5 questions to ask your agent before buying a health insurance policy
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5 questions to ask your agent before buying a health insurance policy

We list out five questions you should ask your agent for picking the right health insurance policy.

  • November 2, 2015  
  • |  
  • UPDATED   16:05 IST


There are plenty of health insurance policies available in the market . Finding the right one could be bit of a challenge. We list out five questions you should ask your agent for picking the right policy.

1) What does the policy cover?

Shop around not just for premium but for coverage too. To understand the coverage first ask your agent what type of policy it is- basic hospitalisation plan, critical illness plan or a daily hospitalisation plan. After understanding what is covers ask about extent the coverage. For example:  Apollo Munich's Optima Vital cover 37 critical illnesses whereas HDFC ERGO's Critical Illness Platinum plan covers just 15 critical illnesses. So the scope of coverage differs from policy to policy. Ask your agent what it covers before buying one.

2) Are there any sub-limits?

There are health insurance policies with sub-limits and without sub-limits. Ask your agent about expenses that are capped. For example there are policies with sub-limits on room rent, doctor's fees, among other things. A little bit of research at the right time will ensure that you do not encounter last minute surprises. If you do not want expenses to be capped ask your agent to offer a policy without sub-limits.

3) Is there any waiting period?

Pre-existing illnesses are generally not covered before the expiry of four years. Though few companies have a waiting period of less than 4 years it is always good to clarify in advance. Then there are disease-specific illnesses. For example cataract and age related eye ailments, arthritis, stone in gall bladder, may not be allowed in the first or second year. So before buying always check out details about waiting period associated with the policy.

4) What are the exclusions?

Every policy comes with an exclusion list, read it once so that you have an idea about what all it excludes. Moreover, there are time based exclusions. Go through them. For example a policyholder has to survive for at least 30 days after diagnosis in case of a critical illness policy. Similarly under basic health insurance policies no claim can be made during first 60 to 90 days commencing from the date of the inception of the policy. Read your policy document carefully so that you know what all it excludes.

5) Are there any add-on covers?
There are policies in the market that cover additional features such as treatments abroad , maternity expenses and Ayurvedic treatment. Do ask your agent what extra your policy covers and the premium charged for it.