Benefits of Buying IFFCO Tokio Individual Health Protector Policy

Having gained years of experience in this field, we are perfectly aware that reimbursement for just hospitalization expenses is not sufficient. Many more variables are involved which if not taken into consideration, can mess up your entire estimate. In order to help you meet all your medical expenses, we have made it a point to include them in the coverage of our Mediclaim policy.

Similarly, recuperating from a medical procedure after discharge from the hospital also often involves expenditure including visits to the doctor, occupational therapy and medications. To save you from all these, we cover the Nursing and Medical expenses during the post-hospitalization period up to 60 days, provided these expenses are related to the ailment for which treatment was received in the hospital.

Not only our Mediclaim policy takes care of your hospitalization expenses, to ease your burden, but you are also entitled to an additional daily allowance of 0.20% of the sum insured value per day during the period of hospitalization. In case of day care procedures where the hospitalization period is less than 24 (Twenty Four) hours, the allowance is adjusted proportionately for the duration of stay in the hospital.

  • Pre and Post Hospitalization Expenses: - You are only admitted to a hospital under the guidance of your consultant physician or expert as they feel that the ailment is not possible to be cured by prescription medicines and needs domiciliary hospitalisation. But in order to reach this decision, your consultant medical practitioner needs to investigate the cause of the medical condition using various diagnostic and investigative procedures, which can cost a lot. All pre-hospitalization expenses incurred during a period of 45 days before hospitalization will be covered if you have bought this Mediclaim policy.

  • Ambulance Charges: - Certain ailments are so grave that they require the patient to opt for ambulance services, to be delivered to the hospital. When you are already burdened by medical bills, even the cost of ambulance services could seem too much. Therefore our Mediclaim policy reimburses ambulance charges up to a maximum of 1% of the sum insured or Rest. 2,500/- (Two Thousand Five Hundred Only) for each episode of hospitalization.

  • Day Care Surgeries: - We understand that for treatment of certain conditions or minor surgical procedures, there is no need for hospitalization. Therefore, we have identified 121 medical procedures as day care procedures, following the treatment for which you can be discharged immediately from the hospital and recuperate at home. All the expenses incurred due to any of these 121-day care procedures will be fully reimbursed insurance plan. This saves you all the hassles involved with admission and discharges even for some minor procedure.

  • Daily Allowance: - We understand that when you or any other insured family member undergoes treatment at a hospital, there are other monetary losses that occur as a result because there are various other expenditures involved in addition to the hospitalization and medical expenses. Additionally, there is also the possible loss of income, if the person undergoing treatment was working and had to take a leave of absence due to the hospitalization.

Cost of Health Check Up: - Our policy reimburses the cost incurred for medical check-up(s) after a block period of four claim free policies with us. You will be entitled to a maximum of 1% of the average sum insured during the block of four claim free periods.

Other than the 121 listed day care surgeries, if you or any other individual policyholder in your family has to stay in the hospital for more than 12 hours but less than 24 hours, you will be reimbursed all hospitalisation related expenses. But the room rent, in that case, will be a capped at a maximum of 50% of the room rent per day. But please make sure that you get the pre-authorization for the treatment and the line of treatment undertaken by your doctors has been agreed upon by our panel of specialists.

In this case, no pre-hospitalisation expenses shall be allowable and post hospitalisation expenses shall be limited to 15 days from discharge.

After a block period of two consecutive claim-free policies (365 days + 365 days or 366 days in case of a leap year), you or another cashless mediclaim policy holder in your family are entitled to a maximum of 10% of the premium paid (excluding taxes). It must be noted that this benefit is available only when you renew the policies on time without any break.

  • Vaccination: - We believe that prevention is better than cure. Although many critical illnesses have rapidly progressed, affecting millions of individuals, medical science has also made significant development simultaneously. Today we have various new vaccines that help control the spread of many such diseases. In order to make sure that you receive all necessary vaccines to safeguard your health against serious ailments, our best cashless Mediclaim policy for family members and individual, also covers the cost of vaccination, received from a registered medical practitioner.

  • Cumulative Bonus: - Do not think that if you have not made any claims against the premium paid for your Mediclaim, in a particular year then it would go waste. We reward our customers with 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.

This feature comes in very handy when you need to undergo a medical procedure or bear hospitalization expenses, as you get additional coverage over and above the basic sum insured in your Mediclaim. This will help you meet out various expenses without affecting your savings in any way. This feature works in the following way: -

For each claim free year, 5% of the basic sum insured at each renewal will be added as a bonus to your cumulative bonus. This 5% will continue being added each year up to a maximum of 50% of the basic sum insured of the expiring policy.

If you make a claim during the policy period, the cumulative bonus shall be reduced by 5% of the basic sum insured, at the next renewal, if the basic sum insured is maintained.

To be eligible for the cumulative bonus you must make sure that the policy is renewed on time or utmost within thirty days of the expiry date. Otherwise, your cumulative bonus may be forfeited.

Emergency Assistance Services: - In modern times, travelling plays a big part of our lives. Whether you are living with your family or living alone, you might have to travel for work related purpose or family requirements and also need to stay away from home for extended durations. But what happens if you are taken seriously ill there and are not in a position to travel back home? You will have to undergo hospitalization to receive proper treatment for your ailment, but who will take care of all the expenses for you? Does that mean you must wipe out your hard earned savings? What can you do in such a situation because your policy does not offer you the benefit of seeking treatment away from your city? This is where our cashless Mediclaim policy comes to your rescue.

Emergency Medical Evacuation: - If according to the attending physicians or consultants, there is a medical emergency and no other suitable medical facility is nearby for your treatment, then our representative will arrange for you emergency evacuation to the nearest medical centre with required facilities, through appropriate means of transport.

Medical Repatriation: - If necessitated by your medical condition according to our physicians and consultants, we will arrange to repatriate you to the registered address as per the policy schedule through suitable means of transportation as suggested by our doctors for travelling. If it is not possible to repatriate using normal air carrier, we shall arrange for the repatriation through air ambulance along with medical supervision.

Emergency Message Transmission: - Our representative will act as the point of contact between your family members if you are unable to do so due to your medical condition. We will arrange for sending the message to and fro, as and when required.

Transportation to join the patient: - We will provide a nominated family member or friend with a round-trip economy class fair through a common carrier to the airport nearest to the hospital. This facility will be available if you had been travelling alone and had been hospitalized for over one week continuously. If required, we shall also arrange for a suitable accommodation for the travelling person. But it should be noted that it would be the responsibility of the travelling friend or family member to arrange for the necessary travel documents and meet the cost of accommodation arranged by us.

Emergency Cash Coordination: - If there is an emergency need for cash and you have arranged for the funds but do not know how to transfer them urgently, then our representative will organize the transfer of cash. It should be noted that arrangement of the funds is your responsibility.

Transportation and Care for minor children: - If due to your serious medical condition, your minor children have been left unattended, our representative shall arrange for shifting the minor children to the house of a nominated friend or family member living in the same city. If required, we shall also arrange for an attendant to accompany the children during transportation.

Return of Mortal Remains: - In an unfortunate scenario of death of any insured person, our representative will pay for all the expenses necessary to return the mortal remains to the registered address. Our representatives will offer all possible assistance necessary for the transportation including obtaining all legal clearances, completing all documentation, obtaining a death certificate and arranging for a casket for safe transit. Once the body reaches the local airport, we shall arrange for transportation of the dead body to the local funeral home or any other destination as per your preference.

Conditions ‘prior to the entitlement to benefits’ under Emergency Assistance Services.

  • Travelling for undergoing a medical treatment.

  • Injuries resulting from attempted suicide or self-inflicted injuries.

  • Services are sought outside the geographical boundaries of India.

  • Involvement in an unlawful act.

  • Consumption of narcotics or drugs or any medication other than those prescribed by the physician or overdose of prescribed medication.

  • Injuries resulting from participation in a war or insurrection.

  • Students at their hostels or campus away from home.

  • Transferring insured person from one medical facility to another, where both facilities have same capabilities and provide a similar level of care.

  • If you had been travelling away from your registered address for over 90 days without any intimation to us.

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