The Policy covers aggregate hospitalization expenses reasonably and necessarily incurred in India in respect of all covered hospitalization during the policy period exceeding the Threshold Level or any amount reimbursed or reimbursable under any Health Insurance Policies/Reimbursement Scheme whichever is higher, upto the Sum Insured stated in the policy.

All claims shall be paid in Indian Rupees only.

Upon happening of any event, notice of Intimation about the hospitalization or claim should be sent to the address of Insurer/TPA stated in the Policy.  In case of emergency hospitalization, notice of intimation to be sent within 24 hours from the time of hospitalization.  

Basis of Payment

Any claim under this policy shall be payable only if the aggregate of covered hospitalization expenses exceeds the Threshold level or any amount received/receivable under any Health Insurance policy/ Reimbursement scheme whichever is higher.

The Policy provides the following benefits subject to the Basis of Payment clause mentioned above.

I. Hospitalisation expenses

1. Room, Boarding and Nursing expenses.

2. Expenses incurred for Surgeon, Anesthetist, Medical Practitioner, Consultants, Specialists Fees.

The Policy is available both on Individual and Floater basis.

Individual basis All family members including the parents can be covered under single policy with difference sum insureds and threshold level.

Group basis Single Sum Insured/Thereshold level for all family members covered under the policy.  Parents can take a separate policy.

1. All Pre-existing diseases upto 48 months of continuous coverage.

2. Vaccination and Inoculation of any kind unless it is post-animal bite

3. General debility and Run down conditions

4. Circumcision, Cosmetic surgery, Plastic surgery.

5. HIV/AIDS

6. Pregnancy, ailments related thereto and child birth

7. War, act of foreign enemy, ionizing radiation and nuclear weapon.

8. Naturopathy

9. Experimental or unproven treatment

10. All external equipments

1. ACCIDENT:

An accident is a sudden, unforeseen and involuntary event caused by external, visible and violent means.

2 (a). ACUTE CONDITION:

Acute condition is a disease, illness/injury that is likely to respond quickly to treatment which aims to return the person to his/her state of health immediately before suffering the disease/illness/injury which leads to full recovery.