Family Health Optima Insurance Plan UIN: IRDAI/HLT/SHAI/P-H/V.III/129/2017-18 ELIGIBILITY
Any person aged between 18 years and 65 years, residing in India, can take this insurance.
Beyond 65 years only renewals.
Child from 16th day of age can be covered as part of the family.
Single policy, wider coverage for whole family at an affordable premium.
Air Ambulance charges upto 10% of the Basic Sum Insured during the entire policy period.
Pre-Hospitalization expenses up to 60 days prior to admission in the hospital.
Post-hospitalisation expenses incurred up to 90 days after discharge from the hospital.
Organ Donor Expenses: Cover upto 10% of the Sum Insured or Rupees One lakh, whichever is less.
Cost of Health Checkup: Expenses incurred towards cost of health check-up up to the limits
New Born Baby cover: Cover starts from 16th day after birth and subject to a limit of 10% of the Sum Insured or Rupees Fifty Thousand, whichever is less
Emergency Domestic Medical Evacuation: Company reimburse the expenses incurred towards transportation of the insured person from the treating hospital to another one upto the limits.
Repatriation of Mortal Remains: the Company shall reimburse up to Rs.5,000/- towards the cost of repatriation of mortal remains of the insured person to the residence of the insured.
AYUSH treatment: Upto the limits
Second Medical Opinion: The Insured Person can obtain a Medical Second Opinion from a Doctor in the Company’s network of Medical Practitioners
Assisted Reproductive Treatment: The Company will reimburse medical expenses incurred on Assisted Reproduction Treatment, where indicated, for sub-fertility
Waiting period of 36 months from the date of first inception of this policy.
Maximum liability of the Company for such treatment shall be limited to Rs.1 lakh for sum insured of Rs.5 lakh and Rs.2 lakhs for sum insured of Rs.10 lakhs and above for every block of 36 months.
Additional Sum Insured for RTA(Road Traffic Accident): If the insured person meets with a Road Traffic Accident resulting in in-patient hospitalization, then the Basic sum insured shall be increased by 25% subject to a maximum of Rs.5,00,000/-
Automatic Restoration of Sum Insured : Available 3 times at 100% each time, during the policy period. Each restoration will operate only after the exhaustion of the earlier one.
Recharge Benefit: Available up to the limits.
Bonus: Following a claim free year bonus of 25% of the expiring basic sum insured in the second year and additional 10% for subsequent years (max.100%) would be allowed. Where there is a claim the Bonus would be reversed in the same order in which it was given.
Co-Payment: 20% of each and every claim for persons above 60 years at entry level and their subsequent renewals.
Pre-Existing Diseases/Illness: Are covered after 48 months of continuous Insurance without break with any Indian Insurance Company.
Amount paid by any mode other than by cash for this insurance is eligible for relief under Section 80D of the Income Tax Act.