Health Insurance

(General Information with terms and conditions, features may vary as per product and company)

1.Family Floater Medi-claim (Also available as Individual Health Policy)

Family Floater health insurance plan gives protection for the entire family on the payment of a single premium under a single sum insured. The sum insured floats among family members insured.

Policy Benefits:
  • Room, boarding, nursing expenses are covered.
  • Surgeon, Anesthetist, Medical Practioner, Consultant and Specilist Fees are covered.
  • Anesthesia, Blood, Oxygen, Operation Theatre charges, cost of pacemaker etc.
  • Cost of medical and drugs.
  • Emergency ambulance charges for transporting the covered patient to the hospital.
  • Pre-Existing Diseases
  • Pre existing diseases are covered after 48 months of continuous insurance with any Indian Insurance Company.
Pre and post Hospitalization cover:
  • Pre hospitalization medical expenses incurred upto 30days prior to the date of admission are payable.
  • Post-hospitalization- medical expenses incurred upto 60days from the date of dischrge are payable.
  • Pre and post hospitalization expenses maximum up to 10% of sum insured are payable.
Following diseases are not covered for first 2 years:
Cataract, Benign Prostatic, Hypertrophy, Hysterectomy for Menorrhagia or Fobromyoma, Hernia, Hydrocele, Congenital internal disease, Fistula in anus, piloes, Sinusitis and related disorders, Gall bladder stone removal, Gout and rheumatism, Calculus disease, Joint Replacement due to Degenerative condition and age related osteoarthritis, Osteoporosis etc.
Day Care Treatment: 101 day care treatment is allowed.


Exclusions:
  • Treatment of any disease contracted by insured person during first 30 days from the commencement date of first policy.
  • War and nuclear perils
  • Treatment of medicine other than allopathic.
  • Naturopathy treatment.
  • Expenses which are purely diagnostic in nature with no positive existence of any disease.
  • Tcosmetic or aesthetic treatment, plastic surgery other than as may be necessitated due to accident or as part of any illness.
  • Expenses incurred for treatment of congenital disease/ defects/ anomalies.
  • Cost of spectacles, hearing aids, walkers, crutches and similar aids.
  • Dental treatment unless followed accidental injuries.
  • Note: For detail list of exclusions please refer policy conditions.

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2.Super Top Up

This policy covers aggregate hospitalization expenses of insured persons exceeding the Threshold Level up to a sum insured. It gives an additional protection at an affordable price. This is irrespective of whether the insured has any other Health Insurance Policy or not.
This policy will respond only when the aggregate of covered hospitalization expenses exceeds the “Threshold Level” stated in the policy.
However, the sum insured under the policy will be available exclusively over and above any reimbursement from any source whatsoever if such amount exceeds Threshold Level.
Thus this policy offers protection in excess of any Primary Health Policy/ Benefit Scheme thet the insured may have.

Types of Policy
  • Super Top-Up Medicare Policy- Individual
  • Super Top-Up Medicare Policy- Family.
e.g.: Family of Husband, Age-34, Wife, Age- 31 and child, Age 7 are covered under basic health plan with Sum Insured Rs 3 Lacs.
They can opt for Super Top Up Plan with Sum Insured Rs 3 Lacs, Rs 5 Lacs or Rs 7 Lacs with Threshold Rs 3 Lacs. So if anyone is hospitalized he/she will have combined cover of Rs 3+3 or Rs 3+5 or Rs 3+& Lacs.
Suppose hospitalization bill is Rs 4 Lacs, then first 3 Lacs will be covered by basic health policy and then only Super Top-Up policy will respond for remaining Rs 1 Lacs.
Option Sum Insured Threshold Level
A 3,00,000 2,00,000
B 5,00,000 2,00,000
C 3,00,000 3,00,000
D 5,00,000 3,00,000
E 7,00,000 3,00,000
F 5,00,000 5,00,000
G 10,00,000 5,00,000
H 15,00,000 5,00,000

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3.Accident Care Insurance Policy

Accident come uninvited and can shatter your life and those of your loved ones.
Accident Care Insurance Policy offers protection to you and your family in case you meet with an accident.
Eligibility: Individuals with age group 18 to 70 years.
Sum Insured shall be fixed on the basis of the monthly income.

Risk Covered:
  • On Accidental Death
  • On permanent disability- total or partial – following an accident.
  • On Temporary Total Disablement, the insured person is eligible fro weekly benefit for 1% of Capital Sum Insured (following an accident), subject to maximum of Rs 5000/- per week up to 100 weeks.

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4.Jeevan Arogya (Table No 904) (Tax Saving u/s 80D)

Jeevan Arogya is a unique non participating non-linked health plan. It gives financial protection in case of hospitalization, surgery etc. Increasing health cover every year. Lump sum benefit irrespective of hospitalization cost. Flexible premium paying options Eligibility: Individuals with age group 18 to 70 years.
Sum Insured shall be fixed on the basis of the monthly income.

Benefits offered:
  • Hospital Cash Benefit (HCB)
  • Major Surgical Benefit (MSB)
  • Day Care procedure
  • Other Surgical Benefit.
  • Ambulance Benefit
  • Premium Waver Benefit (PWB)
Eligibility Criteria
  Min Max
Age 18 65
Maximum Cover Ceasing Age 80 Years
Term 15 62
Sum Assured 50000 No Limit
Modes Yearly, Half Yearly