INDIVIDUAL HEALTH INSURANCE
Life is full of surprises… some bitter, some sweet. For medical emergencies like surgeries, accidents and sudden illnesses, we bring you a complete insurance plan that is flexible enough to cover every member of your family. Anyone in your family can avail of the cover, it can be you, your spouse or your children.
This policy provides for cashless hospitalization in India in designated hospitals for the treatment of any disease or accidental injury suffered during period.
For obtaining mediclaim policy the proposer has to fill up the proposal form and submit two latest stamps sized colored photographs of each family member to be insured.
A discount of 10% in premium is on covering the entire family.
SCOPE OF THE COVER
This policy becomes operative when treatment is taken as an in - patient in a hospital / nursing home in India which satisfies the following criteria:
The policy also reimburses through TPA relevant medical expenses incurred up to 30 days prior to and 60 days after hospitalization subject to the overall sum insured.
1st Month Exclusions
In case of first proposal no claim except those rising out of accidents can be paid in the 1st 30 days of commencement of cover.
1st , 2nd , 3rd & 4th Year Exclusion
The policy does not cover some disease / operations for 1, 2, 3 or 4 Years.
Pre - Existing Diseases
The policy does not cover any pre - existing diseases or anything arising there from. Some companies also offer coverage of pre - existing diseases after completion of four claim free policy years.
ADD ON COVERS
The policy can be extended to cover treatment taken in Nepal and / or Bhutan with prior permission from the insurance company.
The group mediclaim policy can be extended, on payment of additional premium, to cover maternity benefit i.e. expenses incurred in delivery, provided the extension is taken for all the members covered in the group.
WHO CAN TAKE THIS POLICY
The policy can be taken by any person residing in India between the age of 5 and 80 yrs. Children between the age of 3 months and 5 yrs can be covered provided one or both parents are covered concurrently.
HOW TO SELECT THE SUM INSURED
Various options are available ranging from Rs.2 Lacs to Rs.50 Lacs Sum Insured.
NO CLAIM BONUS
In individual mediclaim policy, a cumulative bonus of 5% is given on every claim free renewal whereby the sum insured is increased by 5% on renewal provided there has been no claim in the previous policy period. Maximum cumulative bonus permissible is 50% which would be given after 10 years claim free renewal. In the event of a claim, the increased percentage will be reduced by 10% subject to minimum of the basic sum insured selected.
FLOATER HEALTH INSURANCE POLICIES
Nowadays this is a best selling type of Mediclaim Policy . In this type of policy there is a common sum insured for the whole family & that sum insured floats amongst all family members. The total limit of claim admissible of all family members is also limited to that sum insured per annum. For eg. If there are 4 members in a family & has purchased Floater Mediclaim Policy for Rs 5 Lacs, than the limit of admissible claim per member during a year is Rs 5 Lacs as well as the total admissible limit of claim during the year is also Rs 5 Lacs for all 4 family members together.