Choosing a room rent limit is a very important step while buying your health insurance policy. A lot about this factor has been written widely by a lot of people. So, we will give out the gist of important things a customer should consider about room rent limit while purchasing a health insurance policy.
Room Rent limit is imposed in three different ways,
- Percentage of Sum Insured (1% or 2% of SI) per day. Limit on ICU charges are usually double the normal (ie., 2% or 4% of SI) per day.
- Category of Rooms: Maximum limit of ‘Single Private Room’ or ‘Twin sharing room’. Any category above this is not permitted.
- No Limits is another option. But, not exactly. It is applicable subject to a maximum per day limit of Rs.8,000/- or Rs.10,000/- or so.
What will happen if you choose or are forced to choose higher than this limit?
You are more likely to get into a situation of being forced to choose a higher room rent category than the allowed limit. In most cases, the hospitals are likely to say that they don’t have vacant beds within your limits and ask you to choose a limit/category higher than the allowed limit by your policy. In such cases, you will have to suffer a ‘Proportionate Deduction’ during claim settlement.
Proportionate Deduction:
Proportionate deduction means, all the differentially charged associated treatment charges will also be settled as per the ratio of room rent limit exceeded. This is well explained with an example.
Suppose, you choose a room rent of Rs. 5,000/- per day and against a limit of Rs.4000/- per day as per your policy, then usually all the treatment charges are also considered to be associated with the room rent charges. So, if your overall treatment bill is Rs.50,000/-, the claim settlement is expected to be approximately Rs.40,000/- after proportionate deduction.
Today, in any hospital, the minimum room rent charges are above Rs.2,000/- per day and usually for a medium to above comfortable room, it could cost up to Rs.5000/- per day. While choosing your health insurance plan, choose by the following priority,
- Go for plans that do not have any cap or limit on room rent.
- If not, look out for a single private room as the maximum applicable limit.
- In case of Room Rent being a percentage of SI, go for a limit of at least Rs.5,000/- based on your Sum Insured.
The above is suggested because the likelihood of availability of lower category rooms in hospitals is low and based on emergency, you will be forced to choose a higher category room and end up paying the difference from your pocket.