Download Easy Health Group Insurance

Easy Health Group Insurance
Who can buy?
• Primary Insured - Minimum Entry age 18 years and Maximum Entry age 55 years.
• Spouse - Minimum Entry age 18 years and Maximum Entry age 55 years.
• Maximum 2 dependent children - Minimum Entry age 91 days and Maximum Entry age 21 years.
• Cover is available in both individual sum insured and family floater plans.
What is covered?
Coverage is only available for hospitalization undergone in a Hospital in India.
In-Patient Treatment: In-patient Treatment which requires 24 hours hospitalisation.
Pre & Post Hospitalisation: Expenses incurred up to 30 days prior to the hospitalisation and up to 60 days post hospitalisation are covered.
Daycare Procedures: The Medical Expenses for 140 enlisted daycare procedure or surgery mentioned in the list of daycare procedures where the procedure or
surgery is taken by the Insured Person as an in-patient for less than 24 hours.
Emergency Ambulance : Expenses for utilizing ambulance in case of an emergency.
Optional Critical Illness benefit: Lump-sum benefit if diagnosed as suffering from listed critical illnesses, provided insured person survives for at least 30 days
following such diagnosis. Critical Illness which covers for cancer, coronary artery (bypass) surgery, heart attack (myocardial infarction), kidney failure (end-stage
renal disease), major organ transplantation, multiple sclerosis, paralysis and stroke. (Please note this benefit cannot be opted with family floater plan.)
Additional Information:
• No Sub limits: No sub limits under this policy.
• No Co-Payment: We will disburse the entire admissible amount up to the Sum Insured, supported with bills and other documents required.
• Cashless Facility at over 4000 hospitals.
• Fast claim settlement.
• Tax benefit Section 80D of the Income Tax Act.
Waiting Periods?
30 days Waiting Period:
A waiting period of 30 days (or longer if specified in any benefit) will apply to all claims, except for hospitalisation arising out of an accident.
1-Year Waiting Period:
Illnesses: Arthritis if non infective; Calculus diseases of gall bladder and urogenital system; Cataract; Fissure/Fistula in anus, Haemorrhoids, Pilonidal sinus, Gastric
and duodenal ulcers; Gout and Rheumatism; Internal tumours, Cysts, Nodules, Polyps including breast lumps (each of any kind unless malignant); Osteoarthritis
and Osteoporosis if age related; Polycystic ovarian diseases; Sinusitis and related disorders and skin tumours unless malignant.
Treatments: Benign ear, Nose and throat (ENT) disorders and surgeries (including but not limited to adenoidectomy, mastoidectomy, tonsillectomy and
tympanoplasty); Dilatation and curettage (D&C); Hysterectomy for menorrhagia or Fibromyoma or Prolapse of uterus unless necessitated by malignancy; Joint
replacement; Myomectomy for fibroids; Surgery of gallbladder and bile duct unless necessitated by malignancy; Surgery of genito urinary system unless
necessitated by malignancy; Surgery of benign prostatic hypertrophy; Surgery of hernia;Surgery of hydrocele; Surgery for prolapsed inter vertebral disk; Surgery of
varicose veins and varicose ulcers; Surgery on tonsils and sinuses.
Pre-Existing Diseases: Pre-existing diseases would be covered after 48 months of continuous coverage have elapsed, since inception of the first Easy Health
Group Insurance policy with us.
Key Exclusions:
i) War or any act of war, invasion, act of foreign enemy, war like operations,. Any Insured Person’s participation or involvement in naval, military or air force operation,
racing, diving, aviation, scuba diving, parachuting, hang-gliding, rock or mountain climbing.
ii) Venereal disease, sexually transmitted disease or illness; “AIDS” (Acquired Immune Deficiency Syndrome) and/or infection with HIV (Human immunodeficiency virus)
iii) Pregnancy (including voluntary termination), miscarriage (except as a result of an Accident or Illness), maternity or birth (including caesarean section) except in the
case of ectopic pregnancy in relation to In-patient Treatment only.
iv) Sterility, treatment whether to effect or to treat infertility, any fertility, sub-fertility or assisted conception procedure, surrogate or vicarious pregnancy, birth control,
contraceptive supplies or services including complications arising due to supplying services.
v) Experimental, investigational or unproven treatment devices and pharmacological regimens, or measures primarily for diagnostic, X-ray or laboratory examinations
or other diagnostic studies which are not consistent with or incidental to the diagnosis and treatment of the positive existence or presence of any Illness for which
confinement is required at a Hospital.
vi) Any non-allopathic treatment or dental treatment and surgery of any kind, unless requiring Hospitalisation.
vii) All preventive care, vaccination including inoculation and immunizations, any physical, psychiatric or psychological examinations or testing during these examination
unless certified to be required by the attending medical practitioner as a direct consequence of an otherwise covered claim.
viii) Charges related to a Hospital stay not expressly mentioned as being covered, including but not limited to charges for admission, discharge, administration,
registration, documentation and filing.
ix) Artificial limbs, crutches or any other external appliance and/or device used for diagnosis or treatment.
Group Personal Accident
All members including dependents are covered for Rs. 1,00,000 sum insured under this plan.
Accidental Death: Lumpsum payment to the declared nominee in the event of death due to an accident upto the Sum Insured.
Transportation of Mortal Remains
• Expenses towards transportation of mortal remains in the event of death due to an accident, upto 2% of Sum Insured.
Key Exclusions:
• Self-inflicted injury, suicide or attempted suicide or abuse of intoxicants or hallucinogens including drugs and alcohol.
• Participation or involvement in naval, military or air-force operations or any adventure sports, any breach of law with criminal intent HIV/AIDS, Sexually transmitted
diseases.
• Pregnancy childbirth & it’s complications, congenital internal & external disease, any pre-existing conditions & their complications, Any non allopathic treatment.
Policy Dispatch:
Your Policy document will be dispatched to you through your respective Muthoot branch. Please collect the Policy document from the branch in case it does not reach
within 30 days.
Premiums (Inclusive of 14.5% service tax)
Individual Sum Insured
Age Band/SI (in INR)
0-17
18-35
36-44
45-50
51-55
56-60
100,000
1,832
1,832
2,605
3,521
4,666
6,841
Age Band/SI (in INR)
18-35
36-44
45-50
51-55
56-60
200,000
3,622
5,476
7,170
9,470
13,687
Individual
200,000
300,000
2,356
2,855
2,356
2,855
3,361
4,081
4,551
5,534
6,040
7,350
8,868
10,800
400,000
3,498
3,498
5,008
6,798
9,035
13,286
500,000
3,963
3,963
5,679
7,713
10,255
15,086
Family Floater (2 Adults)
300,000
4,049
6,071
7,996
10,574
15,328
400,000
4,948
7,440
9,811
12,987
18,844
500,000
5,755
8,673
11,460
15,019
22,072
Family Floater (2 Adults+ 2 Children)
Age Band/SI (in INR)
18-35
36-44
45-50
51-55
56-60
200,000
5,743
7,616
9,329
11,649
15,887
Age Band/SI (in INR)
0-17
18-35
36-45
46-50
51-55
56-60
100000
35
133
405
889
1,464
2,313
300,000
6,714
8,762
10,711
13,315
18,094
400,000
7,903
10,423
12,822
16,027
21,912
500,000
8,852
11,800
14,616
18,205
25,288
Optional Critical Illness cover
200000
70
264
811
1,777
2,928
4,626
300000
105
397
1,216
2,667
4,392
6,939
400000
140
529
1,620
3,555
5,856
9,252
500000
175
662
2,026
4,444
7,320
11,565
• If opted critical illness cover shall be on “All or None” basis no selection allowed.
• Critical Illness cover only offered as a additional benefit to hospitalisation cover under Group Health Policy, can not be opted as a stand alone cover
• Benefit Sum Insured shall always be equal to primary sum insured.
• This benefit is not renewable beyond the age of 70 years.
• Benefit cannot be opted with family floater plan.
Please Note • Rates inclusive of service tax and applicable cess
• For family floater premium would be computed as per age of the eldest member.
*Rates only for renewal
DISCLAIMER
This is only a summary of the product features. The actual benefits available are as described in the master policy, and will be subject to the policy terms, conditions and
exclusions. Please seek the advice of your insurance advisor if you require any further information or clarification.
We would be happy to assist you. For any help contact us at:
Toll Free: 1800 3000 1401
E-mail : [email protected]
Apollo Munich Health Insurance Co. Ltd. • 2nd & 3rd Floor, iLABS Centre, Plot No. 404-405, Udyog Vihar, Phase-III, Gurgaon-122016, Haryana • Corp. Off. 1st Floor, SCF-19, Sector-14,
Gurgaon-122001, Haryana • Reg. Off. Apollo Hospitals Complex, Jubilee Hills, Hyderabad-500033, Telangana • Insurance is the subject matter of solicitation • For more details on risk
factors, terms and conditions, please read sales brochure carefully before concluding a sale • IRDA Registration Number - 131 • Corporate Identity Number: U66030AP2006PLC051760