Digit health Arogya Sanjeevani policy

Digit Arogya Sanjeevani Policy benefits

• Eligibility Criteria of Digit Arogya Sanjeevani Policy

  • This policy coveers entry age between 18 years to 65 years
    for Dependent Child to 3 months to 25 years
  • This Policy tenure shall be for a period of one year
  • Product can be opted either on Individual Sum Insured basis or Family Floater Basis
  • Sum Insured of INR 1 lakh and maximum up to INR 5 lakhs in the multiples of INR 50,000.
  • Based on the Proposal Form shared by You, we will advise if any medical tests are required. For all proposals accepted by US, We will bear the costs of pre-policy medical check-ups.

• Coverages of Digit Arogya Sanjeevani Policy

  • Pre and post hospitalisation coverage upto 30 and 60 days.
  • AYUSH Treatment is available
  • There is no age limit for renewals.
  • Expenses related to the treatment of a pre-existing Disease (PED) and its direct complications shall be excluded until the expiry of 48 months of continuous coverage after the date of inception of the first policy with us.
  • Expenses incurred on road Ambulance subject to a maximum of Rs.2000/- per hospitalisation..
  • Coverage for day care treatment in a hospital up to 50% of Sum Insured, specified in the policy schedule, duringthe policy period.

• Exclusions of Digit Arogya Sanjeevani Policy

  • Investigation & Evaluation
    • Expenses related to any admission primarily for diagnostics and evaluation purposes only are excluded
    • Any diagnostic expenses which are not related or not incidental to the current diagnosis and treatment are excluded.
  • Rest Cure, rehabilitation and respite care
    • Expenses related to any admission primarily for enforced bed rest and not for receiving treatment. This also includes:
      • Custodial care either at home or in a nursing facility for personal care such as help with activities of daily living such as bathing, dressing, moving around either by skilled nurses or assistant or non-skilled persons.
    • Any services for people who are terminally ill to address physical, social, emotional and spiritual needs
  • Obesity/ Weight Control
    • Expenses related to the surgical treatment of obesity that does not fulfil the policy conditions
    • Obesity-related cardiomyopathy
    • Coronary heart disease
    • Severe Sleep Apnea
    • Uncontrolled Type2 Diabetes
  • Change-of-Gender treatments
    • Expenses related to any treatment, including surgical management, to change characteristics of the body to those of the opposite sex.
  • Cosmetic or plastic Surgery
    • Expenses for cosmetic or plastic surgery or any treatment to change appearance unless for reconstruction following an Accident, Burn(s) or Cancer or as part of medically necessary treatment to remove a direct and immediate health risk to the insured. For this to be considered a medical necessity, it must be certified by the attending Medical Practitioner.
  • Hazardous or Adventure sports
    • Expenses related to any treatment necessitated due to participation as a professional in hazardous or adventure sports, including but not limited to, parajumping, rock climbing, mountaineering, rafting, motor racing, horse racing or scuba diving, hand gliding, sky diving, deep-sea diving.
  • Breach of law
    • Expenses for treatment directly arising from or consequent upon any Insured Person committing or attempting to commit a breach of law with criminal intent.
  • Excluded Providers
    • Expenses incurred towards treatment in any hospital or by any Medical Practitioner or any other provider specifically excluded by the Insurer and disclosed in its website / notified to the policyholders are not admissible. However, in case of life threatening situations or following an accident, expenses up to the stage of stabilization are payable but not the complete claim.
  • Treatment for, Alcoholism, drug or substance abuse or any addictive condition and consequences thereof.
  • Dietary supplements and substances that can be purchased without prescription, including but not limited to Vitamins, minerals and organic substances unless prescribed by a medical practitioner as part of hospitalization claim or day care procedure .
  • Expenses related to the treatment for correction of eye sight due to refractive error less than 7.5 diopters.
  • Unproven Treatments
    • Expenses related to any unproven treatment, services and supplies for or in connection with any treatment. Unproven treatments are treatments, procedures or supplies that lack significant medical documentation to support their effectiveness.
  • Sterility and Infertility
    • Expenses related to sterility and infertility which includes any type of contraception, sterilization, Assisted Reproduction services including artificial insemination and advanced reproductive technologies such as IVF, ZIFT, GIFT, ICSI, Gestational Surrogacy, Reversal of sterilization
  • Maternity Expenses
    • Medical treatment expenses traceable to childbirth (including complicated deliveries and caesarean sections incurred during hospitalization) except ectopic pregnancy;
    • expenses towards miscarriage (unless due to an accident) and lawful medical termination of pregnancy during the policy period.
  • War (whether declared or not) or invasion, acts of foreign enemies, hostilities, civil war, rebellion, revolutions, insurrections, mutiny, military or usurped power, seizure, capture, arrest, restraints and detainment of all kinds.
  • Nuclear, chemical or biological attack or weapons, contributed to, caused by, resulting from or from any other cause or event contributing concurrently or in any other sequence to the loss, claim or expense.
  • Circumcision unless necessary for treatment of an Illness or as may be necessitated due to an Accident.

  Disclaimer "For the detailed list of exclusions under the policy, kindly refer to the same provided in your policy kit”