Often, the problems encountered with health insurance claims aren't due to bad luck, but rather the result of small mistakes made when purchasing the policy. These decisions seem insignificant at the time of purchase, but when hospitalization becomes necessary, these oversights can become a major setback.

In reality, buying health insurance seems like an abstract concept. You compare premiums, glance at the benefits, upload documents, and move on. The policy then sits quietly in your email inbox for years. The real trouble begins when you actually need to use it.  Hospitalization makes the paperwork a reality, and that's when people realize that some overlooked details can lead to delayed claims, reduced payouts, or even complete rejection. So let's look at the health insurance mistakes that cause the most pain at the time of a claim.

Taking insufficient coverage

The most common mistake is taking less health cover than needed. A cover of ₹3-5 lakhs seems sufficient for young and healthy individuals, but medical inflation is rising rapidly.  A single hospitalization in a major city can easily exhaust the entire sum insured.  The insurance company doesn't reject the claim outright, but pays its share, and you have to bear the remaining expenses out of your own pocket. This shock comes at a time when the family is already under stress.

Not understanding waiting periods and exclusions.
Many people assume that every illness is covered as soon as the policy becomes active, but this is rarely the case. Pre-existing conditions, certain surgeries, and treatments have waiting periods. These conditions are written in the policy, but are often not read. At the time of a claim, complaints like "I've been paying premiums for years" don't work because the insurer makes decisions based on the policy terms and conditions. Taking a policy based solely on low premiums
People are often attracted to low premiums, but cheap policies often come with conditions such as room rent limits, co-pays, or limited hospital networks.  These are precisely the reasons for deductions during claim settlement. The real mistake isn't buying a cheap policy, but failing to understand why it's cheap.

Not disclosing the complete medical history.
This is the most serious mistake, even if unintentional. People often avoid disclosing pre-existing or cured illnesses. However, the hospital's medical report comes to light during claim processing. If it reveals any information that wasn't declared earlier, the claim can be questioned or even rejected, meaning no claim is paid.

Delayed notification and lack of documents
Most policies require timely notification, especially in the case of planned hospitalizations. Focusing on treatment is normal, but delays in the documentation process can hold up the claim.  Even a one-day delay can cause significant problems in cashless claims.

Relying solely on employer-provided health insurance
Health coverage provided by your employer seems reliable, but it can end when you change jobs or retire.  The coverage limits are also often low.  Therefore, relying solely on this can be risky.

Health Insurance Mistakes
Health insurance mistakes aren't apparent at the time of purchase, but they become personal and painful during claim settlement.  Therefore, the right policy is one that you understand and review periodically. A little caution can save you from future regrets. (Note: This information is for general knowledge only; for more details, please consult a qualified insurance advisor.)

Disclaimer: This content has been sourced and edited from Zee Business. While we have made modifications for clarity and presentation, the original content belongs to its respective authors and website. We do not claim ownership of the content.