Health Insurance Traps: Room Rent, Sub-limits, Co-pay Cut Payouts in 2025

• Room rent limits, sub-limits, and co-pay clauses are major reasons for partial health insurance claim payouts in 2025.
• Room rent limits can trigger "proportionate deductions," reducing payments for doctors' fees and nursing charges if a higher-category room is chosen.
• Sub-limits place specific caps on treatments or procedures, even if the overall sum insured is large, leading to limited reimbursement.
• Co-pay clauses require policyholders to bear a fixed percentage of the eligible claim, adding to out-of-pocket expenses.
• To protect yourself, review your policy at renewal for room category eligibility, proportionate deductions, sub-limits, and co-pay clauses, considering plans with better terms.

Why It Matters: Understand health insurance clauses like room rent, sub-limits, and co-pay to avoid partial claim payouts.