What Does “Claim Protect” Mean in Health Insurance?

What is ‘Claim Protect’ Afterall?

It is an optional add-on offered by numerous health insurance companies in India. The objective of this rider is to cover all the expenses which are generally excluded from a regular policy. These include consumables like gloves, PPE kits, surgical masks, syringes, and even documentation or registration charges during hospitalization.

As mentioned before, these expenses might appear petty, but in prolonged treatments, the total amount can be quite substantial, thereby putting extra financial pressure on the policyholder. With “Claim Protect” in place, these additional expenses are reimbursed, reducing your out-of-pocket burden and making your claim settlement more comprehensive.

Why Standard Health Insurance Falls Short?

While purchasing a health insurance policy, we often concentrate on the network hospitals, coverage, number of people included, and the total value of the policy. We also ask questions about preexisting diseases and the ‘waiting period’. However, we often do not ask detailed queries about the exclusions, and while making the claim, we are often served with a substantial bill labelled ‘consumables’ or ‘non-medical items’.

In fact, RDAI guidelines list over 60 non-payable items from thermometers and cotton swabs to hospital stationery and attendant charges that are excluded from claim payouts. For instance, if you or anyone from your family is hospitalized for a period of 15-30 days, and the total bill amounts to ₹5 lakhs, there is a chance that the consumables would be close to 10-15% of the total amount, required to be paid out of pocket.

This is a massive blind spot which often becomes the cause of dispute and issues between the insurer and the policyholder. Standard plans focus on treatment but often ignore these hidden costs. That’s exactly the blind spot Claim Protect is built to address.

What Does It Usually Cover?

It generally takes care of a range of non-medical expenses excluded from the standard insurance policies. Some examples are:

The above costs can make up to 10-15% of the hospital bills, which Claim Protect could cover.

Claim Protect vs Room Rent Waiver vs No Claim Bonus

Here are the differences between the three popular add-ons and riders:

When Should You Opt for Claim Protect?

When you purchase a health insurance plan, a natural expectation is that you will not end up paying anything out of pocket in case of hospitalization or prolonged treatment. However, health insurance coverage often have a few loopholes which can be covered through add-ons.

You might want this add-on in the following situations:

• You have elderly parents or young children covered under your policy.

• You prefer private hospitals where non-medical costs are higher.

• You want to avoid last-minute surprises in your bill.

The total premium payable will slightly increase, but the overall benefits surpass the extra cost you incur annually. The total cost shall be 5-10% of your base premium, depending on your insurance company. However, the exact amount depends on various factors such as your sum insured, age, and the insurer’s pricing.

FAQs

• What is Claim Protect in health insurance?

It’s an add-on that covers non-medical, non-payable hospital expenses.

• Is Claim Protect available with all policies?

No, it’s offered by select insurers as an optional rider.

• Does Claim Protect increase premiums?

Yes, usually by around 5–10%, depending on your base plan.

• Are consumables like PPE kits covered?

Claim Protect covers consumables like gloves, PPE, syringes, etc.

• Is Claim Protect useful for daycare treatments?

It depends on the insurer, but it can apply if non-payable items are billed.