The day I had to use my hospitalisation insurance for my daughter
As an agent, I have processed many claims for my clients. Most times, they are successful, but sometimes, they end up being rejected due to various reasons. When a claim gets rejected, I can feel the frustration and, in some cases, the disappointment faced by my clients. I always try my level best to ensure that the claims officer gets the full picture and appeal for the claims that get repudiated, in the hope of getting a better outcome. Even though my family has our own hospitalization coverage, I have never had to face my own claim due to hospitalisation. However, though the year had only just begun, 2021 ended up being the year where I had to use our hospitalisation coverage for my daughter Ria.
A couple of weeks ago, my son Dhruv got sick. Thanks to Covid, the occurrences have reduced dramatically as compared to when he first started school. Most likely due to better hygiene practices in the school. He had a fever and a bad cold and had to be given an MC of 5 days. Since he had to be kept home, it was quite hard to separate both kids. Eventually, Ria also fell sick. And then I too fell sick. The week prior, Ria had taken the MMR vaccine (Measles, Mumps and Rubella). The doctor had mentioned that she might get a high fever, as a result, the following week. One Saturday morning, she got up with a 39.6-degree fever. Not only was she burning up, but she was also inconsolable. She had a low appetite and was extremely clingy. I immediately texted my paediatrician who was concerned that the fever was rising from a low degree fever (between 37.5 and 38-degrees) to the one that it was. She advised me to bring Ria in and told me that it might be best to admit her into the hospital so that they could run the required tests. We had a urine test, a blood test and even a Covid 19 swab test!
As a parent, when your child gets sick, you want to be able to do everything in your power to make them feel instantly better. At the hospital, I felt completely powerless and at a loss of what I could do.
I can still remember Ria crying till her voice got coarse when they brought her to do her blood test as well as to insert an IV line (FYI, you are not allowed into the room). When she came out with the tapes all over her little hand, my heart sank.
The only upside was that she would begin getting the nutrients her body so desperately needed.
The night stay was tough. I had to sleep with Ria in the bed desperately trying to avoid disturbing the IV drip lines. Nurses came in almost every hour or two to check on her temperature as well as blood pressure and each time Ria would be unsettled and start crying thus disrupting her night sleep. Around 2 am that morning, I woke up due to a cramp from how I was sleeping. I then noticed that the bed was wet and figured that the diaper had leaked. Imagine my horror when I realised that it was due to the IV line being ripped, and there was a drop of blood on the bed too! Thankfully, it had been several hours with the drip, and the nurses said they could already remove it. Phew!
The lab results showed that she was battling an infection but the source of which was unknown. No UTIs nor Covid thankfully. We did not need antibiotics or fever medication since she did not have any fever since admission. So apart from the IV drip, nothing else was given to her. However, her white blood cell and neutrophil levels were low and we were told to keep her home for the rest of the week and restrict people visiting our home. Since the episode, she has had to get another blood test to determine what her neutrophil levels are with another one scheduled in a month. And, this brings me to my claim.
Since our Paediatrician is located at Parkway East, it was only natural to admit Ria into Parkway East Hospital. We stayed all of 1 day and had a blood test, a urine test, a Covid swab test and an IV administered. There was also a surcharge given that it was the weekend.
As an agent, it came as no surprise when I saw the final bill. As a parent, however, I was mortified! The total bill was $2991.35. Yes, I am stating the exact figure because I could not comprehend how a 1-night stay came up to that much, especially for a tiny human!
At the end of the day, I would have paid the amount just to be sure she was safe and healthy. Thankfully, we had taken a hospitalization policy for Ria after 15 days of birth. So this admission into the hospital was covered. We had to pay the 5% deductible given that her plan was purchased after the government regulations kicked in. To mitigate this, I had added a plan to include daily hospital income benefit. So my bill ended up being fully covered in the end. It was even settled within 6 days!
As an agent and a parent, I was relieved. It also made me realise that most people end up being clueless as to what to do in the event of a hospitalization. You become so caught up in the chaos of wanting to make your child feel better that sometimes you forget what to do. As such, I have come up with a checklist for you to make it easier!
Things to remember for hospital claim :
Call your agent, check if your policies are still in effect and if there are any exclusions to your policy: Sometimes due to non-payment etc, policies might lapse! And exclusions on your existing policies might prevent you from claiming fully)
Find out the coverage type you have: Private? Restructured? Ward Type?
Find out how much coverage you have: Is it fully covered? Is it a plan where you have to pay a 5% deductible? Does it pay a daily benefit? Do you need to choose a panel doctor or call a hotline to schedule the hospitalisation?
Do an e-file with your insurer: The hospital administration should be able to help do this. If it cannot be done (due to your policy duration being too short or you are a foreigner etc.) then you should retain ALL your receipts to do a manual claim.
Retain ALL your receipts: For both Pre and Post hospitalization. Most insurers have a provision for this too.
Remember, at the end of the day, it is inevitable to seek medical attention when it is required. Being adequately covered means that we choose to stay vigilant as we can never take our health or the health of our love ones for granted. I hope that you never have to go through what I went through and that this article has been informational. If you have any further questions, you can send me a message in the contact box below. Be well! 😊
