here. If there is a sub-limit on rooms and the policyholder occupies a room with a higher tariff, the proportionate deductions, which are applicable, will not include the cost of the listed expenses.“The regulator has asked insurers to define the associated medical expenses which will be deducted proportionately.
Insurers will have to negotiate with the healthcare providers in their network to see that the increase in rates of the associated costs due to change in room category are under control," said Bhaskar Nerurkar, head-health claims, Bajaj Allianz General Insurance Co Ltd.Until now, when a policyholder would go for a room with higher tariff, the insurer would apply proportionate deduction on all costs.