Health Premia

Get coverage for medical treatment post hospitalisation for all insured members    

The policy will cover pre and post hospitalisation expenses as well. The period of the treatment covered is 90 days before you get admitted to the hospital and 180 days after you get discharged from the hospital.    

Your health insurance will cover a host of dental, ENT and other procedures    

Avail coverage for medical expenses incurred on the organ donor’s treatment as well    

We cover expenses incurred for OPD Treatment and/or Diagnostic Services and/or prescribed medicines for the OPD Treatment taken within India for up to Rs 50,000.(Applicable under Platinum plan)

Get a free extension of 1 year if the policyholder (who is also an insured) passes away or is diagnosed with any of the specified illnesses   

Treatments like Cyber knife/ Robotics surgery, Laser surgery cover, Weight loss (Bariatric) surgery are covered

In case you have exhausted your Base Sum Insured and Loyalty Additions / Enhanced Loyalty Additions (if any) partially or completely, you are entitled for an additional sum insured equal to the base sum insured for a subsequent claim in the same year. This benefit can be availed for both same and different illnesses.

You can avail health check-up for Diagnostic Tests purposes from Day 1 for any insured person (including children). You can undergo a health checkup through our service provider on cashless basis. You can choose tests of your choice up to a sub-limit as per the plan chosen.

Secure your family’s finances against personal accidents

The add-on pays hospital cash for up to 30 days of hospitalisation if hospitalised for more than 48 hours​

Now you are entitled to avail international coverage in USA & Canada also.

•Ancillary hospital charges

•Hazardous activities

•Artificial life maintenance

•Circumcision

•AYUSH treatments, except inpatient treatments taken under Ayurveda, Unani, Sidha and Homeopathy

•Conflict & disaster

•External congenital anomaly

•Convalescence & rehabilitation

•Cosmetic and plastic surgery

•Dental/oral treatment

•Eyesight & optical services

•Experimental or unproven treatment

•Hormone Replacement Therapy

•Hospitalisation not justified

•Inconsistent, irrelevant or incidental diagnostic procedures

•Non-medical expenses

•Obesity and weight control programs

•Reproductive medicine & other maternity expenses

•Robotic Assisted Surgery, Light Amplification by Stimulated Emission of Radiation (LASER) & Cyber Knife Treatments

•Sexually transmitted infections & diseases

•Sleep disorders

•Substance related and addictive disorders

•Unlawful activity

•Treatment received outside India

•Unrecognised physician or hospital

Generally excluded expenses - Any costs or expenses specified in the list of expenses generally excluded at Annexure II of the Policy Document.    

We shall not be liable to make any payment under Critical Illness Cover directly or indirectly caused by, based on, arising out of or howsoever attributable to any of the following unless specifically mentioned elsewhere in the Policy.

• AYUSH Treatment: Any covered Critical Illnesses diagnosed and/or treated by a Medical Practitioner who practices AYUSH Treatment.

• Conflict & Disaster: Treatment for any Injury or Illness resulting directly or indirectly from nuclear, radiological emissions, war or war like situations (whether war is declared or not), rebellion (act of armed resistance to an established government or leader), acts of terrorism.

•External Congenital Anomaly: Screening, counselling or treatment related to External Congenital Anomaly.

•Cosmetic and Reconstructive Surgery: Any Critical Illnesses arising due to treatment undergone purely for cosmetic or psychological reasons to improve appearance.    

•Experimental/ Investigational or Unproven Treatment:

a. Services including device, treatment, procedure or pharmacological regimens which are considered as investigative or Unproven / Experimental Treatment.

b. Biodegradable (bioresorbable, bioabsorbable) polymer drug eluting stents will be considered as experimental and investigational for all purpose.

•Hazardous Activities: Any claim relating to Hazardous Activities.

 HIV, AIDS, and related complex: Any condition directly or indirectly caused by or associated with Human Immunodeficiency Virus (HIV) or Acquired Immune Deficiency Syndrome (AIDS), including any condition that is related to HIV or AIDS.    

• Reproductive medicine & other Maternity Expenses: Any Critical Illness arising out of , directly/ indirectly caused by, contributed to or aggravated by:

•

a. Pregnancy or Child Birth Pregnancy (including voluntary termination), miscarriage, maternity or child birth (including through caesarean section)

b. Birth Control Any type of contraception, sterilisation, abortions, voluntary termination of pregnancy or family planning;

c. Assisted Reproduction Infertility services including artificial insemination and advanced reproductive technologies such as IVF, ZIFT, GIFT, ICSI, gestational surrogacy;

d. Sexual disorder and Erectile Dysfunction. Treatment of any sexual disorder including impotence (irrespective of the cause) and sex changes or gender reassignments or erectile dysfunction;

e. Any costs or expenses related to pregnancy, complications arising from pregnancy or medical termination of pregnancy unless caused by an Accident.

• Sexually transmitted Infections & Diseases: Screening, prevention and treatment for sexually related infection or disease.

• Substance related and Addictive Disorders: Treatment and complications related to disorders of intoxication, dependence, abuse, and withdrawal caused by drugs and other substances such as alcohol or nicotine.

•Traffic Offences & Unlawful Activity: Any condition occurring as a result of breach of law by the Insured Person with criminal intent.

• Unrecognised Physician or Hospital:

a. Treatment or Medical Advice provided by a Medical Practitioner not recognised by the Medical Council of India or by Central Council of Indian Medicine or by Central council of Homeopathy or by relevant authorities in the area or country where the treatment is taken.

b. Treatment or Medical Advice related to one system of medicine provided by a Medical Practitioner of another system of medicine.

c. Treatment provided by anyone with the same residence as an Insured Person or who is a member of the Insured Person’s immediate family or relatives.

d. Treatment provided by Hospital or health facility that is not recognised by the relevant authorities in India or any other country where treatment takes place.

e. Treatment or services received in health hydros, nature cure clinics or any establishment that is not a recognised Hospital or healthcare facility