Exclusions and Waiting Period in Health Insurance Policy

The common features for comfort of a health insurance plan:-

1. 24 hour hospitalization then cashless

2.  day care treatment- covers 541 diseases (no 24 Hr hospitalization )

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.  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 .  recharge / restoration facility

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, Ayurvedic and homeopathic 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)

21.  OPD

22. Critical Illness

  23. Cashless Facility 

24. Tax Benefit Under Sec 80D

25.  new born child

26.  helicopter facility

27.  Multi Year Policy Availability  -1,2,3 yrs

Discounts

• 10% discount on premiums of family members are covered under this policy
• 10% discount if the insured and the spouse are between 18 years and 25 years old
• 5% discount on the premiums if the policy is bought online

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

2 30days waiting in general

3 2yr exclusion for cataract, piles, hernia 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

Exclusions :-

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

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.