This policy is a perfect foil for any unseen problems you might face during your treatment. Here's a quick look at what your policy covers.
Hospitalisation expenses in case of:
- In-patient treatment for covered illnesses /injuries, where the insured person is hospitalised for more than 24 consecutive hours.
- Day-care treatment for surgeries /procedures, where the insured person requires less than 24 hours of hospitalisation due to advanced technology. For the list of Day care treatment. (Please refer to Annexure -I of the policy wordings)
Pre-hospitalisation coverage for:
Medical expenses incurred before hospitalisation. Under the HealthGain policy, you will get coverage for 60 days.
Post-hospitalisation coverage for:
Medical expenses incurred after hospitalisation. Under the HealthGain policy, you will get coverage for 60 days.
Domestic Road Ambulance:
Expenses for domestic-road ambulance services to the nearest hospital in case of life threatening emergencies. Under Plan A, your policy would pay upto Rs 1,500 and upto Rs 3,000 under Plan B.
- For more details, please refer to the policy wordings
Donor expenses:
These are expenses incurred by the organ donor. We will cover up to 50% of the base sum insured, subject to a maximum of Rs. 5 lakh/-
- For more details, please refer to the policy wordings
Domiciliary hospitalisation:
For more details, please refer to the policy wordings
Re-instatement of base sum insured:
- If you exhaust your entire sum insured & cumulative bonus (if any) and still require further hospitalisation for any related or unrelated illness, we will refill the full Sum Insured at no extra cost.
- Please refer to Annexure -II of the policy wordings
Cumulative bonus:
- This is a bonus awarded at the end of each claim free policy period. When you do make a claim in any given policy period.
- 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 be accumulated equal to the amount of base sum insured.
- When you do make a claim in any given policy period, the bonus earned shall be decreased by 33.33% of the base sum insured, in the subsequent year. However, this will not reduce the initial base sum insured & your maximum reduction of cumulative bonus would be zero.
Call Option:
- If you do not make any claim on your policy for 4 consecutive years, then by end of the 4th year your cumulative bonus will be equal to your base sum insured. In the 5th year, you can choose the “Call Option” to double your sum insured by adding this earned cumulative bonus.
- Thereafter, you can accumulate the cumulative bonus again.
Please note that you can choose the Call Option only twice in your lifetime
For more details, please refer to the policy wordings.
Claim service guarantee:
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Cashless claims: If we’re unable to respond within 6 business hours, even after you have completed claim request with correct documentation and information, we will be liable to pay 1% of the claim amount to you, subject to a maximum liability of 6%.
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Reimbursement of Claims: Similarly, if we’re unable to respond within 21 days, even after you have completed your claim request with correct documentation and information, we will be liable to pay 1% of the claim amount to you, subject to a maximum liability of 6%.
For more details, please refer to the policy wordings
Policy service guarantee:
- If, even after receiving all completed documents (including Medical reports, as applicable and premium), there is a delay of more than 10 working days from us in issuing your policy issuance, we will pay you onetime additional sum insured of Rs 10,000/- under Plan A and Rs 20,000/- under Plan B.
- This will be applicable only for 1 year Policy Period and not for renewals/ auto-renewals.
Accidental death cover for no claim renewal:
- Under Plan B, we will provide you an accidental death cover of Rs. 1 Lakh/- at the end of every claim-free policy year with our Company.
- This cover will be valid for only one year.
- This is applicable only if the policy holder is also the insured person in the policy.
Health Insurance Renewal:
- You can renew your medical insurance policy for free, under Plan B, if the person insured in the policy is diagnosed with a 'named critical illness'.
- This benefit is provided once in the lifetime .
- This is applicable only if the policy holder is also the insured person in the policy.
Named critical illness can be referred in the policy wordings.
Wellness Solutions:
- Awesome discounts on various, value-added wellness services and choice of various online solutions through our wellness program.