Term
Disease Sub-limits
Disease sub-limits cap payouts for specific illnesses even if your total cover is high.
What it means
A policy may offer a high overall sum insured, but still set lower treatment-wise caps. For example, cataract may be capped at ₹50,000 or knee replacement at ₹2 lakh regardless of total policy cover.
Why it matters
- When a treatment bill exceeds the disease sub-limit, the extra amount must be paid by you.
- Sub-limits can significantly reduce claim value for expensive planned surgeries.
Practical tips
- Always check disease-specific caps in the policy schedule, not just total sum insured.
- Compare sub-limits for common treatments like cataract, joint surgery, and maternity.
- For expected procedures, estimate likely hospital cost before selecting a plan.