| Scope of Cover | |
| Cashless facility | available at empanelled network of hospitals |
| Re-imbursement | available if treatment taken in non network hospital |
| Pre-hospitalisation | covers medical expenses upto 30 days prior to the hospitalisation |
| Post-hospitalisation | lumpsum calculated at 7% of the hospitalization expenses (excluding room charges) subject to a maximum of Rs.5,000 per occurrence |
| Section 1 (Health Insurance) | |
| Inpatient hospitalisation | covers sickness, illness, diseases and accidental injuries |
| Room rent, boarding | 2% of Sum Insured subject to a maximum of Rs 4000 per day for Class A cities; 1% of Sum Insured subject to a maximum of Rs. 3,000/- per day for Class B cities and 1% of the Sum Insured subject to a maximum of Rs. 1,000/- per day for other cities |
| nursing expenses , surgeon's fees, consultant's fees, anesthetist's and specialists fees | covered |
| Emergency ambulance | covered for Rs 750 per hospitalisation upto maximum of Rs 1500 per policy period |
| Operation Theatre charges, drugs and medicines diagnostic materials, cost of pace maker | covered |
| Section 2 (Life Insurance) | |
| Life Insurance | covers only policy proposer who is also an earning member; pays sum assured on demise of policyholder |
| Surrender value | Nil |
| Exclusions and Waiting Period | |
| under Section 1 (Health Cover) | |
| Pre-existing diseases | covered after a period of 48 months |
| No claim period | Any disease contracted during the first 30 days of commencement of the policy |
| Waiting Period | Certain diseases such as cataract, varicose veins etc. will be covered after a period of 2 years.Certain diseases such as hernia, piles, sinusitis etc. will be covered after a period of 1 year |
| under Section 2 (Life Insurance) | Suicide within 1 year whether sane or insane from commencement/ reinstatement of the policy. |
| Waiting Period | 90 days in case of section 2 (life cover) beginning from the inception of the policy (except for accidental death) |
| General Exclusions | Naturopathy treatmentNon allopathic treatmentCosmetic, beauty, weight reduction and other likely treatments.War, participation in any criminal activity or adventurous activities such as mountaineering etc or any other related condition |
| Annual Premium Option for those under Section 1 (Health Insurance) | ||||||
| Age(years) | Family Size | |||||
| 2Adults | 1Adult + 1Child | 1Adult + 2Children | 1Adult + 3Children | 2Adults + 1Child | 2Adults + 2Children | |
| Sum Insured Rs 1 lakh | ||||||
| 5 Months - 45 | 1765 | 1515 | 1640 | 1785 | 1890 | 2025 |
| 46-55 | NA | NA | NA | NA | NA | NA |
| 56-60 | NA | NA | NA | NA | NA | NA |
| Sum Insured Rs 2 lakh | ||||||
| 5 months-35 | 2890 | 2715 | 2835 | 3085 | 3295 | 3455 |
| 36-45 | 3140 | 3005 | 3075 | 3415 | 3555 | 3675 |
| 46-55 | 5535 | 5265 | 5410 | 5715 | 5925 | 6450 |
| 56-60 | 6400 | 6120 | 6225 | 6645 | 6965 | 7360 |
| Sum Insured Rs 3 lakh | ||||||
| 5 months-35 | 3985 | 3710 | 3825 | 4125 | 4190 | 4310 |
| 36-45 | 4360 | 3940 | 4110 | 4440 | 4830 | 5110 |
| 46-55 | 7605 | 6930 | 7160 | 7630 | 7865 | 8400 |
| 56-60 | 10030 | 9185 | 9725 | 10095 | 10625 | 11090 |
| Sum Insured Rs 4 lakh | ||||||
| 5 months-35 | 5195 | 4750 | 4910 | 5365 | 5295 | 5645 |
| 36-45 | 5565 | 5070 | 5250 | 5725 | 5775 | 6240 |
| 46-55 | 10510 | 9660 | 10150 | 10980 | 11270 | 11870 |
| 56-60 | 13515 | 12730 | 13210 | 13755 | 14290 | 14890 |
| Sum Insured Rs 5 lakh | ||||||
| 5 months-35 | 5920 | 5370 | 5630 | 6035 | 6345 | 6875 |
| 36-45 | 6525 | 5955 | 6285 | 6770 | 7045 | 7675 |
| 46-55 | 12010 | 11550 | 11865 | 12390 | 12815 | 13210 |
| 56-60 | 15855 | 15225 | 15645 | 16275 | 16750 | 17450 |
| Indicative premium; exclusive of service tax | ||||||
| Annual Premium Option for those under Section 2 (Life Insurance) | ||||
| Age (in years) | Sum Insured (in Rs.) | |||
| 1 lakh | 2 lakh | 3 lakh | 5 lakh | |
| for those with Standard Age Proof | ||||
| 18-35 | 900 | 1300 | 1800 | 2800 |
| 36-45 | 1100 | 1900 | 2700 | 4300 |
| 46-50 | 1400 | 2400 | 3500 | 5600 |
| for those with non Standard Age Proof | ||||
| 18-35 | 1000 | 1600 | 2300 | 3500 |
| 36-45 | 1400 | 2400 | 3500 | 5600 |
| 46-50 | 1700 | 3100 | 4400 | 7200 |
| Indicative premium; exclusive of service tax | ||||
