Section 1: Basic Benefits
Inpatient Care: Covers medical expenses like room rent, ICU charges, medical practitioners fee, OT charges, nursing charges etc. incurred during hospitalization due to an illness or accident for period more than 24 hrs.
- Room Rent, Boarding, Nursing Expenses as provided by the Hospital /Nursing Home, up to 2% of the sum insured subject to maximum of Rs.5000/- per day.
- Intensive Care Unit (ICU) /Intensive Cardiac Care Unit (ICCU) expenses up to 5% of sum insured subject to maximum of Rs. 10,000/- per day.
- Cost is included up to sum-insured for Anesthesia, blood, oxygen, operation theatre charges, surgical appliances, medicines and drugs, diagnostics, diagnostic imaging modalities and such similar other expenses.
- Doctor/Surgeons fees is covered
Special Treatments: Special treatments as listed below are covered with up to 50% of the sum-insured:
- Uterine Artery Embolization and HIFU (High intensity focused ultrasound)
- Balloon Sinuplasty
- Deep Brain stimulation
- Oral chemotherapy
- Immunotherapy- Monoclonal Antibody to be given as injection
- Intra vitreal injections
- Robotic surgeries
- Stereotactic radio surgeries
- Bronchical Thermoplasty
- Vaporisation of the prostrate (Green laser treatment or holmium laser treatment)
- IONM - (Intra Operative Neuro Monitoring)
- Stem cell therapy: Hematopoietic stem cells for bone marrow transplant for haematological conditions to be covered
Day Care Procedures: Medical expenses incurred for day care procedures taken at a hospital or day care centre. 24 hours mandatory hospitalization is not necessary in the day care procedure.
Cataract Treatment^: Cataract treatment is covered op to 25% of Sum insured or Rs.40,000/-, whichever is lower, per eye, under one policy year.
Ayush Benefit: The medical expenses for in-patient treatment taken under Ayurveda, Unani, siddha and homeopathy are covered without sublimits.
Pre- Hospitalisation: Covers medical expenses incurred 30 days prior to the date of hospitalisation.
Post- Hospitalisation: Covers medical expenses incurred up to 60 days from the date of discharge.
Emergency Road Ambulance: Actual expenses incurred for utilizing road ambulance service for transporting the insured to the nearest hospital with adequate emergency facilities is covered upto ₹2000 per hospitalisation.
Dental Treatment and Plastic Surgery: Dental treatment & Plastic surgery necessitated due to any disease or accidental injury is covered
Section 2: Co-payment and Cumulative Bonus
Cumulative Bonus: Increase in the sum insured by 5% in respect of each claim free year subject to a maximum of 50% of SI. In the event of claim the cumulative bonus shall be reduced at the same rate.
Co-payment: 5% for all claims
