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Easy Health Standard

Our Easy Health Family floater Plan protects your family not only from unforeseen emergency expenses but also offers a comprehensive cover for medical treatment of illnesses and accidents requiring in-patient hospitalisation. The Plan offers coverage on floater sum insured basis & also offers an add-on optional cover for listed Critical Illnesses. 

Eligiblity

  • We offer coverage from the age of 5 years onwards with maximum entry age of 65 years. A dependent child can be covered from the 91st day (if either parent is covered under this policy).
  • You and/ or your his family members namely spouse, dependent children, dependent parents, parent-in-law, grandparents and grand children are eligible for buying this cover. (we offer a family discount of 5% if 2 family members are covered and family discount of 10% if 3 or more family members are covered under the same policy)
  • Maximum 6 members can be added in a single policy. In a family floater policy, a maximum of 2 adults and a maximum of 5 children can be included in a single policy. The 2 adults can be a combination of Self with Spouse, Father, Father-in-law, Mother or Mother- In-law, grandfather, grandmother.
  • Your premium at renewal may change due to a change in your age or changes in the applicable tax rate.
  • The policy period include period of 1 or 2 year(s) as opted. (We offer 7.5% discount if you opt for a 2 year policy).

Plan Benefits

  • In-Patient Hospitalisation – The medical expenses for coverage for hospitalization of more than 24 hrs.
  • Pre-Hospitalisation - The medical expenses that you incur due to illness during the 60 days immediately before you are hospitalised.
  • Post-Hospitalisation - The medical expenses you incur in the 90 days immediately after you are discharged from hospital.
  • Day-Care Procedures - The medical expenses for enlisted 144 day-care procedures, which do not require 24 hours hospitalization due to technological advancement, are covered.
  • Domiciliary Treatment – The treatment expenses involved in getting a treatment done at home which otherwise would need hospitalization.
  • Organ Donor – Treatment expenses for the organ donor at the time of organ transplant.
  • Emergency Ambulance - Expenses incurred if ambulance service is used on the way to hospital for hospitalization (up to Rs. 2000).
  • Daily Cash for choosing Shared Accommodation - A lump sum amount given for selecting a shared room in a network hospital.
  • Ayush Benefit - The Medical expenses for in-patient treatment taken under Ayurveda, Unani, Sidha and Homeopathy.
  • Health Check-up - A comprehensive health check-up involving a number of medical tests only once at the end of a block of four continuous claim free policy years.
  • Additional cover for Critical Illness (optional) - You can opt for an additional cover for Critical Illness which covers for cancer, coronary artery (bypass) surgery, first heart attack (myocardial infarction), kidney failure (end-stage renal disease), major organ transplantation, multiple sclerosis, paralysis and stroke. The sum insured for Critical Illness can be either 50% or 100% of your basic sum insured subject to minimum of Rs. 100,000.

Others Benefits

  • Cumulative Bonus - You get a cumulative bonus of 10% for every claim-free year accumulating up to 100% (in the event of a claim, cumulative bonus will be reduced by 10% of SI on the next renewal).
  • Cashless Service - You need to obtain a pre-authorization for all planned admissions atleast 48 hours prior to actual admission or regularize any ‘emergency’ admission within 24 hours post the admission. The details of the process and the documentation requirements are given in the guide-book sent along with the policy.
  • Sum Insured Enhancement - Sum Insured can be enhanced only at the time of renewal subject to no claim have been lodged/ paid under the policy. If the insured increases the sum insured one grid up, no fresh medicals shall be required. In cases where the sum insured increase is more than one grid up, the case shall be subject to medicals. In case of increase in the sum insured waiting period will apply afresh in relation to the amount by which the Sum Insured has been enhanced. However, the quantum of increase shall be at the discretion of the company.
  • Portability - If you are insured with some other company’s health insurance and you want to shift to us on renewal, you can. Our portability policy is customer friendly and aims to achieve the transfer of most of the accrued benefits and makes due allowances for waiting periods etc.
  • Tax Benefits - With the Easy Health Insurance Plan you can presently avail tax benefits for the premium amount under Section 80D of the Income Tax Act. (Tax benefits are subject to changes in Tax Laws)

Renewal Policies

  • Our Easy Health policy offers lifelong renewability i.e there is no maximum cover ceasing age in this policy
  • Grace Period of 30 days for renewing the policy is provided under this policy.
  • Waiting periods as mentioned in the policy wording gets reduced by 1 year on every continuous renewal of your Easy Health Insurance policy.
  • Renewal premium are subject to change with prior approval from IRDA. Any change in benefits or premium (other than due to change in age) will be done with the approval of the IRDA and will be intimated atleast 3 months in advance.
Exclusions
  • All treatments within the first 30 days of cover except any accidental injury
  • Any pre-existing condition will be covered after a waiting period of 3 years
  • 2 years waiting period for specific diseases like cataract, hernia, joint replacement surgeries, surgery of hydrocele etc.
  • Expenses arising from HIV or AIDS and related diseases
  • Congenital diseases, mental disorder or insanity, cosmetic surgery and weight control treatments
  • Abuse of intoxicant or hallucinogenic substances like intoxicating drugs and alcohol
  • Hospitalization due to war or an act of war or due to a nuclear, chemical or biological weapon and radiation of any kind
  • Pregnancy, dental treatment, external aids and appliances unless covered under the specific Easy Health Insurance Plan

Please refer to the Policy Wording for the complete list of exclusions.



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Get In Touch

 

customercare@saubhagyaenterprises.in
      
      Contact us at: 011-22571217