Common use of Domiciliary Treatment Clause in Contracts

Domiciliary Treatment. We will cover Medical Expenses of an Insured Person which are towards an Illness/accident or injury which in the normal course would have required Hospitalisation but is taken at home on the advice of the attending Medical Practitioner, under the following circumstances: i. The condition of the Insured Person does not allow a Hospital transfer; or ii. A Hospital bed was unavailable; Provided that, the treatment of the Insured Person continues for at least 3 days, in which case the reasonable cost of any Medically Necessary treatment for the entire period shall be payable. (a) If a claim has been accepted under this Benefit, the payment for Post-hospitalisation Medical Expenses shall not be payable. (b) We will however pay for Pre-hospitalisation Medical Expenses up to 30 days in accordance with Section II.2 above. (c) We shall not be liable under this Policy for any Claim in connection with or in respect of the following: i. Asthma, bronchitis, tonsillitis and upper respiratory tract infection including laryngitis and pharyngitis, cough and cold, influenza, ii. Arthritis, gout and rheumatism, iii. Chronic nephritis and nephritic syndrome, iv. Diarrhoea and all type of dysenteries, including gastroenteritis, v. Diabetes mellitus and Insipidus, vi. Epilepsy, vii. Hypertension, viii. Psychiatric or psychosomatic disorders of all kinds, ix. Pyrexia of unknown origin. All Claims under this benefit can be made as per the process defined under Section VII 5.

Domiciliary Treatment. We will cover Medical Expenses of an Insured Person which are towards an Illnessa Disease/accident Illness or injury Injury which in the normal course would have required Hospitalisation but is taken at home on the advice of the attending Medical Practitioner, under the following circumstances: i. The condition of the Insured Person does not allow a Hospital transfer; or ii. A Hospital bed was unavailable; Provided that, the treatment of the Insured Person continues for at least 3 days, in which case the reasonable cost of any Medically Necessary treatment for the entire period shall be payable. (a) If a claim has been accepted under this Benefit, the payment for Post-hospitalisation Medical Expenses shall not be payable. (b) We will however pay for Pre-hospitalisation Medical Expenses up to 30 days in accordance with Section II.2 above. (c) We shall not be liable under this Policy for any Claim in connection with or in respect of the following: i. Asthma, bronchitis, tonsillitis and upper respiratory tract infection including laryngitis and pharyngitis, cough and cold, influenza, ii. Arthritis, gout and rheumatism, iii. Chronic nephritis and nephritic syndrome, iv. Diarrhoea and all type of dysenteries, including gastroenteritis, v. Diabetes mellitus and Insipidus, vi. Epilepsy, vii. Hypertension, viii. Psychiatric or psychosomatic disorders of all kinds, ix. Pyrexia of unknown origin. All Claims under this benefit can be made as per the process defined under Section VII 5.

Domiciliary Treatment. We will cover Medical Expenses of an Insured Person which are towards an Illnessa Disease/accident Illness or injury Injury which in the normal course would have required Hospitalisation but is taken at home on the advice of the attending Medical Practitioner, under the following circumstances: i. The condition of the Insured Person does not allow a Hospital transfer; or ii. A Hospital bed was unavailable; Provided that, the treatment of the Insured Person continues for at least 3 days, in which case the reasonable cost of any Medically Necessary treatment for the entire period shall be payable. (a) If a claim has been accepted under this Benefit, the payment for Post-hospitalisation Medical Expenses shall not be payable. (b) We will however pay for Pre-hospitalisation Medical Expenses up to 30 days in accordance with Section II.2 above. (c) We shall not be liable under this Policy for any Claim in connection with or in respect of the following: i. Asthma, bronchitis, tonsillitis and upper respiratory tract infection including laryngitis and pharyngitis, cough and cold, influenza, , ii. Arthritis, gout and rheumatism, iii. Chronic nephritis and nephritic syndrome, iv. Diarrhoea and all type of dysenteries, including gastroenteritis, v. Diabetes mellitus and Insipidus, vi. Epilepsy, vii. Hypertension, viii. Psychiatric or psychosomatic disorders of all kinds, ix. Pyrexia of unknown origin. All Claims under this benefit can be made as per the process defined under Section VII 5.