The Swasthya Kavach policy offers coverage for an expansive range of hospital expenses for you and your family. Included in these expenses are:
Room Rent – The standard coverage offered for room rent is up to 1.0% of the basic sum insured and up to 2.0% in the case of ICU/ITU.
Nursing expenses – This plan pays for all the nursing expenses, even those incurred during pre and post hospitalization, given a qualified nurse is employed on the advice of a Medical practitioner.
Medical Practitioner’s fee – It also covers the fees of all kinds of medical practitioners, right from consultants and anesthetists to surgeons.
Ambulance charges – The plan also offers compensation for expenses related to ambulance services.
Daily allowance – Policyholders are liable to receive a daily allowance of up to ₹150 for the duration of their hospitalization.
Domiciliary hospitalization expenses – Expenses for medical treatments, for over three days which would require hospitalization but had to be taken at home due to certain reasons, is what domiciliary treatment refers to. For all such treatments, you shall receive compensation up to a maximum sub-limit of 20% of the basic sum insured.
Pre and post hospitalization expenses – Medical expenses incurred during 30 days before and 30 days after hospitalization.
Organ transplantation – The policy will also take care of the expenses for organ transplantation, lying within the overall and individual limits of the sum insured.
Other hospital charges such as Registration charges, Service Charges, Surcharges, etc. subject to a maximum of 0.5% of Basic Sum Insured will also be paid for under the plan.
Cost of medicines, blood, oxygen, anesthesia, diagnostic and pathological tests, operation theatre charges, cost of chemotherapy, dialysis, pacemaker, artificial limbs, etc. are also covered.
Prescribed package charges of the hospital for specific treatments, subject to a maximum of 80% of Sum Insured or 80% of actual expenses, whichever is less, is covered under the plan.
The overall expense limit is capped for certain diseases/treatments, based on the Sum Insured under the Policy.
Critical Illness Extension
The optional Critical Illness Extension (for doubling of Sum Insured in respect of 10 listed major diseases) can be taken only under the Wider Plan (and not under the Base Plan), on payment of extra 30% on the basic premium.
Cost of hearing aids, spectacles and contact lenses.
Dental treatments that do not require hospitalization.
Expenses relating to or arising out of pregnancy, excluding ectopic pregnancy.
Convalescence, congenital diseases/defects, sterility, general debility.
Cost of external medical equipment.
Claims arising from or related to HIV/AIDS.
Claims arising out of participation in dangerous sports/activities.
War, terrorism and nuclear risks.
Treatment of obesity, hormone replacement therapy, sex change.
All non-medical expenses, including personal comfort and convenience item services.
Expenses on naturopathy, experimental or alternative medicine, acupressure, acupuncture, magnetic and similar therapies.
Genetic disorders stem cell implantation and surgery.
First 10% of any admissible claim, if the insured person is suffering from either diabetes or hypertension and the first 25% of claim, if he is suffering from both diabetes and hypertension. (This provision is applicable for claims arising out of diabetes and/or hypertension only)
Any domiciliary or out-patient treatment.
Pre-existing diseases – This health insurance plan does not cover pre-existing diseases suffered by the policyholder, up to 4 years of continuous coverage from the start of the Medical Policy.
Waiting period – Even in the case of newly incurred diseases (excluding accidents), coverage will only kick in after a waiting period of 30 days has passed.
For certain specified diseases, as listed in the Policy, there are one and two year exclusions periods too.
IFFCO-Tokio will not cancel your insurance policy unless it is a case of misrepresentation, concealment of a material fact or fraudulent act of insured.
Waiting period refers to the number of days for which a health insurance plan does not provide any coverage to the insured, other than for emergency cases like accident.
No. Expenses related to or arising out of pregnancy, (except ectopic pregnancy) are not covered under this plan.
The Swasthya Kavach Policy covers the proposer, spouse and 3 dependents. (children, sibling, nephew and niece in the age group of 3 months-23 years)
Sub-limit is an additional limit that is applied on various aspects of a health insurance claim.
IFFCO Tokio will not cancel your insurance policy, unless it is a case of misrepresentation, concealment of material fact or fraudulent act of insured.
Thanks to IFFCO Tokio . Very good service and fast action. I am impressed with your team work .
Rated by: Virendra Chauhan
Very nice Health policy and it helped me a lot. I will recommend Swasthya Kavach policy to all my friends.
Rated by: Manoj
Rated by: Hitendra Adhikary
Rated by: Jitendra Shelke
Rated by: Ganesh Bhoir