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Individual Health Protector Policy Insurance

A comprehensive health plan for individuals

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Please check Terms and Conditions.

Please check Terms and Conditions.

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Online Individual Health Protector Policy Insurance

This Policy provides a health protection cover for you and your family. Here is something to look forward to when buying this policy from IFFCO-Tokio:

Room, Boarding and Nursing charges are reimbursed as per our existing policy according to which

  • If the sum insured is above ₹5, 00,000/- then actuals as per the Invoice.
  • If the sum insured is ₹5, 00,000/- and below:   
  1. For Normal Room: 
    • Class A cities: - up to 1.75 % of the sum insured.
    • Other cities: - up to 1.50 % of the sum insured. 
  2. For Intensive Care Unit/Therapeutic Expenses: 
    • Class A cities: - up to 3.00% of the sum insured.
    • Other cities: - up to 2.50% of the sum insured.

  • Registration Charges, Service Charges, and other similar charges are reimbursed up to a maximum of 0.5% of the sum insured. 

  • We have identified 161 medical procedures as daycare procedures, following the treatment for which you can be discharged immediately from the hospital and recuperate at home.

  • Daily Allowance is offered as there may be loss of income and various other expenditures involved in addition to the hospitalization and medical expenses.

  • Customers are rewarded with a cumulative (no-claim) bonus feature, which adds a particular amount to your insurance coverage, over and above the sum insured, with each claim-free year.

Imagine how the lack of a Mediclaim policy could rattle your easy-going life and strain your finances, in the event of a critical illness. To help you stay prepared for any such eventuality, we offer you the opportunity to opt for a Critical Illness Cover on payment of a little extra amount. The following are the medical conditions that have been identified as critical ailments, under our individual health protector plan: -

  • Cancer of specified severity.

  • Coma of specified severity.

  • Major Organ/Bone Marrow Transplant.

  • Stroke Resulting in Permanent Symptoms.

  • First Heart Attack - of specified severity.

  • Motor neuron disease with permanent symptoms.

  • Open Chest CABG.

  • Permanent Paralysis of Limbs.

  • Open Heart Replacement or Repair of Heart Valves.

  • Kidney Failure Requiring Regular Dialysis.

  • Multiple sclerosis with persisting symptoms.

Following are the exclusions in case of which our company will not be able to compensate your claims:

  • Frenuloplasty, Circumcision, Preputial Dilatation, Preputioplastyand Removal of SMEGMA.
  • Expenses incurred on diagnostics that do not tally with the treatment for the ailment for which you or your family member has been admitted to the nursing home or hospital. Expenses on account of admission to the hospital mainly for diagnostic purposes without any positive existence of ailment/sickness /injury/disease and there is no further indication of any treatment being administered. Disease or injury directly or indirectly caused due to nuclear materials or weapons.
  • Behavioural, Mental and Psychiatric ailments.
  • Vaccination or Inoculation (other than post-bite treatment and for medical treatment for therapeutic reasons).
  • Cosmetic or plastic surgery (other than necessary as a result of an illness or an accident).
  • Unless necessitated due to accidental injuries warranting hospitalization, dental treatment or surgery are not payable. (Dental implants are not payable).
  • Cost of Nutritional Supplements, hearing aids, infusion pump, spectacles and contact lens, Continuous Ambulatory Peritoneal Dialysis [CAPD], walkers and crutches, Cochlear implants, wheelchairs, CPAP, BIPAP and other such similar aids and procedures and associated expenses for hospitalization.
  • Congenital External Defects /Anomalies and Conditions.
  • Biologicals, Oral Chemotherapy, and Immunotherapy, other than when given as an in-patient, indicated clinically and warranted due to hospitalization.
  • Expenses incurred on Rotational Field Quantum Magnetic Resonance Therapy, Deep Brain Stimulation, Photodynamic therapy, High Intensity Focused Ultrasound, Balloon Sinoplasty, Enhanced External Counter Pulsation, Low-level laser therapy, Uterine Fibroid Therapy and related therapies, Embolisation, Chelation therapy, Hyperbaric Oxygen Therapy, VAX-D, and other such therapies similar to those mentioned herein.
  • Deliberate injury to oneself.
  • Expenses incurred on tonics and vitamins unless they are a part of the treatment and have been certified by the attending physician of the hospital where the treatment is being performed.
  • Expenses that come up due to any condition indirectly or directly caused due to or associated with Human T-cell Lympho Trophic Virus type III (HTLV-III) or Lymphadenopathy Associated Virus (LAV) or HIV / AIDS. However, it is being clarified that patients who are tested HIV positive (Human Immune Deficiency Virus) shall be eligible for expenses borne for treatment. Expenses are not allowed for opportunistic infections and for treatment of HIV/AIDS, given that during the initial start of coverage under this policy, their CD4 count is more than 350.
  • Substance abuse, consumption of intoxicating substances, smoking, drugs/alcohol, and tobacco chewing.
  • Treatment is arising from or traceable to family planning, pregnancy, miscarriage childbirth, abortion and complications due to any of these conditions (other than ectopic pregnancy).
  • Treatment for Assisted Conception, Sub-Fertility, and or other associated complications caused due to the same conditions.
  • Surgical or Medical treatment of the genetic and endocrine disorder and Sleep apnoea, Expenses incurred for Bariatric Surgery or weight management services comprising of surgical procedures for medical treatment of obesity.
  • Medical conditions caused directly or indirectly or attributable to the act of a foreign enemy, war, warlike operations or invasion, whether there is a war declaration or not).
  • The run-down condition, Nutritional deficiency state, convalescence, rest cure or general debility.
  • Experimental, Untested, Unproven and Unconventional therapies.
  • Expenses incurred on Refractive Error Correction treatments such as Lasik Laser, treatment for disorders of eye requiring intravitreal injections and other related complications.
  • Hospital registration charges, record charges, telephone charges, admission charges, or any other such charges.
  • Chondrocyte Implantation, Intraarticular injection therapy, Stem cell Therapy, and Procedures using Platelet Rich Plasma.

Cancellation

You may cancel the cashless Mediclaim policy through written notice. To do this send the written notice within 30 days to us using the standard method of registered post. A refund will be issued using the following scale as a measure.

Your cashless Mediclaim Policy may be canceled by us, on the grounds of moral hazard or misrepresentation/fraud/non-cooperation from your side. For this process, we will send a 30 (thirty) days’ notice using a registered post to your last known address. The only thing that you will be entitled to, in such a case is a pro-rata refund of premium for the unexpired period that remained of the Mediclaim policy. This would be with respect to such insured person(s) for the likes of whom there has been no claim.

Know More About Individual Health Protector Policy Insurance

Benefits of Buying IFFCO-Tokio Individual Health Protector Policy

Cancellation of Individual Health Protector Policy

Common Health Insurance Terms

Exclusions of IFFCO Tokio Individual Health Protector Policy

Benefits of Individual Health Insurance Policy

FAQs

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

There are certain circumstances, when your claim for cashless hospitalization may be denied under your cheapest Mediclaim Policy. Here is why it may happen, read through the following to understand the working behind the denial of your cashless hospitalization claims:

  • Your documents are incomplete and are not what we require;
  • Your contact details registered, do not work or are incomplete as of now;
  • Your medical condition is not covered under our medical policy;
  • The hospital where you are receiving treatment is not under our network;
  • Your illness is of the pre-existing illness type and the stipulated time is not over yet;
  • If the request for pre-authorization was delayed.

Even if your claims are denied, do not worry; you can still try to make a claim for the costs incurred on your end and fill out the claim form duly.

Apart from this, settle the bill on your end and get in touch with us within the stipulated time for making a claim, we will help you out. Other than this, when you run into some problems or are hospitalized, you should get in touch with our customer care straight away to receive immediate help.

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

You can easily change your hospitals while undergoing treatment under your mediclaim plan. You are entitled to receive the best care there is and if shifting hospitals helps, then by all means, do so. We will cover your expenses. However, you will need to undergo consultation with your doctor before doing so. To avoid unnecessary issues, choose a hospital that is covered under our network and get speedy help.

How can I buy a medical insurance policy from IFFCO Tokio?

You can get yourself a mediclaim policy from our website. Our online procedure to buy insurance is easy and simple. Log on to our website, fill out your basic details, follow the instructions as mentioned on the website, make the premium payment and sit back to enjoy the benefits of our amazing Mediclaim plans for individuals. You can renew plans online as well without any problems.

If you are not okay with the online processes, walk into one of our branches with all the relevant documents and get your insurance today.

What is the key to a successful claim for health insurance plans for myself, in case of emergency or planned hospitalization?

When you file for a claim under your cheapest Mediclaim policy, including Mediclaim for senior citizens, you need to understand that you will need to organize all of your medical documents and evidences of your medical history. All of these documents must be submitted to your insurance provider, that’s us. We will examine your documents and then process the claim accordingly.

You should keep all your communication details accessible, and only submit those details that are registered under your name and are still functional. When you submit your claim form, make sure to double check and make sure that all your documents have been duly attached. Any discrepancy here will require you to re-submit the missing documents within the next 15 days.

In case of planned hospitalization under your cheapest Mediclaim policy, including Mediclaim for senior citizens, you should state the same during pre-authorization. This will help you save a lot of time and allow us to help you in every way we can.

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

Sticking to only one Mediclaim plan or policy has many benefits. The biggest benefit of sticking to single insurance is security. If you do not miss out on payments of your premiums you will have back up, for your untimely medical bills. Other than this, for long-running plans, including Mediclaim for senior citizens, there are some exclusive benefits that are available only after 48 months elapse.

Other than this, sticking to a single insurance plan allows you to rack up bonus and enjoy some exclusive benefits. Besides, your coverage will increase over time and also you might get some extra discounts for all Mediclaim policies including Mediclaim for senior citizens.

When you stick to only one Mediclaim plan, including Mediclaim for senior citizens, you may get loyalty discounts, and the claim settlement is faster when you have a long-standing track record with the company, as all the waiting period requirements would be satisfied by then.

VIEW ALL FAQs

Customer Reviews

Since the time I bought a mediclaim policy from IFFCO-Tokio, I feel relieved a lot. I was hospitalized two times to get treatment, and the expense was all covered by IFFCO-Tokio. I am happy that I chose them!

Rated by: Ritika

Customer Reviews

Being a part of a middle-income group, I always have to think more than needed, when getting healthcare treatment. The cost of my illness can affect my monthly expenditure too. But since the time I bought a mediclaim policy from IFFCO-Tokio, I feel relieved a lot.

Rated by: Rina Malhotra

Customer Reviews

On the recommendation of one of my friends, I called the customer care number of IFFCO-Tokio. The executive explained everything extensively which helped me choose a suitable mediclaim policy for my family.

Rated by: Prikshit Verma

Customer Reviews

Best Individual Health Protector Policy from IFFCO-Tokio. This helps in every possible way to me. Thanks, IFFCO-Tokio.

Rated by: Malvikha Adhikari

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