Benefits of Individual Mediclaim Policy in General Insurance

Major benefits of Single (Individual) Helath Insurance policy...
Medical treatment for a period exceeding three days for such illness/disease/injury which in the normal course would require care and treatment at a hospital/nursing care.

Actually taken whilst confined at home in India under any of the following circumstances namely is Domiciliary Hospitalization

The most important features in Mediclaim Policy of General Insurance is as given below.

• The condition of the patient is such that he/she can not be removed to the Hospital/ Nursing home.
• The patient can not be removed to hospital/nursing home for lack of accommodation therein.

Domiciliary hospitalization shall not be cover

• Any treatment not exceeding three days.
• Expenses incurred for pre and post hospital treatment.
• Expenses incurred for treatment of any of the following diseases.

1. Asthma
2. Bronchitis
3. Chronic Nephritis and Nephritic Syndrome
4. Diarrhoea and all types of Dysenteries including Gastroenteritis
5. Diabetes Melitus and Insipidus
6. Epilepsy
7. Hypertension
8. Influenza, Cough and cold
9. All psychiatric or psychosomatic disorders
10. Pyrexia of unkonown origin for less than 10 days
11. Tonsillitis and upper Respiratory tract infection including Laryngitis and Pharingitis.
12. Arthritis, Gout and Rheumatism

Note: When treatment such as dialysis, Chemotherapy, Radio therapy etc. is taken in the hospital/Nursing home and the insured is discharged on the same day, the treatments will be considered to be taken under Hospitalization benefit section.  Liability of the Company under this clause is restricted.

Any One Illness

Any one illness will be deemed to mean continuous period of illness and it includes relapse within 45 days from the date of last consultation with the hospital/nursing home where treatment may have been taken.  Occurrence of same illness after a lapse of 45 days as stated above will be considered as fresh for the purpose of this policy.

Pre- Hospitalisation

In the mediclaim policy this is relevant medical, expenses incurred during period upto 30 days prior to hospitalization on disease/illness/injury sustained will be considered as part of claim.

the medical expenses incurred during period upto 60 days after hospitalization on disease/illness/injury sustained will be considered as a part of claim.

Family Discount:

A discount of 10% in the total premium will be allowed comprising the insured and any one or more of the following

• Spouse
• Dependent Children(legitimate or legally adopted children)
• Dependent Parents

Cumulative Bonus:

Sum insured under this policy shall be progressively increased by 5% in respect of each claim free year of insurance, subject to maximum accumulation of 10 claim free years of insurance. In case of a claim under the policy in respect of insured persons who has earned the cumulative bonus the increased percentage will be reduced by 10% of sum insured at the next renewal .  However, basic sum insured will be maintained and will not be reduced.

Cost of health checkup:

In addition to cumulative bonus, the insured shall be entitled for reimbursement of cost of medical check-up once at the end of block of every four underwriting years provided there no claims reported during the block.