Scope of Cover/Benefits

Hospitalization Expenses

In the event of a claim becoming admissible, the Company will pay the expenses listed below that are reasonably and necessarily incurred by or on behalf of such Insured Person but not exceeding, in aggregate, the Sum Insured mentioned in the Schedule.

	Hospitalization Benefits	Limits
A	(i) Room, Boarding expenses charged by the Hospital/Nursing Home (ii) If admitted in Intensive Care Unit (ICU)	Up to 1% of Sum Insured per day Up to 2% of Sum Insured Per day Overalllimit:25% if the Sum Insured.
B	Surgeon, Anesthetist, MedicalPractitioner, Consultants, SpecialistsFees, NursingExpenses	Overall limit: 25% of Sum Insured
C	Anesthesia, Blood, Oxygen, OTcharges, Surgical appliances, Medicines,Drugs,Diagnosticmaterial & X-Ray, Dialysis, Chemotherapy, Radiotherapy, Cost of Pacemaker, Artificial Limbs, Cost of Stents & Implants	Overall limit 50% of Sum Insured

Claims in respect of the following illnesses / operations, will be subject to the following limits:

Name of Illness / Operation	Maximum Charges Inclusive of Room/ ICU/OT Charges/Surgeons. Anesthetist, doctors fees, medicines, internal appliances and other charges incurred during hospitalization period
Cataract with imported foldable lens	10000/-
Hysterectomy	22000/-
Appendectomy	16000/-
Cholecystectomy	18000/-
Prostate	18000/-
Hemia-Inguinal	16000/-
Hernia-Ventral/Incisional	20000/-
Septoplasty	9000/-
Haemorrhoidectomy	8000/-
Fissurectomy	9000/-
Fistulectomy	10000/-
Angiography	12000/-
Tonsillectomy	7000/-
Tympanoplasty	13000/-
Kidney stone/ lithotripsy	13000/-
Arthoscopy	10000/-
PID-Discectomy	31000/-
Mastectomy (Radical)	36000/-
Exploratory Laprotomy	18000/-

Actual pre-hospitalization medical charges of up to 30 days period immediately before the insured’s admission to hospital for that illness, subject to maximum 5% of hospital bill

Actual post-hospitalization medical charges of up to 60 days period immediately after the insured’s discharge from a hospital for that illness or injury, subject to maximum of 10% of hospital bill.
Expenses incurred for Ayurvedic/Homeopathic/Unani Treatment subject to a maximum limit of 25% of the sum insured per illness, provided the treatment is taken in a Government Hospital.
Ambulance charges, subject to a maximum of Rs. 1000/-
Hospitalization Expenses (excluding cost of organ) incurred on the donor during the course of organ transplant to the Insured. The Company’s liability towards expenses incurred on the donor and the Insured recipient together shall not exceed the sum insured of the latter

Note: Please refer to the policy documents for the complete Insurance Policy subject to the insurance Company.

Premium Rates/ Chart:

Sum insured (Rs.)	Premium (in Rs.)
	60-65 yrs	66-70 yrs	71-75 yrs	76-80 yrs
1,00,000	3850	4250	4700	5150
1,50,000	5720	6310	6980	7650

Loading for renewal between age of 81- 85 years – 10% of the highest age band of 76-80 yrs.

Loading for renewal between age of 86-90 yrs – 20% of the highest age band of 76-80 yrs.

Additional Premium for covering Pre-existing - 10% of basic premium for each condition i.e. Hypertension & Diabetes mellitus from the inception of the policy:

Discount for opting for voluntary excess of Rs.10,000/- - 10%Discount in case spouse is covered - 10%

Note: Please refer to the policy documents for the complete Insurance Policy subject to the insurance Company.