Health3.imimg.com/.../FU/MY-1421784/religare-health-insurance.pdf · 2015-04-18 · Advantages •...
Transcript of Health3.imimg.com/.../FU/MY-1421784/religare-health-insurance.pdf · 2015-04-18 · Advantages •...
Don’t worry, be happy
What makes you happy?A walk in the park with a loved one? A spectacular sunset? An afternoon with your parents? Dropping your kids off to school or watching them play?
Or do you more look forward toMoving from one city to another, closing business deals?Driving that top-of-the-line sports model?A weekend filled with adventure sports?
Whether you prefer taking it easy or opt for that adrenalin rush, we understand that your happiness is based on being comfortable with your state of health. And your happiness is our concern.
Our philosophy
Life’s uncertainties are inevitable. And that’s the case with health too. No one can assure you that you will always be in the pink of health.
We can, however, assure you that while you are unwell, we’ll take up all the hassles related to your treatment. So you can be totally worry-free. We will provide you access to the best healthcare facilities to put you back on the road to recovery, without a care about medical bills and other related expenses. In other words, we will take the worry out of your recuperation.
With us as your health insurer, it is truly Ab Health Hamesha !
- No more worrying about your loved ones
We understand that hospital bills and other related expenses can become a burden when your main concern should be getting well or nursing a loved one back to health.So we want to get those bills out of your way with our simple plans that take care of your expenses. Your only concern should be getting back your health and happiness.
Advantage
In addition to hassle-free claims, we believe you deserve distinct benefits for choosing , and they come your way in the form of certain thoughtfully designed product & service features:
Wide range of sum insured - upto ` 60 Lacs Annual health check-up for insured members - regardless of claims history Get automatic recharge of sum insured if claim amount exhausts your coverage, at no extra cost No upper-limit age on any of our plans Daily allowance to meet incidental expenses Avail medical treatment anywhere in the world Increase sum insured of your existing policy, at your convenience Ease of cashless treatment & settlement of claims directly by the company No pre-policy medical check-up for sum insured less than ` 15 Lacs, till 45 years of age Up to 150% increase in sum insured with No Claim Bonus - SUPER
Highlights
• In-patient Care • Floater Cover • Domiciliary Hospitalisation• Pre & Post hospitalisation • Day Care Treatment • Ambulance Cover• Organ Donor Cover • Lifelong Renewability • Health Check-up • No Claim Bonus • Second Opinion • Tax Benefit
Simple and convenient to manage
We believe in the power of simplicity. Accordingly, ‘ ’ is a straightforward plan designed to offer maximum convenience.
One for all and all for one You no longer need to manage individual health insurance plans for your family members. Under the ‘floater’ plan, you can cover any member of your immediate family (yourself or spouse, parents and children) for the sum insured in a single policy.
Longer policy term The security of your health and resultant happiness should be your prerogative for life. To make the process of renewing your health insurance more convenient, choose a policy with a term of one, two or three years. What’s more! Avail a discount on your premium if you opt for a longer policy term.
Zero payment treatmentWith cashless hospitalisation, you no longer need to run around paying off hospital bills and then following up for a reimbursement. All you now need to do is get admitted to any of our network hospitals and concentrate only on your recovery. Relieve yourself from the worry of arranging for the funds. Leave the bill payment arrangements to us.
File your claims directly with usWe believe in the old adage, “The proof of the pudding is in the eating.” So we back up our promise with an enduringly simple claims procedure, which involves just you and us.
• Either in the case of an emergency or a planned hospitalisation, all you have to do is present the Religare Health Card at our network of more than 3100 leading hospitals pan India and avail cashless service.
• In case of reimbursement of expenses when you use a non-networked hospital, all you need to do is notify us immediately about the claim. Call us directly, send us the specified documents and we’ll process your claim.
Since you interact directly with us, we can be doubly sure that you are satisfied. And when you are satisfied, we feel satisfied too.
We deliver on our promises. We take pride in offering hassle-free clearance and speedy settlements.
Comprehensive, from A to Z
We understand that the meter starts ticking not from the time of hospitalisation, but from the time of diagnosis.And continues beyond your discharge from the hospital, encompassing various expenses.
Your treatment
Hospitalisation for at least 24 hours
If you are admitted to a hospital for in-patient care, for a minimum period of 24 consecutive hours, we pay for - room charges, nursing expenses and intensive care unit charges to surgeon’s fee, doctor’s fee, anaesthesia, blood, oxygen, operation theater charges, etc.
Hospitalisation for less than 24 hours
We also pay for your medical expenses if you undergo a day care treatment at a hospital that requires hospitalisation for less than 24 hours - we cover a comprehensive range of day care treatments.
Treatment at home
Despite suffering from an illness/disease/injury (which would normally require care and treatment at a hospital), hospitalisation may not be possible - perhaps your state of health is such that you are in no condition to be moved to a hospital, or a room may not be available. Don’t worry, we understand that and are happy to let you know that under ‘Domiciliary hospitalisation’, we will reimburse the medical expenses incurred by you during your treatment at home, as long as it involves medical treatment for a period exceeding 3 days and had actually merited hospitalisation.
Pre-hospitalisation
• Examination, tests and medication - Sometimes the procedures that finally lead you to hospital, such as investigative tests and medication, can be quite financially draining. We cover the medical expenses incurred by you before your hospitalisation.
• Getting to the hospital - It is our utmost concern that you get the medical attention you require as soon as possible, especially in an emergency. We will reimburse you for expenses that you incur on an ambulance service offered by the hospital or any service provider, in an emergency situation.
Post-hospitalisation
• Back home and till you are back on your feet - The expenses don’t end once you are discharged. There are bound to be follow-up visits to your medical practitioner, medication that is required and sometimes even further confirmatory tests. We also cover the medical expenses incurred by you after your hospitalisation.
Coverage for non-medical expenses
• It all adds up - A trip to a hospital involves more than merely using the doctor’s services and hospital facilities. You are bound to run up numerous ‘non-medical’ expenses such as transportation, attendant’s cost and other daily expenses that you may not be able to even foresee. We would like to reimburse those out-of-pocket expenses too. To meet these expenses without a bother and as suits you best, we pay - Daily Allowance - a lump sum per day for each day of hospitalisation.
Extra Care with No Claim Bonus - SUPER
No claim filed? Get 50% increase in Sum Insured
If you do not claim on your health insurance policy in a particular year, we raise a cheer to your good health in the form of a substantial bonus. You receive an increase of 50 percent in your sum insured for every claim free year, up to the maximum of 100 percent of the sum insured.
In addition to this, you also get a 10 percent increase in the sum insured, up to maximum of 50 percent, as per the regular No Claim Bonus feature.
It’s just our way to tell you that we’re there for you in good times and in bad.
Year 2
5
0.5
2.5
8
Year 3
8
0.5
2.5
11
Year 4
11
0.5
-
11.5
Year 5
11.5
0.5
-
12
Year 6
12
0.5
-
12.5
Illustration - No Claim Bonus
Sum Insured
NCB
NCB - SUPER
Total Sum Insured
(in ` lacs)
Note: Assuming no claims for 5 consecutive years on SI 5 Lac
We reward you
Health check-up -- regardless of claim history Our concern is your good health. To pre-empt your ever having to visit a hospital, we provide an annual health check-up for yourself and adult members of your family covered by the policy.
Increase your sum insuredAs life progresses, our needs and responsibilities constantly undergo change. What is sufficient today may seem insufficient tomorrow; and similar could be the case with your health insurance coverage. We believe that we have to ensure your health hamesha, whatever be your requirements. And so, should you ever feel the need to increase your sum insured, we offer you the option of doing so, keeping all the other features and benefits of your policy intact.
Reduce your tax liabilityOpting for health insurance is certainly a step in the right direction, and it comes with a two-fold benefit. Not only does it ensure that you and your family can access good medical care at all times, it also enables you to avail of a tax benefit on the premiums you pay towards your health insurance, as per prevailing tax laws of the Income Tax Act, 1961 (u/s 80D).
Health ‘WISE’
In line with our philosophy of ‘health hamesha’, we bring you a unique online platform that is specially designed to help you conduct a health assessment, without having to visit a health care/diagnostic center. A detailed report of the same is sent to you on completion of the assessment.
Advantages• Health Risk report on Cancer, Diabetes, Heart & obesity• Early identification and management of health risks• Awareness about health risks and related preventive measures• Compare your current health status with previous reports
Make a wise move, and monitor your health regularly.
Flexible to your needs
A friend in need is a friend indeed. And we take pride in being there for you at every step, whatever may be your changing requirements. Should you wish to join our family midway into your existing policy or review your policy purchase decision - we have an array of solutions for you to choose from, to best suit your changing needs. No longer will change be an impediment to health.
Come join in anytimeBe a part of the Religare family and continue to get uninterrupted coverage with no compromises at all. Get quality service, enhanced product features and even a reduction in waiting period by the number of years of continuous coverage under a similar plan with your previous insurer.
Avail the treatment of your choiceWe believe that you should be free to decide how to spend your health insurance cover towards getting the best possible medical care. As far as we’re concerned, it is your money. So our plans come without any cap on vital expenses like doctor/surgery fees, operation theater & allied charges, to name a few.
Review your decisionWe have your best interests at heart and at the same time recognise that you know your needs best. Hence, after purchasing the policy, if you find it unsuitable, you can cancel and return the policy to us. Our policies come with a free-look period of 15 days from the date of receipt of policy.
Care anywhereOur care knows no boundaries; literally. So, while we ensure you have access to the best healthcare services, we leave it to your discretion whether you would wish to avail certain specialised treatments in India or abroad. After all, it’s your health, and we stand by every decision you take in its interest.
and more
We are committed to your healthcare needs. Your total well-being is our concern. So we go that extra mile for you.
Recharge your policyA Refill is always welcome! So your sum insured is reinstated just when you need it the most. If, due to claims made, you ever run out of/exhaust your health cover, we reinstate the entire sum insured of your policy, which can be used for any future claims that are unrelated to the claim made during the same year. Our care knows no limits; we are there for you, hamesha!
Organ donor coverWe care about those who help you as much as we care for you. So, beyond ensuring thatyour medical needs are met, we will reimburse you for medical expenses that are incurred byan organ donor while undergoing the organ transplant surgery.
You’re entitled to a second opinionWe take your illness as seriously as you do. If you are suffering from a serious illness and feel uncertain about your diagnosis or wish to get a second opinion of an expert/doctor,we arrange one for you, free of cost.
Plan OptionsFeatures (Sum Insured `) 4 Lac 5 Lac, 7 Lac, 10 Lac
Pre-hospitalisation 30 days 30 days
Post-hospitalisation 60 days 60 days
Day Care Treatments Yes Yes
Room Rent 1% of SI per day Single Private Room
ICU Charges 2% of SI per day No Limit
Doctor’s Fee etc. No Limit No Limit
Other Medical Charges No Limit No Limit
Daily Allowance `500 per day upto 5 days -
Ambulance Cover `1,500 per claim `2,000 per claim
Domiciliary Hospitalisation Up to 10% of SI Up to 10% of SI
Organ Donor Cover `50,000 `1,00,000
Annual Health Check-up Yes Yes
Second Opinion - Yes
No Claim Bonus Up to 150% * Up to 150% *
Recharge of Sum Insured Up to Sum Insured Up to Sum Insured
Care Anywhere - -
-
`2,500 per claim
Up to 10% of SI
`2,00,000
Yes
Yes
Up to 150% *
Up to Sum Insured
-
-
`3,000 per claim
Up to 10% of SI
`3,00,000
Yes
Yes
Up to 50%
Up to Sum Insured
Yes
* Inclusive of No Claim Bonus - SUPER
15 Lac, 20 Lac, 25 Lac
30 days
60 days
Yes
Single Private Room, upgradable to next level No Limit
No Limit
No Limit
50 Lac, 60 Lac
30 days
60 days
Yes
Single Private Room, upgradable to next level No Limit
No Limit
No Limit
Age/Sum Insured
Up to 45 years
46 years and above
Sum Insured less than ` 15 Lac
-
Yes
Sum Insured ` 15 Lac & above
Yes
Yes
Medical Check-up
We would like you to undergo certain medical tests (as per the corresponding grid) that will enable us to get a better understanding of your current and future health needs, and help us in ensuring your sustained good health.
Cost of Medical Check-up -
• The cost of the medical test will be borne by Us in case the policy is opted for 2 or 3 years.
• If the policy is opted for 1 year and the proposal is accepted, we shall reimburse at least 50% of the cost incurred towards Medical Check-up.
• If your proposal is rejected, or policy cancelled during the free-look period, the cost of medical tests will be ded- ucted from the refundable premium.
Minimum entry age 91 days
Maximum age No age bar
Renewal Lifelong Renewability, The Policy can be renewed under the then prevailing Health Insurance Product or its nearest substitute approved by IRDA.
Renewal premium Premium payable on renewal and on subsequent continuation of cover are subject to change with prior approval from IRDA.
Co-payment (SI 5 Lac & above) 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 injury
Waiting period for pre-existing illnesses Four years of continuous coverage
Change in sum insured You can enhance your sum insured under the policy only upon renewal
Grace period 30 days from the date of expiry to renew the policy
Policy Terms
What is not covered?
• Any pre-existing ailment/injury that was diagnosed/accquired 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/contact lenses, dental treatment• 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 fertilisation
Remember, there are some treatments such as non-infective arthritis, joint replacement etc., which are covered only after completion of 2 consecutive policy years.
For a detailed set of exclusions, please log on to www.religarehealthinsurance.com.
About Us
Religare Health Insurance Company LimitedReligare Health Insurance is focused on the delivery of health insurance services. Our promoter's expertise in the spectrum of financial services, healthcare delivery and preventive health solutions, coupled with a robust distribution model, offers us a unique edge to deliver and excel in a business environment that hinges on serviceability and scale. Powered by the best-in-class product design and a customer-centric approach, Religare Health Insurance is committed to delivering on its innate values of being a responsible, trustworthy and innovative health insurer.
The shareholders of Religare Health Insurance comprise of three strong entities - Religare Enterprises Limited, Union Bank of India and Corporation Bank.
Religare Enterprises LimitedReligare Enterprises Limited (REL), a leading emerging markets financial services group anchored in India, offers a wide array of services including broking, insurance, asset management, lending solutions, investment banking and wealth management. With a network that spans across over 1650 locations, and more than a million clients, REL enjoys a dominant presence in the Indian financial services space.
We have also built an Asia and emerging markets-focused Institutional Equities & Investment Banking business and a multi-boutique global asset management platform to tap the broader opportunities offered by the most promising emerging markets around the world.
Union Bank of IndiaUnion Bank of India, a key player in India's public sector banking domain, operates out of over 3500 branches across the country and has a clientele base of more than 24 million. Over the past 90 years, the bank has played a proactive role in infusing cross-sector economic growth in India and has sustained a robust income mechanism from a well-diversified portfolio of assets.
Corporation BankCorporation Bank, a leading public sector bank, delivers its core objectives of sustainably maintaining the highest standards of service to its customers with innovative product & process solutions, through its formidable network of 1707 branches. The Bank has committedly worked towards empowering the rural and urban population alike, and has resultantly been a significant contributor to the economic growth impetus of the nation.
Disclaimer: This is only a summary of product . For more details on risk factors, terms and conditions please read sales brochure carefully before concluding a sale. Please seek the advice of your insuranceadvisor if you require any further information or clarification.
IRDA or its offcials do not involve in activities like sale of any kind of Insurance or Financial products nor invest premiums. IRDA does not announce any bonus. Those receiving such phone calls are requested to lodge a police complaint along with details of phone call and number. Statutory Warning: Prohibition of Rebates (under section 41 of Insurance Act, 1938): No person shall allow or offer to allow, either directly or indirectly as an inducement to any person to take out or renew or continue an insurance in respect of any kind of risk relating to lives or property, in India any rebate of the whole or part of the commission payable or any rebate of the premium shown on the policy, nor shall any person taking out or renewing or continuing a Policy accept any rebate, except such rebate as may be allowed in accordance with the published prospectus or tables of the insurers. Any person making default in complying with the provision of this section shall be punished with fine, which may extend to five hundred rupees.
Insurance is a subject matter of solicitation.IRDA registration Number - 148 and are trademarks of Religare Health Insurance Company Limited.
Ver:
Feb/
14
Religare Health Insurance Company LimitedGYS Global, Plot No. A3, A4, A5, Sector - 125, Noida, U.P. - 201301
UA
N:1
4021
227
U
IN: I
RD
A/N
L-H
LT/R
HI/P
-H/V
.1/2
53/1
3-14
HealthInsurance
-
Religare Health Insurance Offers 160% EXTRAA NO CLAIM BONUS *
AND ALSO
100% RE-CHARGE OF THE SUM ASSURED IN POLICY.*
10 % + 50% NO CLAIM BONUS : value at end of 5 years of renewal
Ie Rs 300,000/- policy becomes Rs 7,50,000/- for Claims.
Ie Rs 500,000/- policy becomes Rs 12,50,000/- for Claims.
Ie Rs 10,00,000/- policy becomes Rs 25,00,000/- for Claims.
PLUS RE-CHARGE OF 100% of BASIC SUM every year for 2nd Claim.
Ie to meet a SECOND CLAIM the same year >
Ie Rs 300,000/- + Rs 300,000/- every year = Rs 600,000/-
Ie Rs 500,000/- + Rs 500,000/- every year. = Rs 10,00,000/-
Ie Rs10,00,000/- + Rs 10,00,000/- every year = Rs 20,00,000/- This RECHARGE IS EXTRA to the No Claim Bonus given above.
( * Other Companies offer only 5% or 10% No Claim Bonus & NO RE-CHARGE)
CASH LESS Card > Company has its own Claim Settlement >
REIMBURSEMENT of Direct Payments within 10 days.
FREE MEDICAL CHECK-UP for YOU & Family > every year.
PORTABILITY from Other Insurance Companies accepted.
Individual & Family Floater policy with above benefits.
MATERNITY BENEFIT > waiting period just 9 months. When you CAN NOT AFFORD a HIGHER SUM of MEDICAL POLICY In these days increasing Hospital Costs >Buy a RELIGARE NCB- SUPER It is your BEST OPTION ! (How will you pay for 2 Hospital treatments in a year each costing up to Rs 300,000/- approx with a
policy of Rs 3 Lakhs only ? > Policy of RELIGARE will pay for both Bills in same year. ( an operation costing Rs 300,000/- today will cost Rs 700,000/- in 3 yrs time so your present policy will NOT be enough to pay the cost. Medical costs increase by 15% every year> Buy a policy of RELIGARE of Rs 4 Lakhs and get insurance claim upto Rs 12 Lakhs over 6 yrs time with same premium0
For more details > CONTACT: M.S.Malia. B-25, Brindavan, Evershine Nagar, Malad-W. Mobile: 9870003498. Email: [email protected]
10 % + 50% NO CLAIM BONUS : value at end of 5 years of renewal
Ie Rs 300,000/- policy becomes Rs 7,50,000/- for Claims.
Ie Rs 500,000/- policy becomes Rs 12,50,000/- for Claims.
Ie Rs 10,00,000/- policy becomes Rs 25,00,000/- for Claims.
PLUS RE-CHARGE OF 100% of BASIC SUM every year for 2nd Claim.
Ie to meet a SECOND CLAIM the same year >
Ie Rs 300,000/- + Rs 300,000/- every year = Rs 600,000/-
Ie Rs 500,000/- + Rs 500,000/- every year. = Rs 10,00,000/-
Ie Rs10,00,000/- + Rs 10,00,000/- every year = Rs 20,00,000/- This RECHARGE IS EXTRA to the No Claim Bonus given above.
CASH LESS Card > Company has its own Claim Settlement >
REIMBURSEMENT of Direct Payments within 10 days.
FREE MEDICAL CHECK-UP for YOU & Family > every year.
PORTABILITY from Other Insurance Companies accepted.
Individual & Family Floater policy with above benefits. When you CAN NOT AFFORD a HIGHER SUM of MEDICAL POLICY In these days increasing Hospital Costs >Buy a RELIGARE NCB- SUPER It is your BEST OPTION ! For more details > CONTACT: M.S.Malia. B-25, Brindavan, Evershine Nagar, Malad-W. Mobile: 9870003498. / 9821833498. Email: [email protected]
Wide range of sum insured options to choose Accidental Death BenefitPermanent Total & Partial Disability CoverChild Education BenefitWorldwide coverage for selected benefits Hassle free claim settlement directly by us
SECURE PERSONAL ACCIDENT COVER
SPECIAL BENEFITS
* Note: Up to means – “Actual expenses incurred or the amount specified, whichever is lower.”
PERMANENT PARTIAL DISABLEMENT
10 Lac
Plan Name
15 Lac / 20 Lac / 25 Lac / 30 Lac
50 Lac / 1 Crore / 2 Crore / 3 Crore
Above 3 Crore up to 25 Crore
Secure 1 Secure 2 Secure 3 Secure 4
Sum Insured - on annual basis (in `.)
Accidental Death Sum Insured Sum Insured Sum Insured Sum Insured
Permanent Total Disablement As per Table As per Table As per Table As per Table
Permanent Partial Disablement As per Table As per Table As per Table As per Table
Fractures Up to `50,000 Up to `1,00,000 Up to `2,00,000 Up to `3,00,000
Child Education No 10% of Sum Insured 10% of Sum Insured 10% of Sum Insured
Major Diagnostics Test No Up to `15,000 Up to `25,000 Up to `50,000
Disappearance No Sum Insured Sum Insured Sum Insured
Mobility cover No Up to `15,000 Up to `25,000 Up to `50,000
Burns No Up to `10,00,000 Up to `20,00,000 Up to `25,00,000
Domestic Road Ambulance No No Up to `5,000 Up to `5,000
Nursing Care No No `1,000 per day, Max for 15 days ̀ 1,000 per day, Max for 15 days
Reconstructive Surgery No No Up to ̀ 10,00,000 Up to ̀ 20,00,000
Repatriation of Mortal Remains No No
Add-on Benefit: Accidental Hospitalization
Hospitalization Expenses Up to ̀ ,00,000 Up to ̀ 1,00,000 Up to ̀ 5,00,000 Up to ̀ 10,00,000
Daily Allowance
Compassionate visit Up to ̀ 15,000 Up to ̀ 15,000 Up to ̀ 25,000 Up to ̀ 50,000
2% of the Sum Insured or Max `1,00,000; whichever is lower
`500 per day,Max for 5 days
`500 per day,Max for 5 days
`500 per day,Max for 5 days `500 per day, Max for 5 days
2% of the Sum Insured or Max `1,00,000; whichever is lower
PLAN CONDITIONS AT FINGERTIPS
ENTRY AGE
Secure is available in Individual basis and not on Floater
You can buy Secure for your dependent Legally married Spouse, Children, Parents, Brother, Sister, Parents-in-Law, Grandparents, Grandchildren, Uncle, Aunt, Nephew
and Niece.
TYPE OF COVER
Minimum Entry Age 91 days
Maximum Entry Age Child : 24 years
Adult : 70 years
Maximum Renewal Age Lifelong
PLAN CONDITIONS AT FINGERTIPS
It is a fixed benefit policy. The benefits are paid in Lumpsum
1 Year, 2 Year & 3 Years
CLAIMS
POLICY TERM
The premium charged under the policy depends upon the plan, sum insured chosen,tenure and Add-on Benefit taken and the health status of the individual
PREMIUM
ACCIDENTAL DEATH
The Company shall pay the Sum Insured in case of death of the Insured Person on account of any Accident/Injury during the
Policy Period or within twelve calendar months from the date of occurrence of such Accident/Injury which occurred during
Policy Period.
In case of any permanent total disablement of the Insured Person on account of any accident/Injury during the Policy Period or within twelve calendar months from the date of occurrence of such Accident/Injury which occurred during Policy Period. The payout of the Sum Insured shall be as per table below:
Total and irrecoverable loss of sight of both eyes, or of the actual loss by physical separation of two entire hands or two entire feet, or one entire hand and one entire foot, or the total and irrecoverable loss of sight of one eye and loss by physical separation of one entire hand or one entire foot
Sr. No.
100%
1.
2.
3.
100%
100%
50%
50%
% of Sum Insured payableInsured Events
PERMANENT TOTAL DISABLEMENT
4.
5.
Total and irrecoverable loss of (a) use of two hands or two feet, or (b) one hand and one foot, or (c) sight of one eye and use of one hand or one foot
Total and irrecoverable loss of sight of one eye, or of the actual loss by physical separation of one entire hand or one entire foot
Total and irrecoverable loss of use of a hand or a foot without physical separation
Paraplegia or Quadriplegia or Hemiplegia
In case of any permanent partial disablement of the Insured Person on account of any Accident/Injury during the Policy Period or within twelve calendar months from the date of occurrence of
such Accident/Injury which occurred during Policy Period. The payout of the Sum Insured shall be as per table below:
PERMANENT PARTIAL DISABLEMENT
PERMANENT PARTIAL DISABLEMENT
Sr. No.
1
2
3
4
5
6
Insured Events % of Sum Insured payable
Total and irrecoverable loss of hearing in: -
a) Both ears 75%
b) One ear 20%
Loss of toes
a) All 20%
b) Both phalanges of great toes bilateral 5%
c) Both phalanges of one great toe 2%
d) Both phalanges of other than great toes for each toe 1%
Loss of four fingers and thumb of one hand 40%
Loss of four fingers of one hand 35%
Loss of thumb
a) Both phalanges 25%
b) One phalanx 10%
Loss of index finger
a) Three phalanges 10%
b) Two phalanges 8%
c) One phalanx 4%
7
8
9
10
11
% of Sum Insured payable Sr. No. Insured Events
Loss of middle finger
a) Three phalanges 6%
b) Two phalanges 4%
c) One phalanx 2%
Loss of ring finger
a) Three phalanges 5%
b) Two phalanges 3%
c) One phalanx 2%
Loss of little finger
a) Three phalanges 4%
b) Two phalanges 3%
c) One phalanx 2%
Loss of metacarpus
a) First or second 3%
b) Third, fourth or fifth 2%
Permanent partial disablement not otherwise provided for under Sr. No. I to X inclusive Such percentage of the Sum Insured as determined in accordance with the medical assessment carried out by the Company’s network Hospital provided that the percentage under Insured Event Sr. No. XI shall not exceed 50% of the Sum Insured.
PERMANENT PARTIAL DISABLEMENT
In case the Insured Person suffers any Injury during the Policy Period resulting into fractures, the company shall pay the amount as specified in the table below:
FRACTURES
Description of Extent of Burn Injury
Hip or Pelvis (excluding thigh or coccyx): Multiple fractures – at least one Compound Fracture and one Complete Fracture
Hip or Pelvis (excluding thigh or coccyx) - All other Compound Fractures
Thigh or Heel: Multiple fractures – at least one Compound Fracture and one Complete Fracture
Thigh or Heel: Multiple fractures – at least one Complete Fracture
Lower leg, skull, clavicle, ankle, elbows, upper or lower arm (including wrist but excluding Colles-type fractures): Multiple Fractures – at least one Compound Fracture and one Complete Fracture
Lower leg, skull, clavicle, ankle, elbows, upper or lower arm (including wrist but excluding Colles-type fractures) :All other Compound Fractures
Colles type fracture of the lower arm – If Compound Fracture
Colles type fracture of the lower arm – If Complete Fracture
S.no.
I
II
III
IV
V
VI
VII
VIII
% of Sum Insured payable
I00%
50%
I00%
50%
100%
30%
100%
50%
*Note: Child education cover is not available for Secure 1 and Secure 5 plans.
Our assurance comes with no boundaries!
No matter what, your children won’t need to compromise. In case you ever suffer from unfortunate accident leading to death or permanent total disablement, we pay an additional lump sum amount (10% of the Sum Insured) towards the education of your children. (i) The child is less than Age 24 at the time of occurrence of the event; and (ii) Valid documentation establishing the relationship between with the child and the Insured Person and the Age of the child is submitted.
CHILD EDUCATION
In case you are required to undergo Diagnostic Test (like CT Scan, MRI etc.) on the written advise of a Medical
Practitioner within 3 Months of occurrence of the Injury In case you meet with some unforeseen accident results into
Permanent Total Disablement or Permanent Partial Disablement, we will reimburse you the expenses towards the tests.
MAJOR DIAGNOSTIC TEST
DISAPPEARANCE
In case the Insured Person’s body cannot be located within 1 year after a forced landing, stranding, sinking or wrecking of a Common Carrier or in any event arising as a result of any Acts of God perils during the Policy Period and it can be reasonably concluded that such Insured Person has died as a result of such Accident, we will pay the Sum Insured.
However, if it is later found that the Insured Person survived such an Accident/Injury for which the Company had paid the claim, the amount paid shall be paid back to the Company.
MOBILITY COVER
In case Insured Person becomes Total Permanent Disabled due to an unforeseen Accident or injury, We will reimburse the expenses incurred for procuring medically necessary prosthetic devices (artificial devices replacing body parts, including artificial legs, arms or eyes), orthopaedic braces (including but not limited to arm, back or neck braces) and durable medical equipment (including but not limited to wheelchairs and Hospital beds) to assist the Insured Person’s basic medical needs, consequent to an Injury and such devices or equipment are procured on the written advice of a treating Medical Practitioner.
BURNS
If the Injury su�ered by the Insured Person solely and directly results in any of the following second or third degree burn injuries, the Company will pay up to an amount as per table below: In case an Injury results in more than one of the ‘Descriptions of Extent of Burn Injury’ above, then the Company’s liability will be only for the highest amount applicable on all the ‘Descriptions of Extent of Burn Injury’ incurred.
Description of Extent of Burn Injury
Third degree burns of 30% or more of the total body surface area
Second degree burns of 30% or more of the total body surface area
Third degree burns of 20% or more, but less than 30% of the total body surface area
Second degree burns of 20% or more, but less than 30% of the total body surface area
Third degree burns of 10% or more, but less than 20% of the total body surface area
Second degree burns of 10% or more, but less than 20% of the total body surface area
Third degree burns of 5% or more, but less than 10% of the total body surface area
Second degree burns of 5% or more, but less than 10% of the total body surface area
S.no.
I
II
III
IV
V
VI
VII
VIII
% of Sum Insured payable
100%
50%
80%
40%
40%
20%
20%
10%
DOMESTIC ROAD AMBULANCE
We will reimburse the expenses incurred for the emergency medical evacuation of the Insured Person, including necessary medical care en-route, consequent to an Injury only if the Claim which is payable in case of Accidental Death or Permanent Total Disablement or Permanent Partial Disablement.
NURSING CARE
We Company will pay for the expenses incurred towards hiring a Qualified Nurse with the purpose of providing care and convenience to the Insured Person to perform his daily activities, which facilitate his activities of daily living and are recommended by a Medical Practitioner in writing.
RECONSTRUCTIVE SURGERY
In case the Insured Person is required to undergo reconstructive surgery consequent to any Accident/Injury, we will reimburse the Medical Expenses incurred on such reconstructive surgery at a Hospital only if the surgery is carried out within 30 days of Accident/Injury and the Claim is admitted in case the Insured person su�ers from Permanent Total disablement or Permanent Partial disablement.
REPATRIATION OF MORTAL REMAINS
We will pay up to an amount as specified in the Policy Certificate for the transportation of Insured Person’s body from the place of death to the city of last known address of the Insured Person as per the Company’s records or as per the request of the Insured Person’s family only if a Claim is payable. The benefit is only applicable in case of the death of the Insured person due to an unforeseen Accident.
ADD-ON BENEFITS - ACCIDENTAL HOSPITALIZATION
This Add-on Benefit aims at providing coverage for the following:
(a) Hospitalization Expenses: This shall reimburse you the expenses incurred at a
Hospital consequent to any Injury as an In-patient Care or as Day Care Treatment.
(b) Daily Allowance: This shall pay you a lump sum amount per day for each day of
your hospitalization up to a maximum of 5 days subject to a deductible of 2 days. The
payment shall be made only in case the Hospitalization Expenses are payable.
(c) Compassionate Visit: This shall reimburse the reasonable incurred towards the
cost of economy class air ticket or equivalent from the city of normal residence to the
place of Hospitalization of the Insured Person, in case you are hospitalized for
treatment of any Injury only if such hospitalization is within three days from the
occurrence of the Injury and the hospitalization is required for a minimum period of 5
consecutive days.
PERMANENT EXCLUSIONS
Any Illness including any pre-existing condition or its complications except where an Insured Event under general conditions applicable to all Benefits results from an illness which arises directly as a consequence of an Injury sustained during the Policy Period;Any pre-existing injury or physical condition;The Insured Person operating or learning to operate any aircraft or performing duties as a member of a crew on any aircraft or Scheduled Airline or any airline personnel;The Insured Person flying in an aircraft other than as a fare paying passenger in a Scheduled Airline;Any intentional self-inflicted injury, suicide or attempted suicide, sexually transmitted conditions, mental or nervous conditions, insanity, disorder, anxiety, stress or depression;Influence of drugs , alcohols or other intoxications or hallucinogens; War (whether declared or not) and warlike occurrence or invasion, acts of foreign enemies, hostilities, civil war, rebellion, revolutions, insurrection, mutiny, military or usurped power, seizure, capture , arrest, restraints and detainments of all kinds;Participation in actual or attempted felony, riots, civil commotion or criminal misdemeanor;
*Note: Please refer to Policy Terms and Conditions for complete list of Permanent Exclusions
Religare Health Insurance Company LimitedRegistered Office: D-3, District Centre, Saket, New Delhi - 110017
Correspondence Office: GYS Global, Plot No. A3, A4, A5, Sector - 125, Noida, U.P. - 201301
To know more, visit our website
1800-200-4488 [email protected]
www.religarehealthinsurance.comOnline renewals Customer support Claim centreQuick quote & buy
Plan Options
HealthInsurance
Religare Health Insurance is focused on the delivery of health insurance services. Our promoter's expertise in the spectrum of financial services, healthcare delivery and preventive health solutions, coupled with a robust distribution model, o�ers us a unique edge to deliver and excel in a business environment that hinges on service-ability and scale. Powered by the best-in-class product design and a customer-centric approach, Religare Health Insurance is committed to delivering on its innate values of being a responsible, trustworthy and innovative health insurer.
The shareholders of Religare Health Insurance comprise of three strong entities - Religare Enterprises Limited, Union Bank of India and Corporation Bank.
Religare Health Insurance Company Limited
e
,
Remember, there are some treatments such as non-infective arthritis, joint replacement etc., which are covered only after completion of 2 consecutive policy years.
For a detailed set of exclusions, please log on to www.religarehealthinsurance.com.
•
• Any diseases contracted during first 30 days of the policy start datexcept those arising out of accidents
• Non-allopathic treatment
• Expenses attributable to self-inflicted injury (resulting from suicideattempted suicide)
• Expenses arising out of or attributable to alcohol or drug use/misuse/abuse
• Cost of spectacles/contact lenses, dental treatment
• 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 fertilisation
Any pre-existing ailment/injury that was diagnosed/accquired within 48 months prior to issuance of the first policy
What is not covered ?
Features / Plan(Sum Insured `)
Deductible
Sum Insured
Post-Hospitalization
Day Care Treatment
Room Rent/Category
ICU Charges, Doctor’s fee etc
Organ Donor Cover
Health Check-up
Enhance Anywhere
Expert Opinion (Add-on Benefit)
Pre-Hospitalization
60 Days
Yes
Single Private Room
No Limit
Up to Sum Insured
Yes
30 Days
In-patient Care Up to Sum Insured Up to Sum Insured
60 Days
Yes
Single Private Room, upgradable to next level
No Limit
Up to Sum Insured
Yes
Yes Yes
No Yes
30 Days
1 Lac, 2 Lac, 3 Lac, 4 Lac or 5 Lac
1 Lac to 25 Lac (As multiple of 1, 2, 3, 4 or 5
times of Deductible)
6 Lac to 30 Lac
(As multiple of 1, 2 or 3 times of Deductible)
6 Lac, 7 Lac, 8 Lac, 9 Lac or 10 Lac
5 Lac
45 Lac 55 Lac
10 Lac 15 Lac 20 Lac
Enhance 1 Enhance 2
40 Lac 50 Lac 35 Lac 45 Lac 30 Lac 40 Lac
Policy Terms
Four years of continuous coverage.
Minimum entry age 1 day
Maximum age No age bar
Renewal lifelong renewability The Policy can be renewed under the then prevailing Health Insurance Product or its nearest substitute approved by IRDA.
Renewal premium Premium payable on renewal and on subsequent continuation of cover are subject to change with prior approval from IRDA.
Co-payment (SI 5 Lac & above) 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 injury.
Based on the assessment of the extra risk on account of medical conditions by the underwriter, the premium shall be loaded accordingly (15%, 30% or 50%).
After 4 years of continuous coverage, you have an option to convert your Deductible plan to Comprehensive Health Insurance Plan (without any deductible).
Group discount 5% to 20%, depending upon the group size.
Change in sum insured You can enhance your sum insured under the policy only upon renewal.
Grace period 30 days from the date of expiry to renew the policy.
Waiting period for pre-existing illnesses
Two years of continuous coverage.Waiting period (Named ailments)
Underwriting loading
Complete care*
UA
N:1
4051
248
U
IN:IR
DA
/NL-
HLT
/RH
I/P-H
/V.I/
305/
13-1
4
HealthInsurance
Ver:
May
/14
Disclaimer: This is only a summary of product . For more details on risk factors, terms and conditions please read sales brochure carefully before concluding a sale. Please seek the advice of your insurance advisor if you require any further information or clarification.
IRDA or its officials do not involve in activities like sale of any kind of Insurance or Financial products nor invest premiums. IRDA does not announce any bonus. Those receiving such phone calls are requested to lodge a police complaint along with details of phone call and number.
Statutory Warning: Prohibition of Rebates (under section 41 of Insurance Act, 1938): No person shall allow or offer to allow, either directly or indirectly as an inducement to any person to take out or renew or continue an insurance in respect of any kind of risk relating to lives or property, in India any rebate of the whole or part of the commission payable or any rebate of the premium shown on the policy, nor shall any person taking out or renewing or continuing a Policy accept any rebate, except such rebate as may be allowed in accordance with the published prospectuses or tables of the insurers. Any person making default in complying with the provision of this section shall be punished with fine, which may extent to five hundred rupees.
Insurance is a subject matter of solicitation.CIN:U66000DL2007PLC161503 , , , , and are trademarks of Religare Health Insurance Company Limited. IRDA Registration Number - 148
We also o�er
Comprehensive Health Insurance
Critical Illness & Personal Accident Plan
Personal Accident Cover
International Travel InsuranceHigh Deductible Health Insurance plan
* Subject to underwriting in case of change in deductible.
is a simple, straightforward plan designed to o�er you an
unmatched hassle-free experience.
But what if the illness is way too critical and expenses tower beyond
what you ever imagined or could a�ord? Considering the growing
medical inflation, you sure don’t want that extra burden turning your
world upside down.
Simply put, if you opt for a ` 6 lac Sum Insured with deductible of
` 2 lac, then 2 lac will be borne by you and 6 lac over and above
the deductible of 2 lac will be borne by us during the policy period.
Which is why, at Religare Health Insurance (RHI), we have designed
- a high deductible health insurance for you and your family.
With , you have that extra safety net of coverage at a significantly
lesser premium as compared to any basic insurance plan. Simply
choose your comfort level in terms of the deductible you can
manage (either by self-financing or any other insurance) along with
your desired Sum Insured and stay worry free when it comes to you
and your family’s current and future healthcare needs.
Think Health Insurance and a hundred questions pop up in your
mind. First among them being, how much insurance cover do I need?
While some feel capable enough to self-finance their healthcare
treatment if and when need arises; others feel satisfied with their
existing insurance cover.
Pre Hospitalization - We cover medical expenses like examination,
tests, medication etc. incurred by you before your hospitalisation.
Post Hospitalization - We also cover the medical expenses incurred by
you on follow-up visits, consultations, therapy, medication etc. after
your hospitalisation.
• Flexible choice of deductible with wide range of Sum insured
options – up to ` 60 lac (Deductible + Sum Insured)
• Annual health check-up for adult insured members – regardless of
claim history
• No pre-policy medical check-up for coverage –
(Deductible + Sum Insured) less than 15 lacs, till 45 years of age
• Avail select medical treatment anywhere in the world with Enhance
Anywhere feature
• Hassle-free cashless treatment at leading hospitals, across the country
• Claim settlement directly by us
Advantage
Highlights• In-patient Care • Organ donor cover
• Day Care Treatment • Floater Benefit
• Pre & Post Hospitalization • Longer Policy Term
• Enhance Anywhere • Tax Benefit
• Expert Opinion (Add-on Benefit)
- Get enhanced coverage for greater protection! - From the worry-free world of RHI. Come join in anytime
Be a part of the RHI family and continue to get uninterrupted
coverage with no compromises at all. Get quality service, enhanced
product features and even a reduction in waiting period by the
number of years of continuous coverage under a similar plan with
your previous insurer.
The table below will help you understand better. We would like you to undergo certain medical tests that will enable
us to get a better understanding of your current and future health
needs, and help us in ensuring your sustained good health.
Cost of Medical Check-up -
• The cost of the medical test will be borne by Us in case the policy
is opted for 2 or 3 years.
• If the policy is opted for 1 year and the proposal is accepted, we
shall reimburse at least 50% of the cost incurred towards Medical
Check-up.
• If your proposal is rejected, or policy cancelled during the free-look
period, the cost of medical tests will be deducted from the refund-able
premium.
Medical Check-up
Plan Enhance 1 Enhance 1 Enhance 2
Deductible + Sum Insured Less Than 15 Lac 15 Lac or above
Yes Yes
Yes Yes
All
No
Yes
Upto 45 yrs
46 yrs and above
One policy. Covers entire family.
Under the ‘floater plan’, you can cover any member of your immediate
family (yourself, spouse and children or parents) for the sum insured
in a single policy.
Longer policy term, more convenience
To make the process of renewing your health insurance more
convenient, you can choose a policy with tenure between one to
three years.
is simple
We believe in the old adage, “The proof of the pudding is in the
eating.” So we back up our promise with an enduringly simple claims
procedure, which involves just you and us.
Either in the case of an emergency or a planned hospitalisation, all
you have to do is present the Religare Health Card at our network
of more than 3500 leading hospitals pan India and avail cashless
service.
In case of reimbursement of expenses when you use a non-network
hospital, all you need to do is notify us immediately about the claim.
Call us directly, send us the specified documents and we’ll process
your claim.
Right from the time of diagnosis to hospitalisation and even beyond
discharge, we take care of your health, hamesha!
Since you interact directly with us, we can be doubly sure that you
are satisfied. And when you are satisfied, we feel satisfied too.
Hospitalisation for at least 24 hours - If you are admitted to a hospital
for in-patient care, for a minimum period of 24 consecutive hours, we
pay for - room charges, nursing expenses and intensive care unit
charges to surgeon’s fee, doctor’s fee, anaesthesia, blood, oxygen,
operation theater charges, etc.
We deliver on our promises. We take pride in offering hassle-free clearance and speedy settlements.
With cashless hospitalisation, you no longer need to run around
paying o� hospital bills and then following up for a reimbursement.
All you now need to do is get admitted to any of our network
hospitals and concentrate only on your recovery. Relieve yourself
from the worry of arranging for the funds. Leave the bill payment
arrangements to us.
Zero payment treatment
File your claims directly with us
Your treatment
is comprehensive
Being committed to your total well-being, we go an extra mile to
provide you with holistic features & services.
Health check-up - regardless of claim historyOur concern is your good health. To pre-empt your ever having to
visit a hospital, we provide an annual health check-up for yourself and
adult members of your family covered by the policy.
We cover organ donors
We care about those who help you as much as we care for you. So,
beyond ensuring that your medical needs are met, we will reimburse
you for medical expenses that are incurred by an organ donor while
undergoing the organ transplant surgery.
Reduce your tax liability
Opting for health insurance is certainly a step in the right direction,
and it comes with a two-fold benefit. Not only does it ensure that you
and your family can access good medical care at all times, it also
enables you to avail of a tax benefit on the premiums you pay
towards your health insurance, as per prevailing tax laws of the
Income Tax Act, 1961.
Review your decisionWe have your best interests at heart and at the same time recognise
that you know your needs best. Hence, after purchasing the policy, if
you find it unsuitable, you can cancel and return the policy to us. Our
policies come with a free-look period of 15 days from the date of
receipt of policy.
comes with much more
works on the simple principle of Policy Deductible, which is
the pre-defined amount that you will bear, through your own
finances or any other insurance, during a medical event. Any amount
over and above policy deductible will be borne by us.
600,000
200,000
75,000
125,000
100,000
100,000
-
-
600,000
200,000
75,000
250,000
300,000
300,000
-
125,000
600,000
200,000
250,000
400,000
400,000
50,000
150,000
400,000
Sum Insured
Scenario 1 Scenario 2 Scenario 3
Deductible
Claim Amount 1
Claim Amount 2
Claim Amount 3
Payable Amount 1
Payable Amount 2
Payable Amount 3
Add On BenefitExpert Opinion
We take your illness as seriously as you do. If you are su�ering from a
serious illness and feel uncertain about your diagnosis or wish to get a
second opinion of an expert/doctor, we arrange one for you.
JOY ADVANTAGES
• JOY – Health Insurance with Maternity & Newborn Cover
• A perfect blend of hospitalisation and maternity insurance
• Only 9 month waiting period for maternity-related insurance claims
• Newborn baby cover
• Long term policy tenure of 3 years
• 100% increase in sum insured with No Claim Bonanza (Optional Cover)
• Offers Tax Benefit under Section 80D
PLAN DETAILSDetails / Sum Insured
Pre-hospitalisation
Post-hospitalisation
Day Care Treatments
In-Patient Hospitalisation
Room Rent
ICU
Ambulance
Maternity Benefit(Including Pre-Natal & Post-Natal Expenses)
Newborn Baby Cover
No Claim Bonanza(Optional Cover)
` 3 Lakh
30 Days
60 Days
Yes
Up to Sum Insured Single Private Room with AC
No Limit
Up to ` 1000/- per claim
Up to ` 35,000/-
Up to ` 30,000
Yes
` 5 Lakh
30 Days
60 Days
Yes
Up to Sum Insured
Single Private Room with AC
No Limit
Up to ` 1000/- per claim
Up to ` 50,000/-
Up to ` 50,000
Yes
` 3 Lakh
30 Days
60 Days
Yes
Up to Sum Insured Single Private Room with AC
No Limit
Up to ` 1000/- per claim
Up to ` 35,000/-
Up to ` 30,000
Yes
` 5 Lakh
30 Days
60 Days
Yes
Up to Sum Insured
Single Private Room with AC
No Limit
Up to ` 1000/- per claim
Up to ` 50,000/-
Up to ` 50,000
Yes
POLICY TERMS
• Non-allopathic treatment• Self-inflicted injury (suicide/attempted suicide)• Contact lenses, spectacles, dental treatment• Medical expenses resultant of alcohol/drug use misuse/abuse• Dental/cosmetic treatment• Treatment of AIDS• Congenital disease
MinimumEntry Age
MaximumEntry Age
Renewal PolicyTerms
Cover Type Free LookPeriod
GracePeriod
Waiting Periods
InitialWaitingPeriod
NamedAilments
Pre-existingDiseases
Maternity
Co-Payment Permanent Exclusions
Adult:18 years
Child:1 day
Newborn:1 day
Adult:65 years
Child:24 years
Newborn:90 days
Lifelong 3 years Individual: Up to 6
individuals
Floater:Only followingcombinations
allowed - 2A,2A+1C,
2A+2C
15day
30days
30days
24months
48months
9months
If the entry period is 61 years or more,customer will have to pay 20% of the claimamount under the policy.
Maternity Cover(including Pre-natal & Post-natal Expenses)
• Covers Maternity expenses• Includes pre-natal & post-natal expenses incurred with respect to Hospitalisation of the Insured Person for the delivery of the child
NOTE: Cover under this Benefit is available only up to 45 years of Age
Newborn Baby Cover • The Newborn is covered from birth till 90 days, including medical expenses • From Day 91 day, the baby is covered under the regular policy upon payment of additional premium
No Claim Bonanza (NCB)
• 100% increase of Sum Insured in case of 3 continuous claim free years• Maximum up to 100% of Sum Insured • In case a claim is made during a policy year, the accumulated NCB is reduced to zero
Maternity Cover(including Pre-natal & Post-natal Expenses)
• Covers Maternity expenses• Includes pre-natal & post-natal expenses incurred with respect to Hospitalisation of the Insured Person for the delivery of the child
NOTE: Cover under this Benefit is available only up to 45 years of Age
Newborn Baby Cover • The Newborn is covered from birth till 90 days, including medical expenses • From Day 91 day, the baby is covered under the regular policy upon payment of additional premium
No Claim Bonanza (NCB)
• 100% increase of Sum Insured in case of 3 continuous claim free years• Maximum up to 100% of Sum Insured • In case a claim is made during a policy year, the accumulated NCB is reduced to zero
Hospitalisation Expenses
(i) In-patient Care
• Covers medical expenses incurred during Hospitalisation for a minimum period of 24 consecutive hours• Includes Room charges, Nursing Expenses and Intensive Care Unit charges, Surgeon’s fee, Doctor’s fee, Anesthesia, Blood, Oxygen, Operation Theater Charges, etc.
(ii) Day Care Treatment
• Covers medical expenses for Day Care Treatment at a hospital or a Day Care Centre that requires Hospitalisation for less than 24 hours
Pre & Post Hospitalisation Medical Expenses (i) Covers medical expenses incurred for a period 30 days immediately before hospitalisation; and
(ii) Covers medical expenses incurred for a period 60 days immediately after discharge
Ambulance Cover Covers expenses incurred on an ambulance service offered by the hospital orany service provider, in an emergency situation
Floater Option
• Eliminates hassle of individual health insurance plans for different family members • Under the ‘floater’ plan, any member of the immediate family (yourself or spouse, parents and children) can be insured for the sum insured in a single policy
Longer Policy Term
• JOY is a 3 year policy, eliminating worries and hassles of policy renewal
Direct, Simple Claims Filing
• In case of an emergency or a planned hospitalisation, customer only has to present the RHI JOY Health Card at networked hospitals• In case of a non-networked hospital, for reimbursement of expenses, customer only has to notify RHI immediately about the claim
Individual Policy Proposition
Customer can propose an Individual Policy for following dependentfamily members • Spouse• Sister• Daughter• Granddaughter• Niece• Daughter-in-law
Corporate Policy Proposition
Employers can also propose a Policy for their Employees in Individual &Floater Option
PRE-POLICYHEALTH CHECK-UP
Note: Cost of the medical tests will be deducted from the premium paid,in case of proposal rejection or return of policy during free-look period.
Age / Sum Insured
Up to 45 years
46 to 55 years
56 years and above
` 3 Lakh
N.A
Set 1
Set 1
` 5 Lakh
N.A
Set 1
Set 1
PRE-POLICYHEALTH CHECK-UP
MER | RUA | HbA1c | CBC with ESRSerum Total Cholesterol | ECG | SGPT | S Creatinine
Set 1` 5 Lakh
N.A
Set 1
Set 1
VALUE PROPOSITION
BENEFITS
Health Indemnity Cover
Maternity Benefit
Newborn Baby Expenses
Tax benefit @ 30%
Tender Care
Cord Cell banking discount
Pre-natal Care
Other diagnostics tests
Consultations
Total Benefits
Total Cost
Total Savings
DESCRIPTION
Premium of 3 year Care for 2A plan
Maternity Sum Insured
Average Newborn Expense in first 90 days
Benefit for a 30% tax bracket
Discount in cord-Cell Banking
50% discount on total test package worth Rs 10,500
25% discount on an average spend of Rs 5,000
Average savings @20% discount on an average spend of Rs 5,000
3 Lac SI
15,585
35,000
15,000
4,500
13,000
5,250
1,250
1,000
90,585
55,445
35,140
5 Lac SI
21,029
50,000
15,000
4,500
13,000
5,250
1,250
1,000
1,11,029
74,773
36,256
FAQs – JOY
What is JOY?
Joy is a health insurance product which provides coverage for maternity as well as health insurance
for a period of 3 years. The Sum Insured options are 3 Lacs and 5 Lacs.
Some of the Key features of Joy are:
• 5 Lac/3 Lac hospitalization cover every year for three years wherein we cover all
hospitalization expenses including day care procedures, pre and post hospitalization
expenses as well as ambulance expenses
• Maternity coverage which can be claimed after only 9 months of coverage
• Coverage for maternity expenses of Rs 35,000 and 50,000 including pre and post natal
expenses
• New born baby cover of Rs 30,000 and Rs 50,000 over and above maternity SI
What is New Born Baby Cover in JOY?
In JOY we have kept the New Born Baby SI separate from Maternity SI. Thereby, you get 90 days
coverage for New Born without paying any additional premium up to the SI specified under the
benefit (Rs 30,000/Rs 50,000) specially kept aside for any unforeseen hospitalization expense w.r.t
new born baby if the child needs to return to the hospital after delivery on account of any adverse
health condition.
This becomes particularly important because most insurance policy do not provide insurance cover
to babies until they are 90 days old which is the time when they need it the most.
Can I include my new born baby to this plan during the policy period?
New born baby coverage for first 90 days is at no additional cost upto the sum insured specified
under the benefit of New Born Baby cover (rs 30,000/Rs 50,000). After that you can include your
child in same policy buy paying additional premium (Example: move from a 2A plan to a 2A1C plan)
How many times can I claim maternity benefit?
You can claim any number of times within the policy period. However, the benefit amount of Rs
35,000/ Rs 50,000 is on a policy period benefit, hence the total amount payable in all claims can not
exceed the benefit amount.
The same rule applies to New Born Baby Cover which can be claimed up to Benefit sum insured (Rs
30,000 / Rs 50,000).
Is abortion covered under maternity care benefit?
Abortion is covered under maternity benefit but NOT if it is a voluntary termination of pregnancy.
Hence, if the abortion is due to medical reasons and advised by the doctor, it is covered under the
maternity benefit.
What if a child is born after 8 months and 15 days of buying the policy?
The maternity benefit will not be given in above case. It will be given only if expense is incurred after
9 months of policy purchase.
Are expenses for IVF treatment covered in this policy?
No, expenses incurred for IVF or any other fertility treatment is not covered under this policy.
However, post IVF Treatment, if there is a successful pregnancy, then the cost of delivery including
pre and post natal expenses can be claimed under the Maternity Benefit of this policy.
Is vaccination covered under New Born Baby cover?
No, vaccination is not covered under this product under any benefit.
What is Post Natal Care and is there any limit on the no of days after delivery for coverage under
Post Natal Care?
Post Natal Care or Postpartum Care is the care given to the woman to recover from the physical
activity of birth. Post Natal period is the period of six weeks from the date of delivery where it is
important to take care of the mother’s health through tests and doctor consultations wherever
there is need. Thus, all expenses incurred for necessary medical care of the mother up to a period of
six weeks from birth will be covered under post natal care.
Is ectopic pregnancy covered under the product JOY?
Yes, Ectopic Pregnancy is covered under the product JOY. Moreover, expenses incurred for
treatment of ectopic pregnancy are covered under the Hospitalization Benefit of 3 Lakh and 5 Lakh
Sum Insured and NOT under the Maternity Benefit Sum Insured. Hence, claims made for treatment
of ectopic pregnancy DO NOT reduce the Maternity Benefit Sum Insured. This is specially
provisioned for Ectopic Pregnancy only.
What is Tender Care?
In addition to the insurance coverage, customers of Religare Health also have the benefit of Tender
Care which is a Value Added Service Package available to them. This package includes following
benefits with empanelled service providers:
• Discount of Rs 13,000 on cord cell banking
• 50% discount on Pre-Natal Diagnostic Packages
• Upto 25% Discount on diagnostics and consultations
What is the Network for the VAS Package – Tender Care?
The network for Tender Care currently includes following service providers. However, this network
will get expanded to include wider choice to the customers and may undergo changes:
• Discount of Rs 13,000 on cord cell banking with CRYO-SAVE
• 50% discount on Pre-Natal Diagnostic Packages at designated centres of SRL Diagnostics
• 25% Discount on diagnostics at designated centres of SRL Diagnostics
• 25% discount on OPD Consultations at designated centres of SRL Diagnostics
• 10% discount on OPD Consultations at FORTIS Hospitals
• 15% discount on OPD Consultations at MAX Hospitals
What is Cord Cell banking and how is it useful?
A cord blood bank is a facility which stores umbilical cord blood for future use. Cord blood contains
hematopoietic stem cells, progenitor cells which can form red blood cells, white blood cells, and
platelets. Cord blood cells are currently used to treat blood and immune system related genetic
diseases, cancers, and blood disorders. The cord blood can be used by the donor baby, or it could be
used by a relative who is a close enough match to receive a transplant from the donor, typically a
sibling.
Some statistics
• It is once-in-a-lifetime chance to collect cord blood – a readily available source when needed
in the future.
• 60% higher chance of locating a matching cord blood unit in the family versus bone marrow.
• Research showed that patients have a lower chance of complications in transplants when
they receive stem cells from a relative and the rates are even higher if the cells are that of
the patient itself
• Some of the most common cancers are treatable with a stem cell transplant. For instance,
lymphoma and leukaemia are two of the top 10 common cancers for adults and among the
top 5 most common childhood cancers in India.
With our product you get to preserve your cord cell with India’s leading diagnostics chain SRL
diagnostics and get discount of Rs 13,000.
Tell me more about Cryo-Save.
Cryo-Save Group N.V. is Europe’s largest adult stem cell storage bank, with more than 170,000
samples stored. The Company was established in 2000, headquartered in The Netherlands, Cryo-
Save has cryo-preserved samples from over 70 countries on six continents, with ultra-modern
processing and storage facilities in Belgium, Germany, Dubai, India and South Africa
Cryo-Save India, a 100% subsidiary of Cryo Save Group N.V which is Europe’s largest adult stem cell
storage bank, is headquartered in Bangalore with a state-of-the art fully automated adult stem-cell
storage facility.
Cryo-Save India has become the first to receive World Health Organisation – Good Manufacturing
Procedures (WHO-GMP) certification. WHO-GMP certification guarantees superior quality, safety
and effectiveness of production.
What tests are covered under Pre-natal Diagnostic packages of SRL available under Tender Care?
Pre-natal care includes undergoing appropriate diagnostic tests during the 9 months of pregnancy.
With Tender Care we have specially designed Pre-natal packages for each trimester. All the below
tests are available at 50% discount.
1st trimester CBC, BLOOD GROUP & RH, HBSAG, URINE RE/ME, TRIPPLE TEST, ANTI HCV, GLUCOSE
TOLERANCE TEST 75 GM 2HRS, S.TSH, HBA2, BLOOD SUGAR FASTING & PP, VDRL, TOXO GM,
OBSTETRICS - USG PELVIS (LEVEL 1), HIV, RUBELLA IGM
2nd trimester CBC, URINE RE/ME, BLOOD SUGAR FASTING & PP, OBSTETRICS - USG PELVIS (LEVEL 2)
3rd trimester CBC, URINE RE/ME, BLOOD SUGAR FASTING & PP, OBSTETRICS - USG PELVIS (LEVEL 2)
Also we offer 25% discounts on any other diagnostic expenses with no limit on total diagnostic
expenses.
Tell me more about SRL diagnostics?
SRL Diagnostics is a leading and reputed Pathology Lab network. SRL is the only Pathology Lab
Network in India to have 12 Reference Labs, 4 Centers of Excellence and 281 Network Laboratories
with a footprint spanning over 5500 Collection Points. We offer more than 3500 tests, using the
most advanced state-of-the-art technology supported by our highly skilled personnel. Today, SRL is
conducting more than 80,000 tests in a day, ranging from simple to high-end tests.
Some key facts about Super Religare Labs:
• South-east Asia’s largest diagnostics service provider
• Over 1100 collection centers
• Covers the entire spectrum of routine-to-specialized pathology and radiology services
• Health monitoring & maintenance and wellness solutions
What is the waiting period for VAS offerings under Tender Care?
There is NO wait period for availing benefits offered under Tender Care including diagnostic
packages and consultations. The same can be availed from the very next day after receiving the
policy kit.
Can I use the benefits under Tender Care for expenses not related to Maternity?
Yes, Tender Care VAS package benefits can be used for any kind of medical expense and not just
Maternity. However, the pre-natal diagnostic package discount can be availed only for maternity.
Is the Tender Care Pre-Natal package available at all SRL Network labs?
Tender Care pre-Natal package is available at company owned laboratories only. Also, it is not
available in the SRL Labs which are present in Fortis Hospitals’ premises. The address of nearest lab
can be taken by calling RHICL Customer Care number.
Is there any limit on number of consultations or expenses on diagnostics at discounted rates under
Tender Care?
No, there is no limit on amount of diagnostics expenses in which discount can be availed; and there
is no limit on the consultations on which discount can be availed under the TENDER CARE package.
But the premium is high?
Let us look at the value JOY provides:
Benefits Description 3 Lakh SI 5 Lakh SI
Health Indemnity Cover Premium of 3 year Care for 2A plan 15585 21029
Maternity Benefit Maternity Sum Insured 35,000 50,000
Tax benefit @ 30% Benefit for a 30% tax bracket 4,500 4,500
Tender Care
Cord Cell banking disc. discount in cord-Cell Banking 13,000 13,000
Pre-natal Care 50% discount on total test package worth Rs 10,500 5250 5250
Other diagnostics tests 25% discount on an average spend of Rs 5,000 1250 1250
Consultations Average savings @20% discount on an average spend of Rs 5,000 1000 1000
Total Benefits 75,585 96,029
Total Cost 55,445 74,773
Total Savings 20,140 21,256
As you can see above the derived value is much higher than the price paid. And that’s not all: the
benefit of New Born Baby Cover is over and above the above benefit table.
Can I port my existing indemnity policy to JOY and vice versa?
Yes, since JOY is retail policy, any person can port his existing cover to JOY OR he can port his JOY
policy to any other retail policy from RHICL or any other insurer as per portability guidelines.
However, please note that if a person ports from existing policy to JOY, the wait period for Maternity
benefit will still apply for 9 months.
call us on 1800-200-4488
visit your nearest branch
e-mail us at [email protected]
visit us at www.religarehealthinsurance.com
Religare Health Insurance Company LimitedGYS Global, Plot No. A3, A4, A5, Sector - 125, Noida, U.P. - 201301
Disclaimer: This is only a summary of product (plan - Assure 4). For more details on risk factors, terms and conditions please read sales brochure carefully before concluding a sale. Please seek the advice of your insurance advisor if you require any further information or clarification. Statutory Warning: Prohibition of Rebates (under section 41 of Insurance Act, 1938): No person shall allow or o�er to allow, either directly or indirectly as an inducement to any person to take out or renew or continue an insurance in respect of any kind of risk relating to lives or property, in India any rebate of the whole or part of the commission payable or any rebate of the premium shown on the policy, nor shall any person taking out or renewing or continuing a Policy accept any rebate, except such rebate as may be allowed in accordance with the published prospectuses or tables of the insurers. Any person making default in complying with the provision of this section shall be punished with fine, which may extent to five hundred rupees.
Insurance is a subject matter of solicitation.IRDA registration Number - 148 and are trademarks of Religare Health Insurance Company Limited. U
AN
:131
1119
4
UIN
: IR
DA
/NL-
HLT
/RH
I/P-H
(C)/
V.I/1
4/13
-14
HealthInsurance
HealthInsurance
Critical Illness & Personal Accident Cover
Medical Check-up
We would like you to undergo certain medical tests (as per the
following grid) that will enable us to get a better understanding of
your current and future health needs, and help us in ensuring
your sustained good health. The cost of these tests will be borne
by us if your proposal is accepted.
Policy Terms
Minimum Entry Age 18 years
Maximum Entry Age 65 years
Waiting Period 90 days (except personal accident)
Grace Period 30 days from the date of expiry to renew the policy.
Policy Tenure 1 year / 2 years / 3 years
What is not covered ?
• Any pre-existing illness
• Any diagnosis of diseases / undergoing of surgery / occurrence
of event, whose signs or symptoms first occur within 90 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
• Cosmetic & aesthetic and obesity related treatment
• Tests and treatment relating to infertility and invitro
fertilization
• War, riot, strike, nuclear weapons induced hospitalisation
This is only an indicative list. For complete list log on to www.religarehealthinsurance.com
Claim Settlement
File your claim directly with us!
We believe in the old adage, “The proof of the pudding is in the
eating.” So we back up our promise with an enduringly simple
claims procedure, which involves just you and us. All you need to
do is notify us immediately about the claim.
Call us directly, send us the specified documents and we’ll process
your claim.
Since you interact directly with us, we can be doubly sure that you
are satisfied. And when you are satisfied, we feel satisfied too.
Points to remember:
• Claim under Critical Illness, Accidental Death & Permanent Total Disablement are mutually exclusive. Policy shall discontinue in case claim is admissible under any of these benefits with the company.
• Claims would be processed on re-imbursement basis only for Critical Illness, Personal Accident and Child Education Benefit.
Religare Health Insurance Company Limited
Religare Health Insurance is focused on the delivery of health
insurance services. Our promoter's expertise in the spectrum of
financial services, healthcare delivery and preventive health
solutions, coupled with a robust distribution model, o�ers us a
unique edge to deliver and excel in a business environment that
hinges on serviceability and scale. Powered by the best-in-class
product design and a customer-centric approach, Religare Health
Insurance is committed to delivering on its innate values of being a
responsible, trustworthy and innovative health insurer.
The shareholders of Religare Health Insurance comprise of three
strong entities - Religare Enterprises Limited, Union Bank of India
and Corporation Bank.
Age / Sum Insured Up to 10 Lac Above 10 Lac
Up to 45 years No Yes
46 years and above Yes Yes
Ver:
Nov
/13
and More!
Our assurance towards your family’s wellbeing and financial
independence! We will pay a lump sum amount equal to the Sum
Insured in the event of Accidental Death or Permanent Total
Disablement of the insured.
Personal Accident Cover
Our concern is your good health. This we make sure by providing
a health check-up, once in a policy year, for you to stay
healthy….hamesha.
Health Check-up
We are committed to your healthcare needs. Your total well-being is
our concern. So we go that extra mile for you.
Our assurance comes with no boundaries!
No matter what, your children won’t need to compromise. In case
you ever su�er from any of the specified Critical Illnesses or unfortu-
nate accident leading to death or permanent total disablement, we
pay an additional lump sum amount (10% of the Sum Insured)
towards the education of your children.
Child Education Benefit
Entitlement to Second Opinion
If you are su�ering with a critical illness and wish to get a second
opinion of an expert/doctor, we arrange one for you, at no extra cost.
You can review your decision
Our policies come with a free-look period of 15 days. Hence, if you
find it unsuitable, you can cancel and return the policy to us.
Enjoy Tax Benefit
You can avail of a tax benefit on the premiums you pay towards your
health insurance, as per the prevailing tax laws of the Income Tax
Act, 1961 (u/s 80D).Comprehensive Coverage, Assured!
Critical Illness, Surgical Procedures, Medical Events – We cover them all
• 20 Critical Illnesses • Annual Health Check-up
• Personal Accident • Second Opinion
• Tax Benefit • Child Education Cover
While an indemnity health cover is a reimbursement plan, critical
illness cover is a benefit plan where you get a lump sum amount
when diagnosed or operated for any of the below specified critical
illness.
1. Cancer
2. End Stage Renal Failure
3. Multiple Sclerosis
4. Benign Brain Tumor
5. Motor Neurone Disorder
6. End Stage Lung Disease
7. Major Organ Transplant
8. Heart Valve Replacement
9. Coronary Artery Bypass Graft
10. Stroke
11. Paralysis
12. Myocardial Infarction
13. Major Burns
14. Coma
15. Blindness
16. Parkinson’s Disease before the age of 50 years
17. Alzheimer’s Disease before the age of 50 years
18. End Stage Liver Disease
19. Bacterial Meningitis
20. Aplastic Anemia
Highlights
Sum Insured 5 Lac, 10 Lac, 15 Lac, 20 Lac, 30 Lac, 50 Lac, 75 Lac, 1 Crore
No. of Critical 20Illness covered
Critical Illness, Medical 100 % of Sum Insured Events and Surgical Procedures
Personal Accident 100 % of Sum Insured(Accidental Death & Permanent Total Disablement)
Child Education Cover 10% of Sum Insured
Health Check-up Yes
Second Opinion Yes
Plan Options
Gone are the days when Critical Illnesses were seldom heard of.
Today’s changing lifestyle has put us at greater risk; and as much as
we would want to ignore it, it has become commonplace.
At Religare Health Insurance, we don’t want a sudden unexpected
bend to burn a hole in your pocket of hard earned savings. Neither
do we want your world to come crushing down due to lack of
su�cient finances.
Which is why, we have designed - a comprehensive cover for
as many as 20 Critical Illnesses along with Personal Accident cover, to
take care and o�er total peace of mind for you and your loved
ones. You get a lump-sum benefit to pay o� expenses as you deem
appropriate.
Assurance. When You Need It The Most.
Life’s uncertainties are inevitable. And that’s the case with health too.
No one can assure you that you will always be in the pink of health.
We can, however, assure you that while you are unwell, we’ll stand
by you and your family so that you can be totally worry-free. With
by your side, you can rest all your financial worries, responsi-
bilities and liabilities with us.
With us as your health insurer, it is truly Ab Health Hamesha!
Our Philosophy
In addition to Critical Illness & Personal Accident coverage, we
believe you deserve distinct benefits for choosing , and they
come your way in the form of certain thoughtfully designed product
and service features:
• Flexible Sum Insured options
• Lump sum payment of Sum Insured
• Hassle free claim settlement directly by the company
• 20 major critical illness covered
• Permanent Total Disability Cover in addition to Accidental Death
• Zero day survival period
• Child Education Cover to ensure complete family security
- No more worrying in life!