New Delhi, Sept. 9 -- Buying a health insurance policy with a Rs.10 lakh or Rs.20 lakh sum insured can give consumers a sense of financial security, but the headline cover does not necessarily mean the insurer will pay the entire hospital bill. Room-rent caps, disease-specific sub-limits, co-payments, deductibles, non-medical expenses and limits on certain treatments can all reduce the final payout.

Experts say consumers often focus on the premium and sum insured while overlooking these conditions. As a result, even a valid and approved claim can leave the policyholder paying a substantial amount out of pocket.

A key distinction consumers need to understand is between the sum insured and the amount the insurer will actually pay for a pa...