I never guess. Every answer is quoted from your policy.

Hi, I'm Sarathi. Your AI guide. Show me a policy — one you have, or one you're considering — and I'll pull out exactly what it will, and won't, do for you. Quoted from the document itself.

See what a policy really covers — before you sign.

Upload a policy you have — or one you're considering — and in about a minute see the real exclusions, waiting periods, sub-limits and the clauses that frequently get claims rejected, quoted from the policy itself. Already had a claim rejected? I'll show you where you stand and how to fight it.

What brings you here?

Your policy

Your PDF is analysed, then deleted — we don't store it. Save a pack and we keep it encrypted, tied to your email, until you delete it.

What's happening?

When did this happen? (optional)

So we count your claim deadlines down to the day.

I'll automatically detect whether this is a health or motor policy — no need to choose.

Not an agent. We don't sell policies and take no commission.

About a minute English · हिंदी

What you'll get

Every exclusion, cap & waiting periodWhat the policy covers — and what it won't — in plain English. Save as PDF or share, account-free.
A clear claim verdictCovered, partial, or not — quoted from your own policy, never guessed.
What you'll actually get back newEnter your bill — see your real payout vs. the shortfall, each cut traced to a clause.
Your deadlines, counting down newThe windows that matter — intimation, documents, settlement — ticking live.
A ready-to-send claim messageDrafted for you from your situation — just fill in the blanks and send.
If you're denied, how to fight backThe escalation path: your insurer → IRDAI → Ombudsman, with the timelines.

Most policies look fine — until you claim. In India the real damage is quiet: health claims pay out just 71% of claim value (IRDAI 2023-24), and on a motor own-damage claim, parts like tyres and batteries are reimbursed at only ~50% (depreciation). The gaps hide in sub-limits, waiting periods and exclusions you never read.Scan a policy with ClaimSarathi before you commit lakhs over decades — and catch those traps first.

Health: only 71% of claim value paid — IRDAI 2023-24 · Motor: ~50% parts depreciation — India Motor Tariff GR.9

Not legal or financial advice. Verify with your insurer.

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Before you buy a health policy: the 7 clauses that decide claims

Most claim disputes are not about fine legal points — they turn on a handful of clauses that were sitting in the policy on the day it was bought. These are the seven to read before you sign, and what each one does to a claim later.

1. The room-rent cap

A cap set as a rupee amount or a percentage of the Sum Insured. Go above it and the insurer can proportionately scale down linked charges — one of the most common reasons a payout comes in below the bill. Our room-rent guide covers what IRDAI's norms do and don't allow.

2. Waiting periods

The initial wait, the pre-existing-disease wait, and disease-specific waits all decide when cover actually starts for what. See our waiting-periods guide — including the 60-month moratorium after which policies can't be contested on disclosure grounds (proven fraud excepted).

3. Sub-limits

Per-disease or per-procedure caps (cataract, knee replacement, maternity are common candidates) quietly override the headline Sum Insured. A ₹10 lakh policy with a ₹40,000 cataract sub-limit pays ₹40,000 for cataract — read the sub-limit table, not just the cover amount.

4. Co-pay

A co-pay clause makes you bear a fixed percentage of every claim. Common in senior-citizen and low-premium plans; legitimate if written in — which is exactly why it must be read before, not after.

5. The exclusions list

Every policy carries a list of what is never covered. Rejections that cite an exclusion are hard to fight when the clause is clear — the time to weigh the list is before signing.

6. Cashless network and approval timelines

Check the insurer's hospital network where you actually live, and know your approval-time rights — our cashless guide covers the 1-hour and 3-hour rules that apply once you're in a network hospital.

7. The definitions

How YOUR policy defines 'hospital', 'day-care procedure', and the pre/post-hospitalisation windows decides borderline claims. These definitions vary between policies — read them in the document itself rather than assuming the market standard.

Don't want to read 40 pages? Don't.

Upload the policy PDF — ClaimSarathi pulls out the caps, waiting periods, sub-limits, co-pay, exclusions and deadlines, quoted from the document, in about a minute. Free, no account. Anything it can't anchor to a clause quoted from the document is left out — never guessed.

General guidance — your policy wording governs. Sources for the figures and mechanics: the linked guides (room-rent, waiting-periods, cashless), each carrying its own IRDAI citations.

Frequently asked

What matters more — the premium or these clauses?

A cheaper premium often buys stricter versions of exactly these clauses (higher co-pay, lower caps, longer waits). Compare two policies on the seven clauses, not the price line alone.

Can the insurer add these limits later?

The clauses that decide your claim are the ones in the policy document you accept. That is why reading them (or scanning the PDF) before you sign matters more than any brochure.

I already own a policy — is this list still useful?

Yes: the same seven clauses decide a claim you file tomorrow. Scan your current policy to see where you actually stand — at renewal, porting is the moment to act on what you find.

ClaimSarathi KB — IRDAI 'Norms on Proportionate Deductions' (2020) / Master Circular on Health Insurance Business, 29 May 2024; figures and mechanics live in the linked guides. Your policy wording governs. · As of 2026-07-04