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The Policy term is one year and is available to any proposer between the age of 18 to 65 years for treatment taken in India. The proposer can also get his family covered.
SALIENT FEATURES OF THE POLICY
i. The Policy term is one year and is available to any proposer between the age of 18 to 65 years for treatment taken in India. The proposer can also get his family covered.
ii. Maximum Entry age for any member, is 65 years however, this can be extended up to 70 years. In such case, an additional premium of 10% (including on all future renewals) will be charged inapplicable rates, including on Optional PA cover.
iii. Sum Insured (SI) available from Rs.1lac to Rs.10lacs.
iv. Pre-existing diseases covered after four consecutive renewals.
v. Lifelong renewals allowed.
vi. Family discount of 10% (including on PA cover) if more than one person is covered under the policy.
vii. Option of voluntary co-payment of 10% and 20% with corresponding premium discount of 10%and 20% respectively on SI of Rs.2 lacs and above. Voluntary co-payment does not apply on PA section.
viii. No medical examination for person up to the age of 55 years.
ix. In case of fresh covers, 50% of the Pre-insurance medical check-up cost reimbursable, subject to acceptance of the Proposal.
x. Daily Hospital Cash allowance in case of more than 2 days of continuous hospitalization.
xi. Hospitalization expenses incurred for donating an organ by the donor (excluding cost of organ) to the insured person, is covered
xii. Ambulance charges covered
xiii. Personal Accident available on optional basis for SI from Rs.2 lacs to Rs.10 lacs.
xiv. Tele medicine Expenses.
xv. Mental Illness Cover.
xvi. Modern treatments and advanced surgeries.
xvii. Free Look Period- A period of 15 days from the date of receipt of the policy to review the terms and conditions of the policy and return the same, if not acceptable.
xviii. Grace period of 30 days is allowed for payment of renewal premium.
xix. Premium adjustment at renewal, for the duration of OMP cover taken from Oriental.
xx. Discount of 5.5% in premium if TPA services not opted for.
EXCLUSIONS: The Company shall not be liable under this section for disablement / death of the Insured Person,
i. on account of Intentional self-injury, suicide or attempted suicide
ii. Whilst under the influence of intoxicating liquor or drugs
iii. Whilst engaging in any hazardous activity including, but not limited to aviation or ballooning, speed contests or racing of any kind(other than on foot), bungee jumping, parasailing, parachuting, ski-diving, paragliding, hang gliding, mountain or rock climbing necessitating the use of guides or ropes, potholing, abseiling, deep sea diving using hard helmet and breathing apparatus, polo, snow and ice sports or involving a 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.
iv. Directly or indirectly caused by venereal disease(s) or insanity
v. Arising or resulting from insured committing breach of law with criminal intent
vi. 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's of people
vii. 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,
viii. Directly or indirectly caused by, contributed to, aggravated or prolonged by childbirth or from pregnancy or in consequence thereof.
Covered Upto 60 days
Medical expenses incurred upto 60 days post hospitalization
Covered Upto 30 days
Medical expenses incurred 30 days prior to hospitalization
Covered Rs.2,000/- OR 1% of the sum insured whichever is less per hospitalization
Rs.2,000/- OR 1% of the sum insured whichever is less per hospitalization subject to aggregate expenses not exceeding Rs. 4000/- under the policy
Covered
Family Covered in this Policy
Covered after four consecutive renewals
Pre-existing diseases covered after four consecutive renewals
Covered 1 % of the Sum Insured per day
Not exceeding 1 % of the Sum Insured per day.
VOLUNTARY CO-PAYMENT: (OPTIONAL)
If the insured opts for a co-payment of 10% or 20%, he is eligible for a corresponding premium discount of 10% and 20% respectively. This option is available only for insured persons having Sum Insured of Rs 2 lacs and above. Co-payment cannot be opted on selective basis
Covered Upto 60 days
Medical expenses incurred upto 60 days post hospitalization
Covered Upto 30 days
Medical expenses incurred 30 days prior to hospitalization
Covered Rs.2,000/- OR 1% of the sum insured whichever is less per hospitalization
Rs.2,000/- OR 1% of the sum insured whichever is less per hospitalization subject to aggregate expenses not exceeding Rs. 4000/- under the policy
Covered
Family Covered in this Policy
Covered after four consecutive renewals
Pre-existing diseases covered after four consecutive renewals
Covered 1 % of the Sum Insured per day
Not exceeding 1 % of the Sum Insured per day.
VOLUNTARY CO-PAYMENT: (OPTIONAL)
If the insured opts for a co-payment of 10% or 20%, he is eligible for a corresponding premium discount of 10% and 20% respectively. This option is available only for insured persons having Sum Insured of Rs 2 lacs and above. Co-payment cannot be opted on selective basis
