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The Policy covers Hospitalization Expenses for In-Patient Care or Day Care Treatment incurred for treatment of an Illness contracted/ Injury sustained during the Policy Period.
SALIENT FEATURES OF THE POLICY
i. The Policy covers Hospitalization Expenses for In-Patient Care or Day Care Treatment incurred for treatment of an Illness contracted/ Injury sustained during the Policy Period.
ii. The Policy provides for Cashless Facility and/or reimbursement of Hospitalization expenses for treatment of illness or injury. Cashless Facility will be available in Network hospitals only if TPA's service is opted in the Policy.
iii. Sum Insured (SI)slabs available from Rs.1 lac to Rs.5 lacs, in multiples of Rs. 50,000, and thereafter, SI slabs available are Rs. 6,8,10,15, & 20 lacs.
iv. All pre-existing diseases covered after 48 months of continuous coverage, subject to the same being declared at the time of application and accepted by insurer.
v. Life long renewals allowed.
vi. 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.
vii. Maximum Entry age for any member, is 65 years.
viii. No medical examination for persons up to the age of 55 years.
ix. In case offresh covers, 50% of the Pre-insurance medical check-up cost reimbursable, subject to acceptance of the Proposal.
x. Life-long renewals allowed with no exit age.
xi. Policy can be issued, as per the option of the Proposer, on
Individual Basis (i.e., Sum Insured and Cumulative Bonus shall apply separately on each Insured Person)
Floater Basis (i.e., Sum Insured and Cumulative Bonus shall apply cumulatively to cover all Insured Persons)
xii. Ambulance charges covered, maximum of Rs. 2000/- per hospitalization.
xiii. Cumulative Bonus of 5% of sum insured for each claim free year maximum up to 50% of sum insured, provided the policy is renewed without any break.
xiv. Specified modern and advanced treatments up to 50% of sum insured for all modern treatments/procedures combined, either as in-patient or as part of day care treatment.
xv. Dental treatment covered, necessitated due to disease and injury.
xvi. Plastic surgery payable, necessitated due to disease or injury.
xvii. AYUSH Treatment covered up to sum insured, without any sub-limits undertaken for inpatient care in AYUSH hospitals.
xviii. 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.
xix. Grace period facility for payment of renewal premium available.
30 days grace for annual premium.
15 days for half yearly, quarterly and monthly modes of premium payment.
xx. Migration facility to other retail Health products of Oriental available, with all accrued benefits intact.
xxi. Portability facility available subject to IRDAI Guidelines for portability.
xxii. Discount of 5.5% in premium if TPA services not opted for.
Covered all day care treatment
. All the day care treatments.
Covered for a fixed period of 60 days
The company shall indemnify post hospitalization medical expenses incurred, related to an admissible hospitalization requiring inpatient care, for a fixed period of 60 days from the date of discharge from the hospital, following an admissible hospitalization covered under the policy
Covered for a fixed period of 30 days
The company shall indemnify pre hospitalization medical expenses incurred, related to an admissible hospitalization requiring inpatient care, for a fixed period of 30 days prior to the date of admissible hospitalization covered under the policy
Covered Rs.2000/- per hospitalization
Expenses incurred on road Ambulance subject to a maximum of Rs.2000/- per hospitalization
Covered up to the limit of sum insured as specified in the policy schedule
The Company shall indemnify medical expenses incurred for inpatient care treatment under Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homeopathy systems of medicines during each Policy Year up to the limit of sum insured as specified in the policy schedule in any AYUSH Hospita
Covered
Dental treatment covered, necessitated due to disease and injury. The Company shall indemnify medical expenses incurred for treatment of Cataract,subject to a limit of 25% of Sum Insured or Rs.40,000/-, whichever is lower, per each eye in one policy year
Covered
Family Covered in this Policy
48 months
All pre-existing diseases covered after 48 months of continuous coverage, subject to the same being declared at the time of application and accepted by insurer
Covered : Up to 2% of the sum insured as per the SI
Upto SI INR 5 Lacs: Up to 2% of the sum insured subject to maximum of Rs. 5000/- per day. SI INR 6, 8, 10 Lacs: Up to 2% of the sum insured subject to maximum of Rs. 10,000/- per day. SI INR 15 & 20 Lacs: Up to 2% of the sum insured subject to maximum of Rs. 20,000/- per day.
Covered increased by 5% in respect of each claim free policy year
Cumulative Bonus of 5% of sum insured for each claim free year maximum up to 50% of sum insured, provided the policy is renewed without any break
