A new study says people still face barriers in healthcare and health insurance. This is according to reporting by Asia Insurance Review. The headline doesn't say which country or group the study covers.
For you, the message is simple. Having a policy doesn't always mean easy, cheap care. Check how your cover really works before you need it.
Key takeaways
- A study reported by Asia Insurance Review says barriers remain in healthcare and health insurance.
- Barriers can mean cost, paperwork, limited access or confusing policy rules.
- A claim can be paid in part, so keep savings ready for the gap.
- Read your policy wording now, not on the day of a hospital visit.
- Costly medical bills can push families into loans, so plan early.
How health insurance barriers work
Health insurance is a deal. You pay a yearly fee, called a premium. The insurer pays hospital bills up to a set limit.
But the deal has rules. Some illnesses have a waiting period before they're covered. Some policies cap the room rent. Others make you pay a share of every bill. That share is called a co-pay.
The study doesn't list which barriers it found. We won't guess. But these are the common hurdles people meet when they try to use a policy.
What it means for your money
Let's look at a simple example. Say you have a ₹5 lakh cover and a hospital bill of ₹2 lakh. What you pay depends on how the claim goes.
| Situation | Hospital bill | Insurer pays | You pay |
|---|---|---|---|
| Full cashless claim | ₹2,00,000 | ₹2,00,000 | ₹0 |
| Policy has 10% co-pay | ₹2,00,000 | ₹1,80,000 | ₹20,000 |
| ₹30,000 of items not covered | ₹2,00,000 | ₹1,70,000 | ₹30,000 |
| Claim rejected | ₹2,00,000 | ₹0 | ₹2,00,000 |
The numbers above are examples, not real claims. Your policy may differ.
Now think about the worst row. If the claim is rejected, many families borrow. A personal loan of ₹2 lakh at 14% for 24 months has an EMI of about ₹9,600. That's the monthly instalment you repay. You'd pay roughly ₹30,400 in interest on top. Use our EMI calculator to test your own numbers. You can also read our personal loan guides before you borrow.
Who is affected
Almost anyone with a health policy, or without one, can feel these barriers. Some groups feel them more:
- Senior citizens, who often face waiting periods and higher premiums.
- People with existing illnesses, who may face exclusions.
- Families in smaller towns, where good hospitals may be far away.
- Gig workers and self-employed people, who often don't get a group cover from an employer.
If you're in one of these groups, plan a little more carefully. Small steps now can save a lot of stress later.
What to do now
You don't need to panic. A few quick checks can protect your savings. Try this short list:
- Find your policy document and read the exclusions page.
- Check the waiting period for illnesses that you or your family already have.
- Look for room rent limits and co-pay rules.
- Save the insurer's helpline and your policy number in your phone.
- Check if your nearest good hospital is on the cashless list.
- Keep an emergency fund of at least three months of expenses.
If a claim is wrongly denied, you can complain. Start with the insurer's grievance team. Then you can go to the insurance regulator, IRDAI. Keep every bill and report safe, because paperwork matters.
Also keep an eye on your wider money plan. A big hospital bill hits your budget like any other shock. You can check your borrowing power on our eligibility page. And you can follow more stories on our news hub.
Frequently asked questions
Does this study mean my health insurance claim will be rejected?
No. The study points to wider barriers and doesn't say anything about your policy. Your cover works as per your policy wording.
What is a co-pay in health insurance?
A co-pay is the share of a bill that you pay yourself. For example, with a 10% co-pay on a ₹2 lakh bill, you pay ₹20,000.
Should I take a loan if my claim is rejected?
Try the insurer's grievance process first. Use savings if you can. A loan should be the last step, because the interest adds to your cost.
BankCreds analysis
The study is a global signal, and the headline gives no India numbers. Don't read it as news that your own policy has changed. Nothing about your premium or cover moves this week.
The real lesson is about gaps between buying a policy and using it. Think of a family of four with a ₹5 lakh cover and a ₹3 lakh surgery. A 10% co-pay and ₹30,000 of excluded items still leave them paying ₹60,000 from savings.
Who gains and who loses
People who read their policy wording gain the most. Those who never check waiting periods or room limits lose most. If your emergency fund is under three months of costs, fix that first. A health cover is not a substitute for ready cash.
This section is BankCreds' own assessment of what the development means for Indian borrowers and savers. It is independent commentary, not part of the source reporting above.
Sources & references
- Asia Insurance Review — originating report https://www.asiainsurancereview.com/News/ViewNewsLetterArticle/id/97452/Type/eDaily/Barriers-still-exist-in-healthcare-and-health-insurance-study-finds
- IRDAI — Insurance regulator where policyholders can learn about claim and grievance rights https://irdai.gov.in/
Source links are shown as plain text, not clickable links. Copy a URL into your browser to read the original report.
Editorial note & disclaimer
How this was reported. The development above is attributed to the source or sources listed. BankCreds does not independently verify a third party's reporting; where a figure or a regulatory position is stated as fact, it is either attributed or drawn from the regulator's own published material. Everything under "BankCreds analysis" is our own assessment.
Rates and figures. Interest rates, per-gram values and premium bands quoted here are indicative, move daily, and differ by borrower profile, city and lender policy. Confirm the final number with the institution before you act on it — the sanction letter or policy schedule governs, not a news report.
Not financial advice. This article is general information for an Indian audience. It is not investment, tax, credit or insurance advice, takes no account of your circumstances, and BankCreds is not a lender, broker, distributor or advisor. Consider speaking to a SEBI-registered investment adviser or a qualified professional before acting.
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