Brief Description :
Mediclaim Insurance is a Health cover which takes care of medical expenses following Hospitalisation/Domiciliary Hospitalisation of the Insured in respect of the following situations:
(A) In case of a sudden illness
(B) In case of an accident
(C) In case of any surgery which is required in respect of any disease which has arisen during the policy period.
Individual Mediclaim policy will be available to any individual between the age of 18 to 65 years (Extended to 70 years) for treatment in India.
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The salient features of the policy are:
(i) The Policy term is one year and is available to any proposer between the age of 18 to 65 years for treatment taken in India. The proposer can also get his family covered (as defined under 2.1).
(ii) Maximum Entry age for any member, is 65years however, this can be extended upto 70 years. In such case, an additional premium of 10% (including on all future renewals) will be charged on applicable rates, including on Optional PA cover.
(iii) Sum Insured (SI) available from Rs.1lac to Rs.10lacs.
(iv) Pre-existing diseases covered after four consecutive renewals.
(v) Life long renewals allowed.
(vi) Family discount of 10% (including on PA cover) if more than one person is covered under the policy.
(vii) Option of voluntary co-payment of 10% and 20% with corresponding premium discount of 10% and 20% respectively on SI of Rs.2lacs and above. Voluntary co-payment does not apply on PA section.
(viii) No medical examination for persons upto the age of 55 years.
(ix) In case of fresh covers, 50% of the Pre-insurance medical check-up cost reimbursable, subject to acceptance of the Proposal.
(x) Daily Hospital Cash allowance in case of more than 2 days of continuous hospitalisation.
(xi) Hospitalisation expenses incurred for donating an organ by the donor (excluding cost of organ) to the insured person, is covered
(xii) Ambulance charges covered
(xiii) Personal Accident available on optional basis for SI from Rs.2lacs to Rs.10lacs.
(xiv) Free Look Period- A period of 15 days from the date of receipt of the policy to review the terms
and conditions of the policy and return the same, if not acceptable.
(xv) Grace period of 30 days is allowed for payment of renewal premium.
(xvi) Premium adjustment at renewal, for the duration of OMP cover taken from Oriental.
(xvii) Discount of 5.5% in premium if TPA services not opted for.
This Health cover is a hospitalisation cover and reimburse the medical expenses incurred in respect of covered disease /surgery while the insured was admitted in the hospital as an in patient. The cover also extends to pre- hospitalsation and post- hospitalisation for periods of 30 days and 60 days respectively
For Details please refer policy documents/ Prospectus
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