Topic: I am looking for mediclaim policy for my family for amount 2 lakhs

Secondly for my father-in-law (separate policy) aged 55.

This message was edited 2 times. Last update was at 23/06/2009 11:14:31

Family Health Optima Benefits
• Hospitalisation Cover: This would protect the insured person for in-patient hospitalisation expenses for a minimum of 24 hours. These expenses include room boarding expenses to a maximum of Rs.1500 per day in Class A cities, Rs.750/- in Class B cities or Rs.500/- in other locations
• Nursing expenses
• Surgeon's fees, Consultant's fees, Anesthetist and Specialist fees
• Cost of blood, oxygen, diagnostic expenses, cost of pace makers etc
• Cost of medicines and drugs
• Emergency ambulance charges for transporting the covered patient to the hospital up-to a sum of Rs.750/- per hospitalization and overall limit of Rs.1500/- per policy period
Additional Benefits
• The sum insured floats among the family members insured. In other words there is no need to take health insurance for each member separately for separate sum insured
• Thus there is considerable premium saving
Family Includes
• Family would mean proposer, spouse, dependent children upto 25 years and those who are economically dependent on their parents
Pre and Post Hospitalisation cover
• Pre-hospitalisation medical expenses up to 30 days prior to the date of admission or post-hospitalisation calculated at 7% of the hospitalisation expenses (excluding room rent) subject to a maximum of Rs.5000 is payable.
Discount
• A discount of 10% on Premium is allowed on renewal of the health insurance policy if there is no claim in the immediately preceding year of the policy. This discount is not cumulative
How much to pay?
Age of the oldest family member covered should be taken for premium calculation
Health Insurance policy cover of 1 lac,2 lac, 3lac, 4 lac, 5 lac available.
Presuming that the highest age of the family member is below 35 years
for 2 adult + 2 child,
the premium for a cover for 2 lac is 3455, 3 lac is 4310, 4 lac is 5645 and 5 lac is 6875. Service tax 12.36% etc.

Tax Benefit
• Premium paid by cheque /credit card for this insurance is eligible for relief under section 80D of the IT Act.
Claim Procedure
• Call the 24 hour help-line to register the details of hospitalization.
• Kindly mention your ID number for easy access to your policy details.
• In case of a planned hospitalisation, please register 24 hours prior to admission to the hospital
• In case of emergency hospitalisation, please regiser within 24 hours of hospitalisation
• In all network hospitals, the cashless facility on payments can be availed
• For treatment in non-network hospitals, payments must be made up-front to the hospital. Reimbursement of the expenses will be effected on submission of the necessary documents.
Exclusions
• Expenses incurred for treatment of any illness/ disease/ condition, which is pre-existing at the time of commencement of insurance
• Any expenses incurred for treatment of illness/ disease/ sickness contracted by the Insured Person during the first 30 days from the commencement of the policy
• First Year exclusions – Hernia, Piles, Hydrocele, Congenital Internal disease/ defect, Sinusitis, Gall Stone / Renal Stone removal / treatment
• Second Year Exclusions – Hysterectomy for Menorrhagia or Fibromyoma, Cataract, Knee Replacement Surgery (other than caused by an accident), Joint Replacement Surgery (other than caused by an accident), Prolapsed Intervertebral Disc (other than caused by an accident), Varicose veins / ulcers
• Naturopathy treatment
• Expenses, which are purely diagnostic in nature with no positive existence of any disease
• Expenses those are mainly cosmetic in nature
• Expenses incurred for treatment of diseases/illness/accidental injuries by systems of medicines other than Allopathic
• Expenses incurred for treatment of congenital disease/defects/anomalies
• For a detailed list of exclusions please refer policy conditions
Eligibility
• Any person aged between 5 months and 60 years residing in India, can take this insurance

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