Health Pulse Family Floater

Health Pulse : Family Health Insurance Plan
A pocket friendly health insurance plan that offers you more for less.

CLASSIC
Cover Available : Up to Rs 10 lakh
Refill benefits : Up to 100% of base sum insured
Cover starts from : Rs 3 lakhs - Rs 10 lakhs
Premium starts from : Rs 8,339 /Yr

ENHANCED
Cover Available : Rs 3 lakhs - Rs 25 lakhs
Enhance Refill benefits : Up to 150% of base sum insured
Cover starts from : Rs 3 lakhs - Rs 25 lakhs
Premium starts from : Rs 8,339 /Yr

Direct Claim Settlement
Avail painless claim process when there are no third parties involved

No Room Rent Cap
Covered up to single private room for SI 5 lakhs and above

Refill Benefit
Get your cover restored if you exhaust your sum insured in the policy year

Day Care Treatment
Get coverage for procedures that don't need hospitalization.

Health Check-up
Annual health check-up from 2nd year onwards

Renewal for life
Once insured with us, you will always remain our customers.

Hospitalization
IN-PATIENT CARE (HOSPITALISATION)
Get cashless coverage for hospitalization expenses for all insured members at network hospitals

HOSPITAL ACCOMMODATION
Get coverage of up to 1% of base sum insured per day for single private room and up to 2% for ICU. This is applicable when sum insured is below 5 lacs. For 5 lacs and above, it is up to single private room and ICU covered up to SI

PRE & POST HOSPITALISATION MEDICAL EXPENSES
The policy will cover pre and post hospitalization expenses as well. The period of the treatment covered is 30 days before you get admitted to the hospital and 60 days after you get discharged from the hospital

HEALTH CHECK-UP
Avail health check-up for yourself and your spouse annually from the second policy year onwards

DOMICILIARY HOSPITALISATION
The policy will reimburse you for the medical treatment taken at home on account of unavailability of a hospital bed or the doctor's advice

DAY-CARE TREATMENT COVERED
Get coverage for procedures that don't need hospitalization

EMERGENCY AMBULANCE
Get coverage for the ambulance expenses upto Rs 1500 for SI below Rs 5 lakhs and upto Rs 2000 for SI greater than or equal to Rs 5 lakhs.

ORGAN TRANSPLANT
Avail coverage for medical expenses incurred on the organ donor's treatment as well

Standout Features
Free Look Period
Get the health pulse policy and you can cancel within 15 days to get a full refund.

Alternative Treatments
We cover In-patient treatment under AYUSH (Ayurveda, Unani, Siddha, and Homeopathy) up to SI

Tax Benefit
Save taxes on the premiums paid under section 80D of the income tax act

Cashless Facility
Avail services at our network hospitals without having to pay any cash

Direct Claim Settlement
There are no third-party agents involved. Get your claims processed painlessly by our customer service team directly

Renewal for Life
Get assured renewal of the policy for life with no extra loadings based on your claim history

Safeguard (Rider)
Get access to additional benefits like- annual increase in coverage based on inflation rate, coverage for non-payable items and no impact on booster benefit / no claim bonus.

Add on Features
Optional Benefits:

Personal Accident Cover
Accident Death
Accident Permanent Total Disability (125% of PA cover SI)
Accident Permanent Partial Disability
Personal Accident cover will be equal to 5 times of Base Sum Insured; maximum up to 50 Lac
Critical Illness Cover Critical illness cover will be equal to Base Sum Insured; maximum up to 10 Lac
e-Consultation Unlimited tele/online doctor consultation
Hospital Cash
For Base Sum Insured of 5 Lac and below: 1,000 per day;
For Base Sum Insured greater than 5 Lac: 2,000 per day
Enhanced No Claim Bonus Increase of 20% of expiring Base Sum Insured in a Policy Year; maximum up to 200% of Base Sum Insured; no increase in sub-limits; no reduction in No Claim Bonus in case of claim
Enhance Re-fill Benefits Re-fill up to 150% of Base Sum Insured

Exclusions
Permanent Exclusions

Investigation & Evaluation
Expenses related to any admission primarily for diagnostics and evaluation purposes only are excluded.
Any diagnostic expenses which are not related or not incidental to the current diagnosis and treatment are excluded.
Rest Cure, rehabilitation and respite care
Expenses related to any admission primarily for enforced bed rest and not for receiving treatment. This also includes:
Custodial care either at home or in a nursing facility for personal care such as help with activities of daily living such as bathing, dressing, moving around either by skilled nurses or assistant or non-skilled persons.
Any services for people who are terminally ill to address physical, social, emotional and spiritual needs.
Obesity/ Weight Control
Expenses related to the surgical treatment of obesity that does not fulfil all the below conditions:
Surgery to be conducted is upon the advice of the Doctor.
The surgery/Procedure conducted should be supported by clinical protocols.
The member has to be 18 years of age or older and;
Body Mass Index (BMI);
greater than or equal to 40 or
greater than or equal to 35 in conjunction with any of the following severe co-morbidities following failure of less invasive methods of weight loss:
Obesity-related cardiomyopathy
Coronary heart disease
Severe Sleep Apnea
Uncontrolled Type2 Diabetes
Change-of-Gender treatments
Expenses related to any treatment, including surgical management, to change characteristics of the body to those of the opposite sex.

Cosmetic or plastic Surgery
Expenses for cosmetic or plastic surgery or any treatment to change appearance unless for reconstruction following an Accident, Burn(s) or Cancer or as part of medically necessary treatment to remove a direct and immediate health risk to the insured. For this to be considered a medical necessity, it must be certified by the attending Medical Practitioner.

Hazardous or Adventure sports
Expenses related to any treatment necessitated due to participation as a professional in hazardous or adventure sports, including but not limited to, para-jumping, rock climbing, mountaineering, rafting, motor racing, horse racing or scuba diving, hand gliding, sky diving, deep-sea diving.

Breach of law
Expenses for treatment directly arising from or consequent upon any Insured Person committing or attempting to commit a breach of law with criminal intent.

Excluded Providers
Expenses incurred towards treatment in any Hospital or by any Medical Practitioner or any other provider specifically excluded by Us and disclosed in Our website / notified to the Policyholders are not admissible. However, in case of life threatening situations or following an Accident, expenses up to the stage of stabilization are payable but not the complete claim.

Treatment for, alcoholism, drug or substance abuse or any addictive condition and consequences thereof.
Treatments received in heath hydros, nature cure clinics, spas or similar establishments or private beds registered as a nursing home attached to such establishments or where admission is arranged wholly or partly for domestic reasons.
Dietary supplements and substances that can be purchased without prescription, including but not limited to vitamins, minerals and organic substances unless prescribed by a Medical Practitioner as part of Hospitalization claim or Day Care procedure

Refractive Error
Expenses related to the treatment for correction of eye sight due to refractive error less than 7.5 diopters.

Unproven Treatments
Expenses related to any unproven treatment, services and supplies for or in connection with any treatment. Unproven treatments are treatments, procedures or supplies that lack significant medical documentation to support their effectiveness.

Sterility and Infertility
Expenses related to sterility and infertility. This includes:
Any type of contraception, sterilization
Assisted Reproduction services including artificial insemination and advanced reproductive technologies such as IVF, ZIFT, GIFT, ICSI
Gestational Surrogacy
Reversal of sterilization

Maternity
Medical treatment expenses traceable to childbirth (including complicated deliveries and caesarean sections incurred during Hospitalization) except ectopic pregnancy;
Expenses towards miscarriage (unless due to an Accident) and lawful medical termination of pregnancy during the Policy Period.

Ancillary Hospital Charges
Charges related to a Hospital stay not expressly mentioned as being covered. This will include RMO charges, surcharges and service charges levied by the Hospital.

Circumcision:
Circumcision unless necessary for the treatment of a disease or necessitated by an Accident.

Conflict & Disaster:
Treatment for any Injury or Illness resulting directly or indirectly from nuclear, radiological emissions, war or war like situations (whether war is declared or not), rebellion (act of armed resistance to an established government or leader), acts of terrorism.

External Congenital Anomaly:
Screening, counseling or treatment related to external Congenital Anomaly.

Dental/oral treatment:
Treatment, procedures and preventive, diagnostic, restorative, cosmetic services related to disease, disorder and conditions related to natural teeth and gingiva except if required by an Insured Person while Hospitalized due to an Accident.

Hormone Replacement Therapy:
Treatment for any condition / illness which requires hormone replacement therapy.

Multifocal Lens and ambulatory devices such as walkers, crutches, splints, stockings of any kind and also any medical equipment which is subsequently used at home.


Sexually transmitted Infections & diseases (other than HIV / AIDS):
Screening, prevention and treatment for sexually related infection or disease (other than HIV / AIDS).

Sleep disorders:
Treatment for any conditions related to disturbance of normal sleep patterns or behaviors.

Any treatment or medical services received outside the geographical limits of India.

Unrecognized Physician or Hospital:
Treatment or Medical Advice provided by a Medical Practitioner not recognized by the Medical Council of India or by Central Council of Indian Medicine or by Central council of Homeopathy.
Treatment provided by anyone with the same residence as an Insured Person or who is a member of the Insured Person's immediate family or relatives.
Treatment provided by Hospital or health facility that is not recognized by the relevant authorities in India.

Artificial life maintenance for the Insured Person who has been declared brain dead or in vegetative state as demonstrated by:

Deep coma and unresponsiveness to all forms of stimulation; or
Absent pupillary light reaction; or
Absent oculovestibular and corneal reflexes; or
Complete apnea.

AYUSH Treatment
Any form of AYUSH Treatments, except as mentioned in your policy document.


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