’re originally from there.

6. Not Appealing the Claim Rejection

You recently had a medical procedure, but when you filed your medical claim, your insurance company rejected the claim. It’s understandable that you are frustrated and upset. But that should not keep you from appealing a claim rejection. Take a step to understand the reason for claim rejection by consulting a claim expert online and checking your options.

A claim expert acts as a trusted advisor and will review your paperwork and policy documents, go over the process of appealing the claim rejection and help you prepare a strong appeal which you can put up confidently to get the insurance company to reverse its decision.      

The Bottom Line

We all make mistakes from time to time. But when it comes to health insurance coverage and medical care, the mistakes can prove to be very costly. The health insurance mistakes mentioned above are spelt out to you so that you don’t commit the exact same mistakes and put yourself at the risk of not using your health insurance to its maximum potential.

Students of Lawsikho courses regularly produce writing assignments and work on practical exercises as a part of their coursework and develop themselves in real-life practical skill.