Claim Settlement Ratio 85.47%
Claim Settlement Facility 100%
Network Hospitals 6000
COVID-19 Cover Yes
Incurred Claim Ratio 115.55
The plan covers the health checkup expenses incurred by the insured customer during the policy period. The time limit to submit the documents to the Third party administrator is at least 45 days prior to the expiry of the policy period. The health checkup option is available every 2 years without a break between the policy periods and the limit of expenses that would be reimbursed would be up to Rs.3000.
The company shall pay the benefit amount if the insured customer is diagnosed with any of the critical illness as mentioned in the policy document. There is a survival period of 30 days before the payment is made. The diagnosis of critical illness should be supported by clinical, radiological, histological and laboratory evidence acceptable to the company. The minimum and maximum sum insured under the critical illness cover would be Rs.2 Lakhs and Rs.25 Lakhs. Pre policy checkup is mandatory for customers availing the critical illness cover between the age of 18 years and 65 years.
The outpatient limit per individual is between Rs.2000 and Rs.10000. The company shall pay for the medical expenses incurred by the insured in case of treatment taken as outpatient which does not require the admission of the insured as an inpatient.