Platinum

PEACE OF MIND FROM AN

EXPERT YOU CAN TRUST

t Health Insurance Plan Heartbeat Health Insurance Plan Customer Guide

Your familys health comes first

We all aspire to provide the very best for our families. Nothing seems more important than their well being, and that, is surely at the top of your mind. When it comes to your familys health, you need a partner you can trust. Someone who will be there for you, through thick and thin.

Today, even as medical science is making revolutionary progress in healthcare, the average age of lifestyle diseases seems to be reducing rapidly. The solution then, would be to make changes towards leading a healthier, happier life. And what would be better if you knew that you also had access to the very best of healthcare; if you might need it some day.

We at Max Bupa, understand what you need - to provide the very best for your family, no matter what. That is why, this plan offers you comprehensive cover and personalised care and service; just what you need.

There is no better solace than knowing that the best treatment is there for you when you need it. And a good health insurance cover gives you just that. Peace of mind, and the freedom to protect your hard earned assets.

Expertise is important, when it comes to delivering excellence.

Max Bupa: Combining local understanding with global expertise

Max India and Bupa, an international health insurance company, have joined hands to bring to India Max Bupa Health Insurance. We believe in nurturing long-term relationships with our customers by providing the highest levels of quality in service. Read more about our parent companies. Bupa brings in a wealth of experience in serving customers directly in Health Insurance across the world. Bupa runs Care Homes for elderly and young disabled people. It also provides health assessment, health coaching and work place health programmes for customers.

Bupa: 60 years of care

Established in 1947 as the British United Provident Association, Bupa today has over 10 million customers across 190 countries.

Max India Limited: A reputation for excellence

The Max India Group brings expertise in Insurance and Healthcare with a strong presence in Life Insurance (Max New York Life Insurance Company Limited), Healthcare (Max Healthcare Institute Ltd.) and Clinical Research (Max Neeman Medical International Limited).

A Rs. 5,000 Crore group, it has over 500 offices across India, more than 20,000 employees and 84,000 agents, all focused on delivering value to its 3.5 million customers.

Recognition and awards Max India Limited:

Max New York Life declared a Superbrand by Superbrands India in 2008 CII-Exim Bank Award for Business Excellence awarded to Max New York Life in 2008 CIO 100 Award for technology implementation Best Healthcare Provider of the Year awarded at the U.K. Corporate Adviser Awards 2009 Best Individual Private Medical Insurance Provider - awarded at the U.K Money Marketing Awards 2009

Bupa:
The Health Insurance Company of the Year Award - awarded at the U.K. Health Insurance Awards 2009 Best International Private Medical Insurance Provider 2008 - awarded at the U.K. Health Insurance Awards Best Medical Insurer Company (2008, Bupa Arabia) - awarded at the Jeddah Chamber of Commerce and Industry Health Committee Awards

I put my trust in a name trusted by 10 million people across 190 countries.

Source Max India Ltd. Annual Report 2008-09 Source - Half year financial report published on www.bupa.com in June 2009

Its not about cover for a year, but a relationship for life.

Heartbeat Health Insurance Plan Start a healthy relationship with us

Heartbeat Health Insurance Plan is a family oriented Health Insurance Policy which is simple to buy and extremely easy to understand. In addition to comprehensive Health Insurance that suits your needs, it also helps you care for your health proactively over time. You dont just buy an annual insurance from us. Our focus is on building a long-term health relationship with you and your family. sum assured. The coverage includes outpatient benefits as well as hospitalisation benefits.

2. We talk directly to you

We talk to you directly, and not through any third parties. We are always there for you when you need us. Because you should concentrate on getting better or looking after your loved ones, rather than chasing a third party for settlement of

We believe that a healthy relationship is built by understanding your needs, by coming closer to you, through a continuous dialogue with you on what matters the most. Which is why our Heartbeat Health Insurance Plan comes with thoughtfully designed benefits. Here are 14 good reasons for you to choose Heartbeat Health Insurance plan.

your claims.

3. Cashless facility at quality hospitals

You can access cashless facility at quality hospitals near you, thanks to our valued relationship with them.

1. Most comprehensive cover

Our Platinum plan can cover an individual or a family for up to Rs.50 lacs of annual

4. Assured plan renewal for life

We assure you renewability for life. We are not here for just one year of your life, we are there for you for a lifetime.

7. More comprehensive coverage:

All day care procedures covered: We cover all day care procedures, not a select few. Limited exclusions: Heartbeat plan has limited exclusions, whether its for one year, two year or permanent exclusions.

5. Maternity & Child care benefits

Maternity benefit: The Family Floater option provides you maternity benefits for up to two deliveries. This benefit is available after you and your spouse have been covered for 24 months continuously. We also pay pre and post maternity expenses. New born coverage: All new born babies (where we have paid the maternity claim) are automatically covered from birth until the next renewal of the plan. Vaccinations: First year vaccinations for all new borns (where we have paid the maternity claim) are covered. Child care: We provide vaccinations as well as nutrition and diet consulting for children up to 12 years.

8. Proactive health relationship & management benefits

Health check-up on renewal: Because your health is precious and should be well looked after.

I should be able to get a health plan, irrespective of my age.

6. No age restriction for enrollment

We cover every member of your family, across every stage in life - from new borns to senior citizens. There is no minimum or maximum age for enrollment.

Heartbeat Health Insurance Plan gives me comprehensive coverage.

beat eart ose H o cho t over sons ive c Rea hens 4 1 e

pr PA t co m no T Mo s vice, er ct S Dire lity f aci life hless fits l for as bene C newa re are c ed ssur Child ent A and y nrollm ernit for e at on M ricti age over rest age ive c t ens No preh emen anag e com or hm ion M healt ultat tive cons ac o tor Pr Doc ialist ec Sp n ent opinio nrollm Eible e ns ice espo serv R ality u igh q d H perio e look e Fr ng savi Tax
24/7 health line: You can access health advice when you need it. Health relationship loyalty programme: If the plan is renewed with us, you are eligible for health services and products worth upto 10% of your renewal premium. with a specialist doctor. We also pay for any diagnostic tests prescribed by the specialists. If your plan is renewed without l f l any break and there is an unutilised amount, we carry forward 80% of this unutilised amount to the next plan year.

10. E-opinion
In case you need a second opinion for a life threatening medical condition, we can provide you one e-opinion for the same.

9. Specialist Doctor consultation and diagnostic tests

You are covered for outpatient consultation

My health insurance takes care of all my needs.

11. Responsible enrollment

To start a relationship that lasts a lifetime, we make every effort to understand your health profile before you sign up. So that when you need us, we are there to provide speedy and efficient support and a hassle free claim experience.

requirements, you can access relevant health information and support to improve your lifestyle and your familys health.

13. Free look period

Our health insurance plans are transparent and easy to understand. In case if you are not satisfied we provide you a 15 day freelook period within which you can cancel your plan stating the reason.

12. High quality service

Relationship manager: We may assign a relationship manager who will personally help you at the time of hospitalisation and attend to your claims settlement, leaving you free to concentrate on getting yourself or your loved ones better. 24x7 customer service: Our 24x7 customer helpline is always there to help you whenever the need arises. The helpline provides you a range of services including pre-authorisation, plan and payment related queries, claims information and other services that you may need. Health information at your fingertips: As a customer, you can access your own page on the Max Bupa website for storing your claims history, health information, health profile, including records of tests you may have taken while enrolling with us. Based on your

14. Tax savings

You will save tax under Section 80D of The Income Tax Act. Tax benefits are subject to change in the tax laws, please consult your tax advisor for details.

Choosing the right plan matters a lot.

Choose your plan

You can choose between three levels of cover, depending on your requirements. Each plan comes with comprehensive family oriented benefits, to ensure your needs are well covered.

The premium for Family Floater option depends on the age of the eldest insured member. This plan is renewable for any age. You can be covered under this plan throughout your life.

Heartbeat Health Insurance Plan can be taken for an individual and/or a family. The Family Floater option is available in any of the following combinations:

My family
1 Adult + 1 Child

is equally important when it comes to choosing a health plan.

2 Adults + 1 Child

2 Adults

1 Adult + 2 Children

2 Adults + 2 Children

Heartbeat - Product benefits table

Overall Sum Insured (Rupees)
In-patient treatment
Surgical operations, including pre and post-operative care Nursing care, drugs and surgical dressings Doctors fees Operation theatre charges and intensive care Pathology, x-rays, diagnostic tests and therapies Prosthetic implants Hospital accommodation Pre and post hospitalisation expenses including doctors consultation, diagnostic tests, medicines, drugs and consumables All day care procedures
Single Private Room. Upgrade to next level, subject to availability

15 Lacs

20 Lacs

50 Lacs

Covered up to Sum Insured

Covered up to Sum Insured Covered up to Sum Insured

Child care benefits

Maternity cover for up to 2 deliveries New born baby cover Vaccinations for children upto 12 years and nutrition and diet consulting

Covered up to Rs 60,000

Covered up to Rs 75,000

Covered up to Rs 1,00,000

Covered up to Sum Insured Covered up to Sum Insured

Further benefits
Health check-up at time of renewal Organ transplant when medically necessary Emergency ambulance (*) Domiciliary treatment

Annual Covered up to Sum Insured Covered at acutal cost in Network hospitals up to Sum Insured
Covered up to Rs 75,000 Covered up to Rs 1,00,000 Covered up to Rs 2,50,000

Out-patient benefits
Out-patient benefits covering specialist consultation and costs of diagnostics tests prescribed by them.

Covered up to Rs 10,000

Covered up to Rs 15,000

Covered up to Rs 20,000

Additional services
24x7 healthline Relationship manager Second e-opinion

Available Available Available

Health relationship programme

Cumulative benefit every year on renewal
Co-pay of 20% of reasonable and customary charges for claims of persons above 65 years of age. * Emergency ambulance - maximum of Rs. 2000/- per event for out-of-network.

Up to 10% of renewal premium

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My health plan gives me accidental cover as well.

What is covered

Your Heartbeat Health Insurace plan covers you for the costs of treatment of a disease, illness, injury or accident that leads to your recovery, conservation of your condition, or to restore you to your previous state of health as quickly as possible.

admission to the hospital and 60 days after discharge from the hospital.

Day care procedures

Domiciliary treatment: Medical expenses for treatment taken at home.

You are covered for emergency and non-emergency treatment, in both network & out-of-network hospitals. We pay, up to the yearly maximum sum insured. Organ donation: Medical expenses for an organ donors treatment for harvesting of the organ.

We cover the following expenses: In-patient treatment: Including medical fees for doctors, diagnostics, medicines, operation theatre, hospital accommodation and other related expenses.

Maternity & childcare benefits: Medical expenses for maternity & childcare (vaccination and nutrition consulting) under family floater plan.

Emergency ambulance: Expenses incurred to transfer the insured person following an

Pre & post hospitalisation medical expenses: Medical expenses incurred due to illness up to 30 days period immediately before an insured persons

emergency to the nearest hospital.

1 1

I need to be absolutely clear about what I am not covered for.

What is not covered

Pre-existing conditions: Benefits will not be available for pre-existing conditions until 48 months of continuous coverage from first plan start date.

puberty; artificial life maintenance; circumcision; conflict and disaster; congenital conditions; convalescence and rehabilitation; cosmetic surgery; dental/oral treatment; eyesight;

90 days waiting period: We will not cover treatment during first 90 days of the plan, unless the treatment needed is a result of an accident or emergency. This waiting period does not apply for renewal plans.

experimental treatment; health hydros, nature cure, wellness clinics etc.; HIV and AIDS; hereditary conditions; non-allopathic treatment; obesity; neurological and psychiatric conditions; self-inflicted injuries; sexual problems and gender issues; sexually transmitted

Specific waiting periods: For persons above 60 years of age some conditions will be subject to a waiting period of 24 months.

diseases; sleep disorders; speech disorders; treatment for developmental problems; treatment received outside India; unrecognised physician or facility.

Co-pay: If any person is 65 years or above on the date of commencement of the plan, we will pay 80% of reasonable and customary charges.

For details of what is not covered please visit www.maxbupa.com/whatisnotcovered

Permanent exclusions: Addictive conditions and disorders; ageing and

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What to do next

If you would like to find out more, or would like a personal quote, please speak to our specially trained sales team or your Max Bupa advisor. We are available to fully understand your requirements and help you select the right plan for you and your family.

Call: 3300 3333 or 1800 3010 3333 (Toll Free) SMS Maxbupa to 53030 or Log on to www.maxbupa.com

Disclaimer: This is only a summary of the product features and is for reference purpose only. The details of benefits available shall be as described in the Plan document, and will be subject to the Plan Terms, Conditions and Exclusions. Please call our customer service if you require any further information or clarification.

Statutory warning: Prohibition of rebates (under Section 41 of Insurance Act 1938); no person shall allow or offer to allow either directly or indirectly as an inducement to any person to take out or renew or continue an insurance in respect of any kind of risk relating to life or property, in India, any rebate of the whole or part of the commission payable or any rebate of the premium shown on the plan, nor shall any person taking out or renewing or continuing a plan accept any rebate, except such rebate as may be allowed in accordance with the published prospectus or the tables of the insurer. Any person making default in complying with the provision of this section shall be punished with fine, which may extend to five hundred rupees.

Max Bupa Health Insurance Company Limited Registered Office: Max House, 1 Dr. Jha Marg, Okhla, New Delhi - 110 020 Corporate Office: D-1, 2nd Floor, Salcon Ras Vilas, District Centre, Saket, New Delhi - 110 017
Delhi: N 9, South Extension II, New Delhi 110 049 Mumbai: Unit Number 31 & 32, 3rd Floor, VIRAJ 124 S.V. Road, Khar West, Mumbai 400 052 Pune: 4th Floor, 415 A/B/C, 132/B/1, Plot No. 1, Ganeshkhind Road, Near University Circle, Pune - 411 007 Bangalore: No. 30/1, Hosur Main Road, Bangalore - 560 095 Chennai: 1st Floor, Ampa Manor, 107/2, Nelson Manickam Road, Aminjikarai, Chennai - 600 029 Hyderabad: 10-5-11 and 12 Main Road, Masab Tank, Road No1, Banjara Hills, Hyderabad - 500 034 HB/PB/0310/V1.0

Insurance is the subject matter of solicitation Max, Max Logo, 'Bupa' and HEARTBEAT logo are trademarks of their respective owners and are being used by Max Bupa Health Insurance Company Limited under license. UAN : MB/BR/09-10/14