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Entry Age
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18 years - 60 years.
Dependent children between the age of 3 months and 25 years can also be covered.
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Policy Period
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Issued for a period of 1 year.
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Renewability
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Renewable till the age of 65 years.
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Basis
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Family floater policy covers individual, spouse and up to 2 dependent children under a single floater sum insured.
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Sum Insured
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Rs.2 Lakhs – Rs.5 Lakhs.
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Plan Benefits
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- Reimbursement of hospitalisation expenses:
- Room rent, nursing expenses and other charges incurred at the hospital: Non ICU- 1% of the sum insured is provided per day. ICU – 2% of the sum insured in giver per day.
- Expenses of surgeon, anaesthetist, medical practitioner, consultant, specialist’s fees and nursing expenses are covered.
- The following expenses are covered:
- Anaesthesia
- Blood
- Oxygen
- Operation theatre charges
- Surgical appliances
- Medicines and drugs
- Diagnostic material
- X-ray
- Dialysis
- Chemotherapy
- Radiotherapy
- Cost of pacemaker
- Artificial limbs
- Cost of organs, etc.
- On paying extra premium, existing conditions like diabetes and hypertension can be covered.
- Pre hospitalisation expenses incurred 15 days before hospitalisation are covered.
- Post hospitalisation expenses incurred 30 days after hospitalisation are covered.
- Cashless facility can be availed through Third Party Administrator.
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Tax Benefit
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The premiums paid up to Rs.15,000 is allowed as deductions every year under the Section 80D of the Income Tax Act. The exemption for senior citizen is Rs.20,000.
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Exclusion
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- Total expenses payable to one illness is only 50% of the sum insured.
- Pre-existing conditions are excluded for the first 4 years.
- Except for hospitalisation due to accidents, other treatments within the first 30 days of buying the policy are excluded.
- There is a 2 year exclusion on:
- Cataract
- Sinusitis
- Piles
- Hysterectomy
- Hernia
- Hydrocele
- Benign prostatic hypertrophy
- Stone removal
- Joint replacement
- Surgical treatment of tonsils, etc.
- Expenses arising from intentional self-injury, drug and alcohol abuse are excluded.
- Cost of vitamins unless they are a part of the treatment.
- Diseases since birth are excluded.
- Medical expenses arising from HIV, AIDS and related diseases are excluded.
- Cost of contact lenses, spectacles and hearing aids are excluded.
- Non allopathic treatment costs are excluded.
- Conditions caused by war or nuclear weapons are excluded
- Pregnancy, miscarriage, abortion or other child-birth related conditions are not covered.
- Service charge, admission fee or surcharge levied by the hospital are not covered.
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