Universal Health Insurance Scheme:
This policy is geared towards reimbursement of hospital expenses up to Rs.30,000 to an individual or a family. It is subject to the following sub–limits:
- Hospital room, boarding expenses: up to Rs.150 per day
- If admitted in the ICU: up to Rs.300 per day
- Surgeon, Anaesthetist, consultant, specialists fees, Nursing expenses: up to Rs.4,500 per illness or injury
- Anaesthesia, Blood, Oxygen, OT charges, Medicines, Diagnostic material & X–Ray, Dialysis, Radiotherapy, Chemotherapy, Cost of pacemaker, Artificial limb, etc: up to Rs. 4,500 per illness or injury
- Total expenses incurred for any one illness: up to Rs. 15,000
It has a Personal Accident Cover whereby a sum of Rs. 25,000 can be reimbursed upon the death of the earning head of the family (as named in the policy papers) due to an accident.
If the earning head of the family is hospitalized due to an accident or an illness, a compensation of Rs.50/– per day will be paid for every day of hospitalization up to a maximum of 15 days after a waiting period of 3 days.
The following medical treatments will not be covered:
- Corrective, cosmetic or aesthetic dental surgery or treatment.
- Cost of spectacles, contact lens and hearing aid.
- Vaccination, inoculation, cosmetic treatment or surgery, HIV, AIDS, Sterility, Venereal Disease, Intentional Self injury, use of intoxicating drugs or alcohol.
- Diagnostic expenses not related to sickness or injury
- This policy offers compensation in case of death or bodily injury to the insured person, directly and solely as a result of an accident, by external, visible and violent means. Death or injury due to any illness or disease is not covered by the policy.
- The policy operates worldwide and is a 24 hours cover.
- Different coverages are available ranging from a restricted cover of Death only, to a comprehensive cover covering death, permanent disablements and temporary total disablements.
- Family Package cover is available to individuals whereby the proposer, spouse and dependent children can be covered under a single policy with a 10% discount in premium.
- Group personal accident policies are also available for specified groups with a discount in premium depending upon the size of the group.
- Expenses incurred for carriage of dead body from place of accident to the residence subject to a limit of 2% of the capital sum insured or Rs.2,500 whichever is less.
- Under an Individual Personal Accident policy or Family Package Policy, an education fund is payable for a maximum of 2 dependent school going children, in case of death or permanent total disablement of the insured person.
Jan Arogya Bima Policy
- This policy is designed to provide cheap medical insurance to poorer sections of society. A premium of up to Rs.10,000 qualifies for tax benefit under Sec 80D of the Income Tax Act. Service tax is not applicable to the policy.
- The coverage is along the lines of an individual mediclaim policy except that the cumulative bonus and medical checkup benefits are not included. The Sum Insured per person is restricted to Rs.5,000.
- The policy is available to individuals and family members. The age limit is 5 to 70 years. Children between the age of 3 months and 5 years can be covered provided one or both parents are covered concurrently.
This insurance policy has been designed to cater to the specific needs of an individual who meets with an accident with a motor vehicle on the road and sustains injuries which requires hospitalization for treatment. The policy also has a provision for compensation for death and permanent disability. There are two sections under the policy.
Section I: Personal Accident for the purpose of compensation payment.
Section II: Medical expenses incurred during hospitalization for treatment of bodily injury caused by and arising out of road accident.
- The Sum Insured under both sections is identical. The available Sum Insured is Rs.25,000, Rs.50,000, Rs.75,000 and Rs.1,00,000.
- The policy is issued on annual basis
- Premium depends upon the Sum Insured chosen
- Policy is also available on group basis
- Individual Personal Accident policy
- Group Personal Accident policy
- Passenger Flight Coupon – Covering personal accident risks whilst traveling as a passenger on a scheduled flight
- Gramin Personal Accident Policy – for persons residing in rural areas where benefits are covered for a capital sum insured of Rs.10,000.
- Janata Personal Accident Policy – where benefits are covered for a maximum sum insured of Rs.1,00,000. Long Term Policies can also be issued up to 5 years.
- Student Safety Insurance – for schools and colleges, covering students against Personal Accidents for a capital sum insured of Rs.10,000.
- Raj Rajeshwari Mahila Kalyan Yojna – for women in the age group of 10 to 75 years are covered for a capital sum insured for Rs.25,000. In case of the death of an unmarried woman due to an accident, Rs.25,000 is payable to the nominee or legal heir. In case of a married woman, if the husband dies due to an accident, Rs.25,000 is payable to the wife but if the wife or insured dies no compensation is payable.
- Bhagyashree Child Welfare Policy – for the girl child in the age group of 0 to 18 years whose parents age does not exceed 60 years. In case of the death of either or both parents due to an accident, a sum of Rs.25,000 is deposited in the name of the girl child with a financial institution named in the policy. The institution will disburse amounts as specified for the benefit of the girl child to the living parent or to the nominated guardian. Group policies can also be issued.