How often do we find ourselves reading any document provided to us? Not many of us do it. The same goes for the Health Insurance policy documents. A majority of us fails to attempt to think that the long pages and jargon make the whole document hard to understand. But a careful reading of the documents helps dispel various misconceptions.
All the efforts in spreading awareness about the benefits of Health Insurance are reaping success as many are securing themselves with Health Insurance plans. However, oftentimes, we rest aside, assuming our job is done right after purchasing a Health Insurance policy. But it is equally crucial to read and understand the policy documents as it holds greater importance in making the right decision before buying the policy.
Below are the important reasons to state the necessity of reading the policy documents.
Stay Informed
Knowledge is power. Reading the policy documents helps you to stay informed. This includes the minute details and features of the policy which might be missed out by the intermediary. As you read, you get to know the inclusion and exclusion of the policy, well in hand. The inclusions entitle you to the coverage, and the exclusions provide the list for which you are not covered. This, in turn, benefits you in making the right decision. Also, all the doubts that cling to the coverage and additional benefits will be clarified.
Reduce Claim Related Misconceptions
The reason behind most of the claim-related disputes is either miscommunication because of not reading the policy document or non-disclosure of the information by the middlemen. Knowledge about the policy will help resolve the claim related doubts. Let's say that the policy document says that the policy covers outpatient expenses only at Network Hospitals. This means, the insurer is not liable to pay the claims for outpatient expenses incurred at a Non-Network Hospital. By mistake, if you get your outpatient consultation in a Non-Network Hospital, then the insurer will reject your claim. However, such situations can be simply avoided by careful reading of policy documents.
Details About the Waiting Periods
Every Health Insurance policy has an initial waiting period of 30 days from the inception of the policy, which most of us are aware. But some people may not know that medical insurance policies also have various waiting periods such as PED and Specific Diseases waiting periods, maternity waiting periods, etc. Knowing each of them by referring to the policy documents is important. Read and analyse how the mentioned waiting period will favour you. Also, be mindful that your claims related to any expenses bound to a waiting period will become admissible only after the completion of the same.
Availability of Add-ons, Discounts & Waivers
Most Health Insurance policies offer add-ons like personal accident cover, top-up policy, etc., which can be added along with the basic Health Insurance policy with an additional premium. Health Insurance add-ons are policy specific. Read the policy documents to be aware of the add-ons offered by your standard Health Insurance policy so that they can be helpful at times of need.
The same goes for discounts that come along with the policy. However, we are carried away by the online premium discount and first purchase discount, etc., but there is more to it. Some policies offer discounts if you add a family member to family health insurance, while some others offer a discount for submitting the required medical reports.
Reading policy documents also make you aware of the waivers offered by the policy, which, in many cases, will be missed out. Waivers help to reduce or skip the waiting period on paying an additional premium.
Some people may wonder why the Health Insurance companies do not settle the entire claim amount for some particular claims. This is where the hidden features of Health Insurance work. By reading the policy document you can understand these features like sub-limits in a better way. Sub-limits refer to the pre-determined limit imposed by the insurer for specific coverage like room rent, cataract treatment, etc. The health insurer will impose sub-limits which come to light only by reading and analyzing the policy document.
Moreover, the policy documents will also elaborate on the working principles of additional benefits like cumulative bonuses, annual health check-ups, second medical opinions, wellness benefits, discounts, etc. This further entitles you to decide how the benefits will work for you. Initially, you may find that reading the policy is taking your time, but actually, it saves your time, effort and last-minute hassles and entitles you to act wisely as you know all the information in advance.
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