Page 151 - IC38 GENERAL INSURANCE

All expenses may not be payable and most products define the expenses
covered which normally include:

i. Room, boarding and nursing expenses as provided by the hospital /
nursing home. This includes nursing care, RMO charges, IV fluids / blood
transfusion / injection administration charges and similar expenses

ii. Intensive Care Unit (ICU) expenses

iii. Surgeon, anesthetist, medical practitioner, consultants, specialists fees

iv. Anesthetic, blood, oxygen, operation theatre charges, surgical
appliances,

v. Medicines and drugs,

vi. Dialysis, chemotherapy, radiotherapy

vii. Cost of prosthetic devices implanted during surgical procedure like
pacemaker, orthopedic implants, infra cardiac valve replacements,
vascular stents

viii.Relevant laboratory / diagnostic tests and other medical expenses
related to the treatment

ix. Hospitalization expenses (excluding cost of organ) incurred on donor in
respect of organ transplant to the insured

A regular hospitalization indemnity policy covers expenses only if the duration
of stay in hospital is for 24 hours or more. However with advancements in
medical technologies, treatment procedures for many surgeries do not require
hospitalization. Now as daycare procedures, they can be conducted at
specialized daycare centers or hospitals as the case may be. Treatments such as
eye surgeries, chemotherapy; dialysis etc. can be classified under daycare
surgeries and the list is ever growing. These are also covered under the policy.

Coverage of outpatient expenses is still very limited in India, with very few such
products offering OPD covers. However there are some plans that cover
treatment as outpatient and also related health care expenses associated with
doctor visits, regular medical tests, dental and pharmacy costs.

2. Pre and post hospitalization expenses

i. Pre hospitalization expenses

Hospitalization could be either emergency hospitalization or planned. If a
patient goes in for a planned surgery, there would be expenses incurred by
him prior to the hospitalization.

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