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IFFCO Tokio’s Family Health policy


The 
policy covers hospitalization expenses which intends to provide coverage to you and your family in the eventuality of high treatment costs for any injury or disease related contingencies like hospitalization, organ transplantation etc. You opt for a compulsory deductible amount, which you bear either through existing health coverage or through own/other sources. The policy acts as an additional cover over and above the deductible amount. The policy therefore addresses galloping medical inflation at a very reasonable price.

What the Policy covers

If the Insured Person contracts any Disease or sustains any Injury due to any accident (including any act of terrorism) and he/she has to incur Medically Necessary Hospitalization expenses, then we will pay Reasonable and Customary Charges of the following Hospitalization expenses:

1. Room Rent (including Boarding and Nursing expense etc.

2. Medical Practitioner/ Anesthetist, Consultant fees.

3. Expenses on Anesthesia, Blood, Oxygen, Operation Theatre, Surgical Appliances, Medicines and Drugs, Diagnostic Materials and X-ray, Dialysis, Chemotherapy, radiotherapy, Cost of Pacemaker, Artificial Limbs, Cost of transplantation of Organs and similar expenses.

4. Expenses on Vitamins and Tonics only if forming part of treatment as certified by the attending Medical Practitioner.

5. Ayurveda and/or Homeopathy and/or Unani hospitalization expenses incurred in Government recognized hospitals. Coverage also includes pre-hospitalization and post hospitalization expenses.

6. Ambulance Charges as per actual or Rs.3000/- (Three Thousand) per claim; whichever is less.

7. An additional Daily Allowance amount equivalent to 0.10% of the Sum Insured for the duration of Hospitalization towards defraying of miscellaneous expenses.

8. The above stated relevant expenses incurred for Domiciliary Hospitalisation if Medically Necessary and at Reasonable and Customary Charges up to a maximum aggregate sub-limit of 20% (Twenty percent) of the Sum Insured.

Saliant Features

Complete Freedom: Choose the way you want:
o Term – One year
o Top up or Super Top up: Chose whether you want the deductible to be applied per claim or an aggregate of all claims in a year.

Sum Insured Options– 8 plans to offer you the widest possible range
o Family Floater or Individual Sum Insured
o Lifelong renewal (if renewed without break)

* High coverage at low premium
* This policy can be purchased without any other basic health policy
* Waiver of Deductible in case of change/Loss of job: On payment of a small additional premium you have the facility to enjoy the full sum insured without the deductible in case of loss of or change in employment, for a period of 30/60/90 days.
* Option to buy standard health policy with continuity of benefits: We will provide you with a facility to buy our standard Health policy without deductible with continuity of coverage in terms of waiver of waiting periods to the extent of deductible opted under this Policy provided the Top Up/Super Top up health product has been purchased for the first time before 50 years of age and continuously renewed without break for a period of at least 4 years.
* Income Tax benefits under Section 80D.
* Cashless claim facility available at over 4000 network hospitals across India.
* Directly serviced by IFFCO TOKIO without any Third party administrator
* EMERGENCY ASSISTANCE SERVICES at no additional cost. We provide you with special assistance when You are traveling within India 150 kilometers or more away from your home.
* Portability: You can switch from any other similar policy of any other insurer to our Top up/Super Top Up policy and protect your continuity benefit as per IRDA Guidelines.

 Optional Cover

The deductible is waived in case of loss or change of employment, if the policy is endorsed to waive the deductible in consideration of additional premium. The proviso shall be subject to the following conditions:

a. The cover is applicable only for insured persons who are in service and are below 55 (Fifty Five) years of age and their dependents. The cover is not available for Self Employed.

b. The cover shall be subject to a maximum period of Waiver of Deductible (WOD) period mentioned in the schedule.

c. In case of multiple job changes during the same policy period, aggregate number of days of coverage during all such breaks shall be subject to maximum of WOD period mentioned in the schedule.

d. Letter of intent for utilization of WOD period should be given at least 15 (Fifteen) days before the date of relieving from the existing job.

i) Advance Notice of 15 days for Letter of intent to cover may be waived on merits by the underwriting authority on case to case base, provided the notice is given on or before the date of relieving.
ii) In case notice is given after date of relieving within a reasonable time, WOD may be granted from the date of notice, subject to confirmation of loss of job and of date of relieving, at the discretion of underwriter on case to case basis.

e. The waiver shall be effective from the next day of date of relieving from the existing job.

f. The cover will cease on the occurrence of any of the following events, whichever shall occur first:

i) expiry of Waiver of Deductible period
ii) Request for termination of cover for WOD by the insured.Request for termination of WOD cover should be given by the insured as soon as the cover under the Employee Health Benefit with the new employer or a newHealth Insurance policy commences. In case of failure to give such notice to the company, the entire WOD period shall be deemed to have exhausted and no further waiver be allowed during the policy period.

g. WOD cover for dependents will simultaneously cease along with the cover of proposer.
How Waiver of Deductible option works: - If you buy a policy of 5 Lacs Sum Insured with a deductible of Rs. 2 Lacs and opt for waiver of deductible for a 30 days period and in case you change your employment you need to give intimation along with supporting documents to us as above. In such case, you will be covered to the full extent of Rs. 7 Lacs (Rs. 5 Lacs + Rs. 2 Lacs) during the 30 days period (from the date of relieving or date of notice whichever is later) or till you place your request for termination of WOD cover, whichever shall occur earlier. WOD may be utilized in multiple times in case of more than one change of job during the policy period subject to maximum of 30 days during the policy period.



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