ReAssure 3.0 is the stronger cover here.

A Longer Wait, Just For You

The insurer can put a named condition on a wait of up to 48 months for one specific person - a year longer than the pre-existing wait, and none of the three waiting-period add-ons shortens it. It is set when you buy, and it is printed on your own schedule.

Drugs Used Outside Their Approval

If your doctor prescribes a drug for something it was not formally approved to treat, the policy will not pay - even though off-label prescribing is routine, particularly in cancer care.

External Medical Devices

A device you can put on and take off yourself, without a surgery to fit it, counts as equipment rather than as treatment, and is not paid for. Each policy draws the line in its own words: some list the items, such as wheelchairs, walkers, crutches, glucometers, oxygen concentrators and machines for sleep apnoea, and others set a test, such as whether the device can be removed without surgery. Where a policy writes a way in, either inside the clause or through an add-on that names the items it will pay for, its own wording says so.

Injuries From Terrorism

Acts of terrorism are excluded. Many Indian health policies pay for terrorism-related injuries, so an exclusion that removes that cover is worth noticing. Where the wording reaches indirect causes too, the clause itself says so.

Life Support After Brain Death

Once a vegetative state or brain death is confirmed and treatment will not bring recovery, life support stops being paid. Families meet this clause at the worst possible moment, so it is worth knowing before you need it.

Which Cataract Lens You Get

On the Classic and Select variants only a mono-focal lens is paid for. If you want a multifocal lens you pay the difference, and this restriction sits in the benefit clause rather than the exclusions list.

Treatment By A Relative Or Unregistered Doctor

Admissions For Recovery, Not Treatment

An admission for recovery rather than active treatment is not paid. Each policy extends the clause in its own direction: some add general weakness, a run-down condition or a nutritional deficiency, others add sanatorium stays, private duty nursing and long-term or custodial care. The clause quoted for each policy tells you which. It costs the most when an elderly patient is kept in hospital after the acute treatment has finished.

Advanced Procedures Excluded By Name

A set of advanced procedures is excluded by exact name - high-technology treatments the policy will not pay for even though hospitals offer them. Before you agree to a procedure with a brand-style name, check that name against the policy's own list.

Anything Treatable Without Being Admitted

If the treatment could reasonably have been given without admitting you, the claim is refused - even though you were admitted. This is one of the most common reasons a hospital bill goes unpaid.

Conditions Excluded On Your Own Policy

Something can be written out of your cover for good, named on your own Policy Schedule when the policy is underwritten. Policies differ in how far that reaches: some can exclude only a disease that is declared and agreed to be excluded at the start, others any illness, injury, treatment or service the schedule names. The printed policy document does not list it, so read your schedule as soon as the policy is issued and ask the insurer to explain anything you do not recognise. Where a policy sets an end date for such an exclusion, or requires your written agreement to it, its own wording says so.

Exclusions Listed On The Website

Some expenses a policy will not pay are listed on the insurer's website rather than in the policy document you receive. When your hospital bill is settled, those items are removed from the claim as well. Ask the insurer for that list before you are admitted, so you know which costs you will pay from your own pocket.

Expensive Drug Infusions

Expensive drug infusions, biologics most of all, are handled separately from ordinary hospital treatment. Some policies pay for them only when you are admitted, and refuse the same drug given in an outpatient infusion chair. Others refuse the admission that was arranged so that the infusion could be given, and a clause may name other costly infusions alongside, such as immunoglobulin or bone-strengthening drugs. Either way a large cost, often a repeated one, stays with you. The clause quoted for each policy tells you which way its own wording runs.

Glasses And Hearing Aids

Glasses, contact lenses and hearing aids are not paid for: they count as external aids rather than as treatment. Each policy groups them with the other corrective aids its own clause names, and some clauses reach further, as far as devices such as cochlear implants. Where a policy writes a way in, a device needed because of an illness or injury, one fitted during an operation, or an implant made necessary by an accident, its own clause says so.

Injections Into A Joint

Injections given into a joint, and the platelet-rich plasma and cartilage treatments offered for knee and joint pain, are excluded. Some clauses bar the treatment itself. Others bar only the admission that was arranged so that the injection could be given, and some reach wider, to an injection into a lesion or to the medicines infused alongside it. The clause quoted for each policy tells you which, and names the injections it means.

Circumcision

Hospital Service Charges

Self-Inflicted Injury

Untested Therapies

Vaccinations

War And Nuclear Events