Term
Disease Sub-limits
A disease sub-limit is a cap on how much the insurer pays for one specific illness, even if your total cover is much higher.
What it means
Your policy might cover ₹10 lakh in total but still put a smaller cap on certain treatments — say ₹50,000 for cataract or ₹2 lakh for a knee replacement. For those treatments, the cap is all you get, no matter how big your overall cover is.
Why it matters
- If the treatment costs more than the cap, you pay the difference yourself.
- These caps can badly dent the value of a planned surgery you already know is coming.
Practical tips
- Do not look only at the total cover — check the caps for individual treatments too.
- Compare caps for common ones like cataract, joint surgery and maternity.
- If you expect a certain surgery, find out its likely cost before you pick a plan.