See Frequently Asked Question
WHAT DOES THE POLICY COVER?
This Policy is designed to give You, the Insured, protection against unforeseen Hospitalisation expenses.
CAN I COVER MY FAMILY MEMBERS IN ONE POLICY?
Yes. You can cover Your family members in one policy, with separate Sum Insured for
each Insured Person.
The members of the family who could be covered under the Policy are:
a) Proposer
b) Proposer’s Spouse
c) Proposer’s Children
d) Proposer’s Parents
IS HOSPITALISATION ALWAYS NECESSARY TO GET A CLAIM?
Yes. Unless the Insured Person is Hospitalised for a condition warranting Hospitalisation,
no claim is payable under the Policy. The Policy does not cover outpatient treatments.
HOW LONG DOES THE INSURED PERSON NEED TO BE HOSPITALISED?
The Policy pays only where the Hospitalisation is for more than twenty four hours. But
for certain treatments specified in the Policy, period of stay at the Hospital could be less
than twenty four hours. Please refer to Clause 2.17 of the Policy for details.
WHAT DO I NEED TO DO AFTER I GET HOSPITALISED?
Immediately on Hospitalisation or within twenty four hours of such Hospitalisation,
please intimate the TPA of this fact, with details of Your Policy Number, Name of the
Hospital and treatment undertaken. This is an important condition of the Policy that you
need to comply with.
IS PAYMENT AVAILABLE FOR EXPENSES INCURRED BEFORE HOSPITALISATION?
Yes. Relevant medical expenses incurred before hospitalization for a period of THIRTY days prior to the date of Hospitalisation are payable. Relevant medical expenses means
expenses related to the treatment of the disease for which the insured is Hospitalised.
IS PAYMENT AVAILABLE FOR EXPENSES INCURRED AFTER HOSPITALISATION?
Yes. Relevant medical expenses incurred after Discharge from the Hospital for a period
of SIXTY days after the date of discharge are payable. Relevant medical expenses means
expenses related to the treatment of the disease for which the insured is Hospitalised.
CAN I GET TREATED ANYWHERE?
Yes, the Policy covers treatment and/or services rendered only in India.
IS THERE A LIMIT TO WHAT THE COMPANY WILL PAY FOR HOSPITALISATION?
Yes. We will pay Hospitalisation expenses up to a limit, known as Sum Insured. In cases
where the Insured Person was Hospitalised more than once, the total of all amounts
paid
a) for all cases of Hospitalisation,
b) expenses paid for medical expenses prior to Hospitalisation,
c) expenses paid for medical expenses after discharge from hospital, and
d) any other payment made under the Policy
shall not exceed the Sum Insured as mentioned in the Schedule.
HOW LONG IS THE POLICY VALID?
The Policy is valid during the Period of Insurance stated in the Schedule attached to the
Policy. It is usually valid for a period of one year from the date of beginning of insurance.