What does the policy cover?
1. Death:
We shall pay the benefit equal to 100% of Sum Insured, specified in the policy schedule, on death of the insured person, due to an Injury sustained in an Accident during the Policy Period, provided that the Insured Person's death occurs within 12 months from the date of the Accident.
2. Permanent Total Disablement:
We shall pay the benefit equal to 100% of Sum Insured, specified in the policy schedule, if an insured Person suffers Permanent Total Disablement of the nature specified below, solely and directly due to an Accident during the Policy Period, provided that the Permanent Total Disablement occurs within 12 months from the date of the Accident
- Total and irrecoverable loss of sight of both eyes or
- Physical separation or loss of use of both hands or feet or
- Physical separation or loss of use of one hand and one foot or
- loss of sight of one eye and Physical separation or loss of use of hand or foot
- If such Injury shall as a direct consequence thereof, permanently, and totally, disables the Insured Person from engaging in any employment or occupation of any description whatsoever
3. Permanent Partial Disablement:
We shall pay allocated percentage of Sum Insured, specified in the policy schedule, if the Insured Person suffers Permanent Partial Disablement solely and directly due to an Accident during the Policy Period provided that the Permanent Partial Disablement shall occur within 12 months of the date of the Accident. For the sum-insured coverage of partial disability refer to the policy wording for more details.
Note:
- The base sum insured chosen and cumulative bonus, if any, is applicable cumulatively for all the three base covers specified above i.e, there is a single sum insured for all the three covers namely, Accidental death, Permanent total disability and Permanent Partial Disability.
- If the accident occurs during the policy period, benefits covered under base covers above are payable, even if death or Permanent Total Disablement or Permanent Partial Disablement or any combination thereof occurs after the completion of policy period, but within 12 months from the date of accident.
Policy offers Add-on Covers for:
1. Temporary Total Disablement*:
If the Insured Person sustains an Injury in an Accident during the Policy Period which completely incapacitates the Insured Person from engaging in any employment or occupation, which the Insured Person was otherwise capable of performing at the time of the Accident, the company shall pay the benefit as specified in the policy schedule, till the time the insured person is able to return to work.
2. Hospitalisation Expenses due to Accident*:
We shall pay medical expenses incurred for hospitalisation arising due to accident during the policy period, up to the limit of 10% of the base sum insured, specified in the policy schedule.
3. Education Grant*:
Following an admissible claim of the insured person under the policy towards Death or Permanent Total Disability of the insured person, the company shall pay a one-time educational grant of 10% of the Base Sum insured (specified in the policy schedule), each, per child to all dependent children of the Insured
*Refer to policy wordings for more details on coverage
Sum-Insured offered in the policy:
₹2,50,000/- to ₹1,00,00,000/- (in the multiples of ₹50,000)**
**On Individual basis – SI shall apply to each individual family member
Cumulative Bonus offered in the policy:
Chosen Sum insured shall be increased by 5% in respect of each claim free policy year, provided the policy is renewed without a break subject to maximum of 50% of the sum insured. If a claim is made in any particular year, the cumulative bonus accrued may be reduced at the same rate at which it has accrued.
Who is eligible to buy the policy:
Minimum entry age shall be 18 years and maximum age is 70 years for the policy proposer. Policy can be availed for self and the following family members
- legally wedded spouse
- Parents and Parents-in-law
- Dependent Children (i.e. natural or legally adopted) between the age of 3 months to 25 years. If the child above 18 years of age is financially independent, he or she shall be ineligible for coverage in the subsequent renewals
How is the policy premium calculated (Premium illustration of a single member for ₹50,000 Sum-Insured):
Customer Profile |
Proposer
| Age 50 |
No of member
| 1
|
Occupation
| Doctor
|
Mode of Purchase
| Digital
|
Basic Cover Sum Insured Opted
| 5,00,000 |
Optional Cover |
Temporary Total Disablement Cover |
Opted
| No |
SI Opted
| NA
|
Hospitalisation Expenses due to Accident Cover |
Opted
| Yes
|
Accident SI (10% of Base SI)
| 50,000
|
Education Grant Cover |
Opted
| Yes |
Education Grant SI (10% of base SI)
| 50,000
|
No of children covered
| 1
|
Basic Cover Premium (A): Base Cover Premium per Lakh SI * SI opted / 1,00,000 * Lives covered
| 205 |
Temporary Total Disablement Cover Premium (B): TTD Cover Premium per 1000 SI * SI opted / 1,000 * Lives covered
| 0
|
Hospitalisation Expenses due to Accident Cover Premium (C): Hospitalisation Cover Premium * Lives covered
| 374 |
Education Grant Cover Premium (D): Education Grant Premium per Child per Lakh SI * No of Children *Lives covered* SI / 1,00,000
| 1.3
|
Total Premium (E) = (A + B + C + D) | 580
|
Occupation Rating (E1=0.75*E) | 435
|
Discounts | |
Digital Discount (F)
| 5% |
Section Discount (G) | 5%
|
Family Discount (H) | 0%
|
Premium before taxes (F) = (E1 * (1-F) * (1-G)*(1-H)) | 391.5 |
Note: The Premium may vary as per the coverage’s opted, risk group, number of lives/children and discounts applicable
Waiting Periods in the Policy
No Waiting Periods are applicable for the policy
What we don't cover#
(i) Any claim for death or disablement, hospitalisation of the insured person, directly or indirectly due to War and war like occurrence or invasion, acts of foreign enemies, hostilities, civil war, rebellion, revolutions, insurrections, mutiny, military or usurped power, seizure, capture, arrest, restraints and detainment of all kinds.
(ii) Any claim for death, disablement, hospitalization of Insured Person
- from intentional self-injury unless in self-defense or to save life, suicide or attempted suicide;
- whilst under the influence of intoxicating liquor or drugs or other intoxicants except where the insured is not directly responsible for the injury/accident through under influence of intoxication;
- whilst engaging in aviation or ballooning, or whilst mounting into, or dismounting from or travelling in any balloon or aircraft other than as a passenger (fare-paying or otherwise) in any Scheduled Airlines in the world, or engaging in any kind of adventure sports for personal gratification. [Standard type of aircraft means any aircraft duly licensed to carry passengers (for hire or otherwise) by appropriate authority irrespective of whether such an aircraft is privately owned or chartered or operated by a regular airline or whether such an aircraft has a single engine or multiengine;]
- arising or resulting from the Insured Person committing any breach of law with criminal intent.
(iii) Any claim for death, disablement, Hospitalization of Insured Person, from participation as a professional in hazardous or adventure sports, including but not limited to, para-jumping, rock climbing, mountaineering, rafting, motor racing, horse racing or scuba diving, hand gliding, sky diving, deep-sea diving.
(iv) Any claim resulting or arising from or any consequential loss directly or indirectly caused by or contributed to or arising from:
- Ionizing radiation or contamination by radioactivity from any nuclear fuel or from any nuclear waste from the combustion of nuclear fuel or from any nuclear waste from combustion (including any self-sustaining process of nuclear fission) of nuclear fuel.
- Nuclear weapons material
- The radioactive, toxic, explosive or other hazardous properties of any explosive nuclear assembly or nuclear component thereof.
- Nuclear, chemical and biological terrorism
(v) Any loss arising out of the Insured Person's actual or attempted commission of or wilful participation in an illegal act or any violation or attempted violation of the law.
Exclusions related to the 'Hospitalisation Expenses due to Accident' add-on cover#:
1. Investigation & Evaluation
- Expenses related to any admission primarily for diagnostics and evaluation purposes.
- Any diagnostic expenses which are not related or not incidental to the current diagnosis and treatment
2. Dietary supplements and substances that can be purchased without prescription, including but not limited to Vitamins, minerals and organic substances unless prescribed by a medical practitioner as part of hospitalization claim or day care procedure
3. Expenses incurred for treatment of accidental injuries by systems of medicines other than Allopathy.
4. Expenses incurred for treatment of accidental injuries which does not warrant hospitalization.
5. Treatment taken outside the geographical limits of India.
#For complete list of exclusions refer to the
policy wordings
Free-look period and Policy Cancellation:
The insured will be allowed a period of fifteen days from date of receipt of the Policy to review the terms and conditions of the Policy, and to return the same if not acceptable. If there has been no claim in the 15 day period, a complete refund of the premium will be given to the policyholder.
The policyholder may also cancel this policy later by giving 15 days written notice and the Company shall refund the premium for the unexpired policy period as detailed below:
Refund of Premium (basis Policy Period) |
Risk Period (Policy in force) |
Refund % |
Up to 30 days | 75.0% |
31 to 90 days | 50.0% |
3 to 6 months | 25.0%
|
6 to 12 months | 0.00% |
Frequently Asked Questions (FAQs)
What is the current GST rate on health insurance premiums?
During the 56th GST Council Meeting in New Delhi, the Indian Government revealed a groundbreaking decision to exempt all health insurance policies from GST, starting September 22, 2025. The GST rate on health insurance premiums has been lowered to zero. Previously, premiums faced an 18% GST, which greatly raised the total cost.With this exemption, only the base premium is charged - making health insurance more affordable and accessible for individuals.
How does the GST exemption impact my health insurance premium?
With Zero GST, your premium is now reduced by up to 18% compared to before.You won't have to pay tax on health insurance policies anymore.This change is effective for new purchases and renewals starting September 22, 2025.
Example: A policy that earlier cost ₹15,000 (including ₹2,288 GST) will now cost approximately ₹12,712 - saving you nearly ₹2,300
Will my existing health insurance policy benefit from the GST exemption?
Yes, renewals made on or after September 22, 2025 will benefit from Zero GST.If your policy was issued before this date, GST still applies.The exemption is tied to the policy issuance and renewal date, not just payment.Future renewals will reflect the GST-free pricing, reducing your premium cost.
Do I need to pay GST on health insurance purchased before September 22, 2025?
Yes, policies purchased or issued before September 22, 2025 still include 18% GST.The Zero GST exemption applies only to policies issued or renewed on or after that date.Future renewals will reflect the GST-free pricing.
What does the new GST regulation effective 22nd September mean for Health Insurance premiums?
Starting 22nd September 2025, the GST (Goods and Services Tax) on individual health insurance premiums has been reduced to 0%, down from the earlier rate of 18%.
What this means for you:
Lower Premiums: You'll now pay only the base premium-no GST added.
Will my Health Infinity renewal premium reduce after the GST removal?
Yes, Your Health Infinity renewal premium will decrease if the renewal takes place on or after September 22, 2025.
Does the GST regulation apply to both new purchases and renewals of Health Insurance?
Yes, the new GST regulation effective from 22nd September 2025 applies to both new purchases and renewals of individual health insurance policies.
Does the GST change impact Health Gain, Health Infinity, Super Top-Up, and Hospi Care plans equally?
Yes, The GST exemption starting from 22nd September 2025 is applicable to health insurance plans such as Health Gain, Health Infinity, Super Top-Up, and Hospi Care. Provided that the policy is issued and the risk begins on or after this date, there will be no 18% GST charged on premiums. This change makes these plans more budget-friendly for both new purchases and renewals.
I renewed my health policy before 22nd September with GST - am I eligible for adjustment?
If your health insurance policy was renewed before September 22, 2025, and you paid GST, you are not eligible for any refunds or adjustments,The GST exemption applies only to transactions made on or after the effective date. Since your payment was completed earlier, the GST charged was valid under the previous tax rules and cannot be retrospectively refunded.
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T&C apply. For more details on risk factors, terms & conditions, brochure, and exclusions, please read the
policy wording carefully before concluding a sale. The details mentioned above are for Saral Surksha Bima, Reliance General - UIN-RELPAIP21641V012021.