This clause is there in almost all Mediclaim policies but it is of very restricted value. The general condition guiding Domicilliary Hospitalisation is :
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It is for condition where a hospitalisation is required but there are no hospital beds available.
or
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It is for an acute condition where the patient cannot be shifted to a hospital an a home treatment is done.
Exclusions
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Usually excludes diseases of respiratory system eg bronchial asthama, diarrohea or dysentry, nephritis or renal failure and pyrexia of unknow origin (PUO) which referes to unknown fever.
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Check your policy for the exact exclusions if any
Limits
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Some policies spell out a sublimit eg 20 % of total sum Insured for Domicilliary Hospitalisation. Check your policy for the exact details
That leaves out very few condition where a treatment can be done at home in place of hospitalisation.
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Here is an example Where an elderly has broken her thigh bone and is so frail that she cannot be shifted to a hospital and will be in traction at home with home visit by the doctor and nursing by registered nurses at home ( difficult to find a registered nurse for home nursing in our country) followed by physiotherapy . This might be covered by the Insurance company for claim.
This is such a controversial and restrictive clause that it is better avoided while filing a claim for mediclaim reimbursement because very few conditions will fit into this coategory.
NO MATTER HOW MUCH YOU ARE COVERED BY YOUR HEALTH INSURASNCE (MEDICLAIM ) , ALWAYS HOPE THAT YOU WILL NEVER HAVE TO CLAIM IT !!!