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12 Common Mistakes in Health Insurance Decisions

Health insurance is no longer optional—it’s a necessity. Rising medical costs and unexpected emergencies can wipe out savings in days. Yet, many people make mistakes while choosing or managing their health insurance policies. These mistakes can leave them underinsured or struggling during critical times.

Here are the 12 most common mistakes in health insurance decisions—and how to avoid them:

1. Delaying the Purchase

Many people postpone buying health insurance until they are older or already facing health issues. This not only makes premiums higher but also brings in waiting periods and exclusions.

Tip: Buy a policy early, when you are healthy. It’s cheaper and gives you uninterrupted coverage for the long term.


2. Relying Only on Employer Coverage

Employer-provided health insurance feels sufficient—until you switch jobs, lose your job, or retire. At that point, the cover ends, and buying a new policy becomes harder and more expensive.

Tip: Always have an individual or family policy in addition to your employer’s coverage.


3. Choosing the Cheapest Plan

Low premiums may look attractive, but often they mean limited benefits, higher co-pays, or exclusions that can hurt during claims.

Tip: Focus on the right balance between premium, coverage, and benefits—not just the lowest cost.


4. Ignoring Adequate Sum Insured

With medical inflation, a ₹2–3 lakh cover that once felt sufficient may no longer cover even a single hospitalization in metros.

Tip: Consider ₹5–10 lakh coverage at minimum. You can also opt for super top-up plans for extra protection.


5. Not Checking Network Hospitals

Cashless treatment is only possible in network hospitals. Many people realize too late that their preferred hospital isn’t included.

Tip: Always review the insurer’s network hospitals list before buying a plan.


6. Overlooking Waiting Periods & Exclusions

Every policy comes with waiting periods for pre-existing diseases, maternity, or specific treatments. Ignoring these can cause unpleasant surprises during claims.

Tip: Read the policy wording carefully and understand what’s excluded and how long you’ll need to wait for full coverage.


7. Not Including Family Members Properly

Sometimes policies cover only the main policyholder, leaving out spouses, children, or elderly parents. Adding them later may become costlier or subject to exclusions.

Tip: Ensure your policy covers all key family members under individual or family floater plans.


8. Skipping Add-ons (or Buying Unnecessary Ones)

Riders like critical illness, personal accident cover, or top-ups can provide valuable protection. On the other hand, blindly adding unnecessary riders just increases cost.

Tip: Choose riders thoughtfully, based on your life stage and health risks.


9. Not Reviewing Policies Regularly

Life changes—marriage, children, aging parents, or higher medical costs—should trigger a review of your coverage. Many people stick with old policies that no longer fit their needs.

Tip: Review your policy every 2–3 years and increase cover when necessary.


10. Ignoring Claim Settlement Ratio & Insurer Reputation

Choosing an insurer only for low premiums can backfire if claims are delayed, rejected, or poorly handled.

Tip: Check the insurer’s claim settlement ratio and reputation for service before buying.


11. Hiding Existing Health Issues or Past Surgeries

At the time of purchasing a policy, many people don’t disclose pre-existing health conditions or past surgeries, if any—sometimes due to lack of awareness, sometimes intentionally. During hospitalization, hospitals share your medical history with insurers, and if hidden issues are discovered, claims may be rejected. In severe cases, the policy itself can be terminated.

Tip: Always disclose all health conditions honestly in the proposal form. Hiding them only creates bigger problems later.


12. Not Choosing the Right Health Insurance Agent

Many people buy policies from neighbors or agents focused only on sales targets. Such agents often don’t explain the importance of disclosing pre-existing conditions or don’t guide customers properly. Some buy through bank outlets, where sales matter more than service. A good agent, however, will ensure accurate details are included and guide you as a service, not just for commission.

Tip: Choose an agent who is knowledgeable, transparent, and genuinely works in your best interest.


Final Thoughts

Health insurance is about more than just ticking a box—it’s about protecting yourself and your loved ones from financial stress during medical emergencies.

👉 A smart health insurance decision today can save your savings tomorrow. Review, compare, and choose wisely.

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