Does the Limit of Hospital Room Rent Affects Your Insurance Claim?

At some time or the other, every person ends up visiting the hospital for treatment. Whether it is a minor accident, major illness, or admitting a relative, everybody knows the experience of getting treatment in a hospital. The most daunting part of this experience is when you need to pay the bill for the treatment.

The bill has to be paid after being treated in the hospital. This hospital bill includes services taken during stay and treatment. There are many things other than the treatment cost on the bill. One of the biggest expense out of those is room rent. When a person is covered after they buy health insurance online, the insurer settles the bill and some of us find it difficult to figure out how to calculate the room rent in the claim. This article sheds light on what room rent capping is and how it affects your insurance claim.

What is room rent capping in health insurance?

The capping or sub-limit on anything indicates its upper limit. The limit on room rent in health insurance is the maximum amount that your insurance company will pay for the room rent for each day you spend in the hospital. If the room rent exceeds the limit, you will have to bear the extra money at the time of claim settlement.

The insurance company states the room rent limit in the health insurance policy document for your reference. It may be a certain amount, for example, ₹ 15000, or a percentage, like 3% of the sum insured. It is also limited to a certain amount for each day of hospitalization.

For example, if you buy an individual health insurance policy with room rent limit of ₹15,000 and your friend buys an insurance policy with room rent with 3% of the sum insured. Now if the sum insured of your friend’s ​​health insurance policy is ₹ 5 lakhs, the room rent limit will be around₹ 15,000.

How Does a Room Rental Limit Affect Your Overall Health Insurance Claim?

When calculating the claim amount, the insurance company considers room rent and applicable capping as major components. The claim amount increases or decreases depending on the fact that you choose to stay in a room that is less than or equal to the room rental limit. You can learn more about this through your health insurance app.

What can you do?

In this situation, there can be two scenarios with your health insurance policy:

  • You are already covered under a policy with room rent capping

In this case, you might consider changing your health insurance plan or switching to a completely different insurance company. This can be done by porting the current plan to one without any capping for room rent. If you want to continue with your current plan, consider upgrading the sum insured of your health insurance policy. This will increase the room rent sublimit and give you space to choose the room you like without greatly affecting the health insurance claim amount.

  • You are looking for a new health insurance policy

Be sure to read all the documents related to the plan to get clarity on room rent limits. If you do not find any document information, we recommend that you contact the insurance company and ask if this is included in your plan.

The concept behind room rent is not commonly known and policyholders often feel cheated by getting a low claim amount. This is where the importance of reading the policy document, fine print, and terms and conditions is highlighted. A person unfamiliar with health insurance may have many questions regarding room rent, co-payments, sub-limits, etc. and will easily resolve those questions when asked by the insurance company.

For all your insurance & wellness needs, download ICICI Lombard’s ILTakeCare App, from Playstore & Appstore today.


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