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5 key indicators of a poor insurance policy you should watch out for

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3 min read | Updated on November 22, 2025, 14:35 IST

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SUMMARY

Some policies have sub-limits on common treatments, like a price limit for lenses in a cataract surgery. This can be burdensome, cause unnecessary worry, or even push you toward substandard treatment options.

bad insurance policy indicators, how to choose the right insurance policy

Many older policies cover hospital stays only if they last more than 24 hours.

A good insurance policy isn’t just about financial coverage, but also about the peace of mind of an individual. When an insurance company has unfair claim approval rules or tries to minimise payout, it not only drains a policyholder’s finances through unexpected expenses despite years of premium payments, but also adds unnecessary stress during an already difficult medical emergency.

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This is why choosing the right insurance policy is very important. If you already have an insurance policy or are struggling to decide which one to buy, let’s take a look at five key indicators of a faulty insurance policy that can add to your stress.

These aren’t just general factors, like poor communication or unaffordable premiums, but particular issues you should be aware of. You can consider and compare these factors across various insurance providers to choose the policy that best suits your needs.

Indicators of a poor insurance policy

Room rent cap: Make sure that there is no room rent cap in your policy. This is because if your room exceeds the allowed rent, all other hospital charges also get proportionately deducted, which means you’ll have to pay a significantly larger amount if your policy has a cap. Get a policy with no room rent limit, or a policy with a single private room inclusion.
Day treatments: Many older policies cover hospital stays only if they last more than 24 hours. However, many treatments now require less than 24-hour hospitalisation, like cataract surgery and other minor procedures. Ensure your policy covers all day-care procedures.
Sub-limits: Some policies have sub-limits on common treatments, like a price limit for lenses in a cataract surgery. This can be burdensome, cause unnecessary worry, or even push you toward substandard treatment options.
Co-pay: Many policies have a ‘hidden’ clause of co-payment, where they ask you to pay a part of the bill if the treatment goes beyond their threshold. Check the policy carefully for this clause and choose a policy with 0% co-pay, unless you're intentionally reducing the premium.
Hospital network: If you choose a policy with poor network hospital coverage, you’ll end up travelling too much for cashless treatments and paying more out of pocket. Before you buy a policy, make sure there are enough network hospitals in your city, and they offer cashless options.

There are many other things that one should take into account, like whether the policy covers consumables (like gloves, syringes, masks, etc), if there are any restrictions on advanced treatments, how long the waiting periods are, if there is any restoration benefit, if it covers OPD and how smooth their claim process is.

You should also check for any hidden clauses, as surprises during emergencies can cause major inconvenience. Prepare a quick checklist for yourself, as per your and your family’s requirements, and choose a policy that covers everything you need.

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About The Author

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Vani Dua is a journalism graduate from LSR College, Delhi. At Upstox, she writes on personal finance, commodities, business and markets. She is an avid reader and loves to spend her time weaving stories in her head.

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