Summary
Good Features
Missing Features
Pricing
Insurer Performanceā
Product Benefits
In Patient Hospitalisation
ICU Room Rent Limit | No Limit |
Room Rent Limit | No Limit |
Pre & PostĀ Hospitalisation
Pre Hosipitalization Expenses coveredĀ | 90 Days |
Post Hosipitalization Expenses coveredĀ | 180 Days |
Day Care Treatment
Financial Limit | No Limit |
No. of treatments covered | All are covered |
Organ Donor
Expenses covered upto | Sum Insured |
DomiciliaryĀ Treatment
Expenses covered upto | Sum Insured |
No. of illnesses not covered | 0 |
ModernĀ Treatment
Financial Limit | No Limit |
BonusĀ
Max Bonus | 500%, max upto Rs. 3 crores |
Reduction inĀ bonus postĀ claim | No (Bonus applies irrespective of claims) |
% of Bonus added every year | 100% (Irrespective of the claim) |
Super BonusĀ
Max Bonus | Not Available |
Reduction inĀ bonus postĀ claim | Not Available |
% of Bonus added every year | Not Available |
Restoration BenefitĀ
No. of times refill can be applied | Unlimited |
Claim in which refill of cover can be applied | Subsequent claims |
When doesĀ restoration trigger ? | Partial exhaustion of Sum Insured |
Illness for which refill will beĀ eligible | Related and unrelated illness |
Non-Medical Expenses CoverĀ (Consumables Cover)
Limit on Non Medical Expenses | No limit |
Cover on Non Medical Expenses | Available |
Additional Features
Alternate Medicine (AYUSH) | Sum Insured |
Worldwide Coverage | Not Available |
Animal Bite Vaccination | Not Available |
Daily Cash Allowance | Not Available |
Discount on Renewal | Available |
Free Health CheckUps | Once a year (for above 18 years) |
Out patient consultation benefits | Not Available |
Maternity Benefits
Available in a difference Plan ActivOne Maternity 1 Cr Combo (3months Maternity Waiting period) | 3 year plan with Rs. 50,000 cover for Maternity |
Limits
Cataract treatment expenses covered up to | Sum Insured |
Joint replacement surgery expenses covered up to | Sum Insured |
Pre-existing Disease Waiting Period | 36 months (Add-on can reduce to 12months) |
Specified Treatment Waiting Period | 24 months |
Initial Waiting Period | 30 Days |
Co-payment | No co-payment |
Deductible | 25K / 50K / 100K / 200K / 300K (Add-on) |
Add-Ons
Reduction in Pre-Existing Disease waiting periodĀ ā RecommendedGet your existing illness waiting period reduced from 3 years to 2 years or 3 years to 1 year.
Note:This rider does not reduce specific illness waiting period.
Durable equipment coverĀ ā Recommended
Get your expenses covered towards below listed medical equipment prescribed or recommended by a healthcare professional.
Equipment : Ventilator, Wheelchair, Prosthetic device, Suction Machine, Commode Chairs, Infusion pump, Continuous Passive motion devices in case of Knee Replacement, Oxygen concentrator
Chronic Care (Day-1 Hospitalization cover)
Get protection against declared Chronic conditions from 1st Day.
Chronic Management Program (OPD)
Get fixed number of i) Medical practitioner'sĀ consultation and ii) diagnostic tests for any chronic conditions listed and as specified by policy schedule at empanelled network providers with a cashless facility basis
Second Medical Opinion
Get coverage for second medical opinion in case of listed
Discounts
Aggregrate Discount :Ā Get a discount on your insurance premium when you agree to pay a certain aggregate deductible amount.ĀDeductible Amount Options : Rs.25,000, Rs.50,000, & Rs.1,00,000
Exclusions
1.Ā Stem cell (except BMT and hormone replacement therapies)2. Expenses related to physical, psychiatric or psychological examinations
3. Certain advanced treatments like KTP Laser, CyberKnife, Femto laser, etc.
4. Nutritional and electrolyte supplements unless certified necessary for a covered claim
5. Prosthesis and devices like hearing aids, vision aids, wigs, toupees, etc. used, unless due to accidentInsurer Performance
% of claims settled in less than 30 days Speed of settling valid claims | 96.63%ā |
Claim Settlement Ratio (No. of claims) % of the claims received were paid | 97.47% |
Claim Rejection Ratio % of claims rejected & repudiated by the insurer | 2.52% |
AmountĀ Settlement Ratio % of the claim amount received was paid | 80.53% |
% of Complaints received on overall claims % customers dissatisfiedĀ with claims | 0.15% |
Incurred Claim Ratio % of premium collected was paid out as claims (ideal : 70-90%) | 84.85% |
No. of Cashless Hospitals | 16,000+ |
Taxes
GST : ZEROIncome Tax Benefits (Old Tax Regime)Ā : Under Section 80D,Ā premium paid for Health InsuranceĀ is tax exempted. Limit is upto Rs. 25,000