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Ayurveda Hospitalization & Insurance: What Policyholders Must Know
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Moneycontrol•21-09-2026, 13:29
Ayurveda Hospitalization & Insurance: What Policyholders Must Know
- •Health insurance coverage for AYUSH treatments (Ayurveda, Yoga, Naturopathy, Unani, Siddha, Homoeopathy) is subject to policy terms and conditions, and not all Ayurvedic facilities qualify as AYUSH hospitals under IRDAI definitions.
- •Before admission, policyholders must verify if AYUSH hospitalization is covered, check for limits or exclusions, and understand that waiting periods or pre-existing disease clauses still apply.
- •Maintain thorough documentation including prescriptions, admission/discharge records, diagnosis, treatment notes, and itemized bills; obtain pre-authorization for cashless treatment.
- •If a claim is rejected, demand a specific reason with reference to policy conditions; insurers must settle or reject claims within 30 days of receiving all necessary documents.
- •If unsatisfied with the insurer's response, escalate the complaint to their Grievance Redressal Officer and then to IRDAI's Bima Bharosa system if unresolved.
Key Questions Answered
IRDAI defines an eligible AYUSH hospital by requirements including appropriate registration, at least five inpatient beds, a qualified AYUSH medical practitioner on duty round the clock, dedicated treatment facilities, and accessible patient records.
If an insurer denies a claim, IRDAI guidelines require them to specifically state the reasons and reference the relevant policy conditions rather than issuing a vague rejection.
Policyholders should request the rejection letter and exact clause cited, compare it with hospital records and policy wording, submit any missing documents in writing, and escalate unresolved complaints to the insurer's Grievance Redressal Officer or IRDAI's Bima Bharosa system.
