What is a ‘hospital’ for the purpose of health insurance policies?

What is a ‘hospital’ for the purpose of health insurance policies?
Institutions set up for treatment and indoor care in respect of sicknesses and/or injuries and that are registered and under active supervision by a medical practitioner. 
Any establishment satisfying the following criteria can qualify as a hospital:
  • 15 patient beds
  • With a fully equipped operation theater of its own if
  • Employing fully qualified nursing staff around the clock
  • Having fully qualified doctors in charge around the clock
Ayurvedic or institutions practicing alternative medicine therapy also qualify as hospitals.

What is meant by hospitalization? 
Where the insured is admitted to a hospital for a minimum period of 24 hours, the event is termed as hospitalization. 
In case of specific treatments like chemotherapy, dialysis, radiotherapy, dental surgery, laser eye surgery, etc where the patient is duly discharged by the same day are also termed as hospitalization.

Is there a limit as to how long I can stay in hospital? 
There cannot be a stated limit to how many days of hospitalization a person might need and hence there are no set limits to how long you can stay in hospital.

What is the meant by domiciliary hospitalization? 
When the treatment is administered at a patients home, the event is termed as domiciliary hospitalization. This is normally the case when conditions are such that the patient cannot be moved from his home to the hospital or when there are no hospital beds available and hence the treatment has to be administered at the home of the person.
Is there a tax deduction on the premium paid? 
As per section 80D of the Income Tax Act, premiums paid up a set limit per annum under the health insurance plan for self, spouse, two dependent children and dependent parents are exempt from tax.

Can I get a refund if I cancel my health insurance plan during the contract term? 
Yes. The insurer is liable to refund the premium if no claim has been made up to the date of cancellation.

What happens when I make a claim on a Critical Illness Plan? Does the policy still continue? 
Usually the policy ceases to continue on making a claim. However there are many insurers who renew the policy on payment of a lesser premium than the one originally paid. 

Can there be a claim of medical expenses incurred before and after a surgery? 

Medical expenses incurred 30 days before and 60 days to 90 days after hospitalization, can be claimed, provided they are related to the ailment/accident for which you were hospitalized. Such expenses are termed as pre and post hospitalization.

Can I claim my dentist's bills?

Dentistry bills cannot be claimed.
For how long is a Critical Illness policy issued? 
A critical illness policy is usually issued for a period of one year. Some insurers offer it for a term of two to five years while a few offer it for a period of 10 years to 30 years; with the premium remaining constant for three years or five years


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