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Question about Arogya Sanjeevani policy

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15 Jan, 2022 by  harivansh agrawal

There is a section in wording in which it said 

.

Other expenses 

i. Expenses incurred on treatment of cataracts subject to the sub-limits 

ii. Dental treatment necessitated due to disease or injury 

iii. Plastic surgery necessitated due to disease or injury 

iv. All the daycare treatments

v. Expenses incurred on road Ambulance subject to a maximum of Rs 2,000 per hospitalization

I have a question regarding points number 2 & 4

for point no. 2 

If I require a root canal treatment that does not require hospitalization will it be covered (which is generally do not covered by health insurance)

for point no. 4

A lot of insurers have a list of day care treatments and they will only cover daycare treatment which is in the list, but in the case of Arogya Sanjeevani there is no list it says all Daycare treatment so does it mean the insurer will cover- all the daycare treatment, no matter how modern they are

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Hello Harivansh jee,


Answering your questions below:


For point number 2, the dental treatment will only be covered if it is due a disease or an injury, it can be an in patient hospitalisation /day care procedure.


OPD procedure will not be covered.


If it is root canal which is generally an OPD procedure will not be covered.


For point number 4, yes all day care procedures are covered, for day care treatment - admission and discharge process is necessary.


About modern treatments, found this in policy wordings



4.6 The following procedures will be covered (wherever 

medically indicated) either as in patient or as part of day 

care treatment in a hospital up to 50% of Sum Insured, 

specified in the Policy Schedule


You can refer this list, if it falls under this, then 50% will be paid otherwise full amount can be claimed.


Hope this helps


Thanks

Gurleen Kaur Tikku



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