IFFCO Tokio Swasthya Kavacha Policy

IFFCO Tokio Key Features of Swasthya Kavacha Policy Insurance

• Room Rent :Capped at 1% of Base Sum Insured
• Co-pay :Co-pay upto 50% on Room Rent for admission in higher room categories
• Restoration Benefit :Restoration upto Claim Amount subject to premium payable
• Multiple sum insured options The Swasthya Kavach Health Insurance Policy comes with four floater sum insured options ranging from ₹2,00,000 to ₹5,00,000. However if buyers wishes for a sum insured that extends beyond ₹5, 00,000 up to a maximum of ₹2,000,000, then multiple policies can be issued to meet the said requirement.
• Coverage for entire family This health insurance policy offers coverage to the proposer, their spouse and 3 dependants (children, sibling, nephew, and niece). All dependents must lie in the age group of 3 months to 23 years at the time of initiation of the cover. The cover can be renewed until the oldest member covered under this policy (except the dependants) reaches 80 years of age.
• No medical check-up All buyers of 60 years of age or less do not need to undergo any medical check-up when buying this plan. For buyers beyond that age, pre-acceptance medical tests (Urine, Blood Sugar & ECG), especially in case of fresh and break coverage will be needed. Buyers of over 60 years of age will need to take a few extra medical tests (LP & KFT) too.
• Premium The premium for this health insurance plan shall depend on the sum insured and plan opted for, number of members covered and the age of the oldest member in the family.
• Insured Eligibility The Swasthya Kavach Policy can be bought by anyone, given they are residents of India.
• 24-hours hospitalization As per the plan, hospitalization of the insured must extend up to a minimum of 24 hours and in any of the network hospitals of the Insurance Company, to be covered. Treatments for 121 listed day care surgeries are however excluded from this and can be considered despite a shorter stay.
• Critical Illness Extension The optional Critical Illness Extension (for doubling of Sum Insured in respect of 10 listed major diseases) can be taken only under the Wider Plan (and not under the Base Plan), on payment of extra 30% on the basic premium.
• Automatic reinstatement of Sum Insured Special provision is available for automatic reinstatement of Sum Insured in the event of a claim under the Policy, to the extent of the claim amount paid, except for some specified chronic diseases. The reinstatement premium is computed on short period basis, from date of hospitalisation till expiry of policy, and deducted from the claim amount itself. This ensures that the Insured does not have any worries about getting the benefit of full Sum Insured again, for a subsequent claim in respect of any family member covered under the Policy, unlike the standard policies available in the market, where Sum Insured gets reduced by the claim amount for the balance period under the policy.
• Wide range of network hospitals IFFCO Tokio has a large number of network hospitals all across the country (exceeding 5000+), where cashless claim settlement facility is available. There is also 24x7 customer support service in place, for any support relating to claims.
• Portability facility Portability facility is available under the Wider Plan option, for persons desiring to switch in from covers under other Insurer’s Policies.
• Emergency medical and personal assistance Unique emergency medical and personal assistance available for all insured persons undertaking domestic travel, through the Value Added Services available under both the Plan options of this Policy,
• Cumulative Bonus Cumulative Bonus (i.e. free enhancement of Sum Insured) of 5% is granted per claim free year on renewal, subject to maximum 50% of Basic Sum Insured. In the event of a claim of any family member covered under the Policy, existing Cumulative Bonus is not entirely withdrawn, but gets reduced by 10% at next renewal, subject to the stipulation that expiring Basic Sum Insured shall be maintained. The facility of Cumulative Bonus is available only under the Wider Plan and not under the Base Plan of this policy.
• Special premium discount scheme A special premium discount scheme is available under this Policy, if the Insured has affected his Motor Insurance Policy with IFFCO Tokio, or if he/she is covered simultaneously as an employee/member under any Group Medical Policy issued by IFFCO Tokio.

IFFCO Tokio Eligibility of Swasthya Kavacha Policy Insurance

IFFCO Tokio Coverages of Swasthya Kavacha Policy Insurance

IFFCO Tokio Exclusions of Swasthya Kavacha Policy Insurance

• Cost of hearing aids, spectacles and contact lenses.
• Dental treatments that do not require hospitalization
• Expenses relating to or arising out of pregnancy, excluding ectopic pregnancy
• Convalescence, congenital diseases/defects, sterility, general debility
• Cost of external medical equipment
• Claims arising from or related to HIV/AIDS
• Claims arising out of participation in dangerous sports/activities
• War, terrorism and nuclear risks
• Treatment of obesity, hormone replacement therapy, sex change
• All non-medical expenses, including personal comfort and convenience item services.
• Expenses on naturopathy, experimental or alternative medicine, acupressure, acupuncture, magnetic and similar therapies
• Genetic disorders stem cell implantation and surgery.
• First 10% of any admissible claim, if insured person is suffering from either diabetes or hypertension and first 25% of claim, if he is suffering from both diabetes and hypertension. (This provision is applicable for claims arising out of diabetes and/or hypertension only)
• Any domiciliary or out-patient treatment
• Pre-existing diseases – This health insurance plan does not cover pre-existing diseases suffered by the policyholder, up to 4 years of continuous coverage from the start of the Medical Policy.
• Waiting period – Even in case of newly incurred diseases (excluding accidents), coverage will only kick in after a waiting period of 30 day has passed.