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A floater policy covering the proposer and his/her family under one Sum Insured under one Policy.
NEW FEATURES IN THE POLICY
a) Extension (on request) to SAARC countries without any additional premium.
b) Diamond Plan introduced- Sum Insured Rs.12 lacs to Rs.20 lacs
c) Organ Donor Benefit- When Insured Person is the donor
d) Medical Second Opinion -Reimbursement
e) Maternity Expenses Cover
f) New Born Baby Cover
g) Life Hardship Survival Benefit under all Plans
h) Restoration of Sum Insured
i) Increase in Day Care Procedure List
j) Telemedicine Expenses
OTHER SALIENT FEATURES AT A GLANCE
Sum Insured from Rs.2 lacs to Rs.20 lacs. Existing Insured Persons covered for Rs.1 lac Sum Insured may continue with the same. Those existing Insured Persons covered for Sum Insured\ of Rs.1.5 lacs, may also opt for Sum Insured of Rs.1 lac.
Three Plans available- SILVER, GOLD and DIAMOND.
A floater policy covering the proposer and his/her family under one Sum Insured under one Policy.
Maximum Entry Age is 65 years for all members. However, this can be extended to 70 years subject to conditions.
Under Silver and Gold Plans, Pre-acceptance medical check-up is required for persons aged 60 years and above. However, under Diamond Plan, the requirement is for persons aged 55 years and above.
Term of the Policy is one year and is renewable lifelong.
Pre-existing Disease coverage after four consecutive Policy periods.
Option of TPA (Cashless facility in network hospitals) and non TPA services.
Personal Accident cover as optional cover
Free Look Period
Discount of 5.5% in premium if TPA services not opted for (no discount on PA premium).
A discount of 5% on premium is allowed, if the Policy is purchased On-line and no Intermediary is involved. This discount is also applicable in case of On-line renewal of Policies, where no Intermediary was involved at any stage- either on the first purchase or in any subsequent renewal thereof.
EXCLUSIONS: The Company shall not be liable under the Personal Accident section for injuries/death on account of
Intentional self-injury, suicide or attempted suicide.
Whilst under the influence of intoxicating liquor or drugs
Engagement in aviation or ballooning, speed contests or racing on any kind(other than on foot), bungee jumping, parasailing, parachuting, ski-diving, BASE jumping, paragliding, hang gliding, mountain or rock climbing necessitating the use of guides or ropes, solo climbing, ice climbing, ice canoeing, scuba diving, caving, cave diving, potholing, abseiling, snowboarding, waveski surfing, deep sea diving using hard helmet and breathing apparatus, polo, snow and ice sports and similar other hazardous activities or involving military, air force or naval operations, or whilst mounting into, dismounting from or travelling in any aircraft other than as a passenger (fare paying or otherwise), in any duly licensed standard type of aircraft, anywhere in the world, unless specifically covered and endorsed on the policy.
Directly or indirectly caused by venereal disease(s) or insanity
Arising or resulting from insured committing breach of Law with criminal intent
War, invasion, act of foreign enemy, hostilities (whether war be declared or not), civil war, rebellion, revolution, insurrection, mutiny, military or usurped power, seizure, capture, arrest, restraints and detainment of people
Directly or indirectly caused by or arising from ionizing radiations or contamination by radioactivity from any nuclear fuel, nuclear weapon material, or from any nuclear waste from the combustion of nuclear fuel
Directly or indirectly caused by, contributed by, aggravated or prolonged by childbirth or from pregnancy or in consequence thereof.
Covered day care treatment
Covered day care treatment as per the list
Covered
Family Covered in this Policy
Covered after four consecutive Policy periods
Pre-existing Disease coverage after four consecutive Policy periods
Covered
2 options-(i) 50% of the sum insured (ii)100% of the sum insured
Copay - 10% of each and every claim
Compulsory copayment 10% of each and every claim
Applicable as per the SI
Medical expenses for a delivery ( including caesarean section) or lawful medical termination of pregnancy limited to two deliveries or terminations or either during the lifetime of the Insured person, after the policy ( Diamond Plan) has been continuosly in force for 24 (twenty four) months. Liability of the company limited to 2.5% of the sum insured.
