Health Insurance Claim: This is why your insurer may not pay the entire claim amount

The basic purpose of buying a health insurance policy is that one doesn’t have to dip into one’s savings to pay for the medical bills after hospitalisation. By paying the premium for a health insurance policy, one is expected to come out of the hospital without settling the bills. The cost of hospitalization is to be borne by the insurance company up to the sum insured opted by the insured.
However, even if one is carrying a cashless health cover that too in a network hospital of the insurer, there could be an instance when the insured may have to bear a portion of the medical bill as an out-of-pocket expense. The reason why your claim may get paid partially is because of a clause called ‘sub-limit’ in the health insurance policy. The mention and the applicability of sub-limits are clearly there in the policy document but not many of us actually read and are in a position to comprehend the terms and conditions.