The policy provides coverage for medical bills incurred due to hospitalisation and day care procedures. The policy also pays for homeopathic or ayurvedic treatment and emergency ambulance expenses.
It also covers treatment under Ayurvedic/Homeopathic and Unani system of medicine. Premium paid under this policy is eligible for tax benefit under Section 80D.
There is a capping on room rent and ICU/ICCU charges.
| Scope Of Cover | |
| Cashless Facility | Available at network hospitals |
| Reimbursement Facility | Available if treatment taken at any non empanelled hospital |
| Pre and post hospitalisation | covers medical expenses upto 30 days immediately prior and 60 days after discharge from hospitalisation |
| Inpatient Hospitalisation | Covered |
| Room rent/ ICU expenses | Room rent and boarding expenses will be covered upto 1% of Sum Insured per day and ICU expenses will be covered upto 2% of Sum Insured per day |
| Surgeon, Anesthetist, Medical Practitioner, Consultant's Specialist fees | Covered |
| Anesthesia, blood, oxygen, OT charges, surgical appliances, medicines, etc. | Covered |
| Day Care Procedures | Covered |
| Ayurvedic/ Homeopathic/ Unani treatment | Covered upto maximum 25% of Sum Insured |
| Emergency ambulance | Covered upto 1% of Sum Insured |
| Expenses of donor for organ transplant | Covered |
| Cost of health check up | Avaialble upto 1% of Sum Insured (restricted to Rs 5,000) at the end of a block of every 3 claim free years. |
| Exclusions and Waiting Period | |
| Pre-existing Diseases/ Illnesses | Covered after a period of 48 months |
| No claim period | 30 days commencing from inception of policy except for accidental injuries |
| Waiting Period | 24 months in the case of all internal and external benign tumors, cysts, polyps of any kind, including benign breast lumps, Benign ear, nose, throat disorders, Benign prostate hypertrophy, Cataract and age related eye ailments, Gastric/ Duodenal Ulcer, Gout and Rheumatism, Hernia of all types, Hydrocele, Infective Arthritis, Piles, Fissures and Fistula in anus, Pilonidal sinus, Sinusitis and related disorders, Prolapse inter Vertebral Disc and Spinal Diseases unless arising from Accident, Skin Disorders, Stone in Gall Bladder and Bile duct, excluding malignancy, Stones in Urinary system, Treatment for Menorrhagia/Fibromyoma, Myoma and Prolapsed uterus, Varicose Veins and Varicose Ulcers, Renal Failure. |
| 48 months in case the above illnesses arise from a pre-existing condition or joint replacement due to degenerative condition, age-related osteoarthritis and osteoporosis. | |
| General Exclusions | Self inflicted bodily injury, Domiciliary Treatment, Dental treatment, Cost of spectacles, braces, contact lenses, Naturopathy treatment, Bodily injury due to engagement in any illegal or criminal activities or due to engagement in adventurous acts such as parachuting, bunjee jumping etc. Bodily injury arising as a result of terrorism. Bodily injury or disease caused as a result of HIV/ AIDS or any related condition, and others. |
| Annual Premium (excluding taxes) | |||||||||||||
| Sum Insured | Age group | ||||||||||||
| <35 | 36-45 | 46-50 | 51-55 | 56-60 | 61-65 | >65 | |||||||
| 1,00,000 | 2708 | 2867 | 4640 | 6924 | 8941 | 10800 | 12400 | ||||||
| 2,00,000 | 3679 | 3898 | 6428 | 9694 | 12714 | 16907 | 22800 | ||||||
| 3,00,000 | 4051 | 4294 | 7136 | 10808 | 14272 | 19049 | 26814 | ||||||
| 4,00,000 | 4659 | 4938 | 8199 | 12410 | 16350 | 21797 | 30754 | ||||||
| 5,00,000 | 5420 | 5747 | 9532 | 14418 | 18954 | 25243 | 35693 | ||||||
| 6,00,000 | 5854 | 6208 | 10292 | 15564 | 20439 | 27208 | 38510 | ||||||
| 7,00,000 | 6288 | 6669 | 11052 | 16709 | 21925 | 29174 | 41327 | ||||||
| 8,00,000 | 6722 | 7130 | 11812 | 17854 | 23410 | 31139 | 44144 | ||||||
| 10,00,000 | 7600 | 8062 | 13349 | 20170 | 26414 | 35113 | 49841 | ||||||
| 12,00,000 | 8263 | 8766 | 14510 | 21919 | 28682 | 38114 | 54142 | ||||||
| 15,00,000 | 9369 | 9940 | 16445 | 24836 | 32465 | 43120 | 61316 | ||||||
