Claim Settlement Ratio 84.52%
Claim Settlement Facility 100%
Network Hospitals 3200
COVID-19 Cover Yes
Incurred Claim Ratio 35.31%
The minimum entry Age under the plan is 90 days whereas the maximum entry Age is 65 years.
The pre and post hospitalization expenses are covered up to 90 days and 180 days.
There are 3 variants in the plan namely Silver, Gold and Platinum which are classified according to the sum insured.
The expenses incurred for emergency ambulance is covered up to a limit of ₹10,000 per hospitalization under the plan. The ambulance cover is payable in transporting the insured person from one hospital to another or from the place of accident to the hospital.
Medical expenses for harvesting the organ from the donor for organ transplantation would be covered for a maximum of ₹2 lakhs under the health insurance plan.
The plan pays for the medical expenses incurred for treatment at home for a period exceeding 3 consecutive days. The benefit is payable on written recommendation of the treating doctor.
Medical expenses incurred for alternative treatments such as Ayurveda, Yoga Unani Siddha and Homeopathy are paid up to the limit mentioned under the policy.
The policy provides an increase in the sum insured for every claim free year. The maximum amount of no claim bonus that can be obtained would be 50% of the base sum insured for every claim free year up to a maximum of 100%. In the event of a claim no claim bonus would be reduced at the same rate at which it is allotted for a claim free year.
The plan offers free health checkup for every claim free year for members above 18 years of age.
Edelweiss health insurance pays for the maternity expenses of the insured up to ₹2 lakhs with a waiting period of 4 years.
The policy provides a hospital cash of up to ₹1500 per day as a fixed benefit from 4rth day till the 10th day for continuous hospitalization arising out of illness or an accident.
The plan pays a fixed benefit of up to ₹1500 per day from the 11th day till the 20th day in case of continuous hospitalization.
Reimbursement of up to ₹1200 per day in case of shared accommodation at the time of hospitalization.
The plan provides for an increase in percentage of base sum insured on first diagnosis as specified in the policy document. The maximum amount of increase in base sum insured would be 100% of the base sum insured.
The policy provides for restoration of 100% of the base sum insured on exhaustion of the sum insured. The restored sum insured can be utilized only for illnesses or diseases unrelated to the illnesses or diseases for which the claims have been made during the policy period.