Healthcare Insurance
Claim case sharing
Hospital Cash Insurance – Period of Hospital Confinement
Mr. Wong took out a hospital cash insurance policy with ABC Insurance Company in March 2018. He slipped at home and was admitted to hospital at 9.00pm on 5 May 2018. He was discharged at 10.00am the next day after treatment. He then filed a claim with his insurance company.
Question:
Can Mr. Wong successfully claim for the hospital cash benefit?
Answer:
Mr. Wong was confined to the hospital for 13 hours. According to the Hospital Cash Insurance policy, “the Insured Person must be confined for a continuous uninterrupted period of at least 24 hours upon the advice of, and under the regular care and attendance of, a physician. The confinement should be in a hospital for which the hospital makes a charge for room and board (unless the charge is waived)”. Although Mr. Wong fulfilled the latter part of the abovementioned clause: to pay for the room and board charges, he failed to fulfil the former part: to stay for a continuous period of 24 hours. Therefore, Mr. Wong was not entitled to the hospital cash benefit.
Customers sometimes misunderstand that hospital cash benefit will be paid when they are admitted to hospital no matter how long they are confined. Customers are advised to read the terms and conditions of the policy carefully or contact their insurance representative for clarification of their own policies.
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