MoneyLens / Health insurance
Your health cover, explained.
Tapti Health Plus · Tapti General Insurance Ltd
Illustrative
Health · Family floater · Policy held
Policy 10 Feb
Sum insured
₹5,00,000
+ ₹50,000 bonus
On an example bill
₹88,000
you pay, of ₹2,28,000
Room rent
₹5,000/day
other charges cut above it
Waiting until
10 Feb 2027
named illnesses and procedures
₹5,00,000 shared by You (41), Spouse (39), ₹21,800 a year. 4 conditions decide what's paid. On the example bill of ₹2,28,000, the policy would pay about ₹1,40,000. The insurer decides what's admissible on a real claim.
Myra's most important observations
Prefilled from your documents · edit freely
Hospital bill: what the policy would pay
Prefilled from CIS p.1, Room rent · CIS p.2, Sub-limits
₹10,000
4
₹1,20,000
₹40,000
₹20,000
₹0
₹8,000
₹0
0
The bill
₹2,28,000The policy would pay
₹1,40,000if admitted in full
You pay
₹88,00039% of the bill
| Step | Taken off | Left |
|---|---|---|
| The bill | — | ₹2,28,000 |
| Consumables not paid Gloves, masks, PPE kits and similar items aren't paid without a consumables cover. | −₹8,000 | ₹2,20,000 |
| Room rent above the limit The policy pays the room rent up to its limit a day; the rest of the room rent is yours. | −₹20,000 | ₹2,00,000 |
| Proportionate cut on room-linked charges Doctors', surgeons', OT and nursing charges are paid in the same proportion as the room rent. Medicines, implants, diagnostics and ICU charges aren't cut. | −₹60,000 | ₹1,40,000 |
Assumptions & limits. The policy's own limits: room ₹5,000 a day, ICU ₹10,000 a day. Order: non-payable items, room rent and the proportionate cut (only on room-linked charges; never medicines, implants, tests or ICU), ICU limit, the treatment's cap, deductible, co-pay, then the ₹5,50,000 available. The whole bill is taken as admissible, for a covered illness past every waiting period, and the hospital's charges vary by room. The insurer decides on a real claim.