Sign-in / Sign-up
The Policy covers aggregate hospitalization expenses reasonably and necessarily incurred in India in respect of all covered hospitalization during the policy period exceeding the Threshold Level
KEY BENEFITS
The Policy covers aggregate hospitalization expenses reasonably and necessarily incurred in India in respect of all covered hospitalization during the policy period exceeding the Threshold Level or any amount reimbursed or reimbursable under any Health Insurance Policies/Reimbursement Scheme whichever is higher, up to the Sum Insured stated in the policy.
SALIENT FEATURES
The Policy is available both on Individual and Floater basis.
Individual basis All family members including the parents can be covered under single policy with difference sum insureds and threshold level.
Group basis Single Sum Insured/Threshold level for all family members covered under the policy. Parents can take a separate policy.
The age of the proposer shall be between 18 and 80 years. Children between the age of 3 months and 18 years are covered provided either or both parents are covered concurrently. Children above 18 years will cease to be covered if they are employed/self-employed or married.
Various Options with different Sum Insureds and Threshold Level are available.
COVERAGE
Basis of Payment
Any claim under this policy shall be payable only if the aggregate of covered hospitalization expenses exceeds the Threshold level or any amount received/receivable under any Health Insurance policy/ Reimbursement scheme whichever is higher.
The Policy provides the following benefits subject to the Basis of Payment clause mentioned above.
I. Hospitalization expenses
1. Room, Boarding and Nursing expenses.
2. Expenses incurred for Surgeon, Anesthetist, Medical Practitioner, Consultants, Specialists Fees.
3. Expenses incurred on Anesthetic, blood, oxygen, Operation theatre charges, surgical appliances, Medicines & drugs, dialysis, chemotheraphy, radiotheraphy, cost of artificial limbs, cost of prosthetic devices implanted during surgical procedure like Pacemaker, orthopaedic implants, infra cardiac valve replacements, vascular stents, relevant laboratory/diagnostic tests, x-ray and similar expenses that are medically necessary and hospitalization expenses (excluding cost of organ) incurred for donor in respect of organ transplant to the insured.
Expenses incurred for covered hospitalization exceeding the Threshold level or any amount received/receivable under any Health Insurance policies/Reimbursement scheme whichever is higher.
II. Cashless facility in more than 7000 hospitals across Pan India.
III. Free Look period of 15 days shall be applicable at the inception of the first policy.
IV. Premium paid for self, spouse, dependent children and dependent parents are exempt from Income Tax under Section 80-D of the IT act.
EXCLUSIONS
1. All Pre-existing diseases upto 48 months of continuous coverage.
2. Vaccination and Inoculation of any kind unless it is post-animal bite
3. General debility and Run down conditions
4. Circumcision, Cosmetic surgery, Plastic surgery.
5. HIV/AIDS
6. Pregnancy, ailments related thereto and child birth
7. War, act of foreign enemy, ionizing radiation and nuclear weapon.
8. Naturopathy
9. Experimental or unproven treatment
10. All external equipments
Covered
The Company shall indemnify Reasonable & Customary medical expenses incurred for inpatient care treatment under Ayurveda system of medicine in an AYUSH hospital/ AYUSH day care centre.
More than 7000 hospitals across Pan India
Cashless facility in more than 7000 hospitals across Pan India
Family Covered in this Policy
Individual basis All family members including the parents can be covered under single policy with difference sum insureds and threshold level
48 months
All Pre-existing diseases upto 48 months of continuous coverage
Covered
Room, Boarding and Nursing expenses Covered subject to the Basis of Payment
Not Covered
This plan doesn't provide coverage for maternity & related claims
