Claim Settlement Ratio 95.84%
Claim Settlement Facility 100%
Network Hospitals 4,300
COVID-19 Cover Yes
Incurred Claim Ratio 90%
The maternity cover can be availed if both self and spouse are covered under the policy. A waiting period of 48 months shall be applicable from the policy inception date and would be applicable under this benefit. The maternity expenses incurred for and including the child birth or for lawful medically necessary termination of pregnancy including abortion and miscarriage required or arising due to accidental injuries. A maximum of up to 2 deliveries or termination of pregnancy can be availed during the lifetime of the insured.
Ayush cover can be availed under the policy for up to 10% sum insured on a reimbursement basis where the insured person has to first settle the hospital bill and then claim from the insurance company. Ayush includes Ayurveda, Yoga, Unani, Siddha and Homeopathy.
This cover provides compensation to the insured in case of loss of income arising from an illness or injury resulting in permanent total disability.
If there are no claims in the previous year policy period then at the time of renewal a cumulative bonus shall be added to the policy in the form of increased sum insured. For support plan 10% of sum insured per claim free policy year up to a maximum of 50% of sum insured and for the premium plan 33.33% of the sum insured per claim free policy year up to a maximum of 100% of the sum insured would be payable under the policy.
The plan also covers new age treatments such as IVF, Bariatric, LASIK, Psychiatric cover etc up to the limits mentioned under the policy.
The reasonable and customary charges incurred for medically necessary consultations with an medical practitioner on an out-patient basis would be paid under the policy.
The sum insured under the policy would be restored upon completion of the sum insured during the policy period. Restoration of sum insured would be done only once during the policy.
The room rent capping would not be applicable for the support plus plan, shield plan and premium plans under the policy.