Frequently Asked Questions

Medical expenses can crop up at any time, and often the treatment cost can increase at a rapid pace, leading to a financial crunch. To avoid this situation, it is paramount that you have a health insurance policy and get protection financial against such expenses. Health insurance offers coverage against unforeseen events such as accidents, illnesses, etc. In case you are hospitalised, the insurer will cover the medical cost.

Ms. Pallavi Roy - Standard Health Insurance

Yes, it is the same.

No. Life Insurance protects your family (or dependents) from financial loss that may arise in the event of your untimely death/or if something happens to you. The payout is made only post the death of the person insured or at the maturity of the policy. Health Insurance protects you against ill-health/diseases by covering the expenses you might incur (for treatment, diagnosis, etc.) in case you are affected by disease or injury. There is no payout made at maturity. Health insurance also needs to be renewed annually.

Health insurance policies are general insurance policies usually issued for a period of 1 year only. However, some companies also issue a two-year policy. At the end of your insurance period, you must renew your policy.er page description.

The coverage amount is the maximum amount payable in the event of a claim. It is also known as “sum insured” and “sum assured”. The premium of the policy is dependent on the coverage amount chosen by you.

If you cancel the policy, your cover will cease to exist from the date of cancellation of policy. Additionally, your premium should be refunded to you on short period cancellation rates. You will find these in the policy terms and conditions in the policy document.

Policy Copy descrition

Under health insurance, the age and the amount of cover are the factors that decide the premium. Usually, younger people are considered healthier and thus pay lower annual premiums. Older, people pay a higher health insurance premium as their risk of health problems or illness is higher.

Yes, there is a tax benefit available under Section 80D of the income tax act 1961. Every taxpayer can avail of an annual deduction of Rs. 15,000 from taxable income for the payment of Health Insurance premium for self and dependents. For senior citizens, this deduction is Rs. 20,000. Please note that you will have to show the proof for the payment of premium. (Section 80D benefit is different from the Rs 1, 00,000 exemptions under Section 80 C)

No. Maternity/Pregnancy-related expenses are not covered in a Health Insurance plan. However, employer-provided group insurance plans often cover maternity-related expenses.

Health Insurance covers all diagnostic tests like X-ray, MRI, blood tests etc as long they are associated with the patients stay in the hospital for at least one night. Any diagnostic tests which have been prescribed in the OPD are generally not covered.

The waiting period is the time when you can't make a claim. If you have any pre-existing medical condition like if you are suffering from critical illness, or if you have undergone any surgery recently, and if you need hospitalisation, you won't be covered for the same.

When you get a new health insurance policy, there will be a 30 day waiting period starting from the policy start date, during which period any hospitalization charges will not be payable. However, this is not applicable to any emergency hospitalization occurring due to an accident. This 30 day waiting period is not applicable when the policy is renewed.

You can increase the sum assured online. When you renew your health insurance policy, you can also increase the sum assured.

A medical checkup is necessary for a new health insurance policy for customers above the age of 45 years. Medical checkups are usually not needed for the renewal of policies.

No documents are required for purchasing health insurance. As of now, you do not even need any PAN Card or ID proof. Depending on the norms of the insurer and the TPA. You might need to furnish documents like ID proof at the time of submitting a claim.

Yes, you can have more than one Health Insurance policy. In case of a claim, each company will pay a rateable proportion of the loss. For example, a customer has Health Insurance from Insurer A for a coverage of Rs. 1 lakh and Health Insurance from Insurer B for a coverage of Rs. 1 lakh. In case of a claim of Rs. 1.5 lakh each policy will pay in the ratio of 50:50 up to the sum assured.

After a claim is filed and settled, the policy coverage is reduced by the amount that has been paid out on settlement. For Example: In January you start a policy with a coverage of Rs 5 Lakh for the year. In April, you make a claim of Rs 2 lakh. The coverage available to you for the May to December will be the balance of Rs.3 lakh.

Any number of claims is allowed during the policy period. However the sum insured is the maximum limit under the policy.

In a cashless Mediclaim settlement, it is settled directly with the network hospital. In cases where this is no cashless settlement, the claim amount is paid to the nominee of the policyholder.

In case there is no nominee made under the policy, then the insurance company will insist upon a succession certificate from a court of law for disbursing the claim amount. Alternatively, the insurers can deposit the claim amount in the court for disbursement to the next legal heirs of the deceased.

The insurer offers cashless facility at their network hospitals. When you seek treatment at a network hospital, you don't have to pay cash. The insurer will directly settle the bill with the hospital.

In the event of hospitalization, the patient or their family will have a bill to pay the hospital. Under Cashless Hospitalization the patient does not settle the hospitalization expenses at the time of discharge from the hospital. The settlement is done directly by the Third-Party Administrator (TPA) on behalf of the health insurer. This is for your convenience.

However, prior approval is required from the TPA before the patient is admitted into the hospital. In case of emergency hospitalization, approval can be obtained post-admission. Please note that this facility is available only at the network hospitals of the TPA.

A Health Insurance policy is a reimbursement of the medical expenses.

Critical illness insurance is a benefit policy. Under a benefit policy upon the occurrence of an event, the insurance company pays the policyholder a lump sum amount. Under a Critical Illness policy, if the insured is diagnosed with any critical illness as specified in the policy.

The insurance company will pay the policyholder a lump sum. Whether the client spends the amount received on the medical treatment or not depends on the client's own discretion.

Ms. Pallavi Roy | Critical Illness Benefit Policy

A Third Party Administrator (commonly referred to as TPA) is an IRDA (Insurance Regulatory and Development Authority) approved specialized health care service provider. A TPA provides the insurance company with a variety of services like networking with hospitals, arranging for cashless hospitalization as well as claims processing & timely settlement.

While filling up the proposal form for insurance you need to provide details of the illnesses you have suffered during your lifetime. At the time of insurance, you should be aware of whether you have any disease and whether you are undergoing any treatment. The insurers refer to such health issues to their medical panel to differentiate between pre-existing and newly contracted illnesses.

Note: It is important to disclose any disease you might be suffering with before buying the health insurance policy. Insurance is a contract based on good faith and any willful non-disclosure of facts might lead to problems in the future.

Ms. Pallavi Roy - Swasthya Raksha Bima

Ms. Neha Ahuja | Mos-Bite Protector Policy

Yes, if you are a student studying in India or working with a valid work Visa.

But if you are a tourist coming to India for three weeks, it will not be worthwhile to buy this as thirty days cooling-off period itself offsets the benefits which you are looking for.

Medical tourism cases are definitely not covered in the policy issued in India.

Naturopathy and Homeopathy treatments are not covered under a standard health policy. The coverage is available only for allopathic treatments in recognized hospitals and nursing homes.

It is strongly advised to have health insurance on your own as well because of reasons of continuity. Firstly, if you change your job, you might not necessarily get health insurance from your new employer. In any case, you will be exposed to health costs in the transition period between jobs. Secondly, the track record that you have built-in health insurance at your old employer will not transfer to the new company policy. Covering pre-existing diseases might be a problem. In most policies, pre-existing diseases are covered only from the 5th year onwards. Therefore to avoid the above problems, it is advisable to take a private policy in addition to your company provided a group health insurance policy.

Yes. You will need insurance. Even if you're young, healthy and haven't had to see a doctor in years, you will need coverage against unexpected events like accidents or an emergency. While your health insurance coverage may/may not (depending on the policy taken) pay for things that aren't too costly like routine doctor's visits, the main reason to have coverage is to have protection against the large treatment expenses of severe illness or injury. No one knows when a medical emergency might strike. It is best to buy health insurance, to save money when an emergency strikes.

Yes, you can cover the entire family under one policy. Your health insurance policy is in force across India. You must check whether there is any network hospital near to you as well as your family's place of residence. You must check if your insurer has a network hospital close to you or where the rest of your family resides. Network Hospitals are the hospitals that have tied up with the TPA(Third Party Administrator) for cashless settlement for expenses incurred there.

If there are no network hospitals at the place of your residence, you could opt for reimbursement mode of settlement.

There is not a single blanket travel insurance coverage amount when it comes to the travel insurance policies being provided by IFFCO Tokio. IFFCO Tokio offers different kinds of plans that have different kinds of coverage amounts. Then again, it also varies based on the sub-limits placed on the policy.

The IFFCO Tokio Travel Insurance Plan has various kinds of coverage. These include the travel health coverage, hijack distress allowance, loss of baggage coverage, flight delay coverage, dental treatment coverage, transportation coverage for mortal remains, hospital daily allowance coverage, financial distress coverage, personal liability coverage, and personal accidental coverage. If you would like to learn more about the coverage that is being provided by the IFFCO Tokio travel insurance plans in detail, you should go through the policy documents.

The medical insurance coverage that is being provided by IFFCO Tokio varies quite a bit depending upon the kind of insurance plan that you have signed up for. If you have signed up for the Gold 500 Benefit Plan then you will be getting a medical insurance coverage of up to $ 500,000. If you have signed up for the Gold 250 Benefit Plan, then you will be getting medical expense coverage of up to $ 250,000. If you are going to sign up for the Gold 100 Benefit Plan, in that case, you would be getting coverage of up to $ 100,000. In case you are planning to go for the Silver Benefit Plan, you will be getting a medical expenses coverage amount of up to $ 250,000. And in case you go for the last plan, which is the Bronze Benefit Plan, you would be entitled to get medical expenses coverage for up to $ 50,000.

IFFCO Tokio does not provide hospital allowance for all of their plans. There are certain specific plans for which IFFCO Tokio provides hospital allowances. The IFFCO Tokio travel insurance states that you will be entitled to receive hospital daily allowance from the company if you are enrolled in the Gold 500 Benefit Plan, the Gold 250 Benefit Plan, or the Silver Benefit Plan. The hospital allowance provided by IFFCO Tokio for both the Gold 500 Benefit Plan and the Gold 250 Benefit Plans is $ 30 per day. This daily hospital allowance will be provided only if the insured is admitted for a period exceeding 48 hours and is limited to a maximum of 20 days of hospitalization.

Yes. IFFCO Tokio provides customers with baggage loss benefits. The baggage loss coverage amount, however, will vary, depending on the kind of plan that you have signed up for. If you sign up for the Gold 500 Benefit Plan, the Gold 250 benefit plan, the Gold 100 Benefit Plan, or the Silver Benefit Plan, you would be entitled to receive a coverage amount of up to $ 1000 from IFFCO Tokio. However, if you sign up for the Bronze Benefit Plan, which is the economic plan being provided by the firm, then you would be entitled to receiving a coverage amount of $ 500.

Yes.IFFCO Tokio travel insurance provides a coverage amount of up to $ 150 to the insured who sign up for the Gold 500 Benefit Plan, the Gold 250 Benefit Plan, the Gold 100 Benefit Plan, and the Silver Benefit Plan. However, for customers who subscribe to the Bronze Benefit Plan, IFFCO Tokio provides coverage amount of up to $ 100.

Yes. IFFCO Tokio understands that the passport is probably the most important document that you would be carrying along with your wallet and other documents. Because of this, the IFFCO Tokio Insurance Company provides passport loss coverage for an amount of up to $ 200, which will help you expedite the process of getting a new or duplicate passport. The coverage amount provided by IFFCO Tokio helps customers with their passport retrieval procedures. If you would like to understand more about the policies and the passport loss allowance procedures, you can contact the IFFCO Tokio customer helpline, who can assist you with the same.

IFFCO Tokio provides its customers with some financial assistance coverage. Financial assistance can be of critical importance, especially when you are traveling abroad to a foreign land. The financial assistance that is being provided by IFFCO Tokio can help the customer tackle the situation in a much better manner. IFFCO Tokio however, is only providing financial assistance coverage to customers who enroll with the Gold 500 Benefit Plan. There is no financial assistance coverage that is being covered by the IFFCO Tokio Insurance Company for the other plans i.e. for Bronze, Silver, Gold 250 and Gold 100.

IFFCO Tokio understands that accidents may happen at any point in time and that they cannot be necessarily predicted. It is due to this that IFFCO Tokio provides a personal accidental coverage amount to the customers. For those customers who have enrolled in the Gold 500 Benefit Plan, the Gold 250 Benefit Plan, the Gold 100 Benefit Plan, or the Silver Benefit Plan, they will be getting a personal accident insurance coverage of up to $ 25,000. For customers who have chosen to go for the Bronze Benefit Plan, IFFCO Tokio provides accident coverage of up to $ 15,000.

IFFCO Tokio does provide a hijack distress allowance. IFFCO Tokio provides hijack distress allowance coverage of up to $ 700. The benefit of receiving a hijack distress allowance from IFFCO Tokio however, is only reserved for those people who have enrolled in the Gold 500 Benefit Plan.

People who enroll with the plans Gold 500 Benefit Option, Gold 250 Benefit Option, Gold 100 Benefit Option, Silver Benefit Plan and the Bronze Benefit Plan by IFFCO Tokio get a dental coverage amount of $ 250.

Yes.

Home insurance covers the following fire and special perils:

• Fire, Lightning, Explosion/Implosion, Aircraft Damage.
• Riot Strike, Malicious and Terrorist Damages.
• Bursting and overflowing of water tanks, apparatus, pipes, Earthquake risk, Flood & Storm risks.
• Impact damage by rail/road vehicle and animal.
• Subsidence and Landslide including Rockslide.
• Missile testing operations.
• Leakage from automatic sprinklers installations.
• Bush fire.

Yes, it covers loss to jewelry due to burglary or robbery but has a certain limit to it.

Domestic (electrical/mechanical) appliance, apparatus or gadget up to 7 years in age belonging to you or Your Family is damaged whilst in Your Home due to electrical or mechanical breakdown, and then we will pay for the Damage or if we choose, affect its repair or replacement.

We will also pay for -

• Cost of dismantling and installation for the purpose of repair;
• Freight, customs duties and other dues payable on replacement of the appliance;
• Provided that these have been included in Sum Insured.

 Yes. Death, Permanent total and Partial Disablement. Temporarily Disablement is all covered.

Yes, and the coverage’s are as mentioned below:

• Payment of EMI to the financier.
• A person cannot engage in any employment/occupation for a period in excess of 30 days.
• Minimum 3 (three) days hospitalization.
• Our Liability will be Maximum for 12 monthly installments.
• Total disablement due to sickness and accident.

Accidental death, bodily injury, illness or disease to any domestic employee mentioned in the Schedule relating to this Sub-Section happening during the Policy Period arising out of and in the course of employment with You as domestic employee at Your Home under the Fatal Accident Act 1855, Workmen’s Compensation Act 1923 or any amendment thereto or under Common Law.

• Legality is liable under the tenancy agreement for Damage to a home rented by you as a tenant.
  • Cause. (Section 1 and 2)
  • Section1 (Fire and Allied Perils) and Section 2 (Burglary, Housebreaking and Other Perils).

• Building Electrical/ installation, overground/underground cables, glass/sanitary fittings other fixtures, fittings.

• Liability to be assessed on a Market Value basis.

A No Claims Bonus is a discount given by an insurer to policyholders who do not claim on their policy in the policy period of car insurance. Typically this starts at 20% in the first claims free policy period of Car Insurance and goes up to maximum of 50%.

Loading is an additional premium, which is paid at the time of renewal of insurance policy if the claims experience during the policy term has been adverse.

There is a discount available if you install anti-theft devices in your vehicle provided the device is approved by the Automobile Research Institute of India and installation approved by automobile associations.

There is no extra premium that is payable in case of a claim but if the claim experience is bad then some loading may be charged as per company policy. You only lose your No Claim Bonus that you could have enjoyed had there been no claim on the policy.

Salvage is the value of wreck after a vehicle meets with an accident resulting in total loss, whereby retrieval of the vehicle into its initial condition is not possible.

Specific Exclusions:

• Any accident outside the geographical area of operation.
• Consequential loss, normal wear and tear.
• Driving without a valid license for that class of vehicle.
• Driving under the influence of liquor / drugs.
• Vehicle not being used as per Limitations to use and.
• Mechanical or electrical breakdown, failure etc which fall under the specific exclusions.
• Willful Damage, Hire or Reward.
• Damage to tires and tubes unless the vehicle is damaged at the same time or the vehicle is stolen.

General exclusion:

• Radioactive contamination, nuclear fission, war invasion.

You can make a claim in following conditions:

• Insurance Policy for that vehicle should exist,
• If you have paid premium for paid driver or, it would be payable, if the car is being driven with your permission.
• The person driving the car is duly licensed as the premium is taken based on the seating capacity, which also includes the person on the driver’s seat.

It is not always necessary to lodge a claim especially if the damage is small. Actually, It is not advisable to make a claim for small damages because, not only will you have to pay for depreciation and excess, reducing the claim amount to an even smaller figure, but you will also lose your 'NO CLAIM BONUS' (if any) at the time of renewal. However, once you have decided not to claim, you cannot claim these damages at a later stage.

You do get full reimbursement for the windscreen glass. However, there is a depreciation of 50% on the rubber lining and sealant. Additionally, you will also need to bear the policy excesses

Any claim can be rejected by an insurance company in certain conditions. Some common reasons for which a claim may be rejected are:

• The policy has expired, or policy has been cancelled or the premium cheque has been dishonored making the policy invalid.
• It could also be that the date of accident or loss falls outside the policy period or
• The person driving the vehicle at the time of the accident did not possess a valid driving license or was under the influence of drugs or alcohol.
• There are also situations where the ownership of the vehicle has changed but the Insurance Company has not been informed within 14 days of such change or the claim was for damages that existed before the policy started.
• Some other reasons could be that the nature of damages does not co-relate with the cause of accident or that the vehicle was being used for other than personal or social purposes.

Insurer refers to the insurance company

Insured refers to the policyholder or the person protected in case of a loss or claim

IFFCO–Tokio is a joint venture between the Indian Farmers Fertilizer Co-operative (IFFCO) and its associates and Tokio Marine and Nichido Fire Group, the largest listed insurance group in Japan. IFFCO-Tokio General Insurance has Pan India presence with 63 'Strategic Business Units' i.e., and a wide network of over 120 Lateral Spread Centres and 255 Bima Kendras

IRDA (Insurance Regulatory and Development Authority) is the apex body overseeing the insurance sector in India. Its main aims are to protect the interests of policyholders and regulate the insurance industry

Premium refers to amount paid to purchase an insurance policy. The frequency of premium payment can vary from monthly to quarterly to yearly or it could even be a one time payment of premium

Insurance is a hedge against the occurrence of unforeseen incidents. Insurance products help you in not only mitigating risks but also helps you by providing a financial cushion against adverse financial burdens suffered.

Accidents... illness... fire... financial securities are the things you'd like to worry about any time. General Insurance provides you the much-needed protection against such unforeseen events. Unlike Life Insurance, General Insurance is not meant to offer returns but is a protection against contingencies. Under certain Acts of Parliament, some types of insurance like Motor Insurance and Public Liability Insurance have been made compulsory.

Yes, Auto Insurance is mandatory in India. Having compulsory liability insurance is a statutory requirement of the Motor Vehicles Act, 1988. However, we recommend a comprehensive policy to limit your financial liability.

Insurance is the subject matter of solicitation. IRDA allows insurance to be sold primarily through following:

Channels

• Company websites
• Buying on phone. It depends upon individual company
• Agents representing an insurance company
• Insurance brokers are allowed to sell products of more than one insurance company Banks, retail houses or any other commercial ventures which are channel partner of these insurance companies

Process

• Approach the insurance company with a duly filled up proposal form, through any of the above mentioned channels
• Seek an approval from the company on the intention of underwriting your policy. (I.e. evaluating your risk and exposures. Risk involves consideration of material facts on the basis of which company will take a decision whether to accept the risk and if so at what rate of premium.)
• Seek premium & other relevant details
• Pay the premium and take premium receipt and cover note/risk held note
• Wait for documents
• Check for its correctness on receipt and store it carefully till the policy expiry date
• Ensure that you renew the policy well in time, before the expiry of the policy

Underwriting of a risk involves consideration of material facts on the basis of which a decision will be taken whether to accept the risk and if so at what rate of premium.

Typically General Insurance contracts are for one year period only

Agents represent an insurance company and sell products of that insurance company only. Whereas, insurance brokers are allowed to sell products of more than one insurance company.

IRDA (Insurance Regulatory and Development Authority) is the apex body overseeing the insurance sector in India. Its main aims are to protect the interests of policyholders and regulate the insurance industry