The room rent restriction is expressed in terms of percentage of Sum Insured (SI) per day for Normal Rooms and ICU. Let’s take an example – say if sum insured (SI) is Rs. 3 lacs and room rent limit is 2% of SI per day for Normal & 4% of SI per day for ICU. If any employee is admitted to a hospital where per day normal room rent charges are Rs.8K whereas allowable room rent limit under the policy is Rs. 6K (2% of 3 lacs), then not just the room rent but the entire hospital bill (excluding medical consumables, diagnostic fees, medical devices) will be settled on a pro-rata basis in the ratio of allowable room rent (6K) to actual room rent (8K) i.e. 75%. This means 25% of the hospitalization bill would need to be borne by the patient out-of-pocket.
Read more about room rent capping.