Insurance Claim Calculator

## What is the Insurance Claim Calculator? The Insurance Claim Calculator helps you understand what you will actually receive from an insurance claim after accounting for deductibles (the amount you pay), depreciation on assets, policy limits, and co-pay clauses. ## Formula Used Net Claim Payable = (Claim Amount - Deductible - Depreciation) x Policy Limit% - Co-pay% Health Insurance: Deductible = Amount you pay before insurance starts (per claim or annual) Co-pay = Percentage you pay from each claim Room rent limit = Maximum room rent covered (% of sum insured) Motor Insurance: Depreciation = Age-based deduction from IDV for parts replaced NCB = No Claim Bonus reduces own-damage claim ## Worked Example Total hospital bill: Rs 5,00,000 Deductible (per claim): Rs 20,000 Depreciation (on non-admissible items): Rs 50,000 Policy limit: 100% of sum insured Net Claim Payable = (Rs 5,00,000 - Rs 20,000 - Rs 50,000) x 100% Net Claim Payable = Rs 4,30,000 Total Deductions = Rs 70,000 ## Frequently Asked Questions 1. What is a deductible in health insurance? A deductible is a fixed amount you pay from your pocket before the health insurance kicks in for each claim or per year. For example, if you have a Rs 2 lakh deductible and a Rs 5 lakh hospital bill, you pay Rs 2 lakh and insurance covers the remaining Rs 3 lakh. 2. How does depreciation affect motor insurance claims? In motor own-damage claims, depreciation is deducted from the claim for metal parts (30% for year 1, increasing to 50% by year 5), rubber parts (50%), and plastic parts (30%). 3. What is a co-pay clause in health insurance? Co-pay means you share a percentage of each claim with the insurer. If your policy has a 20% co-pay and you claim Rs 1 lakh, you pay Rs 20,000 and insurer pays Rs 80,000. 4. Does health insurance cover pre-existing diseases immediately? No, pre-existing diseases have a waiting period of typically 2 to 4 years before they are covered. 5. What is the room rent cap in health insurance? Many health insurance policies cap room rent as a percentage of sum insured (e.g., 1% for Rs 5 lakh cover = Rs 5,000/day room). If you choose a room exceeding this limit, the insurer may proportionally reduce claim payout.