OPD bills should not normally coated below indemnity medical health insurance

NEW DELHI :

Can routine consultations and drugs bills be claimed below my medical health insurance coverage?

—Name withheld on request

Routine consultations and medical bills are OPD (outpatient division) bills, that are normally not coated below an indemnity medical health insurance coverage. Usually, a coverage covers solely hospitalization (in-patient division) bills when lively remedy is run or a surgical procedure is carried out. However, some medical health insurance merchandise can be found out there that additionally cowl OPD bills.

My son has been complaining of a listening to drawback; the paediatrician has steered getting it checked at a hospital. Can I exploit the medical health insurance if the remedy availed is lower than a day at a hospital?

—Name withheld on request

According to the coverage ‘hospitalization’ means admission to a hospital for no less than 24 hours. A buyer can actually declare insurance coverage advantages if hospitalization has not occurred for twenty-four steady hours below outlined day-care procedures. Every medical health insurance coverage covers specified procedures outlined below day-care procedures record, which don’t require 24 hours hospitalization. Due to developments in medical know-how day-care therapies will be availed, which in any other case would require 24 hours hospitalization. Some frequent therapies which might be coated below the day-care record are chemotherapy, cataract, and radiotherapy. 

I’ve lodged a declare after the expiry of my coverage date for an accident that occurred in the course of the coverage interval. Will I nonetheless get the declare?

—Name withheld on request

Any harm, ailment or loss that sustained inside a coverage interval is eligible for a declare, topic to the opposite phrases and situations of the coverage. Most insurance policies have a stipulated time inside which the declare must be intimated to the insurance coverage firm. It is advisable to stay to this time to keep away from any hassles on the time of want.

Atul Deshpande is head-claims, digital and initiatives, at SBI General Insurance. Queries and views at mintmoney@livemint.com.

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