So in India, insurance doesn't cover emergency/casualty charges? My claim just got rejected.
Yes, Health Insurance in India primarily covers hospitalization and associated expenses. Outpatient expenses like regular doctor visits for common fever, cold and cough, medicines etc are not covered under the regular Health Insurance, even if they are carried out inside a hospital.
You need to be admitted under inpatient for the claim to be admissible. Hope this helps.
Great, thanks for the explaination!
What if, someone undergoes a treatment (e.g. Cataract), in which the patient is discharged before 24 hours?
That is covered.. under "day care treatments"
I have claimed for cataract for my father in law from oriental happy family floater policy
This comes under Day care treatment no need of 24 hrs hospitalisation.
500+ Day Care treatments are available
If someone has an heart attack and gets into an emergency ward and then admitted as an inpatient, what will be covered in that case?
If the person gets admitted due to heart attack the entire charges will be paid.
Also upon hospitalisation, pre and post expenses of Medicines, diagnosis and other expenses related to hospitalisation are payable.
Most of the policies cover Hospitalization, Home-care as well as Day-care benefits. For outpatient cases, some of the policies provide OPD cover as well.
If your claim was rejected, please corss-check your policy terms. Thanks