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| Eligibility | |
| Entry Age (years) | |
| Minimum | 18 |
| Maximum | 55 |
| Maximum Policy Renewal Age (years) | 65 |
| Coverage Type | Family floater |
| Sum Insured (Rs) | |
| Maximum | 10 lakh |
| Minimum | 1 lakh |
| Policy Term (years) | 1 |
| Discount | 5% on premium if insurer opts out of Third Party Administrator services |
| No Claim Bonus | Discount of 5% on premium for each claim fre year subject to maximum of 20% |
| Pre Policy Medical Check Up | Not required for persons upto 60 years of age |
| Co Payment Clause | 10% of admissible claim under Silver plan |
| Customer Service | |
| Address |
Oriental House, A-25/27, Asaf Ali Road, New Delhi - 110002 |
| Mail to | [email protected] |
| Call to | 1800 11 8485 (toll free), 011-33208485(non toll free) |
| Network Hospitals | List is available on company's website under Customer Services head. |
| Scope Of Cover | ||
| Silver Plan | Gold Plan | |
| Cashless facility | available if treatment availed in a network hospital | |
| Reimbursement facility | available if treatment availed in a non-network hospital | |
| Section A | ||
| Hospitalisation expenses | ||
| Room, Boarding expenses as provided by the Hospital/Nursing Home | covered upto 1% of Sum Insured per day | |
| ICU expenses | covered upto 2% of Sum Insured per day | |
| Surgeon, Anesthetist, Medical Practitioner, Consultants, Specialists Fees, Nursing Expenses | covered as per the limits stated in the policy document | |
| Anesthesia, Blood, Oxygen, OT charges, Surgical appliances (any disposable surgical consumables subject to upper limit of 7% of Sum Insured), Medicines, drugs, Diagnostic material & X-Ray, Dialysis, Chemotherapy, Radiotherapy, cost of pacemaker, artificial limbs, Cost of stent & implants | ||
| Daily Hospital Cash Allowance | not allowed | 0.1% of sum insured per day per illness subject to a maximum of 10 days upto maximum of 1.5% of the sum insured during a policy period |
| Attendant Allowance (if a child below 10 years of age is admitted) | not allowed | Rs.500 per day of hospitalisation per illness for a maximum of 10 days per illness upto maximum of 15 days during the policy period. |
| Ambulance charges | Rs.1000/- per illness and limited to maximum 1% of the sum insured or Rs.3000/-whichever is less, for the entire policy period. | Rs.2000/- per illness and limited to maximum 1% of the sum insured or Rs.6000/-whichever is less, for the entire policy period. |
| Section B | ||
| Domiciliary Hospitalisation | ||
| Surgeon, Medical Practitioner, Consultants, Specialists Fees, Blood, Oxygen, Surgical Appliances, Medicines & Drugs, Diagnostic Material and Dialysis, Chemotherapy, Nursing expenses. | covered upto 10% of sum insured ; maximum Rs 25000 during the policy period | covered upto Rs 50000 during the policy period |
| Treatment for Dog bite (or bite of any other rapid animal like monkey, cat etc.) | pays upto Rs 5000 for immunization injections in any one policy | pays upto Rs 5000 for immunization injections in any one policy |
| Other benefit(s) | ||
| Organ donor's hospitalisation expenses | covered | |
| Add On Covers (require extra premium) | ||
| Personal Accident for self and dependents | Sum insured upto Rs.500,000 per person aged 18 years and above. 50% of this limit for persons less than 18 years | Sum insured upto Rs.10,00,000 per person aged 18 years and above. 50% of this limit for persons less than 18 years |
| Accidental death | pays 100% of sum insured | |
| Loss of Two entire Limbs, or sight of two eyes or one entire limb and sight of one eye | ||
| Loss of one entire Limb or sight of one eye | pays 50% of sum insured | |
| Permanent Total Disablement resulting in the insured becoming in engaging in any Employment or occupation whatsoever | pays 100% of sum insured | |
| Life Hardship Survival Benefit | not allowed | covers Cancer-metastasis (Stage-IV), End stage Renal disease (ESRD), Stroke leading to paralysis or paraplegia |
| Plan A | 15% of Sum Insured | |
| Plan B | 25% of Sum Insured | |
| Exclusions and Waiting Period | ||
| Pre-existing illnesses | will be covered after 4 consecutive renewals with the company | |
| Survival period in case of Life Hardship Benefit | 180 days or 270 days after discharge for Life Hardship Benefit available only with Gold Plan. | |
| General exclusions | AIDS or related ailmentsTreatment of any mental or related diseaseBeauty and cosmetic treatments | |