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Author: Monkeycap Editor

Room Rent Limit – Why and how it is important

Posted: March 25, 2020

The limit imposed on the coverage of boarding expenses or room rent, along with nursing fees of the hospital is called room rent limit in health insurance.

The limit imposed on the coverage of boarding expenses or room rent, along with nursing fees of the hospital is called room rent limit in health insurance. The limit is expressed as an absolute amount or as a percentage of Sum Insured or by the category of room. For instance,

  • If the allowed room rent limit in your health plan is ₹5,000, your plan would cover your boarding expenses up to ₹5,000.
  • If the limit is expressed as 2% of the Sum Insured and the chosen Sum Insured is ₹5 Lakhs, your plan would cover your boarding expenses up to ₹10,000.
  • If the limit is expressed by the category of room as Single Private room, then your highest eligible category is Single Private Room.
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Why you need an Insurance Broker..

Posted: September 5, 2019

Insurance Broking Companies represent the customers, understands their requirements and offer them choices..they also provide effective claim support.

Insurance Broking Companies play an important role in helping the customer to understand and identify actual needs to make an informed choice. Insurance Agents or Agencies including banks usually represent one or two Insurance companies in selling Insurance Policies, where the choices available to the customer are limited.

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Compare and Save

Posted: August 20, 2019

It is always important to compare the premiums of various insurance companies against benefits offered before buying an insurance policy

Why should you compare insurance policies before buying…

The Premium rates of different insurance companies will vary for the same vehicle and such premiums offered by companies could vary with time.

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Domiciliary Hospitalisation

Posted: September 5, 2019

Insurers allow treatments at home, subject to certain terms and conditions

Domiciliary Hospitalisation (also known as home care treatment) is a treatment of an illness, where hospitalisation of the patient is normally required, but he/she is treated at home.

There are specific conditions under which health insurers will agree for domiciliary hospitalisation.

  • Due to non-availability of accommodation in nearby hospitals/nursing homes (or )
  • The patient’s condition being such that, he/she cannot be moved to the hospital. The decision for home care treatment needs to be as per doctor’s recommendation and all the required treatment facilities are made available at home.
  • In both the above cases, for the claim to be applicable, the treatment should be for a period of more than 3 days.
  • Domiciliary hospitalisation will not be applicable for certain listed diseases as specified in the policy document of the respective insurers. The list of diseases excluded for domiciliary hospitalisation varies from insurer to insurer.
  • And, last but not the least, you also need to watch out for any sub-limit imposed for domiciliary hospitalisation as a percentage of Sum Insured (SI) in your health insurance policy. For example, if the overall SI is Rs.5,00,000/- and the sub-limit is 50% of the SI, then the claims related to domiciliary hospitalisation will be limited to Rs.2,50,000/-.

Co-Payment or Co-pay

Posted: September 5, 2019

20% Co-pay will mean that Insurance company will settle 80% of the claim amount..

If co-pay is opted in an insurance policy, the insured has to pay a fraction of the claim amount. Co-payment is shown as a percentage of the total claim amount. If co-pay is included in the Insurance Policy, the premium will be lower.

For example, if the total hospital expenditure is ₹1,00,000/- and if the co-pay is agreed at 20%, then the insured has to pay an amount of ₹20,000/- and the balance of ₹80,000/- will be paid by the Insurance Company.