Latest news with #Mediclaim
Mint
22-05-2025
- Health
- Mint
Why that deluxe hospital room could cut your insurance cover by 50%
Health insurance is meant to offer peace of mind—but a hidden clause called room rent limit can wipe out that comfort at the time of claim settlement. Most policyholders—and even some professionals—overlook this critical fine print, assuming it's a minor cost difference. But that assumption can cost you lakhs. Mint breaks down how this clause works, why it's so dangerous, and how you can avoid financial shock. Also read: In charts | The health insurance puzzle: 83% Indians aware but only 19% covered What is a room rent limit? Every health insurance policy specifies the type of room it covers—like a shared ward, single room, or sometimes, simply a price cap. Some plans don't mention a room type directly but instead set a daily spending limit. For example, your policy might say 'room rent and ICU covered up to 1% and 2% of the sum insured (SI), respectively.' Let's break that down: If your policy's total coverage (sum insured) is ₹10 lakh, your daily room rent limit could be ₹10,000 (1% of SI). Your daily ICU limit could be ₹20,000 (2% of SI). Other insurers might simply state a fixed maximum amount, like 'up to ₹5,000', regardless of your total sum insured. You might think if your room limit is ₹5,000 and the hospital room costs ₹8,000, you'll just pay the ₹3,000 difference. If you stay for 5 days, you'd expect to pay an extra ₹15,000 ( ₹3,000 x 5 days). However, this is where most people get surprised! Health insurers often don't clearly state in the policy that the room rent limit doesn't just apply to the room itself. It also applies to many other hospital expenses that are linked to the type of room you choose. This means if your room rent is higher than your limit, a much larger portion of your bill might not be covered, not just the room rent difference. Also read: Coming soon: Mediclaim cashless approval in an hour; claim settlement in 3 hours Why room rent limits are deadly If your policy has a room rent limit, the proportionate deduction will not just apply on the room rent, but also on additional expenses such as doctor's visits, surgeon's fees, anaesthetist, operation theatre (OT) and nursing charges, among others. So, if your room rent limit is ₹5,000 and the actual room cost is ₹10,000, the proportionate deduction factor will come in at 50%. All additional expenses linked to the room will get deducted by 50% when the insurance company will calculate the claim amount to be covered by the policy. CA Mayank Gosar shared a telling case: 'An individual with a policy that covered a single private room chose a single deluxe room, unaware of the difference," he said. The hospital bill for three days came to ₹36,000, but the insurer cleared only ₹23,400, a 35% deduction. 'This happened because the deluxe room wasn't covered under the policy. Charges like doctor visits and nursing tend to be higher in such rooms, leading to a proportionate reduction in the entire claim amount," explained Gosar. Also read: Why health insurance during and after pregnancy is essential Bill shock explained To illustrate, Mint created a sample hospital bill to explain the impact of the room rent limit better. Suppose you have a policy with a ₹5 lakh sum insured, a ₹5,000 room limit, and ₹10,000 ICU limit. You're hospitalised for five days—three in a room costing ₹10,000/day and two in an ICU charging ₹20,000/day. That triggers a 50% proportionate deduction (actual cost is double the policy cap). The insurer will apply this deduction on nearly all key expenses— ICU charges, room rent, nursing charges, surgeon fees, anaesthetist charges, OT charges, doctor visit charges, physiotherapy, blood transfusion, and OT equipment charges. Only medications (in-hospital) and diagnostics (USG, X-ray, labs) are paid in full. Consumables (like gloves, syringes) are often excluded unless you've bought a special rider. Result? Against a bill of ₹3.56 lakh, the insurer pays only ₹1.98 lakh, a deduction of 44%. What if you had a policy with no cap on the room rent limit? In that case, only ₹14,000 will get deducted from ₹3.56 lakh due to permanent exclusions, such as consumables (syringes, gloves), medical attendant charges, food and diet, and registration/admin charges, but other expenses will be covered fully. This is why you must avoid policies having room rent limits, otherwise your out of pocket expenses could be huge, irrespective of the sum insured in your health plan. Always opt for comprehensive health insurance policies without any sub-limits in the room rent. Practical limitations Suppose you have a policy of a base cover of say ₹10 lakh with no cap on the room rent. You get hospitalised and opt for a deluxe room. Your insurer may reject cashless approval saying you can only opt for a certain type of a room. If you still go for deluxe, it might make some deductions. This is because they find it impractical for a ₹5 lakh or a ₹10 lakh policyholder to opt for deluxe or a suite room. 'Insurance is a service, not a luxury," said Bhaskar Nerurkar, head of health administration team, Bajaj Allianz General Insurance. Explaining it further, Nikhil Jha, co-founder, Hercules Insurance Advisory, said if the same people are paying from their pocket, they are unlikely to opt for a deluxe but a normal ward because the former increases the total hospitalisation cost by 50-55%. "You buy insurance to cover the treatment cost, not for hotel-like services. From that angle, insurers are correct at taking this stance. If the base cover is high, say ₹50 lakh, one can opt for a suite, but a ₹5 lakh person doing it will not be justified," he said. Furthermore, policyholders should be aware that choosing an expensive room can deplete their coverage much faster, especially with extended hospital stays. Therefore, it's wise to be practical when selecting a room type, even if your policy doesn't have an explicit room rent limit, to ensure your coverage lasts for your actual medical treatment. Also read: The US' angst over health insurance: Lessons for India
Business Standard
17-05-2025
- Business
- Business Standard
More Than Money PayRupik is Lending Hope
Bengaluru (Karnataka) [India], May 16: In a world where access to credit can define opportunities, PayRupik has become more than just a loan app, it's a symbol of hope for millions. Backed by Sayyam Investments Pvt. Ltd., this digital lending platform is quietly reshaping financial access in India while supporting the communities that need it the most. Started in 2021, with a vision to facilitate financial welfare and to provide the finest credit services to all demographics of India, PayRupik has extended the reach starting from tier 2 and tier 3 cities to all core cities and districts in India, and emerged as a highly trusted lendtech platform with a rating of 4.4 star on Google play store, empowering over 5 million individuals with swift, hassle-free financial assistance. What sets PayRupik apart is its deep understanding of the Indian borrower's mindset, engineered to serve salaried professionals, gig workers, and small business owners , individuals who often struggle to secure credit due to documentation requirements, limited credit history, or lack of collateral. PayRupik offers a paperless and fully digital borrowing experience, allowing users to apply for and receive short-term personal loans directly via the mobile app. The approval process is supported by robust backend automation, ensuring that eligible users receive funds within minutes of applying. This speed and reliability have made PayRupik especially valuable during unforeseen emergencies like medical needs, utility payments, school fees, and more. Strategic Growth Backed by Vision The growth of PayRupik has been steady and focused, driven by the vision of Sayyam Investments Pvt. Ltd., a Non-Banking Financial Company (NBFC) that aims to make credit access simple and inclusive for all. With a deep understanding of India's evolving financial needs, PayRupik's expansion is rooted in thoughtful execution, prioritizing ease of use, minimal documentation, and quick processing to meet the growing demand for personal loans. Its user-first approach ensures that even individuals with limited financial literacy or banking access can comfortably apply for and receive short-term credit. As PayRupik continues to grow, Sayyam Investments remains focused on expanding its reach and strengthening its product offerings within the lending space. In a strategic partnership with Medscred, Sayyam has successfully extended medical financial assistance via MediClaim loans. With a simple application form, people across Bengaluru, Ahmedabad, Chennai and Hyderabad have been able to avail loans disbursed directly to hospitals, making the discharge process swifter than ever. With the success of Mediclaim loans, Sayyam plans to extend the medical financial support to individuals via a new product for IVF treatment - 'Care Now, Pay Later' in partnership with Medscred. Enabling Inclusion Beyond Lending Apart from promoting financial inclusion, Sayyam Investments also supports empowerment programs for communities across Tier 1, 2, and 3 cities and rural areas through their CSR initiatives. These efforts span education, environment, health, agriculture, and livelihood support joining hands with Rotary Bangalore South East Charitable Trust, Stem Learning, Stepahead Foundation, Finople Foundation, Vidya Nidhi Foundation, Shanti Sajal Research and Charitable Trust and Society For Rural and Urban Joint Activities, directly impacting lives at the grassroots level. The Company has taken part in various educational development programs across government schools and rural areas, reflecting on their commitment to empowering under-priviledge communities. Furthermore, in association with NGOs, their vision of supporting all sectors of the Indian public reflects on their initiatives towards women empowerment and rural healthcare development. Soon to open up to the people of Nawada, Bihar, Sayyam has extended support to develop a healthcare facility for the underserved, rural population of Nawada, ensuring that quality healthcare is accessible at the utmost convenience. The company believes that access to credit, when combined with education, healthcare, and livelihood creation, can lift entire communities into a cycle of self-reliance and growth. The Road Ahead As India rapidly digitizes and decentralizes its financial systems, Sayyam is well positioned to play a pivotal role in the Indian Lendtech Space. By expanding physical branches in Ahmedabad, Delhi, Kolkata, and Shillong and introducing offline loan applications, Sayyam is making credit more accessible, especially where it's needed most. With a customer-first approach and deep insight into user challenges, they're broadening their loan portfolio, rolling out new products with longer tenures and lower APRs. Upcoming partnerships with leading NBFCs aim to offer co-lending options, empowering users to compare and choose the best terms. In this evolving landscape, the synergy between PayRupik's agile digital model and Sayyam Investments' visionary leadership tells a powerful story — one rooted in innovation, empathy, and impact. PayRupik isn't just a lending platform; it's a catalyst for dreams and resilience across India.
Time of India
22-04-2025
- Business
- Time of India
I-T dept probing exaggerated exemption claims in returns by salaried persons
Nagpur: A number of salaried taxpayers have been issued notices since the start of the financial year by the income tax department, questioning the claims made in their returns. The taxman has initiated a drive probing the returns where unrealistic exemption claims were allegedly made by the taxpayers, said sources. Huge amounts were also shown in the 'other' exemptions column in the tax returns. Even though the taxmen have been taking up such cases from time to time, a concerted effort has been initiated now, said sources. The volume of such claims probed during the drive has also initiated a thought process to make the returns process more foolproof, said sources. The 'others' column covers a wide range of expenditure for which a salaried person can make a claim. These may not be specifically covered under any section in the returns format, said sources. The amounts claimed towards Mediclaim and education loans, specially by salaried assessees, are also under the scanner. The notices are for tax returns over and above those picked up for random scrutiny, said sources. They added that cases of fake returns were found mainly among private sector employees. The notices have been issued asking individuals to revise their tax returns. Those time-barred from filing revised returns, may have to update returns in which simply the additional liability has to be paid up, said the source. by Taboola by Taboola Sponsored Links Sponsored Links Promoted Links Promoted Links You May Like Trade Bitcoin & Ethereum – No Wallet Needed! IC Markets Start Now Undo Sources say that despite all efforts such modes do not help in saving tax beyond a certain limit due to the limits fixed in the tax laws. Even as the amount saved may not be very big, considering the total collections, the drive has been initiated to spread a message that no fake claims can go unchallenged. The taxpayers resort to such means hoping that their returns will not be picked up for scrutiny. Only a small portion of returns are taken up for scrutiny on random basis.
