Shravak Arogyam Phase 7 Gold Plan

FAMILY SIZE

SUM INSURED

PREMIUM FOR 12 MONTHS

Including 15% Service Tax

Family Floater of size 1+7

Rs. 25 Lacs

Rs. 59, 258/-

Family Floater of size 1+7

Rs. 20 Lacs

Rs. 54, 738/-

Family Floater of size 1+7

Rs. 15 Lacs

Rs. 44, 694/-

Family Floater of size 1+7

Rs. 10 Lacs

Rs. 21, 594/-

Family Floater of size 1+7

Rs. 5 Lacs

Rs. 13, 107/-

Family Floater of size 1+7

Rs. 2 Lacs

Rs. 10, 546/-

Strictly for Individual below 40 Yrs

Rs. 2 Lacs

Rs. 2, 626/-

NO MEDICAL CHECK-UP required

FAMILY FLOATER MEDICLAIM Sum insured of Rs. 2 Lacs, Rs.5 Lacs, Rs.10 Lacs, Rs. 15 Lacs, Rs. 20 Lacs & Rs. 25 Lacs

FAMILY DEFINITION: (1+7) maximum 8 members with self-mandatory : Primary Member + Spouse + 4 Dependent children up to 25 years of
age + parents or parents in law (Any one set of parents only allowed)

INDIVIDUAL POLICY with Sum Insured of Rs.2 Lacs available only for member BELOW 40 years

PRE-EXISTING DISEASES are covered from Day One

DAY CARE PROCEDURES covered

NEW BORN BABY covered from Day 1 subject to intimation within 20 days (Only Reimbursement cases)

AGE LIMIT- 0-90 years (Entry Age of Proposer Between 18 to 90 Years)

1st year entry age is upto 90 years and upon renewal they can continue in the policy till LIFETIME

As per INCOME TAX Act deductions under Sec 80D, Proposer will be eligible for exemption. (Exemption for Payment by Cash not applicable)

Hospitalization for AYUSH Treatment (AYURVEDIC / HOMEOPATHIC / UNANI) Rs.10, 000/- covered upto 25% of Sum Insured

Hospitalization arising out of PSYCHIATRIC AILMENTS Covered as per Sum Insured eligibility

Treatment for NASAL SINUS SURGERIES, COCHLEAR IMPLANT, CYBER-KNIFE , ROBOTIC, STEM-CELL
TRANSPLANTATION and FEMTO LASER Covered with 50% co-pay
Knee Replacement Covered from Day 1 for existing members with a Limit of Rs.1.75 Lacs per knee, however waiting period of 1 year for any
Joint Replacement will be applicable for New Members
Maternity Benefit covered for NORMAL Delivery AND for CESARIAN Delivery from Day 1 for existing Members as per Sum Insured eligibility,
however waiting period of 9 months will be applicable for new members
NEW BORN BABY claims covered from Day 1 on Reimbursement basis subject to intimation within 20 days
Hospitalization expenses for ORGAN TRANSPLANT (excluding cost of organ) : The Insurance Company will pay expenses incurred on the
donor and the insured recipient up to the sum insured of the insured recipient

AIR AMBULANCE covered as per Sum Insured eligibility

DOCTOR HOME VISIT & NURSING CARE DURING POST HOSPITALISATION is covered for Rs. 1,500/- per day and maximum of 10 days

HOSPITAL CASH covered for Rs. 1,800/- per day and maximum of 5 days

LASIK SURGERY covered for + / - 7.5 and above cases. FEMTO LASER TREATMENT FOR EYE is covered with 50% co-payment on
admissible amount

Group Personal Accident (GPA) policy is also attached with this policy, applicable for Proposer only

ACCIDENTAL DEATH

PERMANENT TOTAL DISABLEMENT

TERRORISM COVERED

WORLDWIDE COVER

Sum Insured for Personal Accident policy is Rs, 2 Lacs (for Individual Policy's Proposer) and Rs. 2 Lacs, Rs. 5 Lacs, Rs. 10 Lacs, Rs. 15
Lacs, Rs. 20 Lacs & Rs. 25 Lacs for FAMILY FLOATER Proposer as per Mediclaim Sum Insured
100% Sum Insured for EARNING PROPOSER & 50% Sum Insured for NON-EARNING PROPOSER

GENERAL EXCLUSIONS IN PERSONAL ACCIDENT POLICY

Suicide/ Intentional selfinjury

Death due to Pregnancy/child birth etc.

Accident while under influence of alcohol/drugs

Sexually Transmitted Infections

Participation in a criminal act

Participation in a hazardous sport

War, civil war, similar situations etc.

Other exclusion as per Standard Policy Terms & Conditions

GENERAL EXCLUSIONS IN MEDICLAIM POLICY
We strive to provide you maximum cover and benefits; however, we would like you to know some of the major exclusions under the policy.

External Congenital diseases not covered

Any dental treatment unless arising due to an accident

Naturopathy treatment not covered.

HIV, AIDS and related medical conditions not covered

External medical equipment used as post hospitalization care not covered

Cost of contact lens, spectacles, hearing aid, cochlear implants not covered

General debility, use of drugs or alcohol, intentional self-injury, sterility, venereal disease not covered.

Treatment for infertility etc. not covered

Hospitalization treatment for less than 24 hrs. Other than specified treatment not covered

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Injury or disease directly or indirectly caused by or arising from or attributable to War invasion Act or Foreign Enemy Warlike
operations (whether war be declared or not).
The cost of spectacles, contact lenses and hearing aids.
Circumcision unless necessary for treatment or a disease not excluded hereunder or as may be necessitated due to an accident,
vaccination or inoculation or change of life or cosmetic or aesthetic treatment of any description, plastic surgery other than as may
be necessitated due to as accident or as part of any Illness.
Any Dental treatment or surgery which is a corrective, cosmetic or aesthetic procedure, including wear and tear, unless arising from
disease or Injury and which requires Hospitalization for treatment

Naturopathy treatment

Injury directly or indirectly caused by or contributed to by nuclear weapons/materials

GENERAL EXCLUSIONS IN PERSONAL ACCIDENT POLICY

Suicide/ Intentional selfinjury

Death due to Pregnancy/child birth etc.

Accident while under influence of alcohol/drugs

Sexually Transmitted Infections

Participation in a criminal act

Participation in a hazardous sport

War, civil war, similar situations etc

Other exclusion as per the Standard Policy