Individual Mediclaim Insurance Policy

This policy covers hospitalisation and domiciliary hospitalisation expenses incurred by the Insured (including family members) for illness / disease or accidental injury and shall include hospital charges (room & boarding and operation theatre), fees of surgeon, anesthetist, nurses, cost of medicine, oxygen, blood, cost of appliances like pacemaker, artificial limbs and cost of organs.

Scope of Cover
  • The Policy covers individuals aged between 5 and 75 years.( However, children aged between 3 months and 5 years can be covered if one or both parents are covered concurrently).
  • Exemption under section 80 (D) of the Income Tax Act, 1961 is presently available for premium paid by cheque.
  • The Policy offers the feature of Third Party Administrator services.
  • The Policy covers illness / disease or accidental injury leading to expenses of various types referred to above.
  • Hospitalization expenses and domiciliary hospitalisation expenses referred to above shall be subject to a maximum of the sum insured at inception of the policy.
  • The Insured is entitled to reimbursement of the cost of medical check-up once at the end of a block of every four underwriting years provided there were no claims reported during the block. The cost so reimbursable shall not exceed an amount equal to 1% of the average sum insured during the block of four underwriting years.
  • The sum insured under the policy shall be progressively increased by 5% in respect of each claim free year of insurance subject to a maximum accumulation of 10 claim free years of insurance. In the event of a claim under the policy in respect of an Insured Person who has earned any cumulative bonus, the increased sum insured will be reduced by 10 % at the time of renewal. However, the basic sum insured will be maintained at all times.


 

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