Convalescence Benefits in GHI

We all have understood the importance of a health insurance policy after the outbreak of Covid-19. Not just Coronavirus, be it any medical condition, one has to pay a huge amount out of pocket for the treatment. This is where health insurance comes in handy and under this insurance, there is a convalescence benefit.

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*Premium starting from ₹110/Employee/Month for ₹1 Lac Sum Insured covering Health & Wellness Needs (excluding GST)
#Premium may vary on the basis of coverage type & add-ons
**All savings are provided by the insurer as per the IRDAI approved insurance plan. Standard T&C Apply

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What is Convalescence Benefit?

When you purchase an individual or group health insurance policy, you get numerous benefits under it. Convalescence benefit is one of them that helps you get a fixed amount if you have to stay in the hospital more than the pre-decided time.

The amount is decided at the time of purchase. The insurer provides a lump sum amount as per the term and conditions of the insurance policy.

For example, Aman has to go through surgery after which he was allowed to go back home. However, a few complications arise and he has to stay back at the hospital for a while. In this case, the insurance company will provide coverage for the extended stay in the hospital.

What Is Meant By Convalescence Benefit?

When you get treated for a disease, you are required to take proper rest until you fully recover. In simple words, the convalescene period is known as the resting period. When you got your treatment but you have to stay back at the hospital for more than the required duration.

So the benefits that come with the Convalescence period are known as the Convalescence benefits.

Simplifying Convalescence

The basic understanding about group health insurance is that it will provide coverage for the specified medical treatment you get in the hospital. This is not it, the group health insurance comes with numerous other benefits that can help you in different ways.

Other than financial aid for the medical treatment, the group health insurance policy provides coverage for the loss you have to face due to your work getting affected.

Since you could not work because of hospitalization, the loss of income, the convalescence benefits partially cover you with a lump sum amount.

Benefits in Convalescence Example: Group Health Insurance

To make it easier for you to understand, let us give you an example.

Rohan is a field executive in a company. He gets injured during his field visit in an accident. He has to get admitted immediately and has to get hospitalized to get recovered. Since he gets hospitalized, he cannot go to the office which leads to loss of his income.

Under the group health insurance, convalescence benefits, Rohan gets a fixed amount.

Rohan gets this benefit because of being hospitalized for more than 10 days. However, the convalescence lump sum amount as specified in the policy can vary from one insurance company to another.

When To Claim?

Well, when you purchase the group health insurance policy, make sure that convalescence benefit is there in the inclusions of your policy, if not then the insurer will not provide coverage associated with it. However, you can purchase it as an add-on by paying an extra amount. It will come with a separate set of terms and conditions and you will have to meet those terms and conditions to raise a claim.

Remember that the number of days allowed for you to get these benefits is specified in the policy. For instance, if the specified days under this benefit is 10 days then you cannot raise a claim just after 6 days of hospitalization.

Also, the lump sum amount under this benefit is decided between the buyer and the insurer during the purchase. You can check the details related to this in your policy documents or you can contact customer care as well.

Certain Points To Remember

Here are a few things you should know about the convalescence benefit. They are as follows:

  • The duration after which you can avail of the benefits under convalescence is usually after a week or 10 days of hospitalization.
  • This benefit is available in both individual and group health insurance policies.
  • If this benefit is not included in your insurance plan then you can purchase it as an add-on depending on the availability.
  • The policy might include the incurred cost for family visits to the hospital.
  • This benefit is also known as Recuperating benefits and is over and above the medical expenses covered under the group health insurance.

Conclusion

Purchasing a health insurance policy has become a necessity. If you are planning to purchase an individual or group health insurance plan then you are suggested to read the terms and conditions of the policy very carefully so that you do not miss you get any kind of benefit that you are not aware of.

Since convalescence benefit is one of those hidden benefits that you might miss this is why make sure to go through your insurance policy documents thoroughly.

Written By: PolicyBazaar - Updated: 11 April 2022
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