In patient Treatment covered upto Rs 100,000
Doctors’ fees
Diagnostics Tests
Medicines, drugs and consumables
Intravenous fluids, blood transfusion, injection administration charges
Operation theatre charges
Cost of prosthetics and other devices or equipment if implanted internally during Surgical Operation
Hospital Accommodation covered upto Rs 2000 per day
Intensive Care Unit (ICU charges) covered Upto Rs 4000
Pre and post hospitalization expenses covered upto Rs 100,000 (Expenses up to 30 days immediately before and up to 60 days immediately after hospitalization including doctor's consultation, diagnostics tests, medicines, drugs and consumables)
Organ Transplant when medically necessary covered upto Rs 100,000
Emergency Ground Ambulance covered upto Rs 1000 per Hospitalization
Initial Waiting Period: 30 days and Pre-existing waiting period – 48 Months
Co-Payment Amount: 20% co-payment per hospitalization for all ages (For the claim amount is Rs1 lac, then Insurer would pay up to Rs80,000 while the balance would be borne by customer)
Disease Specific Limits
Disease | Amount (Rs) |
---|---|
Appendectomy – Appendix | 32,000 |
Hip Replacement (Bilateral) including cost of implants | 1,00,000 |
Angioplasty including cost of implants and angiography | 1,00,000 |
Hernioplasty/Herniorraphy- Unilateral including cost of mesh and tacker | 32,000 |
Hydrocele | 18,000 |
Haemorrhoidectomy including Cost of stapler | 29,000 |
Total Knee Replacement (Unilateral) including cost of implants | 72,000 |
Cataract per eye including Cost of Lens | 18,000 |
CABG | 1,00,000 |
Cholecystectomy | 26,000 |
Hip Replacement (Unilateral) including cost of implants | 72,000 |
Arthroscopic Surgery ( Other Than ACL / Menisectomy) | 29,000 |
Hernioplasty/Herniorraphy- Bilateral including Cost of mesh and tacker | 37,000 |
PCNL- Bilatera- Stone removal | 43,000 |
Temporary Pacemaker Implantation including cost of temporary pacemaker | 14,000 |
Total Knee Replacement(Bilateral) including cost of implants | 1,00,000 |
Hysterectomy (Abdominal/Vaginal) | 40,000 |
PCNL- Unilateral | 37,000 |
Valve Replacement including cost of implants | 1,00,000 |
*Maximum Payout will be the limit or the Sum Insured amount, whichever is lower |
Addictive conditions and disorders
Ageing and puberty
Artificial life maintenance
Ayurvedic and Homeopathic treatment
Circumcision
Conflict and disaster
Convalescence and Rehabilitation
Cosmetic Surgery
Dental/Oral treatment
Drugs and dressings for OPD Treatment or take-home use
External Congenital Anomaly
Eyesight
Unproven / Experimental treatment
Unani, Yoga and Siddha treatmen
Health hydros, nature cure, wellness clinics etc
HIV and AIDS
Hereditary conditions
Items of personal comfort and convenience, including but not limited to the items as mentioned in the policy wording
Psychiatric and Psychosomatic Conditions, Obesity, OPD Treatment
Reproductive medicine - Birth control & Assisted reproduction
Self-inflicted injuries, Sexual disorder and gender issues
Sexually transmitted diseases, Sleep disorders, Speech disorders
Treatment for developmental problems, Treatment received outside India, Unrecognized physician or Hospital, Unlawful Activity, Genetic disorders
Any expenses as mentioned under the List of Generally Excluded under Hospitalization Cover