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Team AckoFeb 21, 2023
Sale of health insurance policies in India has spiked after the pandemic. People unaware of its benefits are now buying and recognising its need. One prominent feature of health insurance policy that most of us are unaware of is the Convalescence Benefit. In this article, we shed light on everything you need to know about the Convalescence Benefit in Health Insurance.
The Convalescence Benefit in health insurance refers to the time spent recovering from an illness. It is a useful add-on, as it is a compensation for loss of income incurred when you are hospitalised. Many Health insurance companies provide this benefit under health insurance. However, policyholders may need to pay more attention to the coverage and claim as it compensates for the loss of income from extended hospitalisation.
The policy reinstates that since sometimes you may require a prolonged time (8-10 days) to recover, which invites unsolicited medical expenses and loss of income, hence convalescence policy covers it.
The Convalescence Benefit in health insurance may not be a part of every health insurance plan. You must verify it with the insurance company and see the associated document. You may also buy it as an add-on by requesting it from your health insurance provider.
You can claim the benefit depending on the stipulated number of days mentioned in the policy. For example, if your health policy states that you will receive the Convalescence Benefit if you are hospitalised for ten days or more, then you can claim it only if you spend ten days in the hospital. You are not entitled to the benefit if you recover within five days.
Your policy should have this advantage as an inclusion in the policy document. If it is not stated or is part of the exclusions, you may not be able to make a claim. It can, however, be purchased as an add-on. In that case, the terms and conditions of the insurer will apply. The number of days beyond which you are permitted to use this benefit is also specified in the policy document.
For example, you cannot get this benefit if you are only hospitalised for five days and the benefit begins after ten days. So, be sure to read the health insurance policy document to understand the rules related to Convalescence Benefit. Then you can easily get this benefit along with the hospitalisation claim.
Here's an example that will help you to understand the policy in a better way.
Ms. A, a sales executive, is hospitalised due to some unfortunate accident. She is treated immediately, and the doctors advise her to rest for at least 15 days in the hospital. As a result, she cannot report to the office, and there is a loss of income. She receives Convalescence Benefits from the medical company to compensate for this loss of income. She received the benefit because her hospital stay lasted more than a week.
Mr. B owns a stationery shop in the city of Bangalore. He suffers a heart attack and gets hospitalised for 2 weeks. His shop remains closed for that duration. Without the Convalescence Benefit in his health plan, he would suffer a loss of income. He made a reimbursement claim for treatment expenses and received the payment under the Convalescence Benefit as well.
Note that the terms for availing this benefit may vary from one insurer to another.
Here are some things that you must know about before opting for the Convalescence Benefit in your health insurance plan.
The benefit is available for 7-10 days after hospitalisation, depending upon the terms and conditions mentioned in the health insurance policy.
The benefit is available to individuals and can be a part of group plans.
The benefit also includes the cost of family visits to the hospital. You can check the policy document to understand better what is included in it.
If the benefit is not included in the insurance plan, you can opt for an add-on by asking your insurance service provider.
The Convalescence Benefit is above the medical expenses incurred. It is sometimes referred to as a ‘Recuperating Benefit’.
Yes, different companies have different expense caps on Convalescence Benefit. Some insurance companies offer Rs. 1000/day for seven days, while others provide ten-day benefits. You need to read the coverages and terms mentioned in the documents to determine the exact benefit.
No, the benefit is not a part of standard health insurance coverage. It can be an add-on that is available with certain plans. You must go through the terms of the health plan to see if it covers Convalescence Benefits.
The Convalescence Benefit is known as a hidden benefit because most people are unaware of it. You can contact your insurer to check if such a benefit is included in your health plan, so that you can claim it when there is a need and get financial relief.
Yes, the benefit is paid as a lump-sum.
The cost of compassionate family visits is covered under the medical insurance plan under the ‘Compassionate Visit Coverage’. Such inclusion is mentioned in the policy document if it is applicable. Compassionate Visits are not a part of the Convalescence Benefit.
The Convalescence Benefit kicks in after a fixed number of days in the hospital. The expenses paid under this benefit will differ depending on the policy offered by the insurer. You can claim the benefit when you are hospitalised or when the minimum period for eligibility has been passed.
Yes, you can enter your details and search for policies with Convalescence Benefits. Find a plan that suits you and purchase the policy.
Disclaimer: The content on this page is generic and shared only for informational and explanatory purposes. It is based on industry experience and several secondary sources on the internet, and is subject to changes.
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