Convalescence Benefit in Health Insurance

Posted on: Aug 18, 2023 | | Written by:

Convalescence Benefit in Health Insurance

Published on August 08, 2023. EST READ TIME: 3 minutes

Convalescence, in simple terms, refers to the period during which you recover from a severe illness, surgery, or injury. The convalescence period is as challenging as the duration of treatment or might be even more challenging. Treatment may take a day or two, but convalescence may take weeks. A patient might lose weeks’ worth of income due to hospitalisation, which might add to the already existing financial burden. This is where the convalescence benefit in health insurance policy saves the day.

What is convalescence benefit?

Convalescence benefit in your health insurance policy refers to the compensation for loss of income during the time spent recovering from an illness. Most health insurance companies provide this benefit, but the form may vary. As a policyholder, you need to pay attention to the policy details to figure out if this benefit is an integral part of your policy or if it is available as a useful add-on. The policy mentions the minimum period of recovery in the hospital, after which the patient can claim the convalescence benefits.

From where can you claim Convalescence Benefit?

If your health insurance policy does not originally include convalescence benefit, you have to avail of these benefits as an add-on. Without the add-on, you cannot claim the benefit. Once your hospital stay has exceeded the minimum number of days mentioned in the policy, you can claim the convalescence benefit. If your hospital stay exceeds the number of days mentioned in your policy, you will not be eligible to claim the benefits.

How much Convalescence Benefit can you claim?

The coverage provided under convalescence benefit may differ from policy to policy. The minimum period of hospitalisation required may also differ. For example, if your health insurance policy states you will receive convalescence benefits if you are hospitalised for a minimum of 15 days, you have to stay 15 days in the hospital to claim the benefits. If you get discharged after 10 days, you cannot claim convalescence benefit in health insurance. Some policies also cover compassionate visits by relatives under this benefit. In simple terms, if you are admitted to a hospital, and your family comes to visit you from far-off places, under convalescence benefit, you can also claim the conveyance expenses incurred by them.

When can I claim Convalescence Benefit?

Once you are sure that the benefit is included in your policy, or you have availed the add-on, you can only claim the benefit only if your recuperation at the hospital has exceeded the minimum number of days mentioned in the policy. If your hospital stay is less than this period, you are not eligible to avail of the benefits.

Example of Convalescence Benefit in medical insurance

Let us understand this benefit with the help of 2 examples.

Example 1

Mr Sinha, a marketing executive, gets hospitalised due to a sudden illness requiring surgery. After the surgery, he needs a recuperation period of 15 days at the hospital. He cannot join work leading to a loss of income. With the convalescence benefit included in his health insurance policy, he gets a pre-decided lump sum amount as compensation. This amount helps him and his family easily navigate the tough times.

Example 2

Mrs Reetika works in a bank and meets with an unfortunate accident that requires her to stay in the hospital for a month. While her job does cover some paid leaves, once that limit is over, she has to go with a loss of pay. With the convalescence benefit in health insurance that she had opted for while buying health insurance, she can avail of financial benefits that help her overcome the loss of salary.

Things to be aware of while buying Convalescence Benefit in Health Insurance

Here are some points you should be aware of before opting for convalescence benefit in health insurance to make an informed decision:

• There is a minimum stipulated period of hospitalisation beyond which you can avail of the benefit. This period depends upon the terms and conditions mentioned in your health insurance policy.

• You can avail of this benefit under an individual as well as group health insurance plan.

• Some insurance providers also cover compassionate visits by family members under this feature. You should go through the policy in detail to know whether it’s included in your policy.

• Convalescence benefit can also be availed of as an add-on if it is not already included in your health insurance policy.

• The convalescence benefit can be availed in addition to the medical coverage. It is also termed as a ‘Recuperating Benefit’.

Frequently asked questions

1. Is there any limit on the expenses that are covered under the policy?

The coverage provided varies from one insurance provider to another, but yes, there is a cap on the expenses of convalescence benefit. You need to read the terms and conditions carefully in order the understand the limit and make an informed decision.

2. Are convalescence expenses included in the standard health plan?

Some insurance providers may offer convalescence benefits as part of standard health insurance coverage, but mostly it is available as an add-on.

3. Is the benefit paid per day or as a lump sum amount?

The benefit is paid as a pre-decided lump sum amount.

Conclusion

Health insurance takes care of the treatment expenses, but what about the loss of income during the days spent in the hospital for recuperation? Well, to ensure you are compensated for the days when you are unable to work, convalescence benefit in health insurance can help you from facing financial hurdles. If your best health insurance policy does not have convalescence benefit, it’s advisable to opt for it as an add-on so that you can be stress-free not just during the treatment but even during the recovery phase. You and your family can concentrate on your recovery without worrying about the financial strain.

Disclaimer: The above information is for illustrative purposes only. For more details, please refer to policy wordings and prospectus before concluding the sales.

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