Religare Health Insurance - Care policy terms and Procedures

Religare Health Insurance - Care policy terms and Procedures

 Policy Terms

Policy Terms
Minimum entry age	91 days
Maximum age	No age bar
Renewal	Lifelong Renewability. The Policy can be renewed under the then prevailing Health Insurance Product or its nearest substitute approved by IRDA.
Renewal premium	Premium payable on renewal and on subsequent continuation of cover arc subject to change with prior approval from IRDA.
Co-payment	No Co-payment in policy, if age of the eldest member insured with us at the time of first policy is below 61 years. 20% Co-payment will be applicable in policy, if age of the eldest member insured with us at the time of first policy is 61 years or above 61 years i.e. you will have to pay 20% of the claim amount under the policy, if any. We pay the rest.
Waiting period	30 days for any illness except injury
Waiting period for pre-existing illnesses	Four years of continuous coverage
Change in sum insured	You can enhance your sum insured under the policy only upon renewal
Grace period	30 days from the date of expiry to renew the policy

For more details, kindly refer to our health insurance Policy's Terms & Conditions.

Plans Exclusion

The standard policy exclusions are - 

• Any diagnosis of diseases / undergoing of surgery / occurrence of event, whose signs or symptoms first occur within 30 days of Policy Period Start date.
• Expenses attributable to self-inflicted injury (resulting from suicide, attempted suicide)
• Expenses arising out of or attributable to alcohol or drug use/misuse/abuse
• Medical expenses incurred for treatment of AIDS
• Treatment arising from or traceable to pregnancy and childbirth, miscarriage, abortion and its consequences
• Congenital disease
• Tests and treatment relating to infertility and in vitro fertilization.
• War, riot, strike, nuclear weapons induced hospitalization.

For more details, kindly refer to our health insurance policy's detailed exclusion list exclusion list

 Claim Processing

Claim Servicing & Deriving Best Customer Experience

5420 +

Vast & growing hospital network for cashless claims

4.7 Lacs +

Count of claims Services

100%

In-house settlement for better management

92%

Delivering Industry best settlement Ratio

37

Less Grievance Ratio per 10,000 claims

Process for Hospitalization

Process for Everyday Care

Claims Procedure

 Courtesy: ReligareHealthInsurance .com

Religare Health Insurance - Care Policy

Courtesy: religarehealthinsurance.c om

Care Coverage:

 A Comprehensive 

Health Insurance Plan

 to meet everyone's ( individual and family) healthcare needs.

In-Patient Care

 

Pre & Post Hospitalization

Individual & Floater Cover

 

Domiciliary Hospitalization

Daily Allowance

 

Ambulance Cover

Organ Donar Cover

 

Lifelong Renewability

Annual Health-Checkup

 

No Claim Bonus

Second Opinion

 

Tax Benefit

From Diagnosis to Recovery - "Care" at every step!

We understand that the meter doesn't start from hospitalization but from the time of diagnosis and goes on even post discharge. We stand with you throughout the journey and not just for an event.

30 Day Pre-Hospitalization Coverage

The procedures that you undergo before getting hospitalized finally lead you to a hospital, such as investigative tests and routine medication, can be quite financially draining. We cover the medical expenses incurred by you up to 30 days before your hospitalization.

Ambulance Cover

It's our utmost concern that you get the medical attention, you require as soon as possible, especially in an emergency. Which is why, we reimburse expenses incurred by you while availing a domestic road ambulance during your hospitalization. Not just this, some plans of our product care also offers coverage for availing an Air Ambulance if suggested by a doctor.

In-Patient Hospitalization

Hospitalization for at least 24 hours

We pay for – room charges, nursing expenses and intensive care unit charges, surgeon's fee, doctor's fee, anesthesia, blood, oxygen, operation theater charges, etc.; If you are admitted to a hospital for in-patient care, for a minimum period of 24 consecutive hours.

Hospitalization less than 24 Hours

We cover medical expenses if you undergo a day care treatment which might not require you to stay hospitalized for 24 hours or more. As a matter of fact we cover over 540+ day care procedures.

Room Rent

We reimburse every expense occurred while you're staying in single or private room. You can also upgrade your room should there be a need to and is recommended by a treating doctor.

ICU Charges:

In time of an emergency we believe your focus should be only on your recovery. Hence we take care of those ICU charges that come in your way of getting a quality treatment.

60-Day Post – Hospitalization Coverage

Expenses don't end once you're discharged which is why even we don't rest unless you're completely ready to take all the challenges of life head on. We reimburse expenses such as doctor consultations,Diagnostic tests, medications etc that you incur up to 60 days post your hospitalization.

Domiciliary Hospitalization

In case of an emergency or a medical condition that does not allow you to get admitted in a hospital, we provide coverage for medical expenses incurred during your treatment at home for a period exceeding 3 consecutive days. So nothing should delay the treatment you deserve.

Annual Health Check-up

We believe in the old adage that an ounce of prevention is better than a pound of cure. This is why we give an Annual Health Check-up for yourself and all members covered by your policy, including children.

Automatic Recharge of Sum Insured

Keep your worries regarding medical expenses outside the door with Automatic Recharge of Sum insured. If you ever run out of your health cover due to claims made, we will reinstate the entire Sum Insured amount of your policy. This additional amount can be used by you for any other ailment or by any other insured member for treatment of any ailment.

No-Claim Bonus

We raise a cheer to good health for every year that you don't claim by increasing your Sum Insured by 10%, up to a maximum of 50% in consecutive 5 years.

Organ Donor Cover

We care about those who help you as much as we care for you. So, beyond ensuring that your medical needs are met, we will reimburse you for medical expenses that are incurred by an organ donor while undergoing the organ transplant surgery.

Reassurance of Second Opinion

Sometimes reassurance works better than the cure itself. Which is why if, at any moment you feel uncertain about your diagnosis, you can opt for a second opinion at no extra cost specially arranged by us.

No Upper Age Limit of Enrollment

All our plans including 'care', come with no upper age limit of enrollment i.e. even if a person is 100 years old, they can definitely apply.

Lifelong Renewability

We don't leave you in between the journey and honor our commitment by giving our customers option of lifelong renewability i.e. once enrolled an individual can continue to stay covered throughout one's life, provided they renew their policy on time every year.

Even alternate treatments are covered

We understand that sometimes non-allopathic treatments may prove to be more effective. Whether it is Ayurveda, Unani, Sidha or Homeopathy, choose the treatment that suits you and we will cover it up to a specified limit and varies according to the plan chosen.

Add On Covers

No Claim Bonus Super

By choosing an optional cover – NCB Super – you can further increase your sum insured amount by 50% for every claim free year up to a maximum of 100%. Hence – in total with both NCB & NCB Super one can increase their sum insured up to 150% in 5 years.Help me understand working of NCB & NCB – Super!

Everyday Care

Your family may avoid hospitalization for many years at a stretch. However, you have to be really fortunate to avoid doctor consultation for even a few months. For all the visits for all routine visits to the hospital - we give you 1% of your Sum Insured for doctor consultation & diagnostic tests each. This can be availed via a cashless health card and additional premium paid to avail this add- on cover is also applicable for tax benefit under section 80D of IT act.

Unlimited Automatic Recharge

There should never be a time when you run out of coverage, which is why by selecting this add – on cover your sum insured amount if re-instated in your policy every time your sum insured exhausts. And this can be availed unlimited number of times.

Air Ambulance Cover

The right cure may be miles away but never out of your reach with Air Ambulance Cover. For all those times when you might be recommended a treatment which is not in your city of stay.

Personal Accident Cover

Forget the hassles of maintaining two separate policies, one for a health insurance cover & second for personal accident cover. By selecting this add- on cover you get coverage for Accidental Death and Permanent Total Disability for up to 10 times of the Sum Insured opted.

International Second Opinion

We believe that sometimes reassurance works better than the cure itself. Hence before going ahead with the treatment recommended, we give you an option to consult doctors and take a second opinion.

Global Coverage

Quality Healthcare cannot have boundaries. So if you ever feel the need get treated at an overseas facility, rest assured, since with this add-on cover you get Global Coverage that too on a cashless basis across listed network hospitals.

 Plan Details

Super Saver

Care 3 ( 4 Lac )

Elite

Care 4 (5,7,10 Lacs)

Elite Plus

Care 5 (15,20,25,30,40 Lacs)

Global

Care 6 (50,60,75 Lacs)

Global Plus

Care 7 (1,2,3,6 Cr)

Features/ Plan (SI)	Care 4 (5,7,10 Lacs) Elite	Care 5 (15,20,25,30,40 Lacs) Elite Plus
In patient hospitalization	Upto Sum Insured	Upto Sum Insured
Pre-hospitalization	30 days	30 days
Post-hospitalization	60 days	60 days
Day Care Treatments	Yes	Yes
Room Rent	Single Private Room	Single Private Room (upgradable to next level)
ICU charges	No Limit	No Limit
Ambulance Cover	Rs.2,000/ hospitalization	Rs.2,500/ hospitalization
Domicilliary hospitalization	Upto 10% of SI	Upto 10% of SI
Health Check-up	Yes, all members	Yes, all members
Recharge of SI	Yes	Yes
No Claim Bonus	Yes	Yes
Organ Donor Cover	Rs.100,000	Rs.200,000
Second opinion	Yes	Yes
Alternative Treatments	Upto Rs.20,000	Upto Rs.30,000

For complete product details, kindly refer Prospectus and Sales Literature in the Download Section. Click here

Why should you buy Care:

• With Care, you get following Key USPs which are not available anywhere else.
• Annual Health Check-up for all members covered under the policy.
• Up to 150% No Claim Bonus with NCB Super.
• Unique Unlimited Automatic recharge.
• Care anywhere – Global Cover for 12 Critical Illnesses.
• Care is available with different riders, hence ability to fit your needs.