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Tips to Deal with a Bad Health Insurance Plan

By Juhi Walia
21 October 2022, 4:59 PM

These days, a health insurance policy is regarded as a crucial investment because of its high long-term return in the event of an unexpected medical expense. Health insurance plans have emerged to provide many sorts of health insurance with several modifications in various forms. Customers may tailor their healthcare plans to meet their needs and requirements, from family health insurance to individual health insurance and other riders.

However, health insurance can occasionally prove to be inconvenient. This is referred to as "bad health insurance." Many policyholders in India experience problems because their previously acquired policy does not adequately cover their financial and medical requirements. As a result, many people are disappointed with their health insurance options.

What is a Bad Health Insurance Plan?

Your health insurance policy may be classified as "bad health insurance" for various reasons. Such elements consist of:

The Ratio of Claims to Settlements

If the claim-to-settlement ratio for your health insurance company is low, there is a higher possibility that you won't get your coverage when you need it. A bad health insurance policy would be one in which the policyholder cannot employ it when necessary.


Another problem could be sub-limits, which restrict the coverage your insurer provides for various services. A bad health insurance plan typically has too many sub-limits, which act as hidden charges, whereas a good health insurance policy does not.

The Waiting Period 

Time is of the utmost importance in medical emergencies. Since most hospitals are unwilling to begin treatment without obtaining at least a percentage of the medical bills, a bad health insurance policy would have significant waiting periods for reimbursements to clear specific diseases' treatments.

Read more - Waiting Period Clause in Health Insurance

Pre-existing Health Conditions 

Pre-existing medical issues must be sufficiently covered by a solid health insurance plan. Even if there is an additional cost involved, it is worthwhile.

Read more - Pre-existing Disease Cover from Day One

Hospital Coverage 

Even while health insurance plans typically include pre- and post-hospitalisation coverage, some hide this advantage by only covering expenses for a certain number of days. Due to the possibility of small premiums, the policy becomes more alluring. On the whole, nevertheless, the client ends up paying a high price for this.

Insufficient Coverage

A decent health insurance policy must consider growing medical inflation. If it doesn't, you could find yourself footing a sizable portion of the bill in times of medical emergency, thus negating the fundamental point of having health insurance.

What to Do to Tackle a Bad Health Insurance Policy?

Top-up or Super Top-up 

You can choose a top-up or a super top-up health plan if you believe that the sum insured of your present healthcare policy is insufficient to satisfy your family's medical demands. A top-up plan is an extra layer of protection on top of the sum insured by the current plan.

Assume, for instance, that you have coverage with a sum insured of INR 3 lakh, and you purchase a top-up of INR 10 lakh with an INR 3 lakh deductible. Then, if you submit a health insurance claim for INR 5 lakhs, INR 3 lakhs will be covered by your top-up, and the base policy will cover INR 2 lakhs.

The fact that you can only utilise the top-up plan once per year and only after using all the policy limitations is a key aspect of the plan. A super top-up plan pays for medical expenses over the threshold limit like a top-up plan. Therefore, you can use it if you have to be admitted to the hospital more than once a year.

Revise Your Policy 

You can boost your sum insured to the level you need if you are concerned about how to handle a bad health insurance policy as you do not have appropriate coverage. However, it should be noted that this rise in the covered amount is accompanied by higher rates.

Switch Your Health Insurance Policy to Another Company

You can transfer to a different insurer if you are dissatisfied with the existing one's services or believe the premium is excessive. However, you must notify the current insurer at least 45 days before the renewal date of the current policy before you move your policy to a new insurance provider. Then, you can select a different insurer at renewal and benefit from superior services.

Buy a New Policy 

A solid health insurance plan should provide timely and sufficient financial support and allow you to access it when needed. If you don't get this and your present insurance is still giving you problems, get a new one that exactly fits your needs rather than renewing the previous one.

Plan carefully and make sure you read the policy documents completely before purchasing health insurance. Then, if something goes wrong with you or your policy, you may always make it right when the health plan is renewed.


A better description of bad health insurance could be a policy that is not suitable for your needs. While a health insurance policy may not be regarded as 'bad' in an objective sense, it is likely a bad health insurance policy in your situation, if it does not meet your needs. A variety of the aforementioned strategies can be used to compensate for inadequate health insurance. You could always switch to a different health insurance plan if everything else fails. You can switch to a new insurance provider or select a different plan from the same provider that better meets your health and medical needs.


1. Can I upgrade my health insurance?

At the time of renewal, every company gives you the option of increasing your sum insured. The advantage is that there's no waiting period, as opposed to switching to a new health insurance plan, which may have a four-year waiting period for pre-existing disorders.

2. Which pre-existing conditions are excluded from health insurance coverage?

The insurance company may refuse coverage if you have a pre-existing ailment, such as cancer or diabetes, or if you have had a heart attack in the past. In some situations, you may be able to obtain health insurance, but specific diseases may be excluded for the duration of the coverage.

3. What if you fail to declare a pre-existing condition?

If the pre-existing condition is not disclosed, the policy renewal may be denied, or claims for such conditions may be disallowed.

4. What differs a top-up and a super top-up?

The main distinction is that a super top-up plan covers multiple claims above the threshold amount in a year. In contrast, top-up insurance only covers a single claim in a year above the threshold limit.

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