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TrawellTag Insurance - HealthFirst Mediclaim Policy |
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Medical Family Floater Policy - Benefits
- Policy is available for the age between 3 months to 80 years.
- Sum assured can be opted from Rs.100,000/- to Rs.500,000.
- No pre medical tests up to the age 80 years. Address proof with photo ID card is required.
- If you are above 45 years of age, Self declaration medical for duly signed is required.
- Persons covered under family are spouse, 2 children (up to 25 years) and 2 dependant parents up to 80 years.
- Up to 50% of your sum assured dependents parents can claim, but can get 100% in accident case.
- Need hospitalization for 24 hours.
- Expenses incurred for medical reasons in case of specific technologically advanced day care treatments/surgeries where 24 hours of hospitalization is not required
- After 1 year of waiting period maternity benefits are coverage for a maximum 10% of the sum insured. The upper limit of normal delivery is Rs 20,000 and Cesarian section it is Rs 30,000.
- Coverage of pre-existing conditions will be after 2 years of claim free renewal subject to terms and conditions.
- Ambulance charges are also covered up to Rs.1000/-
- Hospital Room Rent - On per day basis 1% of the sum insured for regular room and 2% of the total sum insured per day for ICU/ICCU expenses.
- 20% co-payment is applicable on all claims for proposer/dependents above the age of 60 years subject to terms and condition. Whereas in case of accident 100% payable has been done.
- The claim for the fee paid for Surgeons, Medical Practitioner, Consultants and Specialists is 25% of the of the treatment claim.
- Income tax benefit under section 80-D for claiming the tax deduction for the payment of premium if the proposer pays the premium from his account.
- Proposer/dependent can make use of cataract benefits if they are above 60 years of age as per the sum assured Rs.100000/- to 200000/- Rs.20000/- per eye and Rs.300000/- to Rs.500000/- Rs.35000/- per eye.
- TPA(Dedicated Healthcare Services Pvt. Ltd.) takes care of claim settlement. If the services of TPA are failed to meet customer needs, then the company has right to change the TPA.
- Before the expiration date of the policy, it can be renewed. However grace period of 7 days will be provided for consideration of renewal.
- Certain diseases/injuries are not covered for first 2 years from the inception of the policy as per clause 4.3. 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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