The document summarizes the benefits offered under the Silver and Gold plans of a health insurance policy. Key benefits of the Gold plan compared to Silver plan include higher sum insured amounts (up to Rs. 50 lacs), coverage for room rent at actuals instead of 1% of sum insured, coverage for ayurvedic/homeopathic hospitalization up to Rs. 20,000, maternity expenses, newborn baby cover, bariatric surgery cover, and higher limits for cataract surgery sub-limit. The Gold plan also offers preventive health checks, longer waiting periods for some pre-existing diseases and surgeries, and higher discounts.
The document summarizes the benefits offered under the Silver and Gold plans of a health insurance policy. Key benefits of the Gold plan compared to Silver plan include higher sum insured amounts (up to Rs. 50 lacs), coverage for room rent at actuals instead of 1% of sum insured, coverage for ayurvedic/homeopathic hospitalization up to Rs. 20,000, maternity expenses, newborn baby cover, bariatric surgery cover, and higher limits for cataract surgery sub-limit. The Gold plan also offers preventive health checks, longer waiting periods for some pre-existing diseases and surgeries, and higher discounts.
The document summarizes the benefits offered under the Silver and Gold plans of a health insurance policy. Key benefits of the Gold plan compared to Silver plan include higher sum insured amounts (up to Rs. 50 lacs), coverage for room rent at actuals instead of 1% of sum insured, coverage for ayurvedic/homeopathic hospitalization up to Rs. 20,000, maternity expenses, newborn baby cover, bariatric surgery cover, and higher limits for cataract surgery sub-limit. The Gold plan also offers preventive health checks, longer waiting periods for some pre-existing diseases and surgeries, and higher discounts.
The document summarizes the benefits offered under the Silver and Gold plans of a health insurance policy. Key benefits of the Gold plan compared to Silver plan include higher sum insured amounts (up to Rs. 50 lacs), coverage for room rent at actuals instead of 1% of sum insured, coverage for ayurvedic/homeopathic hospitalization up to Rs. 20,000, maternity expenses, newborn baby cover, bariatric surgery cover, and higher limits for cataract surgery sub-limit. The Gold plan also offers preventive health checks, longer waiting periods for some pre-existing diseases and surgeries, and higher discounts.
Rs.3/4/5/7.5/10/15/20/ Sum Insured Rs.1.5/2lacs 25/30/35/40/45/50 lacs 1 In-patient Treatment Covered 1%of Sum Insured per day or actual, whichever As actuals 2. Room Rent is lower. 3. ICU As actuals As actuals 4. Pre-hospitalisation Covered- 60 days 5. Post-hospitalisation Covered- 90 days 6. Road Ambulance Covered 7. Day Care Procedures Covered 8. Organ Donor Expenses Covered 9. Convalescence Benefit Covered 10. Daily Cash Benefit for Accompanying an Insured Child Covered 11. Sum Insured Reinstatement Benefit Covered
Available-At the end of
block of every Available-At the end of continuous period of 3 block of every years continuous period of 3 Individual Policy- years 1% of the sum ins Individual Policy- ured max up to 1% of the sum ins Rs. 2000/- for ured max up to each member Rs. 5000/- for Floater Policy- each member Available for Floater Policy- proposer & Available for 12. Preventive Health Check spouse only proposer & Up spouse only 13. Ayurvedic / Covered-maximum up Homeopathic Not Covered to Rs. 20000 per policy Hospitalisation Expenses year 14. Maternity Expenses Not Covered Covered Covered-under the 15. New Born Baby Cover Not Covered Maternity Sum insured 16. Bariatric Surgery Cover Not Covered Covered Entry Age Proposer /Spouse /Parents/Sister/ Brother/In laws/ Aunt/ Uncle 18 yrs to 65 years Dependent Children/Grandchildren 3 months – 30 yrs Policy Details Policy Period 1year/2years or 3years
Zone A -“Following cities has been clubbed
in Zone A:-
Delhi / NCR, Mumbai including (Navi
Mumbai, Thane and Kalyan), Hyderabad and Secunderabad, Bangalore, Kolkata, Ahmedabad, Vadodara and Surat. Zone B Rest of India apart from Zone A cities are Premium payment Zone classified as Zone B. Annual for policy with term 1 year Policies with 2 years/ 3 years term- Total premium to be collected at the time of risk Premium Paying Term inception Individual Policy Type Floater Individual option-Self, Spouse, Dependent Children, Grandchildren, Parents, Sister, Brother, In laws, Aunt, Uncle Floater option-Self, Spouse, dependent children. – Family Definition For Parents separate floater policy can be taken.
No Medical tests up to 45 years, subject to
no adverse health conditions. Pre-policy check up Above 45 years medical tests mandatory Sub Limits Per eye 20% of Sum Insured, maximum up to Rs. Cataract 1lac Covered-50% of the Sum insured, subject to Bariatric Surgery Not Covered maximum of Rs 5 lac Sum Insured 3 lac to 7.5 lacs Normal delivery- Rs. 15000/- Caesarean section- Rs. 25000/- Not Covered Sum Insured 10 lacs to Rs. 50 lacs Normal delivery- Rs. 25000/- Caesarean section- Rs. 35000/- Maternity Expenses 10% of base sum insured per claim free year Cumulative bonus maximum 100% Discounts 10% if 2 eligible family members are covered under a single policy 15% if more than 2 of any of the eligible family members are covered under a single policy Note- Family discount is not applicable to Health Family Discount Guard Floater Policies. Co pay Discount Co-pay Discount: If opted voluntarily 10% discount on the policy premium 20% discount on the policy premium 4 % discount is applicable if policy is opted for 2 years 8 % discount is applicable if policy is opted Long Term Policy Discount for 3 years Renewal Period Lifetime For Dependent Children/ Grand Children- Renewal in same policy up to 35 years Waiting periods
Details Silver Plan Gold Plan
First 30 All treatments except any accidental injury days First 30 days Any Pre-existing conditions 36 months 36 months Specific disease like- Cataracts, Hernia of all types, Fistulae, Fissure in ano, Hysterectomy etc 24 months 24 months Joint replacement surgery Surgery for prolapsed inter vertebral disc (unless necessitated due to an accident) Surgery to correct deviated nasal septum Hypertrophied turbinate Congenital internal diseases or anomalies Treatment for correction of eye sight due to refractive error recommended by 36 months Ophthalmologist for medical reasons 36 months Not Maternity applicable 72 months Not Bariatric applicable 36 months
