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Health insurance policies cover the cost of medical expenses which are caused due to hospitalisation. However, there are certain conditions under which all expenses are not covered.
In health insurance, sublimits are the restrictions that are placed by insurance companies on the maximum amount they will be paid for specific expenses within a hospital bill.
The expenses included in sublimits include ambulance services, surgery fees, room rent, and consumables like gowns and gloves.
Sublimits are kept with the intention of preventing excessive spending. This happens by capping the amount the insurer reimburses for particular services or categories of expenses.
Sublimits can also cause misunderstandings because of the expectations of policyholders, as they expect their claims will be fully covered up to their sum insured. However, often certain expenses are only partially covered due to sublimits.
It is very important for policyholders to carefully review the health insurance policy to understand the sublimits. This can be done by asking the insurance company for a detailed explanation of the policy.