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Reliance Health Gain Insurance

The No-Compromise Health Policy

Reliance Health Gain Insurance
Reliance Health Gain Insurance

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Reliance Health Gain Insurance is your ideal financial safeguard against healthcare expenses that can arise from unexpected medical treatments. It is a comprehensive health insurance plan that provides complete protection against a wide range of medical expenses.

While we all hope never to face a critical illness, if it does occur, imagine the rising costs. From consultations, tests, hospitalisation and surgery to post-surgery recovery and care, everything adds up quickly.

It is ideal for anyone seeking financial protection against routine health issues or unexpected critical illnesses. With options for both individuals and families, it is a flexible and reliable solution for comprehensive coverage.

In such a scenario, the Reliance Health Gain Policy can be your financial lifesaver, ensuring no compromise on essential healthcare that comes your way.

₹1 crore*
Maximum Sum Assured
100%
Claim Settlement Ratio
₹243/month*
Starting Premiums
40%*
Discount on Online Premiums
Reliance Health Gain Policy Online

Key Features of the
Reliance Health Gain Policy

Key Features Details
Plan Type Individual/Family Floater
Policy Term 1/2/3 years
Renewability Lifetime
Affordable Premium Premiums start at ₹243/month*
Comprehensive Coverage To cover hospitalisation, pre-and post-hospitalisation, domestic ambulance, domiciliary hospitalisation, accidental death, critical illnesses, and more to ensure no more compromise on your health.
Personalised Coverage Option to customise the coverage with a wide range of add-ons
Extra Cover / Double Cover Get 100% of the base sum insured reinstated for unrelated illness or injury and 20% of the sum insured for related illness or injury.
Loyalty Cover For every completed and continuous policy year, we extend loyalty cover for accidental death and permanent total disability, critical illness, hospital cash and leave compensation benefits.
Bonus
  • Accommodation Bonus- Fixed daily amount for in-patient treatment for specific room categories
  • Cumulative Bonus - 33.33% of the sum insured for every claim-free year
Discounts We offer attractive discounts for online purchases, long-term policies, maintaining good health, and more.
Network of Hospitals Wide network of over 10,000 hospitals across India
Online Purchase Purchase our Health Gain Insurance in a few simple steps online
Hassle-free Claim Process We offer seamless and quick cashless or reimbursement claim settlements
Claim Settlement Ratio 100% for the FY 2023-24
Prompt Customer Service Our dedicated customer service team can address your queries at any time.

What’s Covered Under
Reliance General Insurance Health Gain Policy?

Coverage Plus Power Prime
Base Sum Insured ₹3 lakhs / ₹5 lakhs ₹10 lakhs / ₹15 lakhs / ₹20 lakhs ₹25 lakhs / ₹30 lakhs / ₹50 lakhs / ₹1 crore
Renewal / Call Option Base Sum Insured (₹ in Lakhs) ₹3 lakhs / ₹5 lakhs / ₹6 lakhs / ₹9 lakhs ₹10 lakhs / ₹12 lakhs / ₹15 lakhs / ₹18 lakhs / ₹20 lakhs / ₹24 lakhs ₹25 lakhs / ₹30 lakhs ₹34 lakhs / ₹40 lakhs / ₹48 lakhs / ₹50 lakhs / ₹60 lakhs / ₹72 lakhs / ₹80 lakhs / ₹1 crore
Room Category Single Private Air-Conditioned Room Actuals
Hospitalisation Cover
Hospitalisation Expenses
  • In-Patient Treatment
  • Day Care Treatment
  • Accommodation Bonus
Up to the extent of the sum insured
Accommodation Bonus: Additional fixed daily cash benefit of ₹1000, if applicable
Domestic Road Ambulance Up to ₹3,000 per hospitalisation Intercity ambulance costs beyond 100km up to ₹20,000 per hospitalisation Up to ₹1,500 per hospitalisation Intercity ambulance costs beyond 100km up to ₹20,000 per hospitalisation Actuals, including intercity ambulance costs beyond 100km
Domiciliary Hospitalisation Up to the extent of the sum insured
Modern Treatment Up to 50% of the sum insured Up to 100% of the sum insured
Pre-Hospitalisation Up to 60 days within the sum insured
Post-Hospitalisation Up to 60 days within the sum insured Up to 90 days, within the sum insured
Organ Donor Expenses Up to 50% of base sum insured, limited to a maximum of ₹5 lakhs Up to 50% of base sum insured, limited to a maximum of ₹10 lakhs
Extra Cover / Double Cover
Reinstatement of Base Sum Insured (SI) Get 100% of the base sum insured reinstated for unrelated illness or injury and 20% of the sum insured for related illness or injury.
Extra SI Additional 20% on base SI on the same claim (in single hospitalisation)
Personal Accident Cover
Accidental Death Cover NA 5% of base SI, subject to a minimum of ₹1 lakh
Critical Illness Cover
Waiver of Premium NA Waives off renewal premium on the diagnosis of a listed critical illness.
Renewal Benefits
Cumulative Bonus 33.33% increase in Base Sum Insured for every claim free Policy Year,max upto 100% of Base Sum Insured and 33.33% decrease for every claim year.
Call Option for Enhancement of Base SI After 4 consecutive claim-free years, if you avail of this benefit, the enhanced sum insured is the sum of the expiring base sum insured and the accumulated cumulative bonus.
Loyalty Cover For every completed and continuous policy year, loyalty cover is offered for accidental death, permanent total disability, critical illness, hospital cash, and leave compensation benefits.
Value Added Covers
Wellness Services You can seek medical advice through telephone or online consultation.
Claim Service Guarantee For Cashless Claims - 1% of the delayed claim amount for delays beyond 6 hours to 12 hours (additional 1% for every additional delay of 6 business hours)
For Reimbursement Claims - 1% of the delayed claim amount for delays beyond 21 days to up to 42 days (additional 1% for every additional delay of 6 business hours)
Maximum limit - 6% of the delayed claim amount
Policy Service Guarantee ₹10,000 ₹20,000 ₹20,000

Please Note: The basis of payment and pre-requisites for claim can differ for the specific type of cover. Read through the prospectus/policy wordings to know more.

What’s Not Covered Under
Reliance General Insurance Health Gain Policy?

Exclusions may vary based on the specific coverage. Here is a brief about the standard exclusions.

  • Treatment of pre-existing diseases within the waiting period
  • Treatments for specific illnesses within their particular waiting period
  • Expenses for any medical treatment, except for accidents within the first 30 days of the waiting period
  • Investigation and Evaluation
  • Rest cure, Rehabilitation and Respite Care
  • Obesity or Weight Control
  • Change-of-Gender Treatments
  • Cosmetic or Plastic Surgery
  • Hazardous or Adventure Sports
  • Breach of Law
  • Excluded Providers
  • Substance Abuse and Alcohol
  • Wellness and Rejuvenation
  • Dietary supplements and Substances
  • Refractive error
  • Unproven treatments-code
  • Sterility and Infertility
  • Maternity expenses

Reliance Health Gain Insurance
Add-Ons

Policy Add-Ons Plus Power Prime
Enhanced Covers
Guaranteed Cumulative Bonus This benefit waives off the condition of a decrease in Cumulative Bonus in case of a claim in the immediate previous policy year.
Unlimited Reinstatement of Base SI Get unlimited reinstatement of base SI for unrelated illness or injury and up to 100% of sum insured for related illness or injury. It supersedes the Reinstatement of Base SI under Extra Cover.
Consumable Cover Within the limit of the sum insured
Double Cover Additional, 100% of base SI for the same claim. It supersedes Extra SI under Extra Cover.
Change in Room Rent Limits Category of Room capped to Twin Sharing Category of Room upgrades to Actuals or Category of Room capped to Twin Sharing Category of Room capped to Single Private AC Room
Reduction in Pre-Existing Waiting Period Reduces the pre-existing waiting period to 24 months or 12 months.
Voluntary Aggregate Deductible Options available are ₹10,000, ₹25,000, ₹50,000 and ₹1,00,000
Removal of Co-Payment Waives off the co-payment condition of 20% on the claim amount. (Applicable to policies where the insured’s age who is entering the policy for the first time is greater than or equal to 61)
Hospital Cash Daily cash options: ₹1000, ₹1500, ₹2000, or ₹2500 for a maximum of up to 30 days for in-patient hospitalisation and 15 days for ICU hospitalisation.
Minimum hospitalisation of 72 hours
Convenience Cover
Change in Pre-Post Hospitalisation Limit
  • Pre-Hospitalisation - 90 days
  • Post-Hospitalisation - 180 days
Air Ambulance 7.5% of base SI or ₹5 lakhs, whichever is higher
Radio Taxi ₹1000 per hospitalisation
Convalescence Cover ₹10,000 ₹25,000
Preventive Care Cover
Health Checkup ₹3,000 (Annual)
Vaccination Cover ₹2000 (Annual) ₹3,500 (Annual)
Smart Cover
Change in Modern Treatment Limits 100% of base SI NA
Vision Correction ₹50,000 ₹1,00,000
Second Opinion ₹3,000 ₹5,000
Family Care Cover
Home Care Treatment Within the limit of the sum insured
Companion Cover Per day daily cash of ₹1,000 for a maximum of up to 30 days. Minimum hospitalisation of 72 hours
Child Care Cover Per day daily cash of ₹1,000 for a maximum of up to 30 days. Minimum hospitalisation of 72 hours

Please Note: Optional covers are applicable to policies with a sum insured of ₹5 lakhs or more (except for a change in room rent limit and voluntary aggregate deductible). The basis of payment and pre-requisites for claim can differ for the specific add-on. Read through the prospectus/policy wordings to know more.

Eligibility Criteria for
Reliance Health Gain Policy

Details Eligibility Criteria
Age
  • Child: 91 days to 25 years
  • Adult: 18 years to 65 years
Family Composition for Floater Policy
  • Plus - Maximum of 2 Adults (Self + Spouse) and 6 children
  • Power - Maximum of 4 Adults (Self + Spouse + one set of dependent Parents or Parents-in-law) and 6 children
  • Prime - Maximum of 6 Adults (Self + Spouse + set of dependent Parents + set of Parents-in-law) and 6 children

Please Note: The eligibility criteria can differ for the specific coverage options.

How to Buy
Reliance Health Gain Plan?

  • Step 1: At the top of this Reliance Health Gain Policy page, provide your personal details (name and mobile number) and click on ‘View Prices’.
  • Step 2: Choose the Plan Type: Individual, Family, Parents or In-laws and provide the required details. Choose your sum insured and optional add-ons.
  • Step 3: Eligible discounts get applied and the applicable plan options with the Reliance Health Gain Policy Premium chart will appear. Choose a suitable plan and pay the applicable premium.

Documents Required

  • Proof of Identity- Aadhaar Card, Passport, etc
  • Proof of Address- Aadhaar Card, Passport, Ration Card, Driving Licence, etc
  • Proof of Income- Bank Statements, Salary Payslips, ITR Forms, etc.
  • Medical History Documents, if applicable
  • Photographs
  • Completion of the C-KYC Process (Central Know Your Customer process) as per the AML guidelines issued by IRDAI

How to Renew
Reliance Health Gain Plan?

  • Step 1: Go to the top of this Reliance Health Gain Policy page. Click on ‘Renew Your Health Insurance Policy.
  • Step 2: Proceed by providing the registered mobile number or policy number. Review your existing coverage.
  • Step 3: Modify or enhance the policy by revising the coverage and including optional add-ons. Pay the applicable premium and get your policy renewed right away.

Discounts Available Under
Reliance Health Gain Policy

Online Discount RGI Retail Policy Document (Non-Health)
Get a 10% discount for buying this policy online. Get a 7.5% discount if you have an existing non-health policy with us.
Long-Term Discount RGI Health Policy Discount Employee Discount
Get a 12% discount for buying a 3-year policy (7% for 2 years) Get a 10% discount for if you have an existing health policy with us. Get a 10% discount if you are an existing RGI employee.

How to File a Claim Under Reliance Health Gain Policy?

With our Reliance Health Gain Policy, you can choose between cashless and reimbursement claims. Additionally, with Cashless Everywhere, you can get cashless treatments at all hospitals - network and non-network.

Cashless Claims Process

  • Step 1: Claim Intimation

    Inform us and register a claim by:
  • Step 2: Pre-authorisation

    Visit any of our network or non-network hospitals. Submit the pre-authorisation form at least 48 hours before a planned hospitalisation and within 24 hours in case of an emergency.
  • Step 3: Claim Process and Settlement

    Leave all the medical treatment records and bills at the hospital. We will settle the applicable expenses directly with the hospital.

Reimbursement Claims Process

  • Step 1: Claim Intimation

    Inform us and register a claim by:
  • Step 2: Documents Submission

    Receive the necessary treatment at any authorised hospital and pay the expenses upfront out of your pocket. Submit your scanned original documents, including medical reports, bills and payment receipts, within 7 days of discharge.
  • Step 3: Claim Settlement

    We will examine your claim and reimburse you for the applicable expenses.

Please note: Any uncovered costs, co-payments, and deductibles will be your responsibility.

Documents Required

  • Original claim form, duly filled out and signed
  • Medical Practitioner’s prescription
  • Original bills and payment receipts
  • Medical reports
  • Discharge summary
  • Pharmacy bills
  • First Information Report (FIR), if applicable
  • Any other document specific to personal or specific circumstances

What Do I Need to Consider When Filing a Claim Under My Reliance Health Gain Policy?

Waiting Periods

  • Initial Waiting Period- 30 days from the start of the policy date is the waiting period for the treatment of any illness. It does not apply to claims related to an accident.
  • Specific Waiting Period- 2 years of waiting period applies to specific diseases. A continuous coverage of 24 months is essential after the date of inception of the first policy with us.
  • Pre-existing Diseases Waiting Period - 3 years waiting period for expenses related to the treatment of PED. A continuous coverage of 36 months is essential after the date of inception of the first policy with us.

Terms and Conditions

The terms and conditions can differ for the specific coverage. Some of the general terms and conditions that you need to know are as follows:

  • Misrepresentation, misdescription or non-disclosure of any information, as well as fraudulent or false statements, will result in the forfeiture of the policy.
  • The claim settlement will be made to the extent of that amount for the particular claims.
  • If the policyholder has multiple policies, they can choose to file a claim against any of them.
  • The policy shall terminate if it is not renewed at the end of the policy period. A grace period of 30 days will be provided to renew the policy.
  • Eight continuous years under the Policy is the moratorium period. After this period, claims cannot be rejected except for permanent exclusions or a case of fraud.
  • The policyholder must make the nomination during policy inception to pay claims in the event of their death.
  • In case of any grievance, you can contact the Grievance Redressal Officer with the details mentioned in the policy document.

Responsibility of a Policyholder/ Insured Person

  • Ensure to notify us and submit the essential documents within the stipulated time for the claim.
  • Appear for a medical examination by our medical practitioner, if necessary.
  • Check the applicability of our cashless service with the hospital.
  • Allow our medical practitioner to inspect the medical records.
  • Assist our representatives in pursuing their duties to validate your claim.

Frequently Asked Questions (FAQs)

  • Our Reliance Health Global Policy covers planned treatments abroad, and Reliance Health Infinity Insurance Policy provides extensive coverage.

    Reliance Health Gain Insurance offers comprehensive coverage for complete health care protection with an adequate sum insured.

    It covers a wide range of illnesses and healthcare requirements with customisable features and options to enhance protection.

  • In the event of the policyholder’s death, the nominee will be considered for the purpose of payment of claims under the policy.

  • You can transfer your existing health policy to Reliance General Insurance by using the health insurance portability option. You need to initiate the porting process at least 45 days before your renewal for a smooth transition and retaining the benefits gained.

  • You can check your Reliance Health Gain Insurance details by logging into your account on our website at the top right-hand side of this page or on the Reliance Self-i App.

  • Pre-existing illness is any health condition diagnosed within 48 months prior to the policy issuance date. A waiting period of 36 months is applicable to receive benefits for treatments related to pre-existing illnesses. Diabetes and excessive blood pressure are two examples.

  • Pre- and post-hospitalisation expenses refer to costs incurred prior to and after hospitalisation. It can include consultations, medications before admission, diagnostic tests and follow-up treatments.

  • If you are hospitalised, the Consumables Cover will pay for a variety of consumables like needles, gloves, and syringes that are required for your care.

  • Your health insurance policy is valid for 12 months starting on the day it was issued (Risk Start Date). You can purchase a two- or three-year insurance if you want your coverage for a longer period of time.

  • No, if you enrol your entire family in a single plan, you will only need to pay a single premium to cover everyone.

  • Your insurance premium can be paid with a credit card, debit card, UPI, net banking, or an EMI.

  • When you buy a Reliance Health Gain Policy, you can get a comprehensive coverage of up to ₹1 crore for a wide range of healthcare expenses with an adequate sum insured. It can cover hospitalisation, pre- and post-hospitalisation, accidental death, critical illnesses, and more.

    In addition, it offers a diverse array of add-ons to enhance the coverage. You can benefit from a double cover, the change in room rent limits, and more. Furthermore, and most importantly, you can secure this coverage at an affordable premium while also gaining a number of discounts.

  • With Reliance Health Gain Insurance, you can benefit from the following discounts:

    • 10% discount for online purchases
    • 7.5% discount if you have an existing non-health policy with us
    • 12% discount for buying a 3-year policy (7% for 2 years)
    • 10% discount if you have an existing health policy with us
    • 10% discount if you are an existing RGI employee
  • Reliance Health Gain Insurance covers various medical expenses such as room rent, nursing expenses, ICU charges, surgical expenses, medication expenses, diagnostic procedures, and more. For detailed information, refer to our prospectus/policy wordings.

  • Yes, there are various add-ons available under Reliance Health Gain Insurance, including Double Cover, Consumables Cover, Reinstatement of Sum Insured, Guaranteed Cumulative Bonus, Change in Room Rent Limits, Reduction in Pre-Existing Waiting Period, and more. For detailed information, refer to our prospectus/policy wordings.

  • The proposer is the applicant and the policyholder who is responsible for paying the premium.

  • Yes, however, there is a 30-day waiting period for treating any illness except those arising out of an accident.

  • A Cumulative Bonus is a feature that increases your Sum Insured if you go a whole policy year without making a claim. With Reliance Health Gain, you get a Cumulative Bonus of 33.33% for every claim-free year and 33.33% decrease for every claim year.

  • Yes, you will get a 12% discount if you buy a 3-year policy and a 7% discount if you buy a 2-year policy.

  • No, you can make any number of claims in a policy year as long as you have enough of your coverage amount or Sum Insured available.

  • If you exhaust your sum insured on subsequent claims we will offer an extra or a double cover of up to 100% of your base sum insured as a reinstatement. You can benefit from unlimited reinstatements by choosing the Unlimited Reinstatement of Base Sum Insured add-on.

  • No, you do not need a pre-medical checkup to buy our health insurance. The pre-medical checkup is applicable only if you are above the age of 45 and/or suffering from any Pre-existing injury/illness/disease conditions.

  • Yes, the plan offers lifetime renewability.

  • You can cancel the policy by giving written notice within 15 days. The refund premium for the unexpired policy periods will be initiated according to the policy conditions.

  • Reinstatement of the Sum Insured under Reliance Health Gain gives you the advantage of restoring your Sum Insured if you exhaust it during a policy year.

    One reinstatement is offered as an extra cover. However, to benefit from unlimited reinstatements, you can choose the Unlimited Reinstatement of Base Sum Insured add-on.

  • Yes, Reliance Health Gain covers medical expenses for all your family members if you add them under the family floater plan.

  • The kind of room applicable for hospitalisation will depend on the plan option you have chosen. With the Change in Room Rent Limits add-on, you can also change the room rent limits by upgrading to a better room.

  • The waiting period applicable to pre-existing illnesses under this plan is 36 months. You can reduce it to 24 months or 12 months by opting for the Reduction in Pre-Existing Waiting Period add-on.

  • Changing the sum insured during the policy year may not be possible. However, you can choose a higher sum insured within the same plan option or upgrade to another plan option with a higher sum insured at the time of policy renewal.

  • Yes, the Reliance Health Gain Insurance does cover COVID-19. However, it is applicable after a waiting period of 15 days.

  • You can file claims in person in a few simple steps:

    • Visit any of our Reliance General branch offices nearest to your location.
    • With the help of our representatives, fill out the claim form.
    • Provide the necessary details and submit the required documents to raise your claim.
  • You can get a cashless claim for the hospitalisation expenses covered under the policy in any network or non-network hospital.

  • If you have received healthcare treatment in a non-network hospital, you can still file a cashless claim. However, if you choose reimbursement claims, you can pay for the expenses upfront and later submit the bills and payment receipts for reimbursement.

  • The reason for the rejection will be communicated to you after the claims process. If you find the reason unsatisfactory, you can appeal for the justification at the Grievance Redressal Cell. Read through the prospectus/policy wordings to know more.

Health Gain

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Mrs. Karishma Nijal Surana

December-2024,
Hyderabad

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Mr. Rajasekhar Telakapalli P

October-2024,
Bengaluru

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Gracemathew

September-2024,
Thrissur

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Mr. Nagarjuna Modupalli

November-2024,
Bengaluru

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Mr. Jinu Babu

September-2024,
Kollam

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Mr. Naresh Kumar

December-2024,
Pathankot

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Mr. Surendra Kumar

October-2024,
Lucknow

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Mr. Abdul Raheem S M

November-2024,
Bengaluru

Disclaimers:
*Maximum discount applicable for the policy is 40% excluding long term healthy discount(aggregate) | **These are optional covers and need to be opted separately while purchasing the policy. | ++Tax benefits are subject to conditions under Section 80D of the Act and amendments thereof. The tax laws are subject to amendments/changes from time to time. Please consult your tax advisor for details. | #The premium mentioned is excluding taxes for single person ageing between 5 years to 20 years with individual health policy for Sum Insured of ₹3 lakhs considering no adverse health conditions/pre-existing disease/medical conditions with waiting period of 3 years. For more details, please refer to the policy wordings. Premium used is 2,919/year converted into a month which gives us Rs.243/month (2,919/12). | *T&C apply. For more details on risk factors, terms conditions, brochure, and exclusions, please read the  policy wording and CIS carefully before concluding a sale. The details mentioned above are for Reliance Health Gain Policy. Reliance Health Gain UIN: RELHLIP22229V032122

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