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Taking a health plan does not mean all our expenses on hospitalisation is covered. To name a few, travelling to and fro from the hospital, special diet expenses and expenses for relative staying with patient are not covered under medical plans.
However, there are certain plans that cater to these specific needs as well. Tata AIG General Insurance, Bajaj Allianz General Insurance and Royal Sundaram General Insurance offer hospital cash plans.
These plans can be purchased mostly with the medical insurance policies.
To avail off this facility, the policy holder should be hospitalised either in a registered hospital or in a hospital with a minimum of 15 beds. And, hospitalisation could be due to sickness or accident.
Premium: As per Tata AIG General Insurance's website, this plan is available for any individual aged between 18 to 59 years and includes self, spouse and two dependent children aged between 6 months and 18 years or up to 23 years, if studying in an accredited institution of higher learning and unmarried.
If a family of four buys a cover of Rs 550,000 from Tata AIG, the annual premium would be Rs 4,669 inclusive of service tax.
Benefits provided under this would be hospitalisation due to sickness (Rs 1,000 per day), hospitalisation due to accident (Rs 2,000 per day), medical expenses reimbursement in the event of an accident (Rs 10,000).
With Bajaj Allianz - 30 days Rs 500 Plan, a family of four would pay a premium of Rs 1,362 inclusive of service tax.
Hospitalisation due to illness (in a general) would receive Rs 500 a day, admission in ICU due to illness would get Rs 1,000 per day. Hospitalisation due to accident (general) would get Rs 500 a day and accident admission in ICU would get Rs 1,000.
A premium up to Rs 15,000 a year is eligible for tax exemption under section 80D.
Exclusions: Hospitalisation within 30 days from the time of purchasing the policy, pre-existing diseases, dental treatment or surgery, pregnancy-related treatment, childbirth, natural perils like avalanche, earthquake, volcanic eruptions, accidents from drunken driving are not covered by the policy.
The waiting period for Tata AIG General Insurance's Individual Accident and Sickness Hospital Cash is 90 days, unless hospitalisation is caused by injury.
Routine physical examination where there are no objective indications or impairment in normal health, laboratory diagnostic or X-ray examinations is also not covered, including expenses incurred outside India.
Claim settlement: The illness or claim should be immediately reported to the insurer on phone or in writing (email/letter).
The claimant will need to submit a complete claim form along with documents required - attending doctor's report, hospital discharge card or proof with details of treatment, bills with prescriptions, pathological or X-ray reports.
After submission of the necessary documents, the insurance company's claim team would assess the claim for completeness of documentation and admissibility and send a written communication to the insured for additional documents if any or if the claim is deemed to be inadmissible as per policy.
If the claim is admissible, a pay order and discharge voucher would be sent to the insured.
Max benefits: Tata AIG provides this benefit for 60-180 days in a policy year, Royal Sundaram gives for 180 days and Bajaj Allianz provided 30-60 days depending on the plan.
Policy renewal: The maximum age till which this policy can be renewed is 54 for Tata AIG, 65 for Bajaj Allianz and 70 for Royal Sundaram.