Insurance Claim Estimator
Approximate how much of a hospital bill a health policy may pay after limits and co-pay.
Approximate only — a rough estimate, not an adjudicated claim. Actual settlement depends on your policy terms, sub-limits and exclusions.
- Your share
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- Room-rent factor
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Why your claim can be less than the bill
Health policies often pay less than the full hospital bill because of two common clauses. A room-rent limit triggers a proportionate deduction: if you choose a room above your eligible rent, associated charges are scaled down in the same ratio. A co-pay makes you bear a fixed percentage of the approved amount.
How this rough estimate works
This is an approximate figure, not an adjudicated claim. If actual room rent exceeds
the limit, it applies a factor of limit ÷ actual rent. Estimated payable ≈ min(bill,
sum insured) × factor × (1 − co-pay ÷ 100), and your share is the rest. Real settlements apply
many more rules, sub-limits and exclusions.
How to use the Insurance Claim Estimator
- Enter sum insured and bill. Type your policy sum insured and the total hospital bill.
- Enter room-rent details. Type your eligible room-rent limit and the actual rent per day.
- Enter the co-pay. Type your co-pay percentage, or 0 if your policy has none.
- Read your estimate. See the approximate payable amount and your share update instantly.
Frequently asked questions
What is proportionate deduction?
If you take a room costing more than your eligible limit, the insurer scales down associated charges by the ratio of the limit to the actual rent, so you bear the excess proportion.
Is this the exact amount I will receive?
No. It is a rough approximation. Actual settlements apply many sub-limits, exclusions, tariffs and non-payable item rules that this simple tool does not model.
How does co-pay affect the payout?
A co-pay is the fixed share of the approved amount you pay yourself. A 20% co-pay means the insurer pays 80% of the approved amount and you pay the remaining 20%.
Does this calculator store my data?
No. The estimate runs entirely in your browser; nothing you enter is sent to or stored on a server.