Critical Illness Insurance Cover with Premium Back

Critical Illness Insurance Cover with Premium Back

The world today is moving fast, and adapting to its pace requires a brisk lifestyle. This means less time for everything including taking care of your health. So often we receive news about close acquaintances having acquired major illnesses and continuing their battle against the same. It is pertinent to note that the incidence of such lifestyle induced Critical Illness is rising very fast and so also the cost of treatment. The cost of treatment not only includes the cost of hospitalization but a number of other ancillary cost which are significant in nature like Chemotherapy, Dialysis, Long dosage of expensive injectable, nursing care, flying to other locations for treatment, etc. 


Keeping this in mind, PNB MetLife is proud to present a unique Plan, MetLife Major Illness Premium Back Cover, that will protect your family from financial uncertainties in case of a Major Illness by providing Lump sum in case of such an event. 


What’s more is that in case of no Major Illnesses during the period of the Policy, this Plan refunds back all the premiums paid (excluding the extra premiums and Service Taxes paid) in full upon survival at the end of the Policy Term.

    Critical Illness Insurance Cover with Premium Back

Medical experts are of the opinion that along with change our lifestyles, getting a critical illness medical cover is the only way to battle the rise critical illnesses. The best buy would be to purchase a critical illness insurance plan that covers the 20 major critical illnesses. Good critical illness plans also give out an accidental death/disability cover as well. This provides the customer with security, peace of mind, and confidence to face the unexpected future. All critical illness insurance covers provide a lump sum amount and benefit to pay off your expenses.

Medical experts are of the opinion that along with change our lifestyles, getting a critical illness medical cover is the only way to battle the rise critical illnesses. The best buy would be to purchase a critical illness insurance plan that covers the 20 major critical illnesses. Good critical illness plans also give out an accidental death/disability cover as well. This provides the customer with security, peace of mind, and confidence to face the unexpected future. All critical illness insurance covers provide a lump sum amount and benefit to pay off your expenses.

 


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Pregnancy Maternity Insurance Cover Policy Mediclaim Insurance Cover


Religare Health Insurance launch Maternity Insurance Plan - Buy instant policy, No paper work‎ with Cashless @ 4100 hospitals. Religare Health Insurance launch one of the most joyous experiences one can ever have. 

That’s why we have designed ‘JOY’ - that not only covers hospitalization expenses during pregnancy but also addresses your maternity and health needs, for both today and tomorrow.
When a member of your family is sick or hurt, the last thing you want to think about is how you’re going to pay for it. You just want them to get the care they need right away. 


That’s why its important to do your homework now and get the right family health insurance plan today so you don’t have to think about it when something does come up.Health insurance plans that provide maternity coverage will generally cover the standard medical costs associated with a healthy pregnancy. 

 

‘JOY’ -  with Maternity and new born cover has unique features like Health Insurance Policy
  • Cashless treatment at 4100+ hospitals
  • A perfect blend of hospitalization and maternity insurance
  • Industry’s lowest 'Waiting period' of only 9 months for maternity related claims.
  • New born baby cover
  • 100% increase of sum insured with no claim bonanza

Policy Terms
Entry Age - Minimum
Adult: 18 years
Child: 1 Day
New Born: 1 Day
Entry Age - Maximum
Adult: 65 years
Child: 24 years
New Born: 90 Days
Exit Age
Lifelong
Cover Type
Individual/ Family Floater
Renewal
Lifelong Renewability. The policy can be renewed under the then prevailing Health Insurance with Maternity Benefit Product or its nearest substitute approved by IRDA
Co-payment
If you enroll at the age of 61 years or more, you will have to pay 20% of the claim amount under the policy. We pay the rest.
Waiting Period
30 days for any illness except accident
9 months for maternity
2 years for specific treatments/illness
4 years for pre-existing diseases
Grace Period
30 days from the date of expiry to renew the policy
Policy Tenure
3 years
Maternity Cover
Available only up to 45 years of age

Plan Details
Sum Insured – On annual basis
Rs. 3 Lakh
Rs. 5 Lakh
Hospitalisation Expenses
Yes, up to Sum Insured
Yes, up to Sum Insured
Room Category
Single Private Room with AC
Single Private Room with AC
Pre-Hospitalisation Medical Expenses
Up to 30 days
Up to 30 days
Post-Hospitalisation Medical Expenses
Up to 60 days
Up to 60 days
Ambulance Cover
Up to Rs. 1,000 per Claim
Up to Rs. 1,000 per Claim
Maternity Cover (including Pre-natal & Post-Natal expenses)
Up to Rs. 35,000
Up to Rs. 50,000
Newborn Baby Cover
Up to Rs. 30,000
Up to Rs. 50,000
No Claim Bonanza (Optional Benefit)
Yes
Yes

What is not covered? 
  • Any pre-existing ailment/injury that was diagnosed/acquired within 48 months prior to issuance of the first policy
  • Any diseases contracted during first 30 days of the policy start date except those arising out of accidents
  • Non-allopathic treatment.
  • Expenses attributable to self-inflicted injury (resulting from suicide, attempted suicide)
  • Expenses arising out of or attributable to alcohol or drug use/misuse/abuse
  • Cost of spectacles/contant lenses, dental treatment
  • Medical expenses incurred for treatment of AIDS
  • Congenital disease
  • Tests and treatment relating to infertility and in-vitro fertilisation.
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What is a ‘hospital’ for the purpose of health insurance policies?

What is a ‘hospital’ for the purpose of health insurance policies?
 
Institutions set up for treatment and indoor care in respect of sicknesses and/or injuries and that are registered and under active supervision by a medical practitioner. 
OR
Any establishment satisfying the following criteria can qualify as a hospital:
  • 15 patient beds
  • With a fully equipped operation theater of its own if
  • Employing fully qualified nursing staff around the clock
  • Having fully qualified doctors in charge around the clock
Ayurvedic or institutions practicing alternative medicine therapy also qualify as hospitals.

What is meant by hospitalization? 
Where the insured is admitted to a hospital for a minimum period of 24 hours, the event is termed as hospitalization. 
In case of specific treatments like chemotherapy, dialysis, radiotherapy, dental surgery, laser eye surgery, etc where the patient is duly discharged by the same day are also termed as hospitalization.

Is there a limit as to how long I can stay in hospital? 
There cannot be a stated limit to how many days of hospitalization a person might need and hence there are no set limits to how long you can stay in hospital.

What is the meant by domiciliary hospitalization? 
When the treatment is administered at a patients home, the event is termed as domiciliary hospitalization. This is normally the case when conditions are such that the patient cannot be moved from his home to the hospital or when there are no hospital beds available and hence the treatment has to be administered at the home of the person.
Is there a tax deduction on the premium paid? 
As per section 80D of the Income Tax Act, premiums paid up a set limit per annum under the health insurance plan for self, spouse, two dependent children and dependent parents are exempt from tax.

Can I get a refund if I cancel my health insurance plan during the contract term? 
Yes. The insurer is liable to refund the premium if no claim has been made up to the date of cancellation.

What happens when I make a claim on a Critical Illness Plan? Does the policy still continue? 
Usually the policy ceases to continue on making a claim. However there are many insurers who renew the policy on payment of a lesser premium than the one originally paid. 

Can there be a claim of medical expenses incurred before and after a surgery? 

Medical expenses incurred 30 days before and 60 days to 90 days after hospitalization, can be claimed, provided they are related to the ailment/accident for which you were hospitalized. Such expenses are termed as pre and post hospitalization.

Can I claim my dentist's bills?

Dentistry bills cannot be claimed.
For how long is a Critical Illness policy issued? 
A critical illness policy is usually issued for a period of one year. Some insurers offer it for a term of two to five years while a few offer it for a period of 10 years to 30 years; with the premium remaining constant for three years or five years
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In Mediclaim standard policy exclusions are

Religare Health Insurance - 
The standard policy exclusions are-  
  • Any pre-existing illness.
  • Any diagnosis of diseases / undergoing of surgery / occurrence of event, whose signs or symptoms first occur within 30 days of Policy Period Start date.
  • Expenses attributable to self-inflicted injury (resulting from suicide, attempted suicide)
  • Expenses arising out of or attributable to alcohol or drug use/misuse/abuse
  • Medical expenses incurred for treatment of AIDS
  • Treatment arising from or traceable to pregnancy and childbirth, miscarriage, abortion and its consequences
  • Congenital disease
  • Tests and treatment relating to infertility and in vitro fertilization.
  • War, riot, strike, nuclear weapons induced hospitalization.
For more details, kindly refer to our health insurance policy's detailed exclusion list.
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Claim Processing of Religare health Insurance

Claim Processing of Religare health Insurance

Claim Processing
Claim Intimation
In case of emergency, please intimate us within 24 hours of hospitalisation.
If planned hospitalisation, intimate us 48 hours prior to your admission.
1800-200-4488 1800-200-6677 customerfirst@religarehealthinsurance.com
Cashless
Request for Pre-Authorisation
Re-imbursement
Claim From Submission
Complete the pre-authorisation form available at the hospital's insurance/TPA Desk and send us through email/fax. This form can also be downloaded from here. Submission of claim from along with required documents, as per the policy terms & conditions The form can be downloaded form here.
Approved letter sent by the
claim management team
 
Hospital/Insurance to respond
to any query raised by the
claim managment team
 
You may initiate the
treatment and file for
re-imbursement claim
Approved letter sent by the
claim management team
 
Insured to respond to query,if any, raised by the claim
management team
 
We will communicate
the reason in case of rejection
To see list of network hospitals for cashless treatment or for further information please click here. You may also call us on 1800-200-4488 or write to us at customerfirst@religarehealthinsurance.com
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