Group Health Policy - Scope of Cover
Medical insurance covers almost everything- from the time you step into the hospital to the time you are discharged. The normal costs that are covered are room and boarding expenses, nursing expenses, fees for the surgeon, anesthetist, medical practitioner and consultant, fees for specialists, charges for anesthesia, blood, oxygen and the operation theatre, charges for surgical appliances, medicines and diagnostic materials and charges for X-rays, dialysis, chemotherapy, medicines and so on.
- Cashless facility eliminating the entire trouble of documentation and direct settlement of your bills directly with the hospital.
- Related expenses during pre-hospitalization period and post hospitalization period up to 30 days and 60 days respectively.
- In case of additional premium paid Maternity Benefit can be availed.
- Less than 24 hours hospitalization for specified procedures like Dialysis, Chemotherapy, Radio therapy, Eye Surgery, Dental Surgery, Lithotripsy (Kidney stone removal), D. & C. Tonsillectomy are covered.
Advantages
- Family Floater
- Cashless Hospitalization facility
- Large Hospital Network of more than 4000 Hospitals across India
- Innovative covers offered
- Fast & Efficient Settlement of claims
Main Exclusions
- Any Pre-existing condition or any complication arising from it
- Treatment/surgeries for Cataract, Benign Prostatic Hypertrophy, Hysterectomy for Menorrhagia or Fibromyoma, Hernia, Hydrocele, Congenital Internal diseases/defect, Fistula in anus, piles, Sinusitis and related disorders during the first year of the policy.
- Suicide, attempted suicide
- Cosmetic surgeries for aesthetic purpose, circumcision unless medically required.
- Under the influence of drugs, alcohol & other intoxicants
- Participation in felony, riots, war etc.
- Exposure to nuclear, radioactive materials
- HIV or sexually transmitted diseases
Sum Insured
The sum insured is based on the age and plan opted.
Premium
Based on age, sum insured opted, plan and Risk Class. Premium inclusive of service tax as applicable
Age Group- for Self & Spouse – 21yr. to 70 yr
Children – Birth to 21 yr