Working of medical insurance

Hospitalisation Expenses,
a. Room Rent, boarding and nursing expenses actually incurred subject to a cap of Rs. 5000 per day for
Rs. 5,00,000 Threshold and Rs. 8000 per day for Rs. 8,00,000 Threshold.
b. Intensive Care Unit (ICU) / Intensive Cardiac Care Unit (ICCU) expenses actually incurred subject to a
cap of Rs. 10,000 per day for Rs. 5,00,000 Threshold and Rs. 16,000 per day for Rs. 8,00,000
Threshold .
c. Surgeon, Anaesthetist, Medical Practitioner, Consultants, Specialists Fees.
d. Anaesthesia, Blood, Oxygen, Operation Theatre Charges, Surgical Appliances, Medicines & Drugs,
Dialysis, Chemotherapy, Radiotherapy, Artificial Limbs, Cost of Prosthetic devices implanted during
surgical procedure like pacemaker, Relevant laboratory / Diagnostic test, X-Ray and other medical
expenses related to the treatment.
e. Hospitalization expenses (excluding cost of organ) incurred on the donor during the course of organ
transplant to the insured person. The Companys liability towards expenses incurred on the donor and
the insured recipient shall not exceed the Sum Insured of the insured person receiving the organ.
f. Get Well Benefit of Rs. 5000 for Rs. 5,00,000 Threshold and Rs. 8000 for Rs. 8,00,000 Threshold, will
be paid for Any One Illness. This benefit will be payable only for the first four admissible claims under
the Policy. This benefit will reduce the Sum Insured.
g. Ambulance service expenses actually incurred subject to cap of Rs. 5000 for Rs. 5,00,000 Threshold
and Rs. 8000 for Rs. 8,00,000 Threshold. Payment under this benefit will reduce the Sum Insured.
Ambulance charges will be paid once for Any One Illness for each Insured.
h. Hospital cash will be paid at the rate of Rs. 500 per day for Rs. 5,00,000 Threshold and Rs. 800 per
day for Rs. 8,00,000 Threshold; maximum for 10 days for Any One Illness.This benefit will reduce the
Sum Insured. Hospital cash will be paid for completion of every 24 hours as a day but not part thereof.
i. Payment of any claim relating to Cataract for each eye shall not exceed Rs.50,000/.
j. AYUSH Treatments are payable provided the treatment has been undergone in a government
hospital or in any institute recognized by government and/or accredited by Quality Council of
India/National Accreditation Board on Health.
Expenses on Hospitalisation for minimum period of 24 hours are admissible. However, this time limit is not
applied for some specific treatments like Dialysis, Chemotherapy, Radiotherapy, Eye surgery, Dental
Surgery, Lithotripsy (Kidney Stone removal), D & C, Tonsillectomy or where treatment involves
technological advances necessitating hospitalisation for less than 24 hours.
No payment shall be made for any Hospitalisation expenses incurred, unless they form part of the Hospital
Bill. However, the bills raised by Surgeon, Anaesthetist directly and not included in the Hospital Bill shall be
paid, provided a numbered Bill is produced in support thereof, for an amount not exceeding Rs. Ten
thousand, where such payment is made in cash and for an amount not exceeding Rs. Twenty thousand,
where such payment is made by cheque
Note: Procedures/treatments usually done in outpatient department are not payable under the policy even
if converted as an inpatient in the hospital for more than 24 hours or carried out in Day Care Centres.
http://indianexpress.com/article/india/india-others/govt-to-provide-rs-30000-worth-free-
treatment-for-accident-victims-on-highways/

Government proposes to provide free treatment worth Rs 30,000 for accident

victims on national highways all over the country in a phased manner.
Currently the pilot project is running on the 226 kilometre Gurgaon-Jaipur stretch
and has now been extended to Mumbai-Baroda and Ranchi-Jamshedpur link, a top
official said on Saturday.
Under the pilot project on the busy GurgaonJaipur NH-8 stretch, Ministry of
Road Transport & Highways had provided financial assistance of Rs 30,000 for the
victim of road accidents for medical treatment, Road Secretary Vijay Chibber
said.
He was speaking at a seminar organised jointly by the ministry and International
Road Federation (IRF) here.
After completion of the two new projects on Mumbai-Baroda Highway and
Ranchi-Jamshedpur Highway, it is proposed to be extended to the entire stretch of
National Highways in the country at an annual cost of Rs 500-600 crore, he added.
This will work as insurance for using highways for the road users, he said while
calling on the health and motor vehicle insurance companies to come out with
packages for the new projects.

India leads the world in road accident deaths, with around 1,50,000 people being killed each year.
There is one fatal accident every 3.7 minutes, which means 16 people die every hour and 390 every
day, K K Kapila, Chairman, International Road Federation (IRF) said.

https://www.quora.com/Is-there-any-Indian-law-to-provide-immunity-to-the-person-who-helps-a-
victim-in-a-road-traffic-accident-or-other-accidents

1. Pt. Parmanand Katara v. Union Of India & Ors:

"Every injured citizen brought for medical treatment should instantaneously be given
medical aid to preserve life and thereafter the procedural criminal law should be allowed
to operate in order to avoid negligent death. There is no legal impediment for a medical
professional when he is called upon or requested to attend to an injured person needing
his medical assistance immediately. The effort to save the person should be the top
priority not only of the medical professional but even of the police or any other citizen
who happens to be connected with that matter or who happens to notice such an
incident or a situation.

Further, the court noted: "The treatment of the patient should not wait for the arrival of
the police or completion of legal formalities. All hospitals and doctors are required to
provide immediate medical aid to all the cases, whether medicolegal or not

2. S. Rajaseekaran v. Union of India: The Supreme Court laments the high number of
road accidents in India. It complains about the lack of awareness of Supreme Court's
directives (see above) regarding emergency care to victims and legal protection to
samaritan who offer their help.

List of functionalities
Info of each medicine along with side effects on the app or desktop application.
Medi-claim details of the patient.
243 hospitals in Mumbai have the cash less option in mediclaims.
Complete medical history as an entire body check-up will be done blood reports etc.
All drugs previously used or current medication the patient is on will also be displayed.
The name of the doctor prescribing the medication along with the date of prescription will
be available.
The data base will be centralized allowing only authorised doctors who can access data of a
patient he has treated via finger print.
Registered hospitals will have patients records maintaining security standards.

Sites for medicine descriptions

http://patient.info/in

https://www.drugs.com/medical_dictionary.html