New Delhi, Sept. 8 -- Having an active health insurance policy and paying premiums on time does not guarantee that every hospitalisation will result in a claim payout. Insurers assess claims against the policy's terms and conditions, including waiting periods, exclusions, medical necessity and documentation requirements.

Experts say policyholders often discover these conditions only when they need to use their insurance. Non-disclosure of medical history, claims made during waiting periods and inadequate medical records are among the reasons an otherwise active policy may not result in a payout.

Non-disclosure or incorrect disclosure of medical history is one of the key reasons for claim disputes, according to Bikash Choudhary, CEO, Fat...