Group Critical Illness

What it Covers?

1. the critical illness, medical event and surgical procedure first commenced atleast 30 days after the commencement of the policy period (or first policy period in case of renewal without break) and,

2. Insured person survives for a minimum of 28 days from the date of diagnosis and shall only include:

A. The below mentioned Illnesses:

1. Cancer of specified severity

2. Kidney failure requiring regular dialysis

3. Multiple Sclerosis with persisting symptoms

4. Benign Brain Tumor

5. Motor Neuron Disease with Permanent Symptoms

6. End Stage Lung Failure

7. End Stage Liver Failure

8. Primary (Idiopathic) Pulmonary Hypertension

9. Parkinson’s Disease Before The Age Of 50 Years

B. The following surgical procedures:

1. Organ (Hearth/ Lung/ Liver/ Kidney /Pancreas) or Human Bone Marrow Transplant;

2. Open heart replacement or repair of heart valves

3. Open chest CABG

4. Surgery Of Aorta

C. The following medical events:

1. Stroke resulting in permanent symptoms

2. Permanent Paralysis of Limbs

3. Myocardial Infarction (First Heart Attack of specified severity)

4. Third Degree Burns

5. Loss of Speech

6. Blindness

7. Loss of Limbs

8. Deafness

9. Coma of Specified Severity

10. Major Head Trauma

11. Muscular Dystrophy

Specific Conditions:-

1. The policy will provide one time benefit for the critical illnesses defined above under ‘What is Covered’ in a single policy period.

2. This group policy is available on both individual and family floater basis.

3. For policies on family floater basis, the coverage for the entire family terminates for the remaining policy period once a claim for any family member has been paid. Such a family shall receive coverage in the next renewal of this group policy. In such a case, the family member who has already claimed for a certain specific illness stated above shall have a renewed cover for all other diseases except for the one claimed for already.

What is Not Covered

IFFCO-Tokio will not pay for:

1. Any claim arising out of a pre-existing condition.

2. Any claim if treatment is taken from a family member or a treatment taken is not scientifically recognized or self medication.

3. Any claim if Policy holder/ Insured person does not submit a medical certificate from the Medical Practitioner evidencing diagnosis of illness or injury or occurrence of medical event or the undergoing of the medical surgical procedure.

4. Any external congenital anomaly or birth defects.

5. Any critical Illness which arises or is caused by any one of the following:

   • the ingestion of drugs other than those prescribed by Registered Medical practitioner.
   • Elective, Cosmetic or plastic surgery.
   • Pregnancy (childbirth and their consequences), any infertility or sub fertility or assisted conception treatment
   • Birth control procedures and /or Hormone replacement therapy