Arogya Sanjeevani Policy

IMPORTANT FEATURES

Sum Insured:
The minimum sum insured isRs.1 Lac and maximum sum insured is Rs.5 Lacs (in multiples ofRs.50,000)

On Individual basis - Sum Insured shall apply to each individual family member

On Floater basis- Sum Insured shall apply to the entire family

Minimum & Maximum Age
The minimum entry age is 18 years and the maximum entry age is 65 years.

Persons Covered
Policy can be availed for Self and the following family members

i. legally wedded spouse.

ii. Parents and Parents-in-law.

iii. Dependent Children (i.e. natural or legally adopted) between the ages 3 months to 25 years. If the child above 18 years of age is financially independent, he or she shall be ineligible for coverage in the subsequent renewals

Policy Period
1 year

Renewability
Lifetime renewability is available in this policy.

Portability
Offers portability option to other health insurance policies

Features
Hospitalization & Day Care Treatments

In-patient Hospitalization and Day Care Treatments are covered up to the opted Sum Insured subject to the sub-limits mentioned below.

Ambulance Charges
MaxRs.2000 per hospitalization

Pre & post Hospitalization
30 days Pre Hospitalization & 60 days Post Hospitalization expenses

AYUSH Benefit
Expenses incurred on hospitalization under AYUSH treatment

Cumulative Bonus Cumulative Bonus of 5% of the Sum Insured, up to a maximum of 50% will be provided for each claim free year, It will get reduced in case of Claim at the same rate.

Sub Limits
Sublimit for room/doctors fee:
For hospitalization expenses like room, boarding, nursing expenses up to 2% of Sum Insured or a maximum ofRs.5,000 per day. ICU/ICCU expenses will also be provided up to 5% of sum insured or a maximum ofRs.10,000 per day. Sub-limit for cataract surgery - 25% sum insured orRs.40,000/- , whichever is lower per eye, under one policy year. Modern treatment methods and Advancements in technology: Up to 50% of the Sum insured.
Co-payment
A fixed co-pay for 5% is applicable for all claims and ages in this policy

Waiting Period/Exclusions
Waiting Periods

Pre-Existing Diseases will be covered after a waiting period of forty eight (48) months of continuous coverage

Expenses related to the treatment of any illness within 30 days from the first policy commencement date shall be excluded except claims arising due to an accident.

Specified surgeries/treatments/diseases are covered after specific waiting period of 24 months/ 48 months

Major exclusions in the policy
Following is a partial list of the policy exclusions. Please refer to the policy document for the complete list of exclusions:

Admission primarily for investigation & evaluation

Admission primarily for rest Cure, rehabilitation and respite care

Expenses related to the surgical treatment of obesity that do not fulfill certain conditions

Change-of-Gender treatments

Expenses for cosmetic or plastic surgery

Expenses related to any treatment necessitated due to participation in hazardous or adventure sports

Statutory Warning - Prohibition Of Rebates (Under Section 41 of Insurance Act 1938)

1) No person shall allow or offer to allow, either directly or indirectly as an inducement to any person to take out or renew or continue an insurance in respect of any kind of risk relating to lives or property, in India, any rebate of the whole or part of the commission payable or any rebate of the premium shown on the Policy, nor shall any person taking out or renewing or continuing a Policy accept any rebate, except such rebate as may be allowed in accordance with the published prospectuses or tables of the Insurer.

2) Any person making default in complying with the provisions of this section shall be liable for a penalty which may extend to ten lakh rupees.