Can Health Insurance Claims be Made Even with Less than 24 Hours Hospitalization?

Any gadget we buy comes with a warranty period clause which states that in case of any manufacturing related defects, the company would bear the cost of related services. Thus, whenever we get our products serviced within the warranty period, we are relieved of the inherent expenses but what about after the lapse of the warranty period? We wonder how much would the cost of the service of the appliance be.

Read More

Get ₹5 Lac Health Insurance starts @ ₹200/month*
Get ₹5 Lac Health Insurance starts @ ₹200/month*
Tax Benefitup to Rs.75,000
Save up to 12.5%* on 2 Year Payment Plans
7 Lakh+ Happy Customers

*All savings are provided by the insurer as per the IRDAI approved insurance plan. Standard T&C Apply
*Tax benefit is subject to changes in tax laws. Standard T&C Apply

Get insured from the comfort of your home No medicals required
I am a

My name is

My number is

By clicking on ‘View Plans’ you, agreed to our Privacy Policy and Terms of use
Close
Back
I am a

My name is

My number is

Select Age

City Living in

    Popular Cities

    Do you have an existing illness or medical history?

    This helps us find plans that cover your condition and avoid claim rejection

    Get updates on WhatsApp

    What is your existing illness?

    Select all that apply

    When did you recover from Covid-19?

    Some plans are available only after a certain time

    A similar condition is inherent in our health insurance plans. Health insurance promises great benefits but when it comes to claim settlement, we run from pillar to post to ensure that the financial burden of the hospital bills do not fall on our shoulders and the claims get duly settled. We enlist the help of our brokers to complete the claim settlement procedure in complete tandem with the mentioned formalities. Such a horror in getting the claim settled! But why?

     

    Settlement of claim in a health insurance plan comes with a lot of strings attached. There are certain conditions which are to be fulfilled to get the claims settled. For a claim to be admissible the ailment should be covered by the plan, the insured should be admitted in a hospital which meets certain qualifying criteria, the claim should be properly filed and the hospitalization should be for at least a period of 24 hours.

    Yes, the last requirement leaves many of us stumped. Normal hospitalization claims are settled only after the insured is hospitalized for a continuous period of 24 hours. But what about treatments which do not require a continuous hospital stay? Can we claim insurance benefits for such treatments too?

    Yes, actually we can! Ever heard of Day Care Treatments? Every health insurance plans cover Day Care Treatments and this feature covers treatments availed which do not require hospitalization for 24 straight hours. Let us understand:

    As defined by the policy wordings, Day Care Treatments are defined as those medical treatments or surgical procedures which are undertaken under the influence of a general or a local anaesthesia in a hospital or in a day care centre in less than 24 hours because of technological development in medicine which would have otherwise required a hospitalization of 24 hours.

    Your health insurance plan covers these day care treatments which do not require a 24-hour hospitalization. Some common Day Care Treatments included in the health plans include:

    • Cataract surgery
    • Tonsillectomy
    • Chemotherapy and Radiotherapy
    • Hemodialysis
    • Coronary angiography
    • Nasal sinus aspiration
    • Free skin transplantation
    • Arthroscopic knee aspiration

    These are some of the few treatments covered in a long list of treatments. However, you should note that Out-Patient Expenses like doctor consultations, tests and investigations are excluded from the scope of day care treatments though they might also require hospitalization for less than 24 hours.

    OPD treatments differ from Day Care Treatments in the sense that OPD treatments do not require hospitalization at all irrespective of technological development in medicine. Day Care treatments on the other hand require hospitalization but the duration is reduced because of medical developments.

    So, the next time you fear that your Cataract operation would not be covered or that your Chemotherapy session would be excluded from your health insurance coverage, think again. These fall under the scope of Day Care Treatments and such treatments are covered by your health plan.

    All insurers provide coverage for Day Care Treatments and the only difference is that the list of treatments and surgeries covered vary from insurer to insurer. Moreover, these treatments also provide the facility of cashless claim settlement. Even if you cannot claim the cashless facility, reimbursement of such claims is also possible.

    So, treatments shorter than 24 hours are Day Care Treatments and they are covered. The next time you worry that your hospitalization was not for the stipulated 24 hours, relax! The coverage for Day Care Treatments is there and it would come to your rescue. Just make sure you are claiming for the Day Care treatment and not an OPD treatment and then let your health plan do the rest.

    Written By: PolicyBazaar - Updated: 30 June 2021
    Search
    Disclaimer: Policybazaar does not endorse, rate or recommend any particular insurer or insurance product offered by an insurer.

    Health insurance articles

    Recent Articles
    Popular Articles
    Bid Goodbye to Seasonal Diseases during the Pandemic with 7 Basic Practices

    21 Sep 2021

    Adding to the insurmountable loss of life the ongoing COVID-19...
    What is the Survival Period in Health Insurance?

    21 Sep 2021

    The prevalence of critical diseases in India has increased...
    Health Insurance for Autoimmune Diseases in India

    16 Sep 2021

    Every human body comes with an immune system to fight against...
    Does Health Insurance Cover Multiple Sclerosis In India

    15 Sep 2021

    Due to a hectic lifestyle leading to unnecessary stress and...
    Critical Illness Insurance Policy For Stroke Patients In India

    14 Sep 2021

    Medical emergencies are unpredictable and it brings a lot of...
    Best Health Insurance Plans in India 2021
    Finding the best health insurance plan from so many different health insurance companies can get confusing for many...
    Top Maternity Insurance Plans
    Maternity or pregnancy is an important phase of life, and one needs to prepare in advance to embrace parenthood...
    Top Family Health Insurance Policies in India 2021
    From the air we breathe to the food we eat; everything is intentionally or unintentionally subjected to...
    Health Insurance Claims Ratio- Things You Should Look Before Buying Health Insurance
    There has always been a doubt in customers mind about whether the private company will keep its side of the bargain...
    Best Health Insurance Plans for Senior Citizens in 2021
    Considering the increasing percentage of medical inflation in India, it has become an absolute necessity to buy...
    Close
    Download the Policybazaar app
    to manage all your insurance needs.
    INSTALL