Reliance Health Insurance

Reliance Health Insurance plans come equipped with a number of benefits and offers. The types of plans, riders, policy tenure, coverage, hospital network, and cashless services are some of the many advantages of the health plans.

Reliance General Insurance is one of the leading private general insurance companies of India. Reliance General Insurance offer an exhaustive and customized basket of insurance products that include motor, health, travel, student travel insurance etc with over 94 customized insurance products catering to the corporate, SME and individual customers.

Reliance General Insurance Highlights Updated on 17 Oct 2021

Features Specifications
Network Hospitals 4000+
Waiting Period for Pre-existing Disease 4 years
Incurred Claims Ratio 84.71%
Number of Policies Issued 82134
Grievances Solved 98.49%%
Renewability Lifetime

*For Year 2017-2018

Overview of Reliance General Insurance:

Reliance Health Insurance Plans

A leader in the private-sector of the Indian insurance industry, Reliance General Insurance Co. Ltd. brings to the market a range of protection solutions across varied lines including motor, travel, health, home etc. They are currently present in over 102 cities across India through various distribution channels viz. own-offices, websites, bancassurance partners, corporate alliances and brokers.

Their customer-base includes individuals as well as corporates and small and medium enterprises. Customer satisfaction is an integral part of their service mission while innovation drives their product development process.

This is made evident through the impressive array of plans forming a part of their health insurance line. Each of these plans is devised to meet the financial assurance needs of individuals and their families during times of medical adversity.

  1. Reliance HealthGain Policy
  2. Reliance Critical Illness Policy
  3. Reliance Personal Accident Polic

While the former is a conventional health insurance policy, the latter two are benefit policies offering specific coverage against the risk of an accident and critical illnesses respectively.

The key features and benefits of each of the plans are tabulated below:

Reliance HealthGain Policy:

The latest offering from Reliance General Insurance, this Reliance HealthGain Policy is all-encompassing with special benefits for single women and girl child. It comes with two vizoptions viz. Plan A and Plan B. The two plans are almost similar but Plan B offers more comprehensive coverage.

Entry Age 5 to 65 years (No maximum age limit for 3 Lac sum insurance in Plan A) Maximum: 65 years Minimum: Individual/floater- 5 years or above(Children between 91 days and up to 4 years can be covered under a floater with at least one member aged 21 years or above)
Policy Period 1 year and 2 year plans
Renewability Lifetime
Medical Screening For Plan A Needs to be performed for people above the age of 45 years For Plan B Needs to be performed for people above the age of 18 years
Basis Individual or Floater; (maximum 6 members; 2 members above the age of 21 and 4 children
Sum Assured - Rs.3 lakhs, 6 lakhs or 9 lakhs (Plan A) - Rs.12 lakhs, 15 lakhs or 18 lakhs (Plan B)
Cumulative Bonus Avail 33.33% increase in Base Sum Insured for every claim-free year. Maximum up to 100%, 33.33% decrease in Base Sum Insured for every claim year maximum up to the Bonus earned.
Reinstatement One time Reinstatement of up to 100% of sum insurance subject to the limit of 20% for the same illness
Discounts - Family Discount( Enjoy 5% discount for 2-3 members and 10% for 4-6 members on individual plans - Cross-sell Discount: 5% for existing customers of Reliance Private Car policy and Reliance Householder policy – Either of the following discounts : Female Proposer Discount - 5% for single women, Girl Child discount- %5 discount in floater plan for covering daughters till the age of 20 years.
Co-payment 20% per claim; subject to minimum entry age 61 years
Coverage - Inpatient hospitalisation: Single private room - Day care treatment - Pre/Post-hospitalisation (up to 60 days) - Donor hospitalisation: Lower amount between 50% base sum assured and up to Rs.5 lakhs - Domiciliary hospitalisation: : Lower amount between 10% of sum assured and up to Rs. 50,000 - Domestic Road Ambulance charges: Rs.1,500 (Plan A) Rs.3,000 (Plan B) - Pre-existing diseases; subject to a 3 year waiting period (2 year waiting period applicable to Named Illnesses)
Add-on Covers Accidental Death Cover: 1 Lakh Personal Accident cover for the insured(Applicable only for Plan B)
Benefits - Call option: Avail Call option after every claim-free year. It can be availed maximum 4 times of base sum insured provided the enhanced sum insurance disc <=50 lacs and can be exercised till the age of 60 years. After every 4 claim-free years avail up to 4 times of base sum insured.(Considering the total sum insured is less than or equal to Rs. 50 lakhs) can be exercised up to the age of 60 years Up to 4 times the chosen sum assured, subject to conditions. Policy service guarantee: In the event of delay in issuance of policy beyond 10 working days from the date of receipt of all the documents viz. Medical Reports, Premium etc you receive additional sum insurance of 10k in Plan A, and 20K in Plan B for the first policy period only. Cashless Service Guarantee: Cashless Claims-1% of claim amount for every delay of 6 business hour beyond 6 hours of receipt of all information/documents. Re-imbursement Claims: 1% of claim amount for every delay of 21 days beyond 21 days of receipt of information/documents(Maximum-6% for a claim amount) One time renewal premium waiver if the policy holder/insured suffers from any ‘named critical illness’

Reliance Critical Illness Policy:

Reliance Critical Illness Policy is a specialized benefit policy that provides financial protection against life threatening and lifestyle-disabling diseases.

Entry Age 18 yrs. to 65 yrs- 5 Lacs. 18 yrs to 60 yrs – 7 Lacs 18 yrs to 55 yrs- 10 Lacs
Policy Period 1 yr. or 3 yrs.
Renewability .Lifelong
Medical Screening Required for persons aged 45 yrs.+
Basis Individual
Sum Assured Rs.5 lakhs, Rs. 7 lakhs or Rs.10 lakh; lumpsum payout
Coverage Subject to survival above 30 days and 60 days after diagnosis of the illness for Category 1 and Category 2 respectively. - Life Threatening Illnesses: Multiple Sclerosis, Cancer, Major organ transplant, Aorta Graft Surgery, Third Degree Burns - Lifestyle Disabling: Coma, Total Blindness, Quadriplegia Heart Valve Replacement, Last Stage Renal Disease
Renewal Rewards 5% No Claim discount upon every Claim-free renewal for 1 year policy term & 10% No Claim discount on cumulative basis upon every claim free 3 year policy term subject to a maximum of 50%.

Reliance Personal Accident Policy:

While health plans cover expenses pertaining to illnesses and injuries, this benefit policy helps protect against financial losses due to death or disability resulting from accidents.

Entry Age 5 yrs. to 70 yrs.; insured persons can be considered children between the ages 5 yrs. and 25 yrs.
Basis Single + Family Package
Sum Assured/Coverage Single Insured: As a percentage of the chosen sum assured Death, Total Permanent Disability, Loss of both limbs or both eyes, Loss of one limb and one eye - 100%, Loss of one limb or eye - 50%; Partial Permanent Disability - 1% to 75%, subject to provisions. Family Package: Spouse: If employed - chosen sum assured, if not employed - lower of Rs.1 lakh and 50% sum assured Each dependent child (5 yrs. to 25 yrs).: Lower of 25% of sum assured and Rs.50,000 Enhancement of basic sum assured for every claim-free year: 5% to 50%
Premiums 0.45 to 1.75 per thousand of sum assured depending on risk assessment; rates increase beyond 75 yrs
Add-on Covers 0.45 to 1.75 per thousand of sum assured depending on risk assessment; rates increase beyond 75 yrs
Benefits Education fund: 2 children Reimbursement of costs to bring the body home: Up to Rs.2,500

Note: Information provided on the above mentioned plans is not exhaustive. It is always advisable to note the exclusions and terms and conditions, including current GST and similar charges pertaining to a specific policy.

How to File a Claim with Reliance Health Insurance?

Reliance Health Insurance processes 2 types of claims:

  1. Claim process for cashless hospitalisation: Insured member can admitted in any of the network hospitals of Reliance General Insurance and display the Reliance Health Card at the helpdesk. The hospital will submit a pre-authorisation request form to the TPA of Reliance Health Insurance. Upon approval, the hospital will provide cashless treatment to the insured member. In the case of rejection, the insured member can proceed with the treatment but will have to pay the bills out of his or her pocket and later file a reimbursement claim for the medical expenses.
  2. Claim process for hospitalisation with reimbursement facility: Insured member has to intimate the insurer or TPA of the planned hospitalisation prior to admission or in the case of emergency hospitalisation, within 24 hours of admission. At the time of discharge, collect all the original medical documents and submit it to the insurer along with a duly-filled reimbursement claim form. The insurer will approve or deny the claim as per the policy terms and conditions.

Incurred Claims Ratio of Reliance Health Insurance for the Year 2017-18

Net Earned Premium (in Crore) Net Claims Paid (in Crore) Incurred Claims Ratio (in %)
Rs.671.16 crore Rs.715.08 crore 106.54%

Reliance Health Insurance FAQs:

  1. Why do I need health insurance?

  2. Health insurance policies are your safeguard against unexpected health complications that may prove financially burdensome to you or your family members. Such policies provide sufficient cover for an individual or groups of individuals throughout the insured period. Also, some tax benefits are applicable for health insurance policyholders according to Section 80D of the Indian Income Tax Act.

  3. Can I change the nominee midway through the policy?

  4. Changing nominee is a simple task and can be done anytime during the policy tenure with the insurer. All you have to do is provide the new details to Reliance General.

  5. Can I change the insured amount mid-way through a policy?

  6. This is not possible. However, customers may opt for a different premium at the time of policy renewal, if the company approves it.

  7. What is the general time frame for activation of health insurance policy?

  8. For individuals not more than 45 years of age, policies are approved instantly. For other cases, policies are approved after receiving all the requisite medical reports.

  9. How do I cancel the policy?

  10. Policy cancellation is a simple process that involves writing a letter subjected the same, and addressed to Reliance General Insurance. On receipt of the letter, the premium amount shall be refunded, subject to the unexpired policy being less than 6 months old, and no claim having been lodged during that time.

  11. Are one-day treatments covered by the policy?

  12. Hospitalization treatments are considered for periods more than 1 day. But some specific day care treatments are provided which eliminate the need for extended stays in a hospital, and are covered by Reliance, such as:

    • Chemotherapy
    • Dialysis
    • Lithotripsy
    • Radiotherapy
    • Curettage and Dilation
    • Tonsillectomy
    • Cardiac Catheterization
    • Other new surgeries/procedures
  13. What if I didn’t use the health insurance plan throughout its tenure?

  14. If you don’t make any claims on your policy for a year, you earn a cumulative bonus of 33.33% on your base sum insured, at no extra cost. However, the cumulative bonus can only be accumulated equal to the amount of base sum insured

  15. Is there any deadline for submitting claims form in case of reimbursements?

  16. It is advisable to file claims as soon as possible once reimbursements are in order. The Claim forms can be submitted at Reliance General Offices, may be routed through the Rcare Team

  17. Is there a list of documents I have to submit for claims process?

  18. The following documents have to be submitted with the claim form:

    • First doctor’s prescription denoting the start of symptoms.
    • Hospital bill and receipts
    • All related treatment papers and prescriptions.
    • Diagnostic reports such as ECG, X-ray etc.
    • All hospital, medical, diagnostic center, and medical shop bills in original.
    • Discharge card from hospital.
    • FIR report copy, if any.

Other Products from Reliance Group:

News About Reliance Health Insurance

  • Reliance Capital to turn its health insurance arm into a standalone subsidiary

    Reliance Capital has plans to carve out Reliance Health Insurance from its general insurance business and make it a standalone subsidiary. The move has been approved by the Board of Reliance General Insurance and is subject to necessary approvals from IRDAI (Insurance Regulatory and Development Authority of India) and other authorities. Reliance Health Insurance, which is a profitable segment of the non-life industry, will be wholly-owned by Reliance Capital. In a statement, Reliance quoted that the proposal is expected to enhance management focus on health insurance and offer flexibility to the company through global leaders as equity and strategic partners. The company has appointed a new CEO, Ravi Viswanath who comes with an international experience of more than 20 years in health insurance. Reliance Health Insurance has recorded gross written premium of Rs.570 crore as on 31st March, 2016 with the help of more than 175 branches all over the country.

    20 March 2017

  • Reliance General Insurance partners with Syrian Catholic Bank

    Reliance General Insurance has partnered with Catholic Syrian Bank to widen its distribution network in the country. UCO Bank was the only bancassurance partner of Reliance till 2016. As stated by the CEO of Reliance General Insurance, Rakesh Jain, the company has tie up with many banking partners to sell their policies. The list includes Bank of India, IndusInd Bank, Andhra Bank, Bank of Bahrain & Kuwait, Doha Bank, and SVC Bank. With the new partnership, Reliance General Insurance will look forward to selling its products to 1.5 customers of Catholic Syrian Bank.

    16 March 2017

  • Reliance General Insurance enters into a Corporate Agency agreement with IndusInd Bank

    As the first tie-up after IRDAI’s announcement, Reliance General Insurance has signed a Corporate Agency agreement with IndusInd Bank in order to promote and sell its general insurance products. Reliance General Insurance will be extending its distribution channels across IndusInd Bank branches. As a top insurer in India, Reliance General Insurance offers health insurance, motor insurance, home insurance, travel insurance and other personalised products for customers. IndusInd Bank’s banking portfolio includes products like loans, insurance, investments, deposits, demat and forex services, mutual funds, etc.

    25 May 2016

  • Reliance Capital may spin off Health Insurance Business

    Reliance Capital has indicated it may create a separate unit of its health insurance business from Reliance General to eventually merge it with Cigna TTK Health Insurance. Cigna TTK hopes to restructure with Reliance General stepping in TTK’s place.

    Currently, Cigna TTK is a joint undertaking between Cigna Corporation, a US based company, and TTK Group, an Indian business group. Reliance General recorded good business from its health insurance segment. It hopes to hive off its health insurance segment to focus on and improve business form other general insurance segments.

    3 June 2015

  • 99 year renewal plan by Reliance Health Insurance

    Private life insurance major Reliance Life has launched a new protection plan called ‘Health Total’. Under this plan, policyholders can renew coverage up to 99 years of age.

    This non-participating, non-linked plan is valid for 5 years and premiums payments can be made through the regular pay mode. It comes with two coverage options to be chosen by the customer i.e. the option of higher coverage by choosing a higher sum assured or the option of receiving higher benefits through Medical Reimbursements.

    Coverage includes hospitalisation including ICU costs and surgeries. It also covers 10 specified critical illnesses. Policyholders can make cashless claims under these plans at any one of the company’s 4000 network hospitals.

    07 May 2015

  • Reliance Capital Looking Towards Foreign Investors Post Insurance Bill

    The passage of the Insurance Bill in the Parliament is likely to bring in foreign direct investment (FDI) of 8-10 billion into the insurance sector. Reliance Capital, a major private insurer, has announced its plans to start negotiations with foreign partners for buying stakes in the company. Sam Ghosh, Reliance Capital CEO, has welcomed the move and said it will bring in much-needed capital for the sector, and assist in increasing penetration of insurance throughout the country. The company has started looking for foreign investors for its health insurance arm. Other major Indian players including Bajaj Capital and Religare Enterprises have also welcomed the move and are upbeat about the developments going into the future, as per statements made by the respective heads of the companies.

    Shachindra Nath, CEO of Religare, has also said that the bill signals a nod to global insurance companies, as well as foreign investors to expand footprint in India by infusing fresh capital. MD of Royal Sundaram Alliance Insurance, Ajay Bimbhet went as far as to say that the bill denotes a historic move for the insurance sector in India. He pointed to the primary goal of universal health for the government, and has expressed confidence in the market in terms of innovation and growth going forward.

    16 March 2015

  • Reliance Capital Eyes Opportunities in Health Insurance Segment

    Sam Ghosh, CEO of Reliance Capital, highlighted the potential for growth in the general insurance industry through the health insurance product line. Noting that about 25% of general insurance business is brought in from health insurance products, he underlines the importance of this segment in contributing towards growth and profitability.

    Further noting the expected implementation of the Insurance Amendment Bill, likely to be tabled at the winter session of Parliament, Ghosh sees greater opportunities for Reliance Capital to strengthen its position in this segment through possible collaborations and aims 100% growth in health insurance business.

    24 November 2014

GST rate of 18% applicable for all financial services effective July 1, 2017.

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