Unlimited sum insured in health insurance: what it covers, what it does not

An 'unlimited sum insured' health insurance policy removes the overall monetary ceiling on eligible hospitalisation expenses, but does not cover every medical cost, according to ManipalCigna Health Insurance's head of product development, Vineet Gupta. Room-rent limits, procedure-specific sub-limits, co-payments, deductibles, waiting periods, and exclusions still apply, leaving policyholders with potential out-of-pocket expenses.

Medical inflation in India is estimated at around 14 percent annually, meaning a treatment costing Rs 20 lakh today could cost nearly Rs 74 lakh in 10 years, Gupta said. An unlimited sum insured reduces the risk of exhausting coverage as costs rise, but does not guarantee zero out-of-pocket spending.

Gupta cautioned that increasing coverage later may not be straightforward due to health changes and underwriting. Consumers should evaluate room-rent restrictions, co-payment, waiting periods, exclusions, and the insurer's hospital network beyond the headline sum insured when comparing policies.