Individual Mediclaim
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Individual Mediclaim

Product Information

The policy is available to persons between age of 18 and 65 years.

Dependent children between the age of 3 months and 18 years can be covered provided at least one parent is covered at the same time. Dependent parents can also be covered with the family.

Sum insured range is between `50,000 and 5 lakhs, in multiples of `25,000/-.

The policy can be renewed lifelong.

Coverage

The policy provides the following benefits.

1) Reimbursement of hospitalisation expenses which are reasonably and necessarily incurred, under the following heads :

  • Room, boarding & nursing expenses upto 1% of the sum insured per day& 2% of sum insured per day for ICU. subject to an overall limit of 25% of the sum insured.
  • Expenses incurred for fees of surgeon, anaesthetist, medical practitioner, consultant and specialist subject to an overall limit of 25% of the sum insured
  • Expenses incurred on account of anaesthesia, blood, oxygen, operation theatre charges, surgical appliances, medicines and drugs, diagnostic material, X-ray, dialysis, chemotherapy, radiotherapy, cost of pacemaker, artificial limbs and cost of organs, hospitalization expenses of organ donor  and similar expenses subject to an overall limit of 50% of the sum insured.
  • Ambulance charges upto 1% of the sum insured, subject to maximum of `2000/- in a policy period.

 

2) Expenses for Ayurveda and Homeopathy treatment are admissible upto 20% of the sum insured for any one illness.

 

3) Cover for 140+ day care procedures which require hospitalization for less than 24 hrs.

 

 

 

4) Good health incentives: Cumulative bonus @5% of sum insured for each claim free policy year provided the policy is renewed without break. Health check up expenses will be reimbursed once at the end of a block of 4 continuous claim free policy years, upto a maximum of 1% of the average sum insured of the block.

 

5) Cashless facility available in over 6000+ hospitals across India.

 

6) Family discount: Discount of 10% will be allowed on the total premium if policy is bought for family comprising the insured and/or spouse, dependent children, dependent parents.

 

7) Premium paid for the policy towards self, spouse, dependent children and dependent parents are exempt from Income Tax under Sec. 80D of the l.T. Act.

Key Benefits

The policy covers hospitalization expenses reasonably and necessarily incurred for treatment of illness/disease or injury contracted/sustained by the insured persons during the policy period. It also covers 140+ day care procedures/ surgeries.

Not Covered

  1. No claims would be paid during the first 30 days of inception of the policy, except accidental claims.
  2. All pre-existing diseases will be covered after 48 months of continuous coverage with us.
  3. Waiting periods of 1/ 2 yrs. for certain specific diseases/ illness/ treatment.
  4. HIV/ AIDS/ STD etc.
  5. Pregnancy & related complications, obesity, cosmetic treatment, hormone replacement, genetic disorders.
  6. Psychiatric & psychosomatic disorders, disease/illness/accidental injury arising out of drug/ alcohol abuse.
  7. Dental treatment, cost of spectacles, contact lenses, hearing aid, cochlear implants.
  8. Hospitalisation primarily for diagnostic purposes.

FAQ's

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