| Sum Insured |
| Up to 2 Lakhs |
Up to 50 Lakhs |
| In-patient Hospitalisation Treatment |
- Covers boarding and nursing expenses, intensive care unit charges, surgeons and doctors fee, operation theatre charges etc.
- Admitted in ICU:We will pay up to actual expenses provided by Hospital.
- Surgeon, Anesthetist, Medical Practitioner, Consultants, Specialists Fees.
- Anesthesia, Blood, Oxygen, Operation Theatre Charges, surgical appliances, Medicines & Drugs, Dialysis, Chemotherapy, Radiotherapy, cost of Artificial Limbs, cost of
prosthetic devices implanted during surgical procedure like Pacemaker, orthopedic implants, infra cardiac valve replacements, vascular stents, relevant laboratory diagnostic tests, X-ray and such similar expenses that are medically necessary.
|
| Eligibility |
| Adult 18-65 Years |
Dependent Children/Grandchildren:3 months – 30 Years |
| Room, Boarding and Nursing Expenses |
| Up to 1% of Sum Insured per day (Excluding Cumulative Bonus) or actual, whichever is lower. |
No sublimits |
| Pre-Post Hospitalization: |
| Up to 60 days prior and 90 days post hospitalization respectively |
| Road Ambulance |
| Up to maximum of Rs.20,000 per policy year |
| Day Care Procedures |
| Covered as per the policy terms and conditions. |
| Pre-existing diseases |
| Covered after 3 years of continuous renewal |
| Organ Donor Expenses |
- The company pays expenses towards organ donor’s treatment for harvesting of the donated organ, provided that
- The organ donor is any person whose organ has been made available in accordance and in compliance with THE TRANSPLANTATION OF HUMAN ORGANS (AMENDMENT) BILL, 2011 and the organ donated is for the use of the Insured Person, and
- Company has accepted an inpatient Hospitalisation claim for the insured member under In Patient Hospitalisation Treatment
|
| Convalescence Benefit |
- In the event of insured hospitalised for a disease/ illness/ injury for a continuous period exceeding 10 days, We will pay benefit amount of Rs. 5,000 per policy year
- This benefit will be applicable annually for policies with term more than 1 year.
|
| Sum Insured Reinstatement Benefit |
- The reinstated Sum Insured will be triggered only after the Inpatient Hospitalization Treatment Sum Insured inclusive of the Cumulative Bonus(If applicable) has been completely exhausted during the policy year;
- This benefit will be applicable annually for policies with term more than 1 year.
- The reinstated Sum Insured would be triggered only for subsequent claims made by the Insured Person. In case of relapse within 45 days, this benefit will not trigger
- This benefit is applicable only once in life time of Insured Person covered under this policy for claims regarding CANCER OF SPECIFIED SEVERITY and KIDNEY FAILURE REQUIRING REGULAR DIALYSIS as defined under the policy
- Additional premium would not be charged for reinstatement of the Sum Insured.
|
| Daily Cash Benefit for Accompanying an Insured Child |
| Rs. 500 per day maximum up to 10 days |
| Preventive Health Check Up |
| Plan will reimburse the amount equal to 1% of the sum insured max up to Rs. 2000/- for each member in Individual policy during the block of 3 years. This benefit can be availed by proposer & spouse only under Floater Sum Insured Policies |
| Ayurvedic / Homeopathic Hospitalisation Expenses |
| Not Covered |
Hospitalised for not less than 24 hrs then it is covered |
| Maternity Expenses |
| Not Covered |
Covered |
| Other benefits |
Any Medical Expenses incurred during the first 36 months during which You have the benefit of a Health Guard policy with Us in connection with:
- Joint replacement surgery
- Surgery for prolapsed inter vertebral disc (unless necessitated due to an accident)
- Surgery to correct deviated nasal septum
- Hypertrophied turbinate
- Congenital internal diseases or anomalies
- Treatment for correction of eye sight due to refractive error recommended by Ophthalmologist for medical reasons.
- Bariatric Surgery
|
| Sub-limits |
- Room rent restricted to max 1% per day of Sum Insured opted.
- Cataract Limit per eye 20% of Sum Insured .
|
- Cataract Limit per eye 20% of Sum Insured max up to Rs. 1lac.
- Bariatric Surgery restricted to 50% of the Sum insured, subject to maximum of Rs 5 lac.
- Maternity Expenses- From Sum insured Rs. 3lacs to Rs. 7.5lacs it is restricted to Rs. 15000 for normal delivery and Rs. 25000 for caesarean section and from Sum insured Rs. 10lacs to Rs. 50lacs it is restricted to Rs. 25000 for normal delivery and Rs.35000 for caesarean section.
|
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