IFFCO Tokio offers the best family health and medical insurance policy. It's a reputed brand in the general insurance market in India. Building a strong Pan India branch network, this brand aims to reach out to the maximum number of customers to offer a coverage plan against family health risks and financial distress. This policy gives you cashless hospitalization benefits in more than 3000 hospitals across the nation.

It offers you the best solution by understanding more about your health conditions and coverage needs. IFFCO Tokio's family health insurance policy is affordable and cost-optimized.  Also, the family health insurance premium is competitive, pocket-friendly and budgeted. 

What the Policy covers – Base Plan
  • Hospitalisation expenses incurred for treatment of physical disease or injury sustained/incepted during the Policy Period, although treatment can continue beyond Policy expiry date also. Following expenses would be included: 
    • Room Rent @ 1.0% of Basic Sum Insured daily and ICU/ITU Rent @ 2.0% of Basic Sum Insured daily.
    • Registration, Service Charges, Surcharges etc. of hospital at actual, subject to a maximum of 0.5% of Basic Sum Insured.
    • Nursing expenses, including that incurred during pre and post hospitalisation periods -(only if qualified nurse is employed on advice of Medical practitioner).
    • All types of Medical Practitioner’s (Surgeon, Anesthetist, Consultant etc.) fees.
    • Cost of medicines, blood, oxygen, anesthesia, diagnostic and pathological tests, operation theatre charges, cost of chemotherapy, dialysis, pacemaker, artificial limbs etc.
    • Ambulance charges on actual basis, subject to maximum Rs 750.
    • Daily Allowance @ Rs. 150 per day, for the duration of hospitalisation.

 

  • Domiciliary Hospitalisation expenses, up to a maximum sub-limit of 20% of Basic Sum Insured. This relates to expenses for medical treatment for a period of more than 3 days, which would normally require hospitalisation, but is actually taken at home for specified reasons, as stated in the Policy.
  • Pre and Post Hospitalisation expenses for maximum period of 30 days each, beyond hospitalisation period. The Post Hospitalisation expenses are limited to 7% of the hospitalisation expenses (excluding Room Rent), subject to a maximum of Rs. 7,500
  • Hospitalisation expenses of persons donating organs during organ transplantation of insured person, within the overall and individual limits of Sum Insured specified under the Policy
  • Prescribed package charges of hospital for specific treatments, subject to a maximum of 80% of Sum Insured or 80% of actual expenses, whichever is less.
  • The overall expense limit is capped for certain diseases/treatments, based on the Sum Insured under the Policy.
What the Policy covers – Wider Plan
  • Hospitalisation expenses incurred for treatment of physical disease or injury sustained/incepted during the Policy Period, although treatment can continue beyond Policy expiry date also. Following expenses would be included:
    • Room Rent @ 1.5% of Basic Sum Insured daily and ICU/ITU Rent @ 2.5% of Basic Sum Insured daily.
    • Registration, Service Charges, Surcharges etc. of hospital at actual, subject to a maximum of 0.5% of Basic Sum Insured.
    • Nursing expenses, including that incurred during pre and post hospitalisation periods.
    • All types of Medical Practitioner’s (Surgeon, Anesthetist, Consultant etc.) fees.
    • Cost of medicines, blood, oxygen, anesthesia, diagnostic and pathological tests, operation theatre charges, cost of chemotherapy, dialysis, pacemaker, artificial limbs etc.
    • Ambulance charges on actual basis, subject to maximum Rs 1,500.
    • Daily Allowance @ Rs. 250 per day, for the duration of hospitalisation.

 

  • Domiciliary Hospitalisation expenses, up to a maximum sub-limit of 20% of Basic Sum Insured. This relates to expenses for medical treatment for a period of more than 3 days, which would normally require hospitalisation, but is actually taken at home for specified reasons, as stated in the Policy.
  • Pre Hospitalisation expenses for a maximum period of 30 days prior to hospitalisation and Post Hospitalisation expenses for a period of 60 days after hospitalisation (without any monetary capping).
  • Hospitalisation expenses of persons donating organs during organ transplantation of insured person, within the overall and individual limits of Sum Insured specified under the Policy
  • Cost of health check-up, once at the end of 4 claim free years block @ 1.0% of average Basic Sum Insured.
  • Prescribed package charges of hospital for specific treatments, subject to a maximum of 80% of Sum Insured or 80% of actual expenses, whichever is less.
What the Policy does not cover- Base and Wider Plans
  • Any pre-existing disease, for a period of 4 years of continuous coverage from inception of Insured’s first Medical Policy.
  • An initial 30 day waiting period for newly incurred diseases (not accidents).
  • One year and two year exclusion periods for certain specified diseases, as listed in the Policy.
  • Cost of spectacles, contact lens or hearing aids.
  • Dental treatment, unless requiring hospitalisation.
  • Convalescence, general debility, congenital diseases/defects, sterility.
  • All claims arising from or related to pregnancy, other than ectopic pregnancy.
  • Any domiciliary or out-patient treatment.
  • Cost of external medical equipments.
  • Claims arising out of participation in dangerous sports/activities.
  • Claims arising from or related to HIV/AIDS.
  • War, terrorism and nuclear risks.
  • All non medical expenses, including personal comfort and convenience item services.
  • Treatment of obesity, hormone replacement therapy, sex change.
  • Genetic disorders, stem cell implantation and surgery.
  • Expenses on naturopathy, experimental or alternative medicine, acupressure, acupuncture, magnetic and similar therapies.
  • First 10% of any admissible claim, if insured person is suffering from either diabetes or hypertension and first 25% of claim, if he is suffering from both diabetes and hypertension. This provision is applicable for claims arising out of diabetes and/or hypertension only.
Other features of the Policy
  • Person of any nationality can be covered, but should be primarily a resident of India, since coverage is available for treatment in India only.
  • Coverage is available for proposer, spouse and up to 3 dependents (children, brother, sister, nephew or niece) between 3 months and 23 years of age at the time of commencement of cover. While renewal cover can continue up to the age of 80 years (for the oldest family member), if any dependent crosses the age limit of 23 years as stated above, he will have to be removed from this Policy and granted cover under a separate individual Policy.
  • No medical checkup is required up to 45 years. Beyond that age, pre-acceptance medical tests (Blood Sugar, Urine & ECG) are required to be done for fresh and break coverage only (not for continuous renewals). For persons beyond 55 years, additional tests (LP & KFT) have also to be done for fresh/break coverage.
  • Hospitalisation has to take place in defined institutions for a minimum 24 hours period, except for treatments pertaining to 121 listed day care surgeries, when claims would be considered for shorter duration stay also.
Sum Insured and Premium
  • There are four floater Sum Insured options available under the Policy from Rs. 200,000 to Rs. 500,000. However, if Insured desires cover beyond Rs. 500,000 (up to Rs. 2,000,000), multiple Policies can be issued to meet his requirement.
  • Cumulative Bonus (i.e. free enhancement of Sum Insured) of 5% is granted per claim free year on renewal, subject to maximum 50% of Basic Sum Insured. In the event of a claim of any family member covered under the Policy, existing Cumulative Bonus is not entirely withdrawn, but gets reduced by 10% at next renewal, subject to the stipulation that expiring Basic Sum Insured shall be maintained. The facility of Cumulative Bonus is available only under the Wider Plan and not under the Base Plan of this Policy.
  • Premium depends on the Sum Insured and Plan opted for, number of family members covered under the Policy and age of the eldest insured person in the family.
  • The optional Critical Illness Extension (for doubling of Sum Insured in respect of 10 listed major diseases) can be taken only under the Wider Plan (and not under the Base Plan), on payment of extra 30% on the basic premium.
  • A special premium discount scheme is available under this Policy, if the Insured has effected his Motor Two Wheeler Insurance Policy with Iffco Tokio, or if he is covered simultaneously as an employee/member under any Group Medical Policy issued by  Iffco Tokio.    
Key Benefits of Iffco Tokio’s Policy
  • Digitally signed Policy document can be issued immediately at Iffco Tokio offices, POS centres, or for online purchases.
  • Income Tax benefit is available to the main Proposer u/s 80D of the I.T. Act, for premium paid under the Policy.
  • Special provision is available for automatic reinstatement of Sum Insured in the event of a claim under the Policy, to the extent of the claim amount paid, except for some specified chronic diseases. The reinstatement premium is computed on short period basis, from date of hospitalisation till expiry of Policy and deducted from the claim amount itself. This ensures that the Insured does not have any worries about getting the benefit of full Sum Insured again, for a subsequent claim in respect of any family member covered under the Policy, unlike the standard Policies available in the market, where Sum Insured gets reduced by the claim amount for the balance period under the Policy.
  • Unlike most Policies in the market, there is no provision for any Excess or Co-pay under this Policy and accordingly, the full eligible claim is paid without any deductions, except for diabetes/hypertension claims as stated above under Exclusions.
  • There is no dependence on any external TPA for claims and the entire activity of servicing and processing claims is handled by an expert in-house team comprising of doctors and other paramedical personnel.
  • There are a large number of network hospitals all across the country (exceeding 3000), where cashless claim settlement facility is available. There is also a 24x7 call centre service in place, for any support relating to claims.
  • Portability facility is available under the Wider Plan option, for persons desiring to switch in from covers under other Insurer’s Policies, whereby transfer of credit gained by the Insured for Cumulative Bonus and time bound Exclusion Clauses is effected, at the time of renewal through Iffco Tokio’s Policy. 
  • Unique add-on cover available through the Critical Illness Extension under the Wider Plan option of this Policy, on payment of a small extra premium.\
  • Unique emergency medical and personal assistance available for all insured persons undertaking domestic travel, through the Value Added Services available under both the Plan options of this Policy, at no extra cost.

Reviews

GOOD
Rated by : AMIT KUMAR KIRTY

Excellent Site and process
Rated by : John Pereira

Best company
Rated by : BHARAT SINGH

Very good
Rated by : SONU PRASAD

Good
Rated by : Kumar Sheelvardhan

Gud
Rated by : Pradeep kumar

Very good of timely response
Rated by : VENKATA RAMANA KOMURAVELLI

Your online advisor Mr DHIRAJ DUBEY , JAY KUMAR advised and Instuct me very properly
Rated by : Anees Ahmed

I am very satisfied by serviced improved from iffco tokyo that is online payment of helth policy.
Rated by : JAYUR SHAH

WOW !! Very happy to got policy in 2 minutes
Rated by : Awad Bin Yousuf

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Iffco Tokio General Insurance CompanyFamily Health Insurance Buy family health insurance policy from Iffco Tokio and enjoy all the benefits of family health cover and tax savings. Iffco Tokio offers cashless facilities also. Category: Family Health Insurance 4.46 stars, based on 162 reviews