The Policy provides cover on an Individual basis. A separate Sum Insured for each Insured Person is provided under Individual basis.
| Title |
Description |
| Room Rent Limit |
For SI < Rs. 5 Lacs 1% of Sum Insured. For SI of Rs. 5 Lacs and Above 1% of Sum Insured or Single Occupancy Standard Air-
Conditioned Room Charges whichever is higher |
| ICU Daily Rent Limit |
For SI< Rs. 5 Lacs 2% of Sum Insured. For SI Rs. 5 Lacs and Above Actuals |
| Pre-Hospitalization Expenses |
30 days prior to hospitalisation |
| Post Hospitalization Expenses |
60 days after the discharge from the hospital, Subject to a maximum of 10% of Sum Insured |
| Day Care Procedure Coverage |
Covered. |
| Automatic Restoration of Sum Insured |
Automatic Restoration of Basic Sum Insured is available only for sum insured options from Rs.
3,00,000 and above. |
| Pre-Existing Disease / Illness coverage |
Covered after 48 montsh of continuous coverage |
| Waiting Period for New Policy |
30 days |
| Co-Payment |
For persons with age of entry above 60 years in Family Medicare Policy, every admissible claim under
Base Cover 1 to 5, 7 and 9 above shall be subject to a Co-payment of 10% on the admissible claim |
| Free Health Checkup |
1% of average Sum Insured of preceding 3 years maximum of Rs. 5,000 per person for policies issued on individual sum insured basis |
| Ambulance Expenses |
0.5% of the Sum Insured subject to a maximum of Rs. 2500 per event and 1% of the Sum Insured subject to a maximum of Rs. 5000 per policy period |
| Non-Allopathic Treatments |
For SI 3 Lac upto Rs 10,000. For SI >3Lac to 15Lac upto Rs 15,000. For SI >15,00,000 upto Rs 25000 |
| New Born Baby Cover |
From day 1 up to 90 days, limited to 10% of the Sum Insured |
| Daily Hospitalization Allowance |
SI Upto Rs. 5 Lacs Rs. 500 / day subject to a maximum of Rs. 5000 / policy period.SI >= 5Lac To 15 Lac Rs. 1000/day subject to a maximum of Rs. 10000 / policy period. SI> 15Lac to 25 Lac Rs. 2000 per day subject to a maximum of Rs. 20000 / policy period |
| Donor Expenses |
Covered. |
| No Claim Discount |
5% every claim free year, maximum of 15% |
