Family Health Insurance

The ever-rising medical inflation in India is a major cause of concern for everyone. As a result, a comprehensive health insurance plan covering a range of hospital expenses is all that a family needs to secure its future

Need for Best Health Insurance Plan for Family

While you may think the savings accumulated over the entire career may be enough to take care of your medical needs. The corpus may run out earlier than you think. Health insurance for senior citizens is a crucial tool to safeguard your life savings. It will help you take care of your health needs even in an era of rising medical costs.

Covers Medical Expenses
Covers Medical Expenses
Preventive Health Check-up
Beats inflation
Save Tax
Peace Of Mind

Coverage Offered by Family Health Insurance Policies


What’s covered?

Hospitalisation (Including COVID-19)

We cover all your hospitalisation expenses arising from illnesses and injuries seamlessly. Most importantly, the Optima Secure plan includes treatment costs for Covid-19 as well.

Pre And Post Hospitalisation

Instead of 30&90 days availed normally, get 60 & 180 days pre and post hospitalisation medical expenses covered.

All Day Care Treatments

Medical advancements help in wrapping up important surgeries and treatments in less than 24 hours, and guess what? We cover you for that as well.

Preventive Health Check-Up At No Cost

Prevention is certainly better than cure and that’s why we offer a free health check-up on renewing your health insurance policy with us.

Emergency Air Ambulance

Optima secure plan is tailored to reimburse the cost of air ambulance transport upto ₹5 lacs too.

Road Ambulance

Optima Secure plan covers road ambulance cost upto the sum insured.

Home Healthcare

It will pay for the medical expenses incurred by you on home hospitalisation, if advised by the Doctor on cashless basis.

Organ Donor Expenses

It cover medical expenses for harvesting a major organ from the donor’s body where insured is the recipient.

Alternative Treatments

It cover treatment costs upto the sum insured towards in-patient care for alternative therapies like Ayurveda, Unani, Siddha, Homeopathy, Yoga and Naturopathy.

Lifelong Renewability

Our health insurance policy covers your medical expenses for a lifetime on break free renewals.

What’s  Not Covered?

Adventure Sport Injuries

Adventures can give you an adrenaline rush, but when coupled with accidents, it can be hazardous. Our health insurance plan does not cover accidents encountered while participating in adventure sports.

Breach Of Law

We do not cover expenses for treatment directly arising from or consequent upon any insured person committing or attempting to commit a breach of law with criminal intent.

War

War can be disastrous and unfortunate. However, our health insurance plan does not cover any claim that is caused due to wars.

Excluded Providers

We do not cover expenses incurred towards treatment in any hospital or by any Medical Practitioner or any other provider specifically excluded by the Insurer. (Contact us for list of de empanelled hospital)

Congenital External Diseases, Defects Or Anomalies,

We understand that treatment towards congenital external disease is critical however, we do not cover medical expenses incurred for Congenital external diseases defects or anomalies.
(Congenital diseases refer to birth defects).

Treatment For Alcoholism & Drug Abuse

Treatment for Alcoholism, drug or substance abuse or any addictive condition and consequences thereof remains uncovered.

Group Mediclaim

A Group Mediclaim policy is purchased by an employer from the insurance company for the well-being of the employees. In order to offer this policy, either the employer pays the applicable insurance premium or a specific amount is deducted from the employees’ CTCs (Cost to Company) for paying the premium cost. The primary objective of the plan is to insure a company’s employees against various health risks in accordance with the policy’s terms and conditions. 

When it comes to the group health insurance portfolio, there are a multitude of schemes available, for example, plans for critical illness, plans for individuals, family floater health insurance, etc. On an ideal basis, at least one scheme must be a part of a company or an organization. This provides a kind of financial backup in the time of a health scare.

Happy Employees is Equal to Better Performances

Group Mediclaim Inclusions


  • Pre-Existing Illness: Any illness before joining the company or organization will be covered.
  • Pre- & Post-Hospitalization: All the expenses that occurred due to pre and post-hospitalization processes, such as diagnosis, treatment, medications, surgery, etc. will be covered.
  • Daycare Treatments: Covers all the expenses of daycare treatments, such as cataract surgery, dialysis, chemotherapy, etc.
  • Maternity Coverage: Provides coverage for the medical expenses associated with the maternity treatments, such as deliveries, medications, follow-up treatments, newborn child benefits, etc.
  • Family Coverage: Covers immediate family members of the employee, such as parents, spouse, children, etc.
  • Chronic Illness Coverage: Covers all the expenses related to chronic illnesses, such as diabetes, arthritis, etc.
  • Cashless Hospitalization: During medical emergencies, the employees can avail cashless treatment in the registered hospital. He/she does not need to carry cash in bulk to commence with the treatment.
  • Additional Coverage: The plan also provides coverage for ICU charges, ambulance charges, organ donors, etc.

Group Mediclaim Exclusions

  • Self-Imposed Injury: No coverage for suicide, suicide attempts, etc.
  • Injuries Arising Due to Narcotic Substances: Any expense arising due to consumption of alcohol or drugs will not be covered.
  • Cosmetic Surgery: Plastic surgery, artificial implants, and various other cosmetic treatments are not included.
  • Congenital Diseases: Any disease or disability occurring due to a birth defect will not be covered. Treatment of AIDS, as well as other related diseases, will also not be covered.
  • Non-Allopathic Treatments: Any non-allopathic treatment, such as ayurvedic treatment, will not be covered.

Claim Process

Contacting the Insurance Provider

Attaining Guidance

Filling the Form

Attaching Documents

Sending Claim

Assessment and Verification of Documents

Settling the Claim

Documents Required

 

  • Duly filled claim form with the sign of recognized doctor or hospital
  • Cash memos
  • Medical reports
  • Final medical bills
  • Police report (in accident cases)
  • Investigation report
  • Discharge summary
  • Prescriptions from a recognized doctor