Entry age and eligibility
- 18 years, with no maximum age limit.
- Children can be covered from 3 months of age to 23 years if either parent is covered.
- Entry age for add-on critical illness cover is 65 years.
- Pre-policy medical tests required for new policies to those over 50 years of age.
Policy period and renewal
- Annual policy.
- Lifetime renewability.
- 30 day grace period for renewals.
- Sum insured increases by 5% on renewals after every claim-free year up to a maximum of 50% with cumulative bonus.
Sum insured options
For individual policies
Rs.1 lakh to Rs.5 lakhs in increments of Rs.1 lakh
For floater policies
Rs.2 lakh to Rs.5 lakh in increments of Rs.1 lakh.
- Hospitalization expenses.
- Costs of OT, diagnostic tests, blood, oxygen, internal appliances like pacemakers, etc.
- Room rent limited to 1% of sum insured, up to a maximum sub-limit of Rs.4,000 per day.
- ICU rent limited to 2% of sum insured, up to a maximum sub-limit of Rs.6,000 per day.
- Pre hospitalization medical expenses for up to 30 days before hospitalization.
- Post hospitalization medical expenses for up to 60 days after discharge.
- Day care procedures that require less than 24 hours of hospitalization.
- Expenses on domiciliary hospitalization which lasts a minimum of 3 days.
- Hospitalization due to accident if your sum insured gets used up at some point in the year and you need to cover your second hospitalization due to accident, your sum insured will be ‘reinstated’ or ‘replenished’ up to the claim amount (but not exceeding the initial sum insured). This is available once during the policy-year.
- Maternity cover. 10% of sum insured or Rs.20,000 for normal delivery and 20% of sum insured or Rs.40,000 for a caesarean section.
- New-born baby cover. New-borns will be covered for up to 90 days from the date of birth, post which an additional premium can be paid to cover them under your policy.
- Ayurvedic treatment cover for non-cosmetic treatments up to Rs.25,000.
- Pre-existing diseases are covered after 36 months of continuous policy coverage.
Available on the payment of an additional premium are:
- Double sum insured for treatment of a critical illness.
- Waiver of room rent sub limits.
- Hospital cash – Rs.500 per day from 4th day to 10th day of hospitalization.
- Ambulance charges – Rs.1,500 per hospitalization.
- Recovery benefit – Rs.5,000 when hospitalization exceeds 10 days.
- Health check-ups for all insured persons at the end of 4 continuous claim-free years, limited to 1% of sum insured excluding cumulative bonus.
- Family floater – coverage for insured person, legal spouse and 2 children under the same policy and single sum insured.
- Family discount of 10% is available on the total premium payable if you take individual policies for your entire family.
- Two-year policy option allows for a discount of 5% on the combined premiums for 2 years.
- Co-payment of 10% per claim for those above 80 years of age.
- Hassle free claims process by an in-house team that processes claims and settles decisions within 6 – 8 business hours.
Income tax benefit
Premium paid on this policy is exempt from income tax under Section 80D of the income tax act, 1961.
Treatment arising from or traceable to:
- Pre-existing diseases / illnesses / injuries / conditions for up to 3 years from the start of the policy.
- Intentional self-injury, attempted suicide.
- Any disease contracted during the first 30 days that the policy is in force.
- Cataract, benign prostatic hypertrophy, congenital internal diseases, fistula, piles, and hysterectomy for menorrhagia or fibromyoma, hernia, sinusitis and related disorders for the first 2 years of the policy.
- STDs, HIV / AIDS and its complications.
- Alcohol or drug abuse.