Individual
Family
Senior Citizen
SMC Insurance Brokers Pvt. Ltd.
Parsvnath Metro Mall, Near Pratap Nagar Metro Station, Pratap Nagar, New Delhi-110007
Registration No: 289, Registration Code No: IRDAI/DB-272/04/289, Valid till: 27/01/2026, License category: Direct Broker (Life & General), CIN: U66000DL1995PTC172311
Insurance is the subject matter of solicitation.
Visitors are hereby informed that their information submitted on the website may be shared with insurers.
Product information is authentic and solely based on the information received from the Insurer.
Health Insurance Benefits
Tax Benefits
u/s 80 (D)
Cashless
Treatment
Free Annual
Health Check up
Health Insurance in 2 Mins
Health Insurance Benefits
Tax Benefits
u/s 80 (D)
Cashless
Treatment
Free Annual
Health Check up
Road Ambulance Cover In Health Insurance
If you live close to a busy road in a city, you would have heard ambulance sirens during the day, and god save you if you live near a hospital - then it is a way of life.
Ambulance siren gives us an immediate signal that someone’s not well, and needs immediate treatment.
What if god forbid, we need it? Does health insurance cover ambulance charges? Are there any conditions related to the coverage of road ambulance costs in health insurance that you must be aware of?
Let’s find out!
Are Road Ambulance Charges Covered By All Health Insurance Plans?
Emergency road ambulance costs are covered by nearly all health insurance policies in the country. You’ll have to check the policy document or brochure of your health plan. If it is mentioned explicitly, only then will the ambulance costs be covered.
Are All Types Of Ambulance Expenses Covered?
The insurance company will usually cover the costs of the emergency road ambulance that transports you from the scene of the emergency to a nearby hospital. The expenses incurred for transporting you from one hospital to another hospital for better treatment will also be covered by the insurance company, provided such transportation must be advised and prescribed in writing by the treating doctor. Which means, that if the treatment required is not an emergency, or there is no requirement of an ambulance as per a medical professional, it may not be paid by your insurance plan.
Conditions For Road Ambulance Coverage Under Health Insurance Policies
Here’s a quick rundown of some conditions for coverage of road ambulance charges under health insurance.
-
Covers Only In Case Of Emergency
Like we said, the insurance company will cover the ambulance expenses only if the ambulance service is used in case of an emergency.
But, what does ‘emergency' mean?
‘Emergency’ refers to a serious medical condition or symptom resulting from illness/injury that arises suddenly and unexpectedly, and requires immediate attention from a medical practitioner, usually within 24 hours of the condition’s onset - to prevent death or serious long-term impairment.
For instance -
- Mr. Raichand suffered a heart attack in the middle of the night and was taken to the hospital immediately for treatment.
-
Dhruv was involved in a major road accident where he sustained some serious injuries. He needed immediate medical care and hence, was rushed to the hospital.
Such situations will be considered an ‘emergency’.
-
Mr. Khan has been complaining of a stomach ache for a few months. The doctor has advised a small surgery in his hospital in a couple of weeks. Mr. Khan is all hail and hearty except for this stomach issue on the day of the hospitalisation, and can travel by regular transport, say a cab.
In this scenario, insurance plans may not consider this as an emergency and hence pay for an ambulance service.
-
Approved Inpatient Hospitalisation Claim
Most policies will cover the ambulance charges only if you’re later admitted to the hospital and the insurer has approved a claim under inpatient benefit. Which means that if you travel in an ambulance for an emergency medical requirement, but once you reach the hospital, the doctor after observation does not recommend any hospitalisation, and asks you to rest at home, with some oral medication. In such a scenario, the ambulance charges will not be payable in the plan.
-
Prescribed In Writing By A Medical Practitioner
You cannot take an ambulance for transportation and claim for the ambulance expenses if local transportation could have been used. Hence, most insurance companies put an additional condition that they will cover the ambulance charges only if it is prescribed by a medical practitioner in writing that the patient was in a condition and needed an ambulance. This document may be usually required in situations where it is not explicitly evident that an ambulance was required. For instance, if it is diagnosed that the patient had a heart attack, then the insurer may not ask for such a document.
-
Transportation Only To A Hospital Is Covered
Mostly, the insurance company will pay under this benefit only if the ambulance service is used to take the patient to the hospital. The costs will not be covered if you use the ambulance service for any other purpose, such as for going to a hospital diagnostic centre for evaluation purposes.
You may get admitted to a small hospital which may not have all the infrastructure. Say for a specific test, you are transported to another hospital and got back, this ambulance charge may not be payable under your health insurance plan.
A few health insurance policies, like the Max Bupa Companion Policy and the Max Bupa Reassure Policy, have explicitly mentioned in their policy wordings that they will not cover the costs if the emergency ambulance service is used to visit a hospital diagnostic centre for evaluation purposes.
-
Coverage Limits
Under most health insurance plans there is a financial limit up to which they will cover the ambulance costs under the health plan. Very few plans come without a limit. , such as the Star Health Comprehensive Plan, there are no restrictions on the coverage for an emergency ambulance. There, however, are insurance companies that
For instance, say Amey is covered under health insurance with a sum insured of Rs. 10 Lakhs. There is a limit of Rs. 2500 on the coverage of ambulance expenses under his policy. This means that if Amey undergoes hospitalisation and is taken to the hospital via an ambulance, the insurance company will only cover the ambulance costs of Rs. 2500. Any extra expenses incurred towards ambulance expenses will have to be paid out of his own pocket.
-
Not Able To Use Other Mode Of Transport
Another condition you must be aware of is that the cost of ambulance service under some plans will be covered only if you are unable to be transported to the hospital by any other mode of transportation, such as a car or a two-wheeler.
-
Return Transportation May Not Be Covered
Most insurance companies will not cover the cost of return transportation via the ambulance, i.e., from the hospital to your residence. There, however, are some insurers that cover the return transportation costs, only if the treating doctor has certified in writing that the return transportation via the ambulance is medically necessary.
-
Registered Ambulance Service Provider
The ambulance charges will be covered only if the ambulance service is provided by a registered service provider or health care centre.
Show More
Note: The conditions and limitations for coverage of ambulance costs in health insurance may vary across insurers. So, make sure you go through your policy document before going ahead.
| HDFC Ergo | Aditya Birla | Niva Bupa | |
|---|---|---|---|
Covers Emergency ambulance expenses? |
Yes | Yes | Yes |
Expenses Covered For |
Transportation to hospital from the place of emergency | Transportation to hospital from the place of emergency as well as from one hospital to another if prescribed in writing by the treating doctor. | Transportation to hospital from the place of emergency as well as from one hospital to another if prescribed in writing by the treating doctor. |
Is transportation from hospital to home covered? |
No | No | Yes |
Cover Limit |
Upto ₹2,000/hospitalisation | Upto ₹2,000/event | Upto ₹2,000/event |
Wrapping Up!
If it’s mentioned in your policy document, then the road ambulance costs will be covered by your health plan. The costs, however, will be covered only if specific conditions are met. Make sure you’re aware of these conditions before you go ahead and buy the policy - to avoid any hassles in the future.
Partners - We Are Proud To Have
We have over 30+ insurance partners on our back. Rest assured, you won't be short of choices.
Why Customers Love Us?
- We provide quick claim assistance.
- We are easily approachable through phone, email, and text.
- We are transparent operations with no hidden cost.
- We pursue your claims till the very end.
- We understand your needs, and advise most suitable insurance products to you.
Our Customers' Stories
Sharing the experience of happy and satisfied customers with you.
Sameer Yadav
I was searching for investment plan but I couldn't find it, then I got the call from SMC insurance and they aligned a call with Ishita Sharma as point of contact (POC) for all my queries and she explain me very well. Ishita explain me all investment plan with advantage and disadvantage, I really appreciate her. Ishita always enthusiast towords work and ready to answer all my questions .I have taken two policies ( HDFC click to invest) plan with 15k premium per month. I always recommend SMC insurance to all, for better life and happy retirement with huge health and wealth. Thank You SMC insurance for your best service. Special thanks to Ishita for E2E help and endless support, you did fabulous work. Show More
Dheeraj Bhatia
I am associated with SMC insurance since 2011 and found them to be most ethical, trustworthy and highly responsive. Some of my precious policies done thru other agencies are still running on SMC’s advice. That is a strong testimony to their customer-centric approach. I am glad to be associated with SMC and strongly recommend their services to all concerned. Wishing the very best to Team SMC !Show More
Jyoti Sharma
We were fortunate enough to have selected SMC as our Health Insurance Broker for they have been very helpful in resolving our queries related to health insurance. I would like to cite two examples where SMC's role has been very crucial. One was when payment for cashless hospitalization was not coming through as the insurance company was taking undue longer time to approve the Hospital Bill. It was then I talked to Neha and it was she who through her contacts in the Insurance co. facilitated and expedited the approval for payment of hospital bill. Second was very recently when the Insurance co. had proposed a top up "Enhancer" policy for our existing policy. When I talked to Neha she immediately told me not to take this policy being offered without any medical test as it will not be beneficial to us and may create problem later on account of recent hospitalization. If I had I not consulted Neha, I would have into a big trouble with the insurance co. These two instances speak very high of sincere advice and timely help rendered by the SMC Staff, Ms. Neha Khanna which helped us a lot in time of need.Show More
Sumit Khanna
Hi, I am Sumit here, purchasing insurance policies from SMC for almost 8 years. Would like to recommend this company to other customers because they are taking care of my insurance broking services in a fabulous way. I would like to extend my gratitude and thanks to policy servicing and also insurance claim backend services. They have rendered fantabulous services for me and would like you guys to definitely go and rely on them for all your insurance needs.Show More
Kishor Kumar Bijlani
My experience with SMC Brokers is excellent. They provide support from the beginning till end i.e from issuance of insurance policies till settlement of claims. They explain very nicely various provisions relating to Insurance Policy also facilitate settlement of claims with Insurance Companies. Show More
Megha Singhal
I have purchased HDFC policy from SMC Insurance with the help of Harsh Sharma. I have got the satisfactory services from SMC Insurance. Thank you SMC Insurance.Show More
