"Powered By Ideas, Ideals & Idealism"… A Blog By Prerna Jain !!
The common features for comfort of a health insurance plan:-
1. 24 hour hospitalization is min required for cashless facility
2. day care treatment- covers 541 diseases (no 24 Hr hospitalization required )
3. room rent – general ward, twin suite, single private, deluxe etc
4. I C U rent- no capping
5. doctor/nursing fee- no limit
6. HOME HOSPITALIZATION /domiciliary treatment – 10%
7 . pre- hospitalization care – 30 days
8. post hospitalization care – 60 days
9 . Organ donor’s medical expenses will be covered
10 . ambulance cover
11 . restoration facility – For sum insured of Rs.3 lakh and above, there is 100% automatic restoration of the sum insured (SI) in case the original is exhausted.
12 . free health check up coupons
13 . The policy provides for one medical second opinion for each major illness diagnosed in one policy period
14 . cumulative/ no claim bonus
15. individual / floater option for family
16 . group policy for corporate
17. pregnancy (it is natural phenomenon and not a disease)
18 . Vaccination of children up to the age of 12 years will be covered up to Rs. 1,000
19. Allopathic and non allopathic- Ayurvedic , homeopathic , Unani and Sidha treatments will also be covered
20. hospitalization cash-For staying in hospital for more than 3 days, some minor expenses are provided on daily basis (if you are employed/ salaried, you get daily allowance)
22. Critical Illness
23. Cashless Facility
24. Tax Benefit Under Sec 80D
25. new born child
26. helicopter facility / Emergency Air Ambulance
27. Multi Year Policy Availability -1,2,3 yrs (Advance premium upto 3 years)
28. Cashless facility in more than 6000 hospitals
29. No medical test required upto age 75 starting from Rs 3 lac SI
30. Option to avail PA (Personal Accidental Policy) along with health insurance in a single policy
31 RECHARGE BENEFIT – It would get activated even when the entire sum insured is not exhausted, and the claim is raised for the same illness. This benefit is applicable for sum insured in the range of Rs.3 lakh and Rs.5 lakh. The recharge amount is in the range of 15% to 30% of sum insured depending on the zone and sum insured opted. Note: Both the restore and recharge can be used up for the same hospitalization.
32 PORTABILITY –
If you want to transfer the policy to another insurer, the plan allows you to do so without losing your accrued benefits after the waiting periods.
33 SUM ASSURED ENHANCEMENT- You can apply for the sum increase at the time of renewal. However, there should not be any claim made on the policy for considering the request.
34 FREE LOOK PERIOD – For any reason, should you decide not to proceed with the policy, you can return the same and request for a refund within 15 days from the date of receipt of the policy document.
|Co-payment||20% of the claim depending on age and insurer|
GST rate of 18% applicable for all financial services effective July 1, 2017.
Disclaimer: Premiums may vary depending upon factors like age, location and prevailing taxes/GST.
Common Features :-
1 ..accidental cover from day 1 – A 30 days cooling off period for all claims except any arising out of accidental injuries. (cooling off period)
2.. 30days waiting in general
3 ..2yr exclusion for cataract, piles, hernia, kidney stone etc
4.. pre-existing dieases- 4yr waiting
5 … different age slabs have different premiums – so go for 3 yr combo instead of just 1 yr and get discounts
1 HIV AIDS
2 cosmetic or dental surgery
3 over dose of alcohol, tobacco, drugs
4 drink & drive
5 treatment of non MBBS doctor
6 riots & war
7 by birth problem
8 non consumable items
What is not covered
Please refer to the Policy Wording for the complete list of exclusions.
Comply T & C by Govt of India, State Govts, UTS, SEBI, AMFI , RBI, NHB, IRDA, RERA and other authorities. Provide copy of AMFI, NISM, EUIN, IRDA, RERA and other relevant certificates.