Conditions Associated With Hospital Cash Benefit
Now, let’s have a look at the various conditions that may crop up if you claim the hospital cash benefit. Please note that these conditions may vary across insurance companies. Ensure you go through your policy documents carefully.
At Least 24-48 Hours Of Hospitalisation Is Necessary
You will be given the daily cash allowance only if your hospitalisation goes beyond 24-48 hours.
Example - Arun is hospitalised for 3 days and his policy specifies that he’ll receive the hospital cash benefit after 24 hours. In this case, the insurer will pay a cash benefit for 2 days. The initial hospitalisation period of 24 hours will not be taken into account.
Daycare Treatment - Not Covered
A hospital cash benefit is not provided by most insurers for daycare procedures, i.e., treatments or surgeries carried out within a span of 24 hours.
For instance, Manoj injured his hand while working with machinery. He needed immediate first aid and a few stitches. As he did not require a hospital stay, his health insurance did not cover the treatment.
Domiciliary Hospitalisation - Not Covered
If there is an unavailability of beds in the hospital or if you can’t be moved to the hospital due to severe injury/illness, you can receive treatment from the comfort of your home under a certified doctor's supervision. This is called domiciliary hospitalisation. However, several insurers do not provide a hospital cash benefit for domiciliary hospitalisation.
For example, Max Bupa doesn’t cover domiciliary hospitalisation.
For example, Divya was cleaning her loft, when she slipped and broke her leg. As she can’t be moved to the hospital in this condition, her doctor arranged for domiciliary hospitalisation. She incurred additional expenses for blood tests and other tests in addition to her treatment costs. Since, her health insurance doesn’t provide hospital cash benefits for domiciliary hospitalisation, she had to bear these extra expenses.
Double Cash Allowance For ICU Admission
For every 24 hours you spend in the Intensive Care Unit (ICU) of a hospital, some insurers will double the daily cash allowance specified in your policy’s hospital cash benefit. The expenses in an ICU are significantly higher than a regular room, which explains the higher pay.
For example, Care Insurance and Digit Insurance provide double cash allowance.