Health Insurance Shock: Why Your 'Full Cover' Policy Still Leaves You Paying Big Bills

• Many policyholders discover room rent limits and sub-limits only when claims are partially approved, leading to unexpected out-of-pocket expenses despite sufficient cover.
• Room rent limits cap daily room costs and can trigger proportionate deductions on the entire hospital bill, affecting nursing, doctor fees, and even procedures.
• Sub-limits place caps on specific treatments (e.g., cataract surgery, knee replacement) regardless of the overall sum insured, shifting risk to the policyholder.
• Both room rent and sub-limits can apply simultaneously, drastically reducing the final approved claim amount and leaving patients with significant unexpected costs.
• While insurers use these to control costs, policyholders often perceive them as hidden traps; reviewing policy wording for these clauses is crucial before buying or renewing.

Why It Matters: Hidden clauses like room rent and sub-limits drastically reduce health insurance payouts, demanding careful policy review.