“IRDAI has mentioned that insurers need to define the associate medical expenses which will be deducted proportionately if a person opts for a higher room category than the category that is eligible as per terms and conditions of the policy. Additionally, it has mentioned that expenses like cost of pharmacy, cost of implants, cost of diagnostics, etc. will not fall under the definition of ‘associate medical expenses’ and hence, proportionate deduction for such expenses will not be applicable along with the ICU charges as well. Insurers will negotiate with their hospital networks to see that the increase in rates of the associate medical expenses with change in room category are in control so as to benefit the customer,” Bhaskar Nerurkar, head,health claims, Bajaj Allianz General Insurance said.