Medi Classic Insurance Policy (Individual)
IRDAI UIN: SHAHLIP23037V072223
HIGHLIGHTS
Plan Essentials
Sum Insured
The Sum Insured options available under the plan are - 1.5/2/3/4/5/10/15 lakhs, and Gold plan are - 3/4/5/10/15/20/25 lakhs.
Automatic Restoration
On exhaustion of the limit of coverage during the policy period, 200% of the basic Sum Insured will be restored once during the policy year.
Instalment Options
The policy premium can be paid on a quarterly or half-yearly basis. It can also be paid on an annual, biennial (once in 2 years) and triennial (once in 3 years) basis.
Non Allopathic / AYUSH
Expenses incurred for the treatment under Ayurveda, Unani, Siddha and Homeopathy systems of medicines in AYUSH hospitals are covered.
New Born Cover
Under gold plan, if the mother is covered for 12 months without any break, then the hospitalisation expenses for the new born baby are covered from the 16th day onwards as per the specified limits.
Zone Wise Premium Bifurcation
The premium under this policy is bifurcated zone wise to provide wide coverage.
Day Care Procedures
Medical treatments and surgical procedures that require less than 24 hours of hospitalisation due to technological advancements are covered.
Organ Donor Expenses
Under Gold plan, If the insured person is the recipient, then the hospitalisation expenses incurred for organ transplantation are covered.
DETAILED LIST
Understand what’s included
IMPORTANT HIGHLIGHTS
Entry AgeAny person between 5 months and 65 years can avail this policy. |
In-Patient HospitalisationHospitalisation expenses incurred for a period of more than 24 hours on account of illness, injury or accidents are covered. |
Pre-HospitalisationIn addition to in-patient hospitalisation, the medical expenses incurred up to 30 days before the date of admission to the hospital are also covered. |
Post-HospitalisationPost-hospitalisation medical expenses up to 60 days from the date of discharge are covered as per the limits mentioned in the policy clause. |
Room RentRoom, boarding and nursing expenses incurred during in-patient hospitalisation are covered up to 2% of the basic Sum Insured of Rs. 5000/- per day. |
Road AmbulanceAmbulance charges up to Rs. 750/- per hospitalisation and over all limit of Rs. 1,500/- per policy period for transportation of the insured person by private ambulance service are covered. |
Day Care ProceduresMedical treatments and surgical procedures that require less than 24 hours of hospitalisation due to technological advancements are covered. |
Modern TreatmentExpenses incurred for modern treatments such as Oral Chemotherapy, Intra Vitreal injections, Robotic Surgeries, etc. are covered up to the limits mentioned in the policy clause. |
Non Allopathic Treatment / AYUSHExpenses incurred for the treatment under Ayurveda, Unani, Siddha and Homeopathy systems of medicines in AYUSH hospitals are covered up to 25% of the Sum Insured subject to the maximum of Rs. 25,000/- during the policy period. |
Cataract TreatmentExpenses incurred for Cataract treatment are covered up to the limits mentioned in the policy clause. |
Automatic Restoration of Basic Sum InsuredOn exhaustion of the limit of coverage during the policy period, 200% of the basic Sum Insured will be restored once during the policy year that can be utilised for illness or disease unrelated to illness or disease for which claims were made. |
Psychiatric and Psychosomatic coverageExpenses incurred for the treatment of Psychiatric and Psychosomatic disorders for the first time are covered if the insured person is hospitalised for 5 consecutive days. |
Family Package PlanAvailable for persons from 5 months to 45 years. The sum insured is apportioned equally among insured family members. Health Checkup benefits will be calculated on the policy Sum Insured and equally divided among all the insured persons. |
Cumulative BonusThe insured person will be eligible for Cumulative bonus calculated at 5% of the basic Sum Insured for every claim free year subject to a maximum of 25% of the basic Sum Insured. |
Health Check-UpExpenses incurred towards the cost of health check-ups are covered up to 1% of the basic Sum Insured subject to the maximum of Rs. 5000/- for the basic Sum Insured of Rs. 2,00,000/- and above. The insured person is eligible for this benefit after every block of four claim free years subject to a continuous coverage. |
Co-paymentThis policy is subjected to a Co-payment of 10% of each and every admissible claim amount, for fresh as well as for the policies subsequently renewed for insured persons whose age at the time of entry into this policy is 61 years and above. |
IMPORTANT HIGHLIGHTS (FOR GOLD PLAN)
Entry AgeUnder Gold Plan, any person aged between 16 days and 65 years can avail this policy. |
In-Patient HospitalisationHospitalisation expenses incurred for a period of more than 24 hours on account of illness, injury or accidents are covered. |
Pre-HospitalisationIn addition to in-patient hospitalisation, the medical expenses incurred up to 30 days before the date of admission to the hospital are also covered. |
Post-HospitalisationPost-hospitalisation medical expenses up to 60 days from the date of discharge from the hospital are covered. |
Room RentRoom, boarding and nursing expenses incurred during in-patient hospitalisation are covered up to the limits mentioned in the policy clause. |
Road AmbulanceAmbulance charges up to Rs. 2,000/- per hospitalisation for transportation of the insured person by private ambulance service are covered. |
Day Care ProceduresMedical treatments and surgical procedures that require less than 24 hours of hospitalisation due to technological advancements are covered. |
Modern TreatmentExpenses incurred for modern treatments such as Oral Chemotherapy, Intra Vitreal injections, Robotic Surgeries, etc. are covered up to the limits mentioned in the policy clause. |
Cataract TreatmentExpenses incurred for Cataract treatment are covered up to the limits mentioned in the policy clause. |
Psychiatric and Psychosomatic coverageExpenses incurred for the treatment of Psychiatric and Psychosomatic disorders for the first time are covered if the insured person is hospitalised for 5 consecutive days. |
Health Check-UpExpenses incurred towards the cost of health check-ups are covered up to 1% of the basic Sum Insured subject to the maximum of Rs. 5000/- for the basic Sum Insured of Rs. 2,00,000/- and above. |
Cumulative BonusFor every claim free year the insured person will be eligible for Cumulative bonus calculated at 25% of the basic Sum Insured in the second year and an additional 20% of the basic Sum Insured for each subsequent years subject to the maximum of 100% overall. |
Automatic Restoration of Basic Sum InsuredOn exhaustion of the limit of coverage during the policy period, 200% of the basic Sum Insured will be restored once during the policy year that can be utilised for illness or disease unrelated to illness or disease for which claims were made. |
Super RestorationOn exhaustion of the limit of coverage during the policy period, under the gold plan, 100% of the Sum Insured will be restored once for the remaining policy year that can be utilised for all claims. |
Domiciliary HospitalisationExpenses incurred for domiciliary hospitalisation, including AYUSH on the advice of a medical practitioner for a period exceeding three days are covered. |
Shared AccommodationIf the insured person opts for shared accommodation in a Networked Hospital, a cash benefit is provided for the opted Sum Insured as mentioned in the policy clause. |
Organ Donor ExpensesIf the insured person is the recipient, then the hospitalisation expenses incurred for organ transplantation are covered. |
Additional Basic Sum Insured for Road Traffic Accident (RTA)If the basic Sum Insured gets exhausted, then for hospitalisation due to Road Traffic Accidents, it will be increased by 50%. |
Hospitalisation Expenses for Treatment of New Born BabyThe coverage for the New Born Baby starts from the 16th day after its birth till the expiry date of the policy and is subject to a limit of 10% of the basic Sum Insured or Rupees Fifty thousand, whichever is less, subject to the availability of the basic Sum Insured, provided the mother has been insured under the policy for a continuous period of 12 months without break. |
Non Allopathic Treatment / AYUSHExpenses incurred for the treatment under Ayurveda, Unani, Siddha and Homeopathy systems of medicines in AYUSH hospitals are covered up to 25% of the Sum Insured subject to the maximum of Rs. 25,000/- during the policy period. |
Patient CareThe expenses incurred for one attendant at the residence of the insured person immediately after discharge from the hospital provided this is recommended by the attending physician are covered. Such expenses are payable up to Rs. 400/- for each completed day up to 5 days per occurrence and 14 day per policy period. |
Hospital Cash BenefitA cash benefit of Rs.1000/- for each completed day in the hospital is provided for a maximum of 7 days per hospitalisation and 14 days per policy period. |
Co-paymentThis policy is subjected to a Co-payment of 10% of each and every admissible claim amount, for fresh as well as for the policies subsequently renewed for insured persons whose age at the time of entry into this policy is 61 years and above. |
Family Discount5% discount on premium is available if 2 or more family members are covered under this policy. |
Major Organ Donor DiscountIf the insured person submits proof that he/she has donated a major organ, a discount of 25% of the premium is available at the time of renewal. This discount is available even for subsequent renewals as well. |
Please refer to the Policy Documents to know the policy details and Terms & Conditions.
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