29/04/2021
No Room Rent Capping and No Room Category Limit – All You Need To Know!!
What is Room Rent Capping?
Earlier most policies used to put a limit on Room Rent as 1% of the Sum Assured which means the room you can rent in a hospital cannot be more than 1% of the Sum Assured. For eg: If the policy value is Rs. 2 Lacs then you can rent a room with rent of Rs. 2000 and if the rent is higher you will have to pay the difference from your own pocket and also, the hospital bill will be settled pro-rata basis the room rent eligibility.
Imagine someone gets admitted to a hospital and gets a room with a rent of Rs. 5000 per day but his policy is only of Rs. 2 Lacs. Most earlier policies used to have a room rent capping of 1% of Sum Assured due to which this client will only get Rs. 2000 per day as room rent and additionally, all his bills would be settled pro-rata at 40% (Rs.2000/5000*100) leaving a big hole in his pocket.
This is where No Room Rent Capping is of huge benefit, where even in such a case, he will still get his bill settled as per the actual room rent and all his other hospitalization bills will be settled 100%. This is where No Room Rent Capping is a real benefit.
However, did you know that even with No Room Rent Capping, you can be at a disadvantage in many other cases. Imagine, someone has a policy of Rs. 5 Lacs in the same case with No Room Rent capping and is admitted for a treatment which might not cost him more than Rs. 1 Lac overall, can he go for the best room in the hospital? I am sure you are aware that all hospitals have rooms starting from Single private room to Deluxe to Super Deluxe to Luxury Rooms. This person cannot rent the best room despite no room rent capping because in most policies, there is a capping on Room Category where it is specified that the person can only book a Single Private Room. If he rents a room higher than Single Private Room, then he will have to bear the difference in the room rent and also the hospital bill will be settled pro rata.
So, while No Room Rent Capping is definitely a Real Benefit, you need to ensure there is no limit on the Room Category also. This helps you to customize your treatment and room category depending on what treatment you are seeking and helps you get the best treatment in the best possible way and with maximum comfort. This is very important for HNIs who want the best treatment possible with maximum comfort but end up buying a policy with No Room Rent Capping but a limit on Room Category.
So, go ahead and check if your Health Insurance has a Room Category Limit or not. If yes, then you may want to upgrade or port your existing policy to a policy with no Room Rent Capping and No Category Limit.