Day Care Treatment
Day Care Treatment in health insurance refers to medical procedures or surgeries that require hospitalization for less than 24 hours due to advanced technology and modern medical practices. Traditionally, insurance coverage applied only when the patient stayed in the hospital for at least a full day, but with day care coverage, shorter-duration treatments are also included. Examples include cataract surgery, dialysis, chemotherapy, tonsillectomy, lithotripsy (kidney stone removal), endoscopy, and certain ENT or orthopedic procedures. These treatments are performed under specialized care and may still involve anesthesia, operation theatre charges, and post-procedure monitoring, even though the patient is discharged the same day. Day care treatment coverage ensures that policyholders are not denied claims simply because the hospital stay was short, making health insurance more aligned with modern medical advancements and reducing out-of-pocket expenses for such procedures.
Why Choose Insurance Mart.
At Insurance Mart, we are not insurance sellers — we are your trusted advisors, committed to protecting your interests, not an insurer’s profit. Our role begins long before you face a claim and continues until every issue is resolved to your satisfaction. We decode complex policies into simple, clear terms, ensuring you understand every clause, limit, and exclusion before committing. We select and recommend plans only after analysing your unique needs, claim history, and risk profile — so you get coverage that truly works when you need it most. When a claim arises, we become your dedicated partner, handling documentation, liaising directly with insurers and TPAs, and pushing for fair, timely settlements. We also review and audit policies annually, negotiating better coverage and cost efficiency for the future. With Insurance Mart, you get expertise, transparency, and unwavering support — because in times of uncertainty, you deserve more than a policy, you deserve a partner
How Insurance Mart Advisors Resolve These Issue
Insurance Mart Advisors resolve day care treatment issues by taking a proactive, hands-on approach from the very beginning. We first verify whether the planned procedure is covered under the insurer’s approved day care list, eliminating the risk of claim rejections due to non-listed treatments. Before hospitalization, we brief the patient or HR/admin team on the exact documents required — such as prescriptions, discharge summaries, bills, diagnostic reports, and hospital registration proof — and ensure they are complete and accurate. During the claim process, our team directly coordinates with the insurer or TPA, clarifying medical coding, resolving queries, and pushing for speedy approvals. In cases of disputes, we present strong documentation and policy interpretations to secure fair payouts. Beyond individual claims, we also analyse frequently used treatments within the group and negotiate during policy renewals to include more relevant day care procedures, ensuring broader coverage and fewer future disputes.
Required Documents for Policy Setup
Claim rejection because the procedure is not on the approved day care list
Partial payments due to misunderstanding room rent or consumables coverage
Missing hospital or doctor documentation
Confusion between OPD and day care (OPD generally not covered)
Common Problems Faced
Claims partially paid or rejected due to hidden exclusions
Delays in claim settlement due to incomplete documents
Confusion about what’s covered (room rent limits, pre-existing diseases, maternity benefits, etc.)
Lack of clarity in adding/removing members during the policy term
