OPD expenses are not usually covered under indemnity health insurance

Can routine consultations and medication bills be claimed beneath my medical insurance coverage?

—Title withheld on request


Routine consultations and medical bills are OPD (outpatient division) bills, that are often not coated beneath an indemnity medical insurance coverage. Often, a coverage covers solely hospitalization (in-patient division) bills when lively remedy is run or a surgical procedure is carried out. Nevertheless, some medical 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 take advantage of the medical insurance if the remedy availed is lower than a day at a hospital?

—Title withheld on request


In accordance with the coverage ‘hospitalization’ means admission to a hospital for at least 24 hours. A buyer can actually declare insurance coverage advantages if hospitalization has not occurred for twenty-four steady hours beneath outlined day-care procedures. Each medical insurance coverage covers specified procedures outlined beneath day-care procedures listing, which don’t require 24 hours hospitalization. As a consequence of developments in medical know-how day-care remedies will be availed, which in any other case would require 24 hours hospitalization. Some frequent remedies which can be coated beneath the day-care listing are chemotherapy, cataract, and radiotherapy. 


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

—Title 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 needs to be intimated to the insurance coverage firm. It’s 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 Common Insurance coverage. Queries and views at mintmoney@livemint.com.


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