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Key Highlights

* Rs. 3 lakh cover for a family of two at Rs. 2513 per annum

* 24 x 7 cashless facility and TPA support

* No medical check-up up to age of 45 years

* Income Tax benefit under Section 80 D


Features

Access to quality healthcare is a necessity today. The Reliance Healthwise Policy ensures you provide the best medical care to your family. We offer a health insurance policy that gives you the optimum value for money without compromising on the quality of medical attention

Key Advantages

* We offer premiums as low as Rs.2513 p.a., for a Sum Insured of Rs. 3 lakhs, for a couple

* The Family Floater benefit covers the entire family, ensuring that the cover is used optimally

* Policies are available for renewal to people up to the age of 65 years

Convenience all the way

* No health checkups for people under the age of 45 years

* With our instant health-kit issuance, your health cover gets an instant start

* A 24-hour cashless facility is provided at more than 4,300 hospitals across India

The Reliance Advantage

* Pre-existing illnesses will commence after two years or four years (depending on the plan you choose) of continuous cover

* We also provide you and your family with extended coverage for pre- and post-hospitalisation expenses

* What's more, we reward you with a no-claim bonus of 5% on every claim-free renewal. This can be accumulated up to a maximum of 50%

Tax-wise

* With the Reliance HealthWise Policy, you can avail of tax benefits under Section 80D of the Income Tax Act

Policy Coverage

The coverage offered by Health-wise Policy includes:

* Hospitalisation Expenses:-The policy will cover expenses incurred for room and operation-theatre charges, doctors’ fees, cost of nursing, medical tests, medicines, blood, etc

* Day-Care Treatment :-The policy will cover expenses incurred towards technologically advanced treatment that does not require hospitalisation for 24 hours.

* Domiciliary Hospitalisation :-We also provide cover for treatment administered at home, subject to specified conditions.

* Pre- and Post-Hospitalisation :- Reliance Healthwise covers medical expenses for treatment up to 60 days before (and up to 90 days after) the hospitalisation, depending upon the plan selected

* Critical Illness :- The policy provides for separate double sum insured for treatment of ten critical illnesses listed.

* Donor Expenses :- In the event of a major organ transplant, this policy will cover hospitalisation expenses incurred on the donor

Value Added Benefits

Reliance General Insurance strives to provide more than what is expected. Our value-added benefits include:

* Nursing allowance for a maximum of five days.

* Reimbursement of charges towards ambulance services

* Allowance for expenses of a person accompanying the insured, for a maximum of five days

* Reimbursement of cost of health check-up after four claim-free renewals.

Exclusions

In order to ensure that you do not face any unpleasant surprises when you make a claim, we would like you to know some of the major exclusions under the policy.

* Any pre–existing illness for the first two years/ four years of the policy.

* Specified illnesses for the 1st year.

* Specified illnesses in the case of domiciliary hospitalisation.

* Any treatment for the first 30 days from the time of inception of policy, unless due to an accident.

* Treatment related to HIV / AIDS

* Treatment due to abuse of alcohol or intoxicants.

* Vaccination and inoculation.

* Nuclear and war perils.

* Naturopathy treatment


Eligibility

Eligibility norms for this policy are:

* Children above the age of three months and adults below the age of 65 years.

* Children between three months and five years can be covered only if one or both parents are covered.

* No health checkups for people under the age of 45 years.

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STAR FAMILY HEALTH OPTIMA





Family Health Optima from Star Health is a health insurance plan that gives protection for the entire family on the payment of a single premium under a single sum insured.The sum insured floats among the family members insured.It's just one more way to tighten the family bonds.

Policy Benefits

Hospitalisation Cover:Protects the insured person for in-patient hospitalisation expenses for a minimum of 24 hours.These expenses include room and boarding charges as per policy conditions
  • Nursing expenses
  • Surgeon's fees,Consultant's fees, Anaesthetist's and Specialist's fees
  • Cost of medicines and drugs
  • Emergency ambulance charges for transporting the insured patient to the hospital upto a sum of Rs.750/- per hospitalization and overall limit of Rs.1500/- per policy period
  • A Super Saver Policy

    • Single Sum Insured
    • Coverage for entire family
    • Single Premium
    • Considerable saving in premium as the family is covered under one policy

    Pre and Post Hospitalisation Cover

    • Pre-hospitalisation medical expenses upto 30 days prior to the date of admission
    • Post-hospitalisation calculated at 7% of the hospitalisation expenses(excluding room charges),subject to a maximum of Rs.5000 is payable.

    Family Includes

    • Proposer,spouse,dependent children upto 25 years those who are economically dependent on their parents.

    Eligibility

    • Any person aged between 5 months and 60 years residing in India can take this insurance.

    How much to pay?

    A: Adult C: Children upto 25 yrs. NA: Not Available





    Age of the oldest family member covered should be taken for premium calculation
    Service tax extra


    Discount

    • A discount of 10% on Premium is allowed on renewal of the policy if there is no claim in the immediately preceding year of the policy. This discount is not cumulative.

    Exclusions

    • Expenses for the treatment of any illness/ disease/condition which is pre-existing
      Treatment of illness/disease/sickness contracted by the insured person during the first 30 days from the commencement date of the policy
    • First Two Years Exclusions:Cataract,Hysterectomy for Menorrhagia or Fibromyoma,Replacement surgery for knee and/or joint (other than caused by an accident),Prolapse of intervertebral disc(other than caused by accident),varicose veins and varicose ulcers
    • First Year Exclusions:Benign Prostate Hypertrophy,Hernia,Hydrocele,Fistula in anus,Piles,Sinusitis and related disorders,congenital internal disease/defects, removal of gallstones and renal stone
    • Naturopathy treatment
    • Expenses which are purely diagnostic in nature with no positive existence of any disease
    • Expenses incurred for non-allopathic treatment
    • Treatment of external Congential disease/defects/anomalies
    • Expenses which are mainly cosmetic in nature

      NOTE:For a detailed list of exclusions, refer policy document.

    Claims Procedure

    • Inform the ID number for easy reference
    • In case of a planned hospitalisation, please inform 24 hours prior to admission into the hospital
    • In case of emergency hospitalisation, information to be given within 24 hours after hospitalisation
    • At non-network hospitals,payments must be made upfront and then reimbursement will be effected on the submission of documents

      NOTE:The benefits and exclusions mentioned herein are only an outline of the policy.For complete details, please contact your nearest Star Health office

    National Insurance Company Health plan



    Features:

    1. Family floater coverage available up to 6 memebers of a family including dependant children and dependant parents.

    2. Covers
    - Pre-existing diseases covered immediately (excluding Chemotherapy, Radiotherapy & Dialysis) &
    - Maternity Coverage
    { Nine months waiting period applicable}
    » Rs. 25,000/- for a Cesarean &
    » Rs. 15,000/- for a normal delivery.
    All these at no extra cost !!

    3. No Medical Test required.



    4.Applicable Age Group: 3 months to 65 years;

    5.Cashless policy;

    6.Critical illnesses buffer cover: Additional coverage up to Rs. 75,000/- per family for hospitalization in case of :
    Heart Surgery , Organ Transplant, Neuro Surgery; Cancer Road Traffic Accidents

    Other Features:
    Income Tax benefits available u/s 80 (D):

    - Rs. 15,000/- for covering self, spouse and dependant children.
    - An additional Rs. 15,000/- (Rs 20,000/- if they are senior citizens) for covering parents.




    National Health Plan – Frequently Asked Questions

    Who all can be covered under the term ‘family’ in context of the policy?

    The family can be made up of 1+5 persons, i.e. Primary member + Spouse + Dependent children + Dependent Parents.
    For children who are enrolled with any recognized educational institution as students, the age limit will be 25 years. Dependent daughters who are unmarried shall be added to family of insured members irrespective of their age.

    Family member needs to be aged between 3 months and 65 years to be eligible for getting insured under this policy.


    What are options available for the sum insured value?

    The policy offers 5 sum insured options of Rs.1,00,000/-, Rs.2,00,000/-, RS 3,00,000/-, Rs.4,00,000/- and Rs.5,00,000/- for coverage to a family. These options are available with the family floater benefit

    What is the standard cover available under the policy?

    The benefits under this policy will be available to all the insured persons provided the stay in the hospital is for a minimum of 24 Hours as per the attending Doctor’s advises. This time is however not applicable for specific treatments i.e. dialysis, chemotherapy, radiotherapy, eye surgery, dental surgery, lithotripsy, tonsillectomy, and dog bite.

    The expenses covered under the policy, subject to maximum of the sum insured amount chosen and various sub limits mentioned in the policy document, are:
     Room, boarding expenses as provided by the hospital/Nursing Home.
     Nursing Expenses
     Surgeon, anesthetist, Medical Practitioner, Consultants, Specialist’s Fees
     Anesthesia, Blood, Oxygen, Operation Theatre Charges, Surgical appliances, Medicines and drugs, Diagnostics materials and X-ray, Dialysis, Chemotherapy, Radiotherapy, Cost of pace maker, Artificial limbs and Cost of organs and similar expenses.
     Ambulance charges will be reimbursable subject to maximum Rs.500/- per hospitalization.

    Here, “Hospital/Nursing Home” means an institution in India established for indoor care and treatment of sickness and injuries and which has been registered either as a hospital or Nursing Home with the local authorities and is under supervision of registered and qualified medical practitioner or should comply with minimum criteria as under:
    a. It should have least 15 inpatient beds.
    b. Fully-equipped operation theatre of its own where surgical operations are carried out.
    c. Fully qualified nursing staffs under its employment round the clock.
    d. Fully qualified Doctor (s) should be in charge round the clock.

    Are there any medical tests required to be undertaken for this policy?

    No medical tests are required for taking this policy.


    Does the policy cover pre-existing diseases?

    All pre-existing diseases are covered under the policy. There is no waiting period for this coverage to come into effect.
    However, the treatment for Chemotherapy / Radiotherapy and Dialysis will not be covered for persons who are already suffering from Cancer and Renal Disease at the time of commencement of policy.

    Does the policy provide maternity benefit coverage?

    Yes, the policy covers the maternity expenses for an insured person to the extent of Rs.15,000 for a normal delivery and Rs.25,000 for a caesarian delivery. This cover is subject to a waiting period of 9 months from the date of commencement of policy.

    Does the policy cover the pre and post hospitalization expenses?

    Yes, the relevant medical expenses incurred up to 15 (Fifteen) days prior to hospitalization and up to 30 (thirty) days post-hospitalization are covered under the policy.


    Does the policy critical illnesses diagnosed during the currency of the policy?

    Yes, the policy covers the treatment of 5 critical illnesses, that is heart surgery, neurosurgery, organ transplant, cancer and road traffic accidents. This cover is available in the form of an additional buffer of Rs.75,000/- per family.





    Is there a provision for ‘Day Care Treatment’?

    Yes, there is a provision for Day Care treatment in some cases as would be applicable in a normal health insurance policy.


    How much premium does one need to pay for this policy?


    The premium payable for this policy (inclusive of service tax) is:









    Sum Insured Value Self Self + Spouse Self + Spouse + 1 Dependant Self + Spouse + 2 Dependants Self + Spouse + 3 Dependants Self + Spouse + 4 Dependants
    Rs.1,00,000 Rs.3,711 Rs.4,074 Rs.4,436 Rs.4,798 Rs.5,161 Rs.5,523
    Rs.2,00,000 Rs.6,442 Rs.7,131 Rs.7,821 Rs.8,511 Rs.9,200 Rs.9,890
    Rs.3,00,000 Rs.8,836 Rs.9,813 Rs.10,791 Rs.11,768 Rs.12,745 Rs.13,722
    Rs.4,00,000 Rs.11,008 Rs.12,245 Rs.13,483 Rs.14,721 Rs.15,959 Rs.17,197
    Rs.5,00,000 Rs.13,180 Rs.14,678 Rs.16176 Rs.17,675 Rs.19,173 Rs.20,672



    To whom is the premium required to be paid?

    Premium cheque needs to be issued as in favor of “NATIONAL INSURANCE CO. LTD.”.


    Who is the TPA (third party administrator) servicing this policy?

    M/s. Family Health Plan Ltd. will be the TPA for this policy. The details about the network of hospitals for this policy is available at website www.fhpl.net

    Once the policy is issued, the TPA will send the photo-id card and the process to be adopted in case of an emergency