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September 29, 2022 10:36 am

Convalescence Benefit in Group Health Insurance

Group health insurance policy has an inclusion known as the Convalescence Benefit. Convalescence is the resting period to get better after a medical procedure or from an illness or disease. The benefit given by a group insurance policy during the Convalescence period is known as the Convalescence Benefit.

Convalescence Benefit is given after a medical procedure or during the recovery period after a surgery. Convalescence Benefit in group health insurance https://www.ethika.co.in/group-health-insurance can be understood as a fixed amount of money given for a fixed period of time to help recover the insured after a medical procedure. The Convalescence Benefit is usually paid for a fixed period of time such as 10 days or 15 days and the amount would be on a per day basis multiplied by the total number of recovery days up to a maximum limit mentioned under the policy.

It is important to note that the Convalescence Benefit is given as a lump sum amount under the group health insurance policy. Most of the group health insurance policies limit the Convalescence Benefit payable to once in a policy period. Convalescence Benefit is paid in addition to the medical costs which would be paid from the base sum insured mentioned under the group health insurance policy.

There would be certain costs which would not be payable under the base sum insured of the group health insurance policy. If a person is hospitalized, he/she might lose out on the salary due to their inability to report to work or they might incur certain other expenses such as the food and lodging expenses of an attendee which would not be covered under the base sum insured of the group health insurance policy. This is where the Convalescence Benefit would come into play as it pays a lump sum amount for a fixed period of time.

Convalescence Benefit may be available as an inbuilt benefit or can be purchased as an add-on. There would be a minimum waiting period in the number of days before the hospitalization benefit is payable. For example if the policy mentions that the minimum number of days the insured should be hospitalized to avail Convalescence Benefit is 3 days then the benefit would be payable from the 4rth day up to a maximum number of days on a per day basis payable in lump sum as mentioned in the group health insurance policy.

For example Mr. V has enrolled under the group health insurance policy of his company which pays a Convalescence Benefit of Rs.100 per day for a maximum of 10 days and requires at least 3 days of hospitalization then in case Mr.V is admitted to a hospital due to an accident for 5 days then the Convalescence Benefit would be payable for 2 days as the first 3 days would be exempted for the payment. This way the claim would be payable under the Convalescence Benefit of group health insurance policy which benefits the insured customer.

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