Group Seasonal Byte

This is Your Group Seasonal Byte Policy which has been issued by Us relying on the Information disclosed by You in Your Proposal for this Policy or its preceding Policy/Policies of which this is a Renewal. It contains details of what is covered, what is not covered, the conditions and the basis on which all claims will be settled. The proposal, Policy Schedule, Policy document and endorsements are part of the Policy. Your Policy is evidence of the contract of insurance.

SCOPE OF COVER
Your opted plan/ coverage(s) are mentioned in the Policy Schedule / Certificate of Insurance. We will provide the coverage as detailed below for an event that occurs during the Policy Year. Each coverage is subject to the terms, conditions and exclusions of this Policy. We will pay as specified under each of the coverage in the Policy Schedule / Certificate of Insurance, provided that

a. The Insured Person is diagnosed with the Dengue Fever as defined in the Specified Illness of this Policy; and

b. Such Specified Illness is diagnosed after 15 days from the date of commencement of first Policy and being renewed thereafter within the Grace Period.

INDEMNITY PLAN

INPATIENT TREATMENT - We will cover Reasonable and Customary charges for Medically Necessary Treatment taken by the Insured Person during the Policy Year for the Specified Illnesses as mentioned in the Policy Schedule / Certificate of Insurance.

INPATIENT HOSPITALISATION
We will cover the following Medical Expenses incurred as In-Patient in a Hospital for more than 24 consecutive hours:

Expenses shall include -
a. Room Rent and Nursing charges;
b. Intensive Care Unit (ICU) charges;
c. Operation Theatre charges;
d. Fees of Medical Practitioner/Specialists;
e. Investigation & Diagnostic procedures;
f. Medicines, Drugs and Consumables;
g. Anaesthesia, Blood, Oxygen

PRE - HOSPITALISATION
We will cover the Pre-hospitalization Medical Expenses incurred up to 15 days before the date of
admission to the Hospital.

Note
The date of admission to the Hospital for this coverage shall be the date of the Insured Person's first admission to the Hospital in relation to Any One Illness.

POST- HOSPITALISATION
We will cover the Post-Hospitalization Medical Expenses incurred up to 15 days after the Insured Person's date of discharge from the Hospital.
However, In case of Any one illness where Insured Person undergoes more than one Hospitalization within 45 days, the cover for post hospitalization expenses cumulatively shall not exceed 15 days

AYUSH
We will cover the Medical Expenses incurred on In-patient Hospitalization up to the Sum Insured for Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homeopathy treatment undergone in:
a. A government Hospital or in any institute recognized by government and/or accredited by Quality Council of India/National Accreditation Board on Health.

b. Teaching Hospitals of AYUSH colleges recognized by Central Council of Indian Medicine (CCIM) and Central Council of Homoeopathy (CCH).

c. AYUSH Hospitals

NOTE AYUSH Hospitals and AYUSH Day Care Centers should have either pre entry level certificate (or higher level of certificate) issued by National Accreditation Board for Hospitals and Healthcare Providers (NABH) or State Level Certificate (or higher level of certificate) under National Quality Assurance Standards (NQAS), issued by National Health Systems Resources Centre (NHSRC).

[B]EMERGENCY ROAD AMBULANCE / REPATRIATION OF MORTAL REMAINS (RMR) / FUNERAL EXPENSES
We will cover the expenses up to the sub-limit stated in the Policy Schedule incurred towards transportation of an Insured Person by a registered healthcare or ambulance service provider in case of an Emergency provided that We have accepted the claim under In-patient Hospitalization Expenses shall include:

a. Transportation Costs towards transferring the Insured Person to Hospital or from one Hospital to another Hospital or to a Diagnostic Centre for advanced diagnostic treatment where such facility is not available at the existing Hospital and advised by the treating Medical Practitioner.

b. When the Insured Person requires to be moved to a better Hospital facility due to lack of super specialty treatment in the existing Hospital. When the Insured Person requires to be moved to home after discharge from the Hospital. The medical condition of Insured Person is such that it requires services of Ambulance and is certified by treating Medical Practitioner.

c. We will also cover the following expenses if the Insured Person dies in the Hospital during the course of Hospitalization.

i. Transportation of Mortal remains from Hospital to home and/or to cremation ground for funeral purpose;

ii. Cremation Expenses;

iii. Coffin Charges.