Health Insurance Primers

Miscellaneous Health Insurance FAQs


Wednesday 05 December 2007

How is a hospital defined with regards to the health insurance policies?

Any institution established for indoor care and treatment of sickness and/or injuries, which is duly registered and supervised actively by a registered medical practitioner.

OR

Any establishment that satisfies the following criteria can qualify as a hospital:

  • With at least 15 patient beds
  • With a fully equipped operation theater of its own if surgical procedures need to be carried out
  • Employing fully qualified nursing staff around the clock
  • Having fully qualified doctors in charge around the clock

Note:

For Class 'C' towns, the number of beds is relaxed to ten.

Ayurvedic or institutions practicing alternative medicine therapy also qualify as hospitals.


What is meant by hospitalization?

An instance where the insured individual is hospitalized for a minimum period of 24 hours can be termed as hospitalization.

Specific treatments like dialysis, chemotherapy, radiotherapy, laser eye surgery, dental surgery, etc when the patient is discharged on the same day are also considered hospitalization.


What is 'Any one illness' with reference to health insurance policies?

'Any one illness' would mean the continuous period of illness, including relapse within 45 days from the last consultation with the hospital where the treatment was taken.


See also:

Health Insurance FAQs about Coverage

Health Insurance FAQs about Claims

Health Insurance FAQs about Premiums


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