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TrawellTag Insurance - HealthFirst Mediclaim Policy
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Medical Family Floater Policy - Benefits
- Age Limit - 3 months to 80 years
- Sum Insured – Rs.100,000/- to Rs.500,000/-
- No medical reports upto the age of 80 Yrs. Identity photo and residence proof required.
- After the age of 45 yrs. Self declaration form is required duly signed.
- Family means self, spouse, 2 children(upto 25 yrs.) and 2 dependant parents upto 80 yrs.
- Dependant parents can claim 50% of the sum insured but can get 100% in accidental case.
- 24 Hrs. hospitalization is necessary.
- Medical expenses towards specific technologically advanced day care treatments/surgeries where 24 hrs. of hospitalization is not required.
- Medical expenses related to your treatment for 30 days before and 60 days after hospitalization are payable.
- Maternity benefits are covered after 1 year waiting period. Maximum 10% of the sum insured. Upper limit for Normal Delivery-Rs.20000/- and Cesarian section- Rs.30000/-.
- Pre-existing diseases are covered after 2 claim free yrs. (Conditions apply)
- Ambulance charges upto Rs.1000/-.
- Hospital Room Rent – 1% of the sum insured per day for Regular room and 2% of the sum insured per day for ICU/ICCU expenses.
- For Proposer/Dependents above the age of 60 yrs. – 20% Co-pay is applicable on all claims (Conditions apply). But 100% payable in accidental case.
- 25% of the treatment claim will be paid for the fees of Surgeons, Medical Practitioner,Consultants,and Specialists.
- If the proposer pays the premium from his account, then he can avail upto Rs.15000/- Tax benefit under Section 80 D. ( Only on National Ins. Co. premium)
- Proposer/Dependant above the age of 60 yrs. Can get Cataract benefits – For sum insured Rs.100000/- to 200000/- Rs.20000/- per eye and Rs.300000/- to Rs.500000/- Rs.35000/- per eye.
- Claims are settled by our TPA(Dedicated Healthcare Services Pvt. Ltd.). If the services of TPA are not satisfactory, then the company has right to change the TPA.
- Policy has to be renewed before the expiry date. However grace period of 7 days will be provided for consideration of renewal.
- As per clause 4.3, certain ailments are not covered for first 2 years from the inception of the policy. These are Cataract, Benign Prostatic Hypertrophy, Fistula in Anus, Piles, Hysterectomy for Menorrhagia of Fibromyoma, Hernia, Sinusitis and related disorder.
Some Important Sub limits of the Policy
- Co pay upto 20% for all claims except accidental are applicable to the member under the policy incase of age above 60 years.
- Parents can claim upto 50% of the chosen sum insured.
- Capping
- Per day Room rent upto 1% of the chosen Sum Insured.
- Per day ICU (Intensive Care Unit) Rent upto 2% of the chosen Sum Insured.
- Surgeon, Medical Practitioner, Consultants and Specialist Fees - Upto 25% of the illnes.
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Insurance is the subject matter of solicitation
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