Family Health Protector Policy FAQs

What do you mean by Family Floater Policy?

A family floater policy is a single insurance policy that covers all your family members and dependent children with a single sum insured. This family health insurance plan takes care of all medical and hospitalization expenses incurred during the validity of the policy.

In most cases taking a floater health mediclaim policy for your family is a better option as you can enjoy a higher sum insured with minimum premium payment, as chances of multiple family members falling ill together are very remote.

What is Health Insurance?

A health insurance policy can be described as a binding contract between IFFCO Tokio and you wherein we agree to indemnify you and other insured members of your family for any hospitalization expenses incurred while you are under the coverage of medical policy for the family. It covers all hospitalization related expenses for most medical conditions.

Which Family Health Insurance policies are offered by IFFCO Tokio?

At IFFCO Tokio, we understand the importance of the wellbeing of your family members for you. Therefore we offer a vast variety of mediclaim for family plans with varying coverage and benefits, to choose from. You can choose a policy according to your preference and offer protection to your family against any unforeseen exigencies.

Why is a Health Mediclaim Policy important?

In modern-day society, health insurance has become more of a need rather than a luxury. With the kind of polluted and dangerous surroundings that we live in, access to quality medical care is very crucial. But with quality medical care becoming very expensive, if any of your family members need to be hospitalized in the absence of a health insurance plan for the family, there are good chances that all your savings might be wiped off.

With health insurance plans for family, you and your family members are able to enjoy the safety blanket offered by a floater policy wherein depending on your policy, your medical expenses up to the extent to Rs. 30 Lacs shall be reimbursed to you in case you ever need to make a claim.

What kinds of Family Health Insurance covers are available?

At IFFCO Tokio, we understand that different families have different needs; that is evident in our health insurance plans for family. The premium for the medical insurance for the family depends on the extent of coverage and range of additional benefits chosen by you. We also offer you the benefit of opting for additional cover for critical illness by paying a basic premium amount and enjoy much higher coverage benefits. For more details, you can Click here or get in touch with our customer care department.

Is cashless facility available under Mediclaim Policy for Family?

At IFFCO Tokio, we have strategic tie-ups with over 4000 Hospitals, Nursing Homes and Medical care providers to offer cashless treatment for a vast range of ailments and medical conditions under our health insurance plans for family. All the hospitals under our network offer you the benefit of cashless treatment, where you need not pay any charges out of your own pocket, every expense is taken care of by us. Though you should remember that there are certain sub-limits applicable to some treatments and if your expenditure is beyond that limit, you might have to pay some amount out of your pocket.

We would suggest you obtain a pre-authorization, if the ailment is not life-threatening, for the impending hospitalization for your medical condition. This way your claim settlement and cashless treatment process would be very streamlined when you purchase our health insurance policy for family.

What are the tax benefits I get if I opt for Family Health Insurance Policy?

What makes an investment in family medical insurance an attractive option is the benefits under Sec 80D of the Income Tax Act. At present, the Government allows a deduction of up to Rs. 25,000/- when you buy family health insurance.

What are the factors that affect the Family Health Insurance premium?

The premium for your family mediclaim policy depends on a variety of factors including: -

  • Number of Family members included.
  • Age of the family members.
  • Previous medical history.
  • Existing Medical Conditions.
  • Optional Critical Illness cover.
  • Optional Additional benefits.
  • Claim free years.

At IFFCO Tokio our only priority is the well being of your family. Therefore we offer attractive family insurance policies at very reasonable premiums so that you do not think twice before opting for our health insurance policy for family.

What does a Family Health Insurance policy not cover?

Certain pre-existing conditions are not covered by our family health insurance policy.

Cosmetic treatments which are purely optional are not governed by medical compulsions. They are also not covered under our health insurance plans for family. Then there are certain medical conditions that are only covered after a waiting period of 12, 24 or 48 months in case of a new family mediclaim policy. For more information, please click here or call our customer care center at 18001035399.

Is there any waiting period for claims under a Family health plan?

When you buy a family medical insurance policy for the first time, there is a waiting period of 30 days before you can file a claim under the policy coverage, starting from the coverage commencement date. During this period, no claim will be accepted by the company. But this waiting period of 30 days is waived off in case the hospitalization is due to an accident. Policies that are pending for renewal do not have any such waiting period applicable.

How is a pre-existing condition defined under Family health insurance policy?

A pre-existing condition means any particular disease or ailment that you or any other insured family member was suffering from before you buy a family insurance policy. The coverage for treatment of pre-existing conditions will not come in force until after 48 months of continued coverage. But in case you are porting from some other insurance plan to IFFCO Tokio, then your policy comes into effect right from the date you sign up for our mediclaim policy for the family.

If my policy is not renewed in time before the expiry date, will I be denied for renewal?

We will suggest you make sure that the family insurance plan’s renewal premium is paid on time, much before the due date so that you and your family members can continue to enjoy the benefits of continuity as well as an accumulated bonus. If due to any circumstances, you are unable to pay the premium on time, please make sure you make the payment within 30 days of the date of premium being due.

  • If you are unable to pay the premium even after 30 days, then your family mediclaim policy will be deemed canceled, and the protection cover for your family would cease to exist. Thereafter, you will need to buy family health insurance online or through our offline channels.

Can I transfer my health insurance plan(s) for the family from one insurance company to another without losing the renewal benefits?

Yes, as per the guidelines of the IRDA, customers can freely port their health insurance plan(s) for the family from one insurance company to another without losing the continuity and renewal benefits accumulated over the years.

At IFFCO Tokio, we have a vast range of health insurance plans for a family, from which you can choose the one suitable for your family and enjoy the amazing benefits on offer.

What happens to the mediclaim policy for the family’s coverage after a claim is filed?

After you file a claim for undergoing medical treatment for yourself or any of the insured family members, the total claim amount is deducted from the sum insured, and the remaining amount is available for the rest of the policy period as defined in the terms and conditions of our health insurance policy for family.

If the whole policy amount for the health insurance plans for a family is exhausted, you can pay a small amount and opt for reinstatement of the basic sum insured to continue paying for the treatment.

What is the maximum number of claims allowed over a year?

Under our health insurance plans for the family, there is no limit on the number of claims that can be filed during a year. Though the maximum amount that could be claimed is limited to the extent of the Sum Insured.

Does your health insurance plan for family cover everything from accident, surgery, normal hospitalization?

Yes, all our health insurance plans for family offer extensive coverage against a vast range of ailments, injuries, and accidents for you and all your insured family members. There are no exceptions to claims against accident-related hospitalization.

However, please make sure that when you purchase a family health plan online or through other channels, you disclose all pre-existing conditions as well as medically relevant information, so that there are no issues while settling claims against your health insurance plan for a family.

What are the advantages of sticking to one Insurance company for a long time?

We would like to recommend that you should continue with the insurance company on a continuous basis to enjoy a maximum range of benefits. Sticking with one company for your requirement of health insurance plans for a family will make it easier for you to claim the continuity benefits. There are certain pre-existing conditions, for which the coverage starts only after 48 months waiting period. This condition makes it preferable to not shuffle around too much.

  • Moreover, if you stick to one insurance company with your health insurance plans for a family, you also get to enjoy the benefits of accumulated bonuses, which provide you additional coverage over and above the sum insured.
  • Claim settlement is also faster when you have a long-term association with the company, as all the waiting period requirements would be satisfied by then.
  • As such, if you do not have some serious unresolved grievances with your insurer for family medical insurance, then changing your insurer makes little sense.

What is the key to a successful claim for health insurance plans for a family in case of emergency and planned hospitalization?

Staying organized while filing a claim for hospitalization and other related expenses, is the success mantra for a successful claim settlement with our amazing health insurance plans for a family. You should keep all your documents and record up to date. Organize all your test reports, doctor prescriptions, treatment details in a folder, so that when asked to submit any document, you do not have to search through different files.

You should also make sure that your communication details are up to date in our records, as all the family mediclaim policy-related communication shall be directed to the registered details only. When you submit your documents and reports for claim settlement with the TPA, please double check to make sure that all your documents have been submitted. Otherwise, it may cause unnecessary delays or even rejection of the claim.

If you are going for planned hospitalization under our health insurance plans for a family, then we would suggest that you get a pre-authorization from our side. This way, when it would come to the stage of settling the hospital bills, you need not pay anything from your pocket.

How can I buy a family medical insurance policy from your company?

At IFFCO Tokio, we offer you a vast range of options to purchase from any of our health insurance plans for a family.

You can buy family health insurance online from our website. We offer a very user-friendly process for you to get a mediclaim policy for your family online. Just log on to our website, fill in some basic details, follow the instructions, make the premium payment, and sit back to enjoy the benefits of our amazing health insurance plans for a family. If you are an existing policyholder, you can easily renew the family health insurance online through our website.

If you are reluctant to buy family health insurance online, you can walk into any of our well-located offices throughout India and purchase the best health plan for your family.

During the course of my treatment, can I change the hospitals?

Yes, under our family health insurance plans, after approval from the TPA, you can change hospitals for want of better treatment. But please ensure that the change is done only if required after due consultation with your doctors, and only if the patient is physically capable of undergoing the stress of shifting.

To avoid unnecessary hassles, we would suggest to you select the best hospital from our network as per your understanding. This way you will not face any issues with claim settlement later on for your family health plan.

What are the situations under which I may be denied cashless hospitalization under your family health insurance plans?

Yes, under certain circumstances, your claim for cashless hospitalization may be denied. So, we suggest that you read them carefully and make sure you do not face such a situation while being covered under the best health plan for your family: -

  • You have not submitted the complete documents.
  • Your contact details registered with us are incomplete.
  • If the illness or medical condition is not covered under the policy.
  • If the hospital where the treatment is being undertaken is not on our network.
  • If the ailment is pre-existing and the waiting period of 4 years is not over.
  • If the request for pre-authorization was delayed.

Even if your cashless treatment request as per the claim on your family health plan is denied, do not worry. You can get the treatment from the hospital, settle the bill from your own funds, get discharged from the hospital and then file for a claim with the TPA or with our concerned department directly. Just make sure that you submit the completed documents in one go so that your claim under a health insurance policy for the family can be reimbursed as soon as possible.

I have a small family and we all are young and healthy individuals. We lead a very healthy lifestyle and have never been to a doctor. Do I still need a family health insurance plan?

Yes, you should definitely get a family mediclaim policy to cover you and your family members against any unforeseen emergency medical conditions. Remember that trouble would never give you any advance warning. The family health mediclaim policy makes sure that you do not end up wiping off all your savings when you or any other family member needs to undergo any major medical procedure. You can also consider our health insurance policy for family as a protection cover against various medical conditions.

I have a life insurance policy, do I still need a family health plan?

Here you are confusing between life insurance and family mediclaim policy. A life insurance is a policy to indemnify you against death of an insured family member, in which the pay-out is to be made only on the maturity of the policy or death if an insured person Whereas under a family mediclaim policy you are reimbursed for any medical expenses, covered under the purview of our health insurance policy for family, which have to be incurred for treatment of a specified illness.

Are diagnostic and investigative tests covered under the family Mediclaim policy?

Yes, various diagnostic tests such as MRI, CT-scan, X-ray, Blood tests, etc. are covered under our health insurance plans for family. But the said diagnostic tests must have been prescribed by a specialist medical practitioner and shall be related to the identification and treatment of the ailment for which the claim has been filed.

Can I buy more than one family health plans?

Yes, you can buy more than one health insurance plan for the family, but in case you or an insured family member must file a claim, then the claim shall be reimbursed by both the respective companies in rateable proportions. For instance, if you have a mediclaim policy for family from Company A for Rs. 1 Lakh and from Company B for Rs. 1 Lakh, then in case of a claim for Rs 1 Lakh, both the companies will pay in the ratio of 50:50 for the sum assured.

Who can help me calculate my family Mediclaim policy premium?

You can use our premium calculator for family mediclaim policy available online to get an accurate estimate of the premium payable by you. You can also contact our customer service department executives who will be more than happy to assist you with the calculation of your policy premium.