Summary
Good Features
Not so great Features
Pricing
Insurer Performance
Product Benefits
In Patient Hospitalisation
ICU Room Rent Limit | No Limit |
Room Rent Limit | No Limit |
Pre & Post Hospitalization
Pre Hosipitalization Expenses covered | 60 Days |
Post Hosipitalization Expenses covered | 180 Days |
Day Care Treatment
Financial Limit | No Limit |
No. of treatments covered | All are covered |
Organ Donor
Expenses covered upto | Sum Insured |
Modern Treatment
Financial Limit | No Limit |
Bonus
Max Bonus | 100% |
Reduction in bonus post claim | No (Bonus applies irrespective of claims) |
% of Bonus added every year | upto 100% |
Super Bonus
Max Bonus | Not Available |
Reduction in bonus post claim | Not Available |
% of Bonus added every year | Not Available |
Restoration Benefit
No. of times refill can be applied | Unlimited |
Claim in which refill of cover can be applied | Subsequent claims |
When does restoration trigger ? | Partial exhaustion of Sum Insured |
Illness for which refill will be applicable | Related and unrelated illness |
Non-Medical Expenses Cover (Consumables Cover)
Limit on Non Medical Expenses | No limit (Add-on) |
Cover on Non Medical Expenses | Available (Add-on) |
Add-Ons
Claims Safeguard+ Benefit ★ Recommended- All Non-Medical items will be covered (as per list I, II, III, IV) : Consumables
Day 1 Pre-Existing Disease Coverage ★ Recommended
- Get protection against declared chronic conditions from day one such as: Diabetes, Hypertension, Dyslipidemia, Hypothyroidism, Hyperthyroidism, Asthma
Wellconsult+
Wellconsult+ extends your health cover beyond hospitalisation to include wellness and outpatient benefits. You can choose up to 5X of the premium as your Wellconsult+ Sum Insured and enjoy a complete care experience.
Benefits include:
- Tele/Video consultations with General Practitioners
- Physical consultations with Specialists and General Practitioners
- Prescribed diagnostics and pharmacy expenses
- Dental procedures and Ophthalmological consultations
- Prescribed physiotherapy consultations
- Online sessions on Emotional Wellness (via Partner Network)
- Diet & Nutrition Coaching and AI-led Smart Fitness Coaching (via Partner Network)
- Access to Global Wellness Content and Gym Memberships (via Partner Network)
Discounts
Aggregrate Deductible : Get a discount on your insurance premium when you agree to pay a certain aggregate deductible amount.Deductible Amount Options : Rs.10,000, Rs.20,000, Rs.30,000, Rs.50,000, & Rs.1,00,000
Voluntary Co - Payment : Get discount as per co-pay option choosen. It is a percentage of admissible claim that you will pay in case of a claim
Co-pay Options : 10%, 20%, 30%, 40%, 50%
Medical Practitioner Discount : Get 5% discount if any of the insured person is a medical practitioner
HeadsUp Discount : Call 48 hours before any hospitalization and get treated at recommended provider. (For emergency: within 24 hrs of admission)
20% Co-payment if treatment taken outside the recommended list.
Tiered Network Discount : Get 15% discount in premium with 20% Co-Pay applicable on treatment outside the tiered network list. Co-Payment is not applicable for maternity claims network listLimits & Exclusions
Disease wise Sub Limit | No Limit |
Zonal Wise Co-Pay | No Co-Pay |
Pre-existing Disease Waiting Period | 36 months |
Specified Treatment Waiting Period | 24 months |
Co-payment | No co-payment |
Deductible | 10K / 20K / 30K / 50K / 100K (Add-on) |
Insurer Performance
Claim Settlement Ratio (No. of claims) % of the claims received were paid | 91.35% |
Claim Rejection Ratio % of claims rejected & repudiated by the insurer | 7.3% |
Amount Settlement Ratio % of the claim amount received was paid | 74.32% |
% of Complaints received on overall claims % customers dissatisfied with claims | 0.43% |
Incurred Claim Ratio % of premium collected was paid out as claims (ideal : 70-90%) | 58.10% |
No. of Cashless Hospitals | 10,000+ |
Taxes
GST : ZEROIncome Tax Benefits (Old Tax Regime) : Under Section 80D, premium paid for Health Insurance is tax exempted. Limit is upto Rs. 25,000