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Category: Health Insurance

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.

Suppose you choose a room rent that exceeds the limit, then all the other charges related to the treatment will be settled by the Insurance company on the same proportion. For example, if your room rent limit is 3000 and you opt for a room rent of 4000, then if your overall claim is 1,00,000, the insurance company will pay only 75,000 considering the ratio in with the room rent limit was exceeded. This is called the proportionate deduction under the terms and conditions of the policy.

Exclusions and Waiting Period in Health Insurance

Posted: April 13, 2020

While buying health insurance policy for the first time, all the insurers exclude coverage of certain diseases for a specified period of time from the date of inception of the policy.

It is imperative for any insurance buyer to know the details of coverage extended by various insurers before buying.

Two of the most important terms of health insurance are Exclusions and Waiting periods.

While buying health insurance policy for the first time, all the insurers exclude coverage of certain diseases for a specified period of time from the date of inception of the policy. Those are called exclusions and the period of exclusion of coverage is called waiting period.

Continue reading “Exclusions and Waiting Period in Health Insurance”

Daycare Procedures

Posted: September 5, 2019

Treatments that require less than 24 hours of hospitalisation

Due to advancements in technology, outpatient procedures such as cataract operations, etc., do not require 24 hours of hospitalisation. These come under the list of daycare procedures covered by an insurance company. The list of daycare procedures covered varies from one insurer to another. The full list of such procedures will be specified in the policy.

Ambulance Charges

Posted: September 5, 2019

Benefits paid towards usage of ambulances

As per a limit specified in the policy, the insurer pays for the Ambulance Charges related to each and every emergency hospitalisation. Usually, the limit is Rs. 1000 to Rs. 1500 per emergency hospitalisation.

Convalescence Expenses

Posted: September 5, 2019

Benefits that are paid towards the insured’s recovery expenses

Convalescence benefit is also known as recuperating/recovery benefit. Under this benefit, the health insurance company covers the incurred recovery expenses for the insured. This acts as a cushion for the insured, paying any costs that may arise during and after hospitalisation. See Post Hospitalisation.

Critical Illness

Posted: September 5, 2019

A critical illness insurance policy covers the insured against life-threatening critical illnesses such as cancer, heart attack, renal failure etc. Upon surviving a minimum number of days, the insured can avail the benefits as mentioned in the Policy

Cumulative/ No Claim Bonus

Posted: September 5, 2019

Bonuses that are added on from previous policy years

Cumulative bonus is similar to no claim discounts. For every claim free year, the Sum Insured will progressively increase year on year, as specified in the policy. However, the cumulative bonus is subject to an amount that can never exceed 50% of the Sum Insured and provided the policy was renewed continuously.