Determine Post Hospitalization Medical Expenses in Worker Compensation Insurance

The workmen's compensation policy offers coverage to the injured person suffering from a cause in the workplace. A worker who sustained an injury may avail of the pre-hospitalization and post-hospitalization expenses in the workmen compensation insurance policy. Every employer is mandated to offer appropriate compensation to the workers who suffered from a bodily injury while discharging their duties. Therefore, the employer is subject to the workmen compensation act.

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Post Hospitalization Expenses in Workmen Compensation Insurance

Post-hospitalization expenses in workmen compensation insurance policy start from the expenses incurred after the proper hospitalization of the person. Following are the post-hospitalization expenses in workmen compensation insurance.

Medicines

The medicines prescribed by the doctors shall be considered post-hospitalization expenses. The medicines are consulted upon the proper checkup of the patient. Therefore, in order to conduct a complete check for serious injury, the person is required to be hospitalized.

Consultation fee

The patient after the hospitalization keeps in good care by the hospital. However, upon discharge, the patient is required to pay several visits to the doctor in the stipulated time. The visit is necessary to interpret the improvement of the health of the patient.

Hence, the doctor charges a sum for the consultation in which he guides the patient to follow some advice for a speedy recovery. So, the consultation fee is included in the post-hospitalization expenses in workmen compensation insurance policy.

Regular Tests

Patients, with serious injuries, are required to visit the hospital for a regular test which is expected to be conducted after discharge. The tests are crucial for the speedy recovery of an individual. Further, it is also imperative to monitor the progress in the health of the individual. Therefore, the regular test is subject to be included under the post-hospitalization expenses n workmen compensation insurance policy.

Exclusion of Post-Hospitalization Expenses

The following expenses shall not be included under the post-hospitalization expenses in the liability insurance. Further, the insurer shall not be liable to reimburse for such expenses. However, the workmen may incur such expenses on their own.

Acupuncture

A patient may feel or realize the need for acupuncture. It is important to gain more energy and enjoy better sleep. However, it is not necessary under the insurance policy. A workman may live and recover without the treatment of acupuncture.

Naturopathy

Naturopathy is essential in order to advance the ability of the human body to heal itself. It is an amalgamation of modern and traditional therapy. However, it is not considered a necessary treatment for the workmen. Hence, it shall not include in the post-hospitalization expenses.

The aforementioned expenses are not necessary. People seek such treatment to lose fatigue and gain energy.

New Ailment

No compensation shall be paid for the new ailment a patient may suffer during hospitalization. The insurer is only liable to reimburse or bear the medical expense of the ailment caused during the discharging of the duty. Hence, the patient is required to bear such expenses.

Case Study

A worker, while discharging his duty, suffered from an injury.

First Scenario: Pre-Hospitalization Expense

  • He approached his doctor who suggested some tests.
  • The doctor conducted the test and advised him to hospitalization.

Second Scenario: Hospitalisation Expense

  • The patient, owing to the advice of a doctor, was admitted to the hospital.
  • He underwent several treatments and was discharged.

Third Scenario: Post-Hospitalisation Expense

  • The doctor prescribes some medicine to be taken at the stipulated intervals.
  • He paid several visits for consultation for a speedy recovery.

Conclusion

A beneficiary must produce a copy of discharge with regard to his hospitalization in order to cover the post-hospitalization expenses in the workers compensation policy. He is required to carry the prescriptions suggested by the medical practitioners and bills for relevant tests.

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