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  • L&T Health Insurance

    L & T Health Insurance
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    Cashless Treatment

    Customer Service

    Medical Coverage

    Claim Experience

    Company Limited L&T General Insurance Company Limited (L&T Insurance) is a wholly owned subsidiary of Larsen & Toubro Limited. L&T General Insurance offers products like Motor Insurance, Health Insurance, corporate Insurance and Home Insurance.


    L&T Health Insurance at a Glance

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    Coverage for your most loved ones

    Total members covered

    Coverage for a maximum of 4 family members with up to 2 adults and 2 children

    You get a choice of coverage tenure

    Pre and Post Hospitalization cover

    Medical expenses covered for 30 days before your hospitalization and 60 days for post hospitalization for related medical expenses

    The next best thing to having a doc in the family

    Health Check-ups

    For all Insured Persons at the end of four continuous claim free Policy Years

    * For a family health cover product.

    Critical Factors of the Plan

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    Not a paisa goes from your own pocket!

    Co-Pay

    10% copayment after the age of 80 years

    You?re covered for any future medical expenses

    Life long renewable

    Plans are lifelong renewable and covers you for your entire lifetime.

    Get essential cover for existing ailments

    Pre-existing Diseases

    Pre-existing diseases are covered after a 3 year waiting period

    Hospital room rent determines your treatment bill

    Room Rent

    No Sub-limits on hospital room rents

    *These Features may be included as part of different products and are subject to the insurer's terms & conditions.

    Additional Features of L&T Health Insurance

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    Good health offers multiple rewards

    Option to buy a two year policy at a 5 % discount

    The world is your healthcare oyster

    Cashless facility is available only at our network hospitals

    *These add-ons may be included as part of different products and are subject to the insurer's terms & conditions.

    Overview

    L&T General Insurance Co. Ltd. is a subsidiary owned entirely by Larsen & Toubro Ltd. , one of the largest Indian business enterprises.

    L&T General has developed assurance solutions for all segments of the market ranging from individuals to small and medium enterprises to large corporates and for all lines including property, casualty, motor and health among others. It pays particular attention to rural areas through its rural and micro insurance plans.

    The company has adopted a customer-centric approach, keeping quality at the forefront at all times. It follows a prudent and disciplined method to underwriting and leverages on technology to facilitate smooth and efficient operations.

    It benefits from the world-class branding of its parent group Larsen and Toubro which is known all over the globe for its strong standing in the fields of engineering, construction and technology. Financial services is a strategically important, though relatively new, segment in L&T’s business portfolio.

    L&T’s strong financials has placed it in an advantageous spot within the Indian insurance industry. Health insurance is a line of growing importance and L&T has a number of options for its customers in this segment as well.

    They have a host of interesting health insurance plans crafted for individuals and families alike.

    1. Medisure Prime Insurance
    2. Medisure Classic Insurance
    3. Medisure Super Top Up Insurance
    4. Medisure Plus Insurance
    5. Personal Accident Insurance

    Details of individual plans are provided below.

    Why Compare L&T Health Insurance Plans on BankBazaar?

    Medisure Prime Insurance

    Coverage

    Standard Cover

    • Hospitalisation - payout limit is the chosen sum assured.
    • Pre-hospitalisation: 60 days.
    • Post-hospitalisation: 90 days.
    • Ambulance costs: Rs.1,500 per hospitalisation (reimbursed).
    • Cash allowance: Rs.1,000 per day for hospital stay beyond 3 days; maximum 10 days.
    • Escort: Rs.500 per day for hospital stay beyond 3 days; maximum 8 days.
    • Health check costs: Reimbursed, upon completion of 2 successive renewals, for insured members aged 45 years and above.

    Prime Covers

    • Critical Illness Cover: 9 specific illnesses; sum assured is twice that of the base plan
    • Maternity/Newborn Cover:
      • Hospitalisation for delivery; payout is the lower of 5% of the chosen sum assured or Rs.25,000 (normal deliveries) and the lower of actuals or 10% of the sum assured or Rs.50,000 (c-sections).
      • Up to 2 children.
      • Waiting period: 4 years.
      • Newborn coverage is valid till 90 days from birth, subject to limits of the maternity cover.
      • Restoration of sum assured:
          • Hospitalisation due to accident; restored to 100% of original value after a successful claim, once until renewal, if balance for next claim is inadequate.
    • Lumpsum payout for recovery due to extended hospital stay: Rs.10,000.
    • Free health checks every two claim-free years, for insured members aged 45 years and above.
    • Pre-existing conditions subject to waiting period of 2 successive policy years.
    • All day care procedures limited to the chosen sum assured.
    • Organ donor hospitalisation expenses.

    Sum Assured

    • Rs.3 lakhs to Rs.10 lakhs, in increments of Rs.1 lakh.
    • Sub-limits: None; Co-payment of 10% for insured members over 80 years.
    • Basis: Individual or Family Floater (Family means the proposer, spouse and 2 dependent children aged below 18 years).
    • No-claim/Cumulative Bonus: Increase in sum assured upon renewal @ 5% after every claim-free year, maximum of 10 years i.e. 50%. (NCB earned in one year is utilised for subsequent claims).

    Premiums

    • Prime Cover: 1 year term: Rs. 4,290 to Rs.6,09,780; 2 year term: Rs.8,151 to Rs.11,03,445.
    • Depends on age, location, basis and family size.
    • Discount for more two additional members (maximum 6 members) for plan taken on individual basis i.e. premium payable and sum assured is applicable to each insured member.

    Policy Period

    • 1 year or 2 years.

    Benefits

    • Superior claim service: Approval for cashless claims within 6 hours or settlement of reimbursable claims within 6 working days; Rs.1,000 payout in case of delay.
    • Concierge service: For certain areas; assigned executive to help process cashless claims.
    • Personal Case Manager: For certain areas; assigned executive to discuss the policy.
    • 24-hour claim support.

    Eligibility

    • Entry Age: 18 years to 65 years; 3 months to 18 years for children, provided at least one parent is also covered.
    • No maximum renewability age.
    • Medical screening: Not required for persons below 45 years.

    Major Exclusions

    • Claims made within the 30 days immediately following policy inception.
    • Domiciliary treatment
    • 2 year waiting period for: Cataract, Benign Prostatic Hypertrophy, Congenital Internal Diseases, Anal Fistula, Piles, Hysterectomy, Hernia, Sinusitis and associated ailments.
    • Suicide attempts, self-harm, mental disorders, use of intoxicants.
    • HIV/AIDS and related illnesses.

    Other Features

    • Premium payments qualify for tax rebated U/S80D as per the law.
    • Free Look Period: 15 days from policy receipt, for cancellation, for refund subject to conditions.

    Medisure Classic Insurance

    Coverage

    • Inpatient hospitalization expenses (minimum stay of 24 hours):
      • Surgeon, Anaesthetist, Nurses, Specialists, OT, Diagnostic and Lab Tests, Medicines, Blood, Oxygen and prosthetic devices forming part of treatment.
      • Room and Nursing: Lower of actuals or 1% of the sum assured or Rs.4,000 for each day of stay.
      • ICU: Lower of actuals or 1% of the sum assured or Rs.6,000 for each day of stay.
      • Pre-hospitalization: 30 days.
      • Post-hospitalization: 60 days.
      • Day-care procedures: Approved on a case to case basis (does not include diagnostic and outpatient procedures).
      • Domiciliary Hospitalization: Includes pre-hospitalization costs up to 30 days.
    • Relapse of treated illnesses within 45 days of hospitalization.
    • Add-on coverage at additional premium:
      • For Critical Illness: Basic sum insured is doubled in the event of contracting any one of the specified critical illnesses; available to persons up to the age of 65.
      • To do away with sub-limits on room expenses.

      Sum Assured

      • Basis: Individual or Family Floater (Family includes Proposer/spouse/2 children up to 23 years.)
      • Individual basis: Rs.1 lakh to Rs.5 lakhs, in increments of Rs.1 lakh.
      • Floater basis: Rs.2 lakhs to Rs.5 lakhs, in increments of Rs.1 lakh.
      • Sub-limits:
        • Hospitalization Costs: Actuals or 1% of sum assured, whichever is lower; room, including nursing, charges: Up to Rs.4,000 a day.
        • ICU Costs: Actuals or 2% of sum assured; room, including nursing, charges: Up to Rs.6,000 a day.
        • Maternity/Newborn Cover: Lower of actuals or Rs.20,000 or 10% of sum assured (normal delivery); Lower of actuals or Rs.40,000 or 20% of sum assured (C-section).
      • No-claim/Cumulative Bonus: 5% increase in the sum assured, upon renewal, after every claim-free year, on a cumulative basis for a maximum bonus of 50%.
      • Up to 100% restoration to original sum assured: If balance sum assured, after the first claim, is inadequate to pay for second claim; the first claim amount is added back; One-time option for a policy period.
      • Maternity/Newborns: 10% of sum assured or Rs.20,000 (normal delivery) and 20% of sum assured or Rs.40,000 (C-sections); first 2 deliveries/terminations, waiting period of 4 years; newborn coverage for 90 days from birth.
      • Ayurvedic (non-cosmetic) Treatment: up to Rs.25,000 in a policy year for inpatient hospitalization more than 24 hours; prior approvals and waiting period apply.
      • Pre-existing conditions: Subject to a 3 year waiting period.

      Premiums

      • For policy period of 1 year: Rs.1, 994 to Rs.82, 642; For policy period of 2 years: Rs.3, 789 to Rs.1, 57,020.
      • Premiums are calculated based on: Age of the insured, Basis of the policy, Chosen sum assured, Family size, Add on covers and sub-limits.
      • Family Discount: 10% of total premium if the policy is taken on individual basis, for more than 2 additional members (maximum of 6).

      Policy Period

      • 1 year or 2 years.

      Benefits

      • Health checks after every 4 successive claim-free years; costs reimbursed up to 1% of sum assured.

      Eligibility

      • Entry Age: 18 years minimum; 3 months to 23 years for children
      • Medical screening: Required for persons above 50 years.

      Major Exclusions

      • Claims made within the 30 days immediately following policy inception.
      • Domiciliary treatment
      • 2 year waiting period for: Cataract, Benign Prostatic Hypertrophy, Congenital Internal
      • Diseases, Anal Fistula, Piles, Hysterectomy, Hernia, Sinusitis and associated ailments.
      • Suicide attempts, self-harm, mental disorders, use of intoxicants.
      • HIV/AIDS and related illnesses.

      Other Features

      • Premium payments qualify for deduction under section 80D of the Income Tax Act.
      • Free Look Period: 15 days from policy inception, for cancellation with refund (adjusted)

      Medisure Super Top-Up Insurance

      A top-up policy with a an option of deductibles, to enhance the cover of the base health insurance plan in an economical manner.

      Coverage

      • Inpatient Hospitalization expenses, no sub-limits.
      • Pre/Post Hospitalization expenses up to 30 and 60 days, respectively.
      • Pre-existing diseases subject to a waiting period of 3 successive years.
      • Day Care Procedures as approved for coverage; excludes diagnostic and outpatient procedures.

      Sum Assured

      • Amount:
        • Rs.3 lakhs or Rs.8 lakhs, deductible is Rs.2 lakhs.
        • Rs.7 lakhs or Rs.12 lakhs, deductible is Rs.3 lakhs.
        • Rs.6 lakhs, Rs.11 lakhs or Rs.16 lakhs, deductible is Rs.4 lakhs.
        • Rs.5 lakhs, Rs.10 lakhs, 15 lakhs or Rs.20 lakhs, deductible is Rs.5 lakhs.
      • Basis: Individual and Floater

      Premiums

      • Rs.865 to Rs.19, 157 (inclusive of 12.36% service tax); depends on age, sum assured and deductible, basis and family size.
      • 5% discount on total premium if 2 a year plan term is chosen.

      Policy Period

      • 1 year or 2 years.

      Eligibility

      • Entry Age: 18 to 65 years; 91 days to 23 years for children
      • Medical screening: For persons above 55 years

      Medisure Plus Insurance

      A novel offering from L&T that offers a standard health insurance cover while letting customers design the plan to suit their requirements.

      Coverage

      • Standard: Grandparents, Siblings, Grandchildren, Sons/Daughters-in-law, Nieces, Nephews. Customised (at no extra premium): Waive coverage of pre/post hospitalization expenses and deductibles.
      • Customised (nominal, additional premium): Add-on cover for critical illnesses, Restoration of Sum Assured, Waiver of sub-limits on room and ICU expenses, Extended pre/post-hospitalization coverage, Recovery benefits, Escort expenses.

      Sum Assured

      • Basis: Individual or Family Floater.
      • Up to Rs.25 lakhs.

      Premiums

      • 10% discount on final premium for more than 2 additional members, if plan is taken on an individual basis

      Policy Period

      • 1 year or 2 years.

      Eligibility

      • Entry Age: 18 years to 65 years; 91 days to 23 years for children.
      • Medical screening:
      • Parents and in-laws under same plan if taken on individual basis

      Personal Accident Insurance

      The Personal Accident Insurance offered by L&T is a product that is aimed specifically at damages caused by an unfortunate incident. In its purview are instances of accidental death and even permanent or temporary disability cause by such incidents, to the extent of covering disability caused by a loss of limbs. Some of the benefits the policy will offer are things like payment of the cost of a child’s education and covering the loss of income that may be incurred as result of the accident. It will also cover the cost of hospitalisation as per the premiums paid. This policy is available to anyone between the ages of 5 years and 70 years.

      L&T Health Insurance FAQs

      1. What are the hospital claim exclusions in the Medisure Classic insurance policy?
      2. The major hospital claim exclusions in the Medisure Classic are as follows-

        • Hysterectomy, Anal Fistula, Hernia, Piles, Sinusitis and ailments associated with the same.
        • HIV/AIDS and any illnesses related to the same.
        • Suicide attempts, self-harm, mental disorders, use of intoxicants.
      3. What are the optional features of coverage of the L&T health insurance plan?
      4. Following are the optional features of the L&T health insurance plan-

        • Two year policy renewal offered after 24 months versus the norm of 12 months
        • After the age of 45, free health checkup offered
        • Health insurance offered on pre-existing disease after completing 24 months of holding health insurance policy
        • Issuance of policy instantly
        • Lifetime renewal of policy offered
        • Equivalent of the sum insured is given as additional coverage for treatment of critical illness excluding cumulative bonus
        • Room rent sub limits waiver available
      5. What is the advantage of taking a L&T health insurance policy?
      6. The advantages of taking the L&T health insurance policy are as follows-

        • Assurance of claims service wherein all cashless decisions for requests made between 9 am and 9 pm on working days is settled within 6 hours. All cash reimbursement is made within 6 working days.
        • Provision of concierge service on request in select cities which includes assistance on any cashless procedures between 9 am and 9 pm, when there is a claim.
        • A personal case manager is assigned upon request to define benefits and resolve any doubts.
        • Around the clock services for claims assistance provided.
      7. What are the various critical illnesses included in the L&T health insurance plan?
      8. The list of critical illnesses including in the L&T health insurance plan is as follows -

        • Cancer
        • Coronary artery bypass surgery
        • First heart attack
        • Kidney failure
        • Multiple sclerosis
        • Major organ transplant
        • Stroke
        • Aorta graft surgery
        • Primary pulmonary arterial hypertension
      9. What is the age limit to be eligible to be covered by L&T health insurance plan?
        • The age limit of the proposer of the L&T health insurance plan is between the ages of 18 years and 65 years of age.
        • There is lifetime renewal of the L&T health insurance policy once the policy has been issued.
        • If one or both parents are insured under the L&T health insurance policy then children up to 18 years of age can also be covered under the policy.
        • For subscribers who are above the age of 45 years, the issuance of the L&T health insurance policy is subject to pre acceptance of medical and thereof approval by L&T health insurance.
      10. I have a Medisure Prime insurance policy. What is the policy period for the same?
      11. The policy period for the Medisure Prime insurance policy is 1 year or 2 years.

        I would like to apply for the Medisure Classic insurance policy. What is the eligibility for the same?

        In order to apply for the Medisure Classic insurance policy, you have to fulfill the following counts-

        • Completed 18 years of age
        • Persons above 50 years of age require medical screening
      12. Are there any discounts offered on the premiums of Medisure Prime insurance policy?
      13. Yes, there are discounts offered for two or more additional members upto a maximum of 6 members for a Medisure Prime policy taken on individual basis.

        The sum assured as well as the premium payable is applicable to each of the insured members.

      14. What health insurance plans are offered by L&T health insurance?
      15. Following are the insurance policies offered by L&T health insurance-

        • Medisure Plus Insurance
        • Medisure Classic Insurance
        • Medisure Prime Insurance
        • Medisure Super Top Up Insurance

      16. I have a Medisure Super Top Up Insurance policy. Can my parents be insured under the same plan?
      17. Under the Medisure Super Top Up Insurance policy, parents and inlaws both can be insured under the same plan so along as the plan is taken on individual basis.

      18. I am 60 years old. Am I eligible for the Medisure Super Top Up Insurance policy?
      19. Yes, you are eligible for the Medisure Super Top Up Insurance policy as long as you have undergone medical screening which is a mandate for persons above 55 years applying for the Medisure Super Top Up Insurance policy.

      Examples of Network Hospitals in Major Cities

      CITY NAME OF HOSPITAL
      DELHI JEEVAN ANMOL HOSPITAL
      MUMBAI HOLY SPIRIT HOSPITAL
      KOLKATA KOTHARI MEDICAL CENTRE
      BANGALORE HEALTHCARE GLOBAL ENTERPRISES LIMITED
      CHENNAI K. J. HOSPITAL PVT. LTD.

      *Disclaimer - This is not an exhaustive list but an indicative representation of hospitals that form a part of the company's wider network.


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