Standard exclusion — Excl04

Investigation & Evaluation

These are IRDAI's codes and IRDAI's words, not ours.

Official wording — reproduced verbatim

What the standard text says

a) Expenses related to any admission primarily for diagnostics and evaluation purposes only are excluded.

b) Any diagnostic expenses which are not related or not incidental to the current diagnosis and treatment are excluded.

Source: IRDAI, Guidelines on Standardization of Exclusions in Health Insurance Contracts, page 7. Open the official PDF ↗

In plain English — our reading

What that means on the page

An admission made mainly to run tests or evaluate a condition is excluded. Tests that are unrelated to the diagnosis and treatment at hand are also excluded.

This explains the standard wording. Your policy schedule, endorsements and other clauses may change how the document applies to you.