About this tool

Room Rent Proportionate Deduction Calculator

See the rupees a health insurer deducts when the hospital room exceeds your room rent limit, and the sum insured a given room tariff needs.

A room rent proportionate deduction calculator works out how much of a hospital bill a health insurer will refuse when the room you occupied costs more per day than your policy's room rent limit — and states the answer in rupees you pay, not in a ratio. It applies the standard formula reproduced in IRDAI-standardised policy wordings: associated medical expenses (room rent, nursing, operation theatre, and the surgeon, anaesthetist or specialist fees inside the same hospital) are paid in the same proportion that the admissible rate per day bears to the actual rate per day. It is for anyone choosing a room at admission, checking a settlement letter after discharge, or working backwards from a room tariff to the sum insured that would clear it.

How to use Room Rent Proportionate Deduction Calculator

1. 1

   Open Room Rent Proportionate Deduction Calculator on AltFTool — it loads instantly in your browser.

2. 2

   Enter the sum insured from your policy schedule and the room rent limit, either as a percent of sum insured per day (commonly 1%, or 2% for ICU) or as a flat rupee amount per day.

3. 3

   Enter the hospital's actual tariff for the room occupied and the number of days billed at that tariff.

4. 4

   Split the bill into the charges the ratio applies to — room and board, nursing, operation theatre, surgeon and anaesthetist fees, consultations — and the charges it does not: pharmacy and consumables, implants and devices, diagnostics.

5. 5

   Add any non-payable items and your copay percent, and set the two switches for whether the hospital bills differently by room category and whether your wording proportions diagnostics.

6. 6

   Read the out-of-pocket figure and the five lines that make it up, then check the same numbers against your own policy wording and the settlement letter.

Why use Room Rent Proportionate Deduction Calculator

• Answers in rupees, not ratios

  The headline is the out-of-pocket figure, broken into five lines — room rent excess, proportionate cut, sum insured shortfall, copay and non-payables — that add up to it exactly.

• Keeps the non-proportioned items separate

  Pharmacy and consumables, implants and medical devices, and diagnostics sit in their own bucket the ratio never touches, matching the standard definition of associated medical expenses.

• Handles the differential-billing carve-out

  Where a hospital does not price by room category, the standard wording says the proportion is not applied; one switch leaves the associated charges whole and deducts only the room rent excess.

• Reverse mode from tariff to sum insured

  A percent-of-sum-insured cap inverts exactly, so a target room tariff converts straight into the sum insured that would carry it with no deduction.

Common use cases

• Decide at the admission desk what a room above your 1%-of-sum-insured limit will actually cost, before signing the form
• Reconcile a claim settlement letter that paid far less than the bill, by separating the room rent excess from the proportionate cut, the sum insured shortfall, the copay and the non-payable items
• Find the sum insured a Rs 8,000-a-day private room needs under a 1% per day room cap, and the gap from your current cover
• Check whether pharmacy, implants and diagnostics were wrongly proportioned, since the standard definition of associated medical expenses excludes all three

Frequently asked questions