Claim case sharing
What does Room & Board Benefit cover?
Two weeks ago, Mr. Wong's 4 year-old daughter was admitted to hospital for 4 days with gastroenteritis. He submitted a claim to his insurance company for reimbursement of hospital expenses from his medical policy covering his daughter. The insurance company quickly settled his claim but did not reimburse the cost of meals ordered during hospitalisation.
Mr. Wong knew that the benefit limit of Room and Board was HK$1,500 per day. The room charge for his daughter was HK$1,000 per day and the food ordered was around HK$450 per day. The food ordered was for meals and drinks for Mr. and Mrs. Wong and relatives who visited his daughter. Notwithstanding, Mr. Wong wondered why the cost of meals was not paid as his policy covered Room and Board.
The term “Room and Board” has been used for over 20 years in the medical insurance industry. In the past, hospitals in Hong Kong would provide meals to patients and the cost was included in the room charge. But nowadays, people prefer to eat their own food or order food themselves and, as a result, with the exception of The Canossa, most hospitals no longer provide meals. Therefore, the Room and Board Benefit in most medical insurance policies refers to benefit covering daily room charges as billed by a hospital for the cost of accommodation, meals and general nursing care.
In any event, even if an insurance company does cover extra meals ordered, it only covers food consumed by the patient. If the cost of food ordered is unreasonably high for the patient, insurance companies will investigate and will only pay for food consumed by the patient. In the case above, the patient was a 4 year-old suffering from gastroenteritis and it therefore appeared unlikely that she could eat enough food to justify a claim for HK$450 per day. Therefore, after investigation, as the food was not for the patient, the insurance company rejected this part of the claim.