What is 24-Hour Hospitalisation Exclusion

Posted on: Jul 28, 2025 | 3 mins | Written by: HDFC ERGO Team

What is 24-Hour Hospitalisation Exclusion

Investing in health insurance is one of the most prudent financial decisions in your life. However, to get the most out of your medical insurance, it is critical to know your plan’s inclusions and exclusions. This way, you can avoid disappointment when your claims are rejected. One of the common exclusions that catch policyholders by surprise is the 24-hour hospitalisation.

24-Hour Hospitalisation Exclusion

While reading your policy document, one of the important exclusions you should know about is the 24 hour hospitalisation exclusion. This means that your insurance service provider can deny your claims if you are claiming medical expenses for treatments not requiring a 24-hour hospital stay. Though not all policies, some medical insurance plans still have this exclusion listed in their terms.

However, this exclusion has met quite a lot of criticism recently. Historically, many medical treatments were done using conventional methods requiring patients to be hospitalised for more than 24 hours. However, today, with sophisticated advancements in medical technology, the same treatments are now completed in a few hours, and patients are sent back home the same day.

One example to explain this case further is the cataract surgery. Many years ago, this was a complicated process, and patients were hospitalised for at least 3 days. Today, it takes just about a couple of hours for doctors to perform this procedure. Patients are sent home 1-2 hours after the surgery. If you buy a policy with this exclusion policy today, your insurance company will not cover your medical expenses for this surgery, thereby leaving you to pay for this out of your pocket.

Recently, in December 2023, the Consumer Affairs Ministry decided to approach the IRDAI (Insurance Regulatory and Development Authority of India) about taking away this exclusion from all medical insurance plans in the future.

Even today, considering the growth of medical advancements, many insurance companies have removed this exclusion from their terms. Instead, they have included a new category, “daycare expenses.” Under this category, insurers cover the medical expenses for treatments that don’t need 24-hour hospitalisation.

Conclusion

The 24-hour hospitalisation rule might seem like a drawback, but it shouldn't discourage you from investing in a good health insurance policy. Many insurers now offer coverage for daycare procedures that don’t require extended hospital stays, reflecting the shift in modern medical practices. To avoid unexpected claim denials, it’s important to read your policy carefully and choose a plan that suits your healthcare needs.

FAQs

1. Is it mandatory to have a 24-hour hospitalisation for submitting insurance claims?

No, only a few medical insurance plans currently require a minimum of 24-hour hospitalisation to process claims.

2. What is meant by exclusion in health insurance?

Exclusion refers to an item for which you are not eligible for coverage under your medical insurance policy.

Disclaimer: The above information is for illustrative purposes only. For more details, please refer to the policy wordings and prospectus before concluding the sales.

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