8 Facts Your Health Insurance Agent May Hide From You; Check Details Here – News18


To avoid potential issues, it’s essential to thoroughly read the policy documents, ask questions to clarify any doubts, and compare multiple insurance options before making a decision. (Representative image)

Health insurance plans can be intricate with various exclusions, sub-limits, and riders. While agents are trained, they might not always have all the nuances

Insurance plays a crucial role in financial security by acting as a safety net against unforeseen events. While most health insurance agents are honest and provide transparent information, there may be some instances where certain details are not fully disclosed.

Agents earn commissions based on the plans they sell. This can sometimes lead them to prioritise plans with higher premiums, which might not be the most cost-effective option for you. Agents may feel pressure to meet sales quotas, which could lead them to focus on closing the deal quickly rather than fully explaining all the details of a plan.

Also Read: No More Paper Work? This Big Rule In Insurance Has Come Into Force On April 1, Check Details Here

Health insurance plans can be intricate with various exclusions, sub-limits, and riders. While agents are trained, they might not always have all the nuances at their fingertips. There’s a lot to unpack with a health insurance plan. Agents might not intentionally hide something, but they might overlook explaining a specific detail assuming it’s common knowledge.

Here are 8 things your health insurance agent may hide from you;

  1. Exclusions and Limitations: Agents may not fully disclose all the exclusions and limitations of the health insurance policy. These exclusions could include pre-existing conditions, specific treatments, or certain illnesses. It’s crucial to carefully review the policy documents to understand what is covered and what is not.
  2. Commission Bias: Agents earn commissions based on the plan they sell. This can incentivise them to push plans with higher premiums (meaning more commission for them) even if they aren’t the best fit for your needs.
  3. Alternative Treatment Coverage: Ask about coverage for Ayurveda, Yoga, and other AYUSH treatments if these are important to you. Not all plans cover them, but some do.
  4. Sub-limits: Some health insurance policies come with sub-limits on certain benefits, such as room rent, doctor’s fees, or specific treatments. Agents may not highlight these sub-limits or may downplay their significance, potentially leaving you with out-of-pocket expenses during a medical emergency.
  5. Claim Settlement Process: Agents may not provide clear information about the claim settlement process or the documentation required to file a claim. Understanding the claims procedure is essential to ensure smooth and timely reimbursement in case of hospitalisation or medical treatment.
  6. Co-payment Requirements: Certain health insurance policies require policyholders to share a portion of the medical expenses in the form of co-payments. Agents may not adequately explain the co-payment terms or their implications on policy premiums and out-of-pocket costs.
  7. Waiting Periods: Health insurance policies typically come with waiting periods for specific coverage, such as pre-existing conditions, maternity benefits, or certain treatments. Agents may not emphasise the waiting periods or the consequences of making claims during these periods, leading to misunderstandings later on.
  8. Renewal blues: Premiums can increase upon renewal, especially with age. While agents should explain this, be aware that future costs might be higher than initial quotes.

To avoid potential issues, it’s essential to thoroughly read the policy documents, ask questions to clarify any doubts, and compare multiple insurance options before making a decision.

Buying Insurance Carefully: Don’t Purchase Just By Looking Ads

Big brand insurance companies have their advantages, but there are also reasons to consider looking beyond their flashy ads.

Big companies spend a significant amount on advertising. Those costs can get factored into their premiums, potentially making them pricier than some competitors. By getting quotes from smaller regional or online insurance providers, you might find plans with similar coverage at a lower cost.

Additionally, consulting with a trusted financial advisor or insurance expert can provide valuable insights into choosing the right health insurance policy for your needs.

Disclaimer: The views and investment tips by experts in this News18.com report are their own and not those of the website or its management. Readers are advised to check with certified experts before making any investment decisions.



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