I never guess. Every answer is quoted from your policy.

Hi, I'm Sarathi. Your AI guide. Show me a policy — one you have, or one you're considering — and I'll pull out exactly what it will, and won't, do for you. Quoted from the document itself.

See what a policy really covers — before you sign.

Upload a policy you have — or one you're considering — and in about a minute see the real exclusions, waiting periods, sub-limits and the clauses that frequently get claims rejected, quoted from the policy itself. Already had a claim rejected? I'll show you where you stand and how to fight it.

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What you'll get

Every exclusion, cap & waiting periodWhat the policy covers — and what it won't — in plain English. Save as PDF or share, account-free.
A clear claim verdictCovered, partial, or not — quoted from your own policy, never guessed.
What you'll actually get back newEnter your bill — see your real payout vs. the shortfall, each cut traced to a clause.
Your deadlines, counting down newThe windows that matter — intimation, documents, settlement — ticking live.
A ready-to-send claim messageDrafted for you from your situation — just fill in the blanks and send.
If you're denied, how to fight backThe escalation path: your insurer → IRDAI → Ombudsman, with the timelines.

Most policies look fine — until you claim. In India the real damage is quiet: health claims pay out just 71% of claim value (IRDAI 2023-24), and on a motor own-damage claim, parts like tyres and batteries are reimbursed at only ~50% (depreciation). The gaps hide in sub-limits, waiting periods and exclusions you never read.Scan a policy with ClaimSarathi before you commit lakhs over decades — and catch those traps first.

Health: only 71% of claim value paid — IRDAI 2023-24 · Motor: ~50% parts depreciation — India Motor Tariff GR.9

Not legal or financial advice. Verify with your insurer.

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Room-rent limit deductions: why your health claim paid less

A room-rent limit caps how much of your daily hospital room charge the policy will pay — usually a rupee amount or a percentage of the Sum Insured. Choosing a room above that cap doesn't just trim the room bill; the insurer can scale down other linked charges too. This is one of the most common reasons a health payout comes in below the bill.

How proportionate deduction works

Where a policy has a room-rent sub-limit and you take a costlier room, insurers typically pay the associated charges in the same proportion — commonly the ratio (Eligible room rent ÷ Actual room rent) applied to the linked bill. So a ₹6,000/day room against a ₹3,000/day limit can mean linked charges paid at roughly half. The exact method is set by your policy wording, not prescribed by regulation, so check it.

What the IRDAI norms restrict

IRDAI's Norms on Proportionate Deductions (2020), carried into the consolidated 29 May 2024 health framework, put limits on the practice. Proportionate deduction may apply to the room rent itself, but not to ICU charges, and not to items that cannot be counted as the deductible 'associated medical expenses' — such as implants, pharmacy, diagnostics and medical devices. Those stay payable; they simply aren't proportionately cut. And if the hospital does not price rooms differently by category, there is no basis for a proportionate deduction at all.

If it's been over-applied

An over-deduction — proportionate cuts taken on ICU or on those items — is challengeable. Ask the insurer for the deduction worked out line by line, then raise a grievance citing IRDAI's proportionate-deduction norms if it doesn't hold up.

General guidance — verify with your insurer and policy wording. Sources: IRDAI 'Norms on Proportionate Deductions' (IRDAI/HLT/REG/CIR/151/06/2020, eff. 1 Oct 2020); IRDAI Master Circular on Health Insurance Business, 29 May 2024.

Frequently asked

Can the insurer cut my whole bill if I take an expensive room?

Only proportionately, and only where the policy has a room-rent sub-limit. Under IRDAI's proportionate-deduction norms, the cut cannot be applied to ICU charges or to items that can't be counted as deductible associated expenses (implants, pharmacy, diagnostics, medical devices) — those stay payable.

Is proportionate deduction still legal?

Yes. Room-rent sub-limits and proportionate deduction on the room component remain legal — the IRDAI norms restricted the practice, they did not abolish it.

When does no deduction apply at all?

If the hospital does not price rooms differently by category, there is no basis for a proportionate deduction.

IRDAI 'Norms on Proportionate Deductions' (IRDAI/HLT/REG/CIR/151/06/2020, effective 1 Oct 2020), carried into the consolidated IRDAI Master Circular on Health Insurance Business, 29 May 2024 · As of 2026-07-02