Please note that the premium rates specified in the illustrations below are standard premium rates exclusive of any loadings and GST.

Illustration 1: Self, Spouse and 2 Dependent Children

A. WAITING PERIOD - EXCLUSIONS

The Company shall not be liable to make any payment under the policy in connection with or in respect of following expenses till the expiry of the waiting period mentioned below:

1. Pre-Existing Disease Waiting Period (Code- Excl01):

a. Expenses related to the treatment of a pre-existing disease (PED) and its direct complications shall be excluded until the expiry of 48 months of continuous coverage after the date of inception of the first policy with us.

1. Notification of Claim

Upon the happening of any event which may give rise to a claim under this Policy, the Insured Person/Insured Person’s representative shall notify the TPA in writing providing all relevant information relating to claim including plan of treatment, policy number etc. within the prescribed time limit as under:

The coverages available under this policy are classified as Base Cover and Optional Cover. Base Cover refers to the coverage available as default under Super Top-Up Medicare Policy whereas Optional Cover is available only upon payment of additional premium.

BASE COVER

The Policy provides base coverage as described below in this section:

ELIGIBILITY

The terms defined below and at other junctures in the Policy have the meanings ascribed to them wherever they appear in this Policy and, where, the context so requires, references to the singular include references to the plural; references to the male includes the female and references to any statutory enactment includes subsequent changes to the same.

This is an annual aggregate deductible policy. 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. The Policy provides cover on an Individual basis or Family Floater basis.