POS - Mediclassic Insurance Policy (Individual) -Gold Plan
Health Insurance Policy by csc center Best Health Policy
Version_1.0_SP Parameters
About the policy - Covers hospitalization expenses incurred as a result of illness and/or accidental injuries
Type of Cover - Individual
Entry Age - For Adults: 18 years – 65 years For Dependent Children: 16 days to 25 years
Co-payment - 10% Co-payment is applicable if the Insured age at entry is 61 years and above
Renewal - Lifelong
Policy Term- One Year, Two Years & Three Years
Pre Policy Medical Checkup - Required for persons above 50 years of age
Discounts - (i) 5% if 2 or more family members are covered (Family = Self, Spouse & Dependent Children) (ii) 25% for major organ donor at the time of renewal & subsequent renewals
Sum Insured Options (Rs.) - 1.5 Lakhs 2 Lakhs 3 Lakhs 4 Lakhs 5 Lakhs
Hospitalization - Room Rent - 2% of Basic Sum Insured maximum of Rs.5,000
Shared accommodation benefit (admission & discharge days excluded) - 500 per day & 3,000 per hospitalization (Applicable for Rs 3 Lakhs to Rs 5 Lakhs) Payable for every 24hrs of stay in a networked hospital (payable if hospitalization exceeds 48 hours)
Cataract (Rs) - 12,000 per person per policy period 20,000 (Limit per eye), 30,000 (Limit per period)
Health Check-up benefit (for every claim free year) - 1,500
ICU, Dr Fees, Tests, Medicines - Covered (Actuals)
Organ Donor Cover - Covered (Actuals)
Domiciliary hospitalization - Covered (Actuals) – Covered for the period exceeding three days
Ambulance Charges - Rs.2,000 per hospitalization
Day Care Procedures - All day care procedures are covered up to Sum Insured (Except for Cataract)
Pre & Post Hospitalization - 30 days & 60 days (Actuals)
Non-Allopathic Treatment - Up to 25% of the Basic Sum Insured subject to a maximum of Rs.25000 per policy year
Psychiatric & Psychosomatic - If diagnosed for the first time and hospitalized for minimum 5 consecutive days (Actuals)
Coverage for New Born Baby - Cover starts from 16th day - up to 10% of the Sum Insured or maximum up to Rs.50,000 (available if the mother is covered under this policy for a continuous period of 12 months)
Auto Restoration of Sum Insured - Up to 200% once in a year - Can’t be utilized for illness/s for which claim/s was/were made
Super Restoration - Up to 100% once in a year – Can be utilized for illness/s for which claim/s was/ were made
Additional Sum Insured for RTA - 50% additional sum insured will be given for wearing helmet either riding or as pillion rider
No Claim Bonus - 25% after first claim free year & 20% for each subsequent claim free year, max up to 100%
Instalment Options - Quarterly/ Half-Yearly/ Yearly, Premium can also be paid Annually, Biennial (Once in 2 years) and Triennial (Once in 3 years).
Modern treatments - Based on the Sum insured chosen limits differ, refer policy wording for further details
Optional Covers
Hospital Cash - Rs.1,000 per every 24 hours, up to 7 days per hospitalization & max 14 days in a policy year
Patient Care - Rs.400 per every 24 hours up to 5 days per hospitalization & max 14 days in a policy year
Waiting Period
Initial waiting period Code Excl 02 - 30 days for all illnesses (except accident)
For Specific diseases Excl 03 - 2 years
For Pre-existing diseases Code Excl 01 - 4 years
* The information provided in this document is only indicative. For more details on the terms and conditions, please read the policy wordings before concluding a sale.
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Mediclassic Insurance Policy (Individual) -Gold Plan Click Here Pdf
