What is it?
The Health Claim Calculator estimates how much of a hospital bill your health insurance will pay and how much you will pay yourself. It shows each cut, such as room-rent limits, items not covered, co-pay and deductible.
Who is it for?
Anyone admitted to hospital with insurance, and families checking why a claim was cut.
How to use it
- Enter the Total hospital bill and Sum insured left.
- Enter the Room rent charged per day and the Room rent limit in your policy per day (0 if none).
- Enter the Part of the bill linked to room rent (doctor, nursing, tests), the Items not covered (gloves, masks, admin fees), and your Co-payment % and Deductible.
The room-rent trap
The calculator shows the “proportionate deduction” many policies apply when you take a costlier room than allowed: linked charges are cut in the same ratio. If your limit is ₹5,000 and you take an ₹8,000 room, linked charges like doctor fees and nursing may be paid at only 5/8. Medicines and implants are usually not cut.
Reduce the gap
- Ask the hospital for a room within your limit at admission.
- Check your policy for consumables cover (an add-on that pays for gloves, PPE and similar).
- Keep all bills and the discharge summary; ask the TPA for a written reason for each deduction, and escalate to the insurer’s grievance cell or the Insurance Ombudsman if it seems wrong.
Your policy wording decides the final amount.
Errors and how to fix them
- A result shows a dash (—): a box is empty or has something that is not a number in it, such as a comma or a letter. Type plain digits; use a dot for decimals.
- The insurer pays much less than the bill: look at Room-rent cut first. Choosing a room above your policy’s limit cuts most of the bill, not just the room charge.
- My insurer paid a different amount: policies have extra rules (disease-wise limits, waiting periods). Check your policy wording or ask the insurer’s TPA.
Open the tool: Health Claim Calculator
Still stuck?
Contact support. Tell us which tool or page you were using, what you tapped, what you saw, and your phone or computer and browser (for example: Android phone, Chrome). We reply by email.
Questions, or an error not listed here?
Tell us in the comments: what you were doing, the exact message you saw, and your device and browser. We read every comment and add new fixes to this article.