Insurance cover options - Family Floater or Individual Sum Insured.
Health Protector Plus Policy
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Health Protector Plus Policy goes beyond insuring you in case of a serious illness as it includes a range of benefits to help you in time of need.
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BUY/RENEW POLICYWhat it covers?
Hospital room rent (including Boarding and Nursing expense, etc.).
Fees of Medical Practitioner/ Anesthetist, and Consultant.
Various expenses during hospitalization including Anesthesia, Blood, Operation Theatre, Oxygen, Surgical Appliances, Medicines, Diagnostic Materials and X-ray, Dialysis, Chemotherapy, radiotherapy, Cost of Pacemaker, Artificial Limbs, Cost of transplantation of Organs and similar expenses.
Expenses incurred during pre and post-hospitalization.
Costs of Vitamins and Tonics provided in the medications form a part of treatment as certified by the attending Medical Practitioner.
Alternative medicine expenses including Ayurveda and/or Homeopathy and/or Unani hospitalization expenses incurred at Government recognized hospitals.
Ambulance Charges- ₹3000/- per claim or as incurred, whichever is less.
Daily Cash Allowance amount equivalent to 0.10% of the Sum Insured for miscellaneous expenses for the duration of Hospitalization.
The above stated relevant expenses (except for clause 7 and 8), incurred for Domiciliary Hospitalization, if medically necessary and at Reasonable and Customary Charges up to a maximum cumulative sub-limit of 20% (Twenty percent) of the Sum Insured.
Major Exclusions
Any payment unless the admissible Medical Expenses exceeding the Deductible.
Any pre-existing condition or any complication arising out of the condition until 48 (Forty-eight) months of continuous coverage since the inception of the first Policy with us for the first time, without any break.
Any expense on Hospitalization for an illness during the first 30 (Thirty) days of commencement of the policy.
Any medical expense during the first 2(two) continuous years of the policy for specific diseases including Cataract, Benign Prostatic Hypertrophy, Hysterectomy (for other than due to carcinoma), etc. (for complete list refer to the policy wordings).
Injury or Diseases directly or indirectly arising out of the war, invasion, the act of a foreign enemy, warlike operation, performing duties as a serving member of a military or a police force.
Circumcision, unless needed for the treatment of a disease or an accidental bodily injury.
Plastic surgery except those relating to the treatment of Injury or Disease.
Expenses for spectacles, contact lens, hearing aids.
Dental Treatment or surgery of any kind, unless due to an Accident requiring Hospitalization.
Treatment of mental illness and other psychological disorders, sterility, venereal disease, self-inflicted injury, treatment arising from the use of intoxicating drugs/alcohols, and treatment resulting from any criminal act.
Diagnostic, X-Ray, or Laboratory examination costs unless related to the active treatment of Disease or Injury under the Hospitalization claim.
Maternity expenses and related conditions.
Injury or Diseases directly or indirectly as an outcome of nuclear weapons/material.
Any Medical Expense on OPD (Out Patient Department) Treatment.
Expenses incurred in naturopathy, Experimental/Unproven Treatment, and such other therapies.
Any expense related to Disease/Injury suffered while engaging in adventure sports.
Cost of treatment undertaken at any of the Hospital(s) or from any of the Medical practitioner(s) not specified in the list.
This is not a comprehensive list of exclusions, for a complete list of exclusions please refer to the policy wordings of Health Protector Plus Policy.
Additional Cover Option
This health insurance policy also comes with the choice of optional coverage to help extend your scope of policy coverage. It is important to purchase a health plan that meets your requirements, so always consider the plan benefits and also look for additional cover options to extend the cover.
Health Protector Plus Policy comes with the choice of optional cover i.e. Waiver of Deductible.
Adding this coverage to your health insurance will help you waive off the deductible (i.e. the amount that you pay out-of-pocket before for availing any healthcare benefits under the policy) in case of loss or change of employment if the policy is endorsed to waive the deductible at inception in consideration of an additional premium.
Cancellation
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Policy has a free look period which is applicable at the inception of the policy and the insured is allowed a period of at least 15 days from the date of receipt of the Policy to review the terms and conditions of the Policy and to return the same if not acceptable. Plus, the free look period is applicable only in the case of fresh policies.
The services offered under the emergency assistance services are as follows:-
Pre-hospitalization and post hospitalization expenses are covered for 60(Sixty) and 90(Ninety) days respectively as defined under the Policy. The expenses will be reimbursed along with the hospitalization expenses subject to the overall Sum Insured limit.
Notification of claim should be done as soon as possible, but not later than 7(Seven) days from the date of Hospitalization. This notification of claim is mandatory, even for claims falling within the deductible.
In order to register a claim with IFFCO TOKIO, you must furnish all original bills, receipts, certificates, information and evidences of all the expenditures related to attending Medical Practitioner/Hospital/Chemist/Laboratory in the manner and form as required by us.
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