The Bharat Sookshma Udyam Suraksha Office Package Policy is a comprehensive plan designed to meet the unique needs of micro-enterprises in India. Unlike a standalone fire insurance or personal accident policy that you purchase separately, this policy allows you to get a wide range of relevant covers under a single policy umbrella. One such cover under this policy is Hospital Cash Daily Allowance. Let’s take a deep dive into this cover.
Hospital Cash Daily Allowance
In the event of person insured facing accidental bodily injury or illness that leads to their hospitalisation within the policy period, the insurance company may provide coverage under the Hospital Cash Daily Allowance. There are two primary components of this coverage for this type of general insurance:
For each continuous and completed period of 24 hours of hospitalisation necessitated solely by the accidental bodily injury or illness, the insurance company pays the insured a daily allowance.
Intensive Care Unit (ICU) Allowance
In cases where the insured or named insured needs to spend time in the ICU of a hospital due to the accidental bodily injury or illness, the insurance company provides two times the daily allowance for each continuous and completed period of 24 hours spent in the ICU.
The maximum period of coverage for daily allowance and ICU allowance is 7 days for each hospitalisation.*
It's important to note that this general insurance
cover has specific exclusions. The insurance company will not offer coverage for the following situations:
The policy does not cover any medical condition or complication arising from it, which existed before the policy's commencement or for which care, treatment, or advice was sought, recommended, or received from a physician.
Treatment not performed by a physician
Any treatment not performed by a qualified physician, or any treatment of a purely experimental nature is not covered.
The policy excludes various illnesses, except in the case of invasive malignant melanoma.
Illness classified as an epidemic
Any illness classified as an epidemic by the Central or State Government is not covered.
Certain surgeries and conditions
The policy excludes surgeries or treatments such as cataracts, benign prostatic hypertrophy, hysterectomy, menorrhagia, fibromyoma, and many others during the first year of a series of Daily Hospital Allowance Policies renewed without interruption.
Self-inflicted injuries, alcohol, and drugs
Injuries or conditions resulting from attempted suicide, or the use or misuse of drugs or alcohol are excluded.
Pregnancy and related conditions
Hospitalisation related to pregnancy, childbirth, caesarean section, and related pre and postnatal care is not covered.
The policy excludes claims arising from war, invasion, natural perils, and hazardous activities.
Radiation and non-allopathic treatment
Claims related to radioactive contamination and non-allopathic treatment are not covered.
When Making A Claim
In case of an insured event that may result in a claim, certain conditions must be met as a prerequisite to the insurance company's liability:
The insured or someone claiming on the insured's behalf must inform the insurance company in writing immediately and within 14 days of the event.
Consultation with a physician
The insured must consult a doctor or medical practitioner promptly and follow their advice and treatment recommendations.
Mitigation of consequences
The insured must take reasonable steps to minimise the consequences of any claim.
The insured may be required to have a medical examination by the company's medical advisors at the company's cost.
The insured or someone claiming on the insured's behalf must promptly provide the company with the necessary documentation and information to investigate the claim or make a payment.
Documents Required To Make A Claim
The specific documents required to make a claim under the Hospital Cash Daily Allowance included in this type of MSME insurance cover depend on the nature of the claim. Common scenarios where you may make a claim are:
- Permanent or Temporary Total Disability/Permanent Partial Disability
- Children’s Education Bonus
- Hospital Confinement Cover/Medical Expenses Reimbursement/Hospital Cash Daily Allowance
You may refer your policy documents or consult your insurance provider to get a better idea of what document. Claims are subject to terms and conditions set forth under MSME insurance policy.
The Hospital Cash Daily Allowance cover in the Bharat Sookshma Udyam Suraksha Office Package Policy is a valuable component that provides financial support to policyholders during hospitalisation due to accidental bodily injury or illness. While this cover offers important benefits, it's essential for policyholders to be aware of the exclusions and the conditions that must be met when making a claim. By understanding the policy's provisions and requirements, policyholders can make the most of their insurance coverage and ensure they receive the financial support they need during challenging times. Additionally, the option to enhance the sum insured provides policyholders with flexibility in tailoring their coverage to their specific needs.*
*Standard T&C Apply
Insurance is the subject matter of solicitation. For more details on benefits, exclusions, limitations, terms, and conditions, please read the sales brochure/policy wording carefully before concluding a sale.