Know health insurance clauses to avoid surprise bills

Health insurance policies often have clauses like co-pay, sub-limits, and room rent caps that reduce claim payouts.

Many policies only cover room rent up to a certain limit; choosing a higher category room increases out-of-pocket costs.

Pre-existing disease waiting periods and disease-specific exclusions can lead to claim rejections.

Cashless treatment may not cover all expenses; items like consumables, doctor fees, or diagnostic tests can be billed separately.

Policyholders should read their policy document carefully and ask insurers about specific clauses before hospitalization.