Reliance HealthGain Health Insurance Plan

Entry Age

1. 5 Years and above.
2. For children 91 days to 4 years if at least one member is above 21 years of age

Basis

Individual / Family floater health insurance

Policy Period

1 year or 2 years

Renewability

Lifelong

Sum Insured

1. Plan A: Rs. 3 lakhs, Rs. 6 lakhs or Rs. 9 lakhs
2. Plan B: Rs. 12 lakhs, Rs. 15 lakhs or Rs. 18 lakhs

Discount

1. 5% discount is offered if a girl child or a single woman is insured under this policy
2. 5% discount when family members are covered individually under this policy

Co-Payments

Family Floater

Individual

Coverage

1. Pre hospitalisation expenses covered up to 60 days before hospitalisation
2. Post hospitalisation expenses covered up to 60 days after hospitalisation
3. Hospitalisation for covered injuries or illnesses if hospitalisation is for longer than 24 hours
4. Day care treatments for specified procedures or surgeries when hospitalisation is not required
5. Ambulance charges up to Rs. 1,500 under Plan A and Rs. 3,000 under Plan B
6. Medical expenses incurred by organ donors will be covered up to 50% of the sum insured subject to a limit of Rs. 5 lakhs
7. Medical expense for domiciliary treatment Pre-existing conditions will be covered after a waiting period of 3 years
8. Specific ailments will be covered after a period of 2 years
9. Only accidental injuries will be covered in the first 30 days of the policy
10. Room rent for single occupancy room

Benefits

1. Every claim free year increments the base sum insured by 33.33% subject to a maximum of 100%
2. If there is a delay in issuing the policy Under Plan A
3. The policy can cover up to 6 people individually (4 children and 2 adults)
4. If no claims are made for 4 consecutive years the base sum insured can be double twice in your life
5. Delays in settling cashless claims will entitle you to 1% (subject to a limit of 6%) of the claim amount
6. If there is a delay of more than 10 days in issuing the policy then you get an additional sum assured of Rs. 10,000 under Plan A and Rs. 20,000 under Plan B
7. Under plan B the insurance can be renewed for free once if the insured is diagnosed with a specified critical illness
8. Discounts ranging from 10% to 50% on medicines, consultation and investigations at specified outlets
9. Access to general physicians or specialists to discuss health issues over the phone

Add-ons

Accidental death cover of Rs. 1 lakh under Plan B. Valid for 1 year and provided for every claim-free year

Exclusions

1. Cosmetic surgeries
2. Intentional harm done to self which includes substance abuse like drugs and alcohol
3. Treatment outside India will not be covered
4. Stem cell treatments will not be covered
5. Dental procedures or surgeries will not be covered
6. Non-allopathic treatment including experimental or unproven treatment will not be covered