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Day Care treatment - "Day Care treatment" means treatment undertaken in a Hospital/ Nursing Home on the recommendation of a Medical Practitioner for the following diseases, illness or injury which requires hospitalisation for less than 24 hours and includes such of those treatments which require hospitalisation for less than 24 hours due to technologically advanced treatment protocol.
- a) Dialysis
- b) Radiotherapy
- d) Eye surgery
- e) Dental surgery
- f) Lithotripsy (kidney stone removal)
- g) Tonsillectomy
- h) Dilatation & Curettage
- i) Cardiac Catheterization
- j) Hydrocele surgery
- k) Hernia repair surgery
- l) Surgeries/procedures that require less than 24 hours’ hospitalization due to medical/ technological advancement and infrastructural facilities.
- m) TURP (Prostate Surgery)
Deductible - Deductible means, in respect of each and every claim, the amount stated in the Schedule which will first be paid by each Insured Person or apply for the period of time stated in the Schedule.
Dependent Child or Dependent Children - Dependent Child or Dependent Children means Your Children Aged between 91 days and 21 years at the commencement of the Policy Period if they are unmarried, still financially dependent on You and have not established their own independent households.
Disease - "Disease" means an alteration in the state of the body or of some of its organs, interrupting or disturbing the performance of the functions, and causing or threatening pain and weakness or physical or mental disorder and certified by a Medical Practitioner.
Doctor - Doctor means a person who holds a qualification in medicine from a recognized institution and is registered by state council, governed by the Medical Council of India in which he operates and is practicing within the scope of such license and will include (but is not limited to) physicians, specialists and surgeons who satisfy the aforementioned criteria.
Domiciliary Hospitalisation Benefit - DOMICILIARY HOSPITALISATION BENEFIT means Medical treatment for a period exceeding three days for such illness/disease/injury which in the normal course would require care and treatment at a hospital/ nursing home but actually taken whilst confined at home in India under any of the following circumstances, namely: i) The condition of the patient is such that he/she cannot be removed to the hospital/nursing home or ii) The patient cannot be removed to the hospital/nursing home for lack of accommodation therein Subject however that domiciliary hospitalisation benefits shall not cover: i) expenses incurred for pre and post hospital treatment, and ii) expenses incurred for the treatment for any of the following diseases: 1. Asthma 2. Bronchitis 3. Chronic Nephritis and Nephritic Syndrome 4. Diarrhea and all types of dysentries including Gastroenteritis 5. Diabetes Mellitus and Insipidus 6. Epilepsy 7. Hypertension 8. Influenza, Cough, and Cold 9. All Psychiatric or Psychosomatic disorders 10. Pyrexia of unknown origin for less than 10 days 11. Tonsillitis and upper respiratory tract infection including Laryngitis and Pharyngitis 12. Arthritis, Gout and Rheumatism Note: When treatment such as Dialysis, Chemotherapy, Radiotherapy is taken in the Hospital/Nursing Home/Clinic and the insured is discharged the same day the treatment will be considered to be taken under Hospitalisation Benefit section. Liability of the Company under this clause is restricted as stated in the Schedule attached hereto.
Domiciliary hospitalization - "Domiciliary hospitalization" means medical treatment for a period exceeding three days for any disease, illness or injury which in the normal course would require care and treatment at a Hospital/Nursing Home but is actually taken whilst confined at home in India under any of the following circumstances, namely: -
- a) The condition of the patient is such that he/she cannot be removed to Hospital/Nursing Home, or
- b) The patient cannot be admitted to Hospital/Nursing Home for lack of accommodation therein.
- a) Pre and post Hospital treatment,
- b) Treatment of any of the following diseases:
- i) Asthma
- ii) Bronchitis
- iv) Diarrhoeaandalltypesofdysenteries including astroenteritis
- v) Diabetes mellitus and insipidus
- vi) Epilepsy
- ix) Allpsychiatricorpsychosomaticdisorders
- x) Pyrexia of unknown origin for less than 10 days
- xi) Tonsillitis and upper respiratory tract infection including aryngitisandpharangitis