Raheja QBE Cancer insurance

Raheja QBE Cancer insurance benefits

• Eligibility criteria of Raheja QBE Cancer insurance

  • Entry Age:
    1 day to 70 years can opt for this insurance cover.
  • For policies continued without any break there will be no exit age.

• Coverages details of Raheja QBE Cancer insurance

  • All individuals in the age group of 1 day to 70 years can opt for this insurance cover with Raheja QBE.
  • In case an insured is diagnosed with Cancer and this requires diagnostic investigation or treatment by a duly qualified medical practitioner or medical practitioner, Raheja QBE pays the insured:
    • 50% of the Sum Insured or Rs. 250,000.00 whichever is less, as a lump sum amount on the acceptance of a claim under the Policy; and
    • reasonable charges for medical expenses actually incurred by the insured in the diagnostic investigation or medical treatment on the medical advise of a medical practitioner of Cancer, in excess of 75% of the benefit amount paid as a lump sum as stated above.
  • It is agreed and understood that the total liability of Raheja QBE under this Policy for any and all claims made in respect of the insured is restricted to the sum insured mentioned in the schedule.
  • Reimbursement of medical expenses will be based on submission of original bills and receipts of tests only. Reimbursement of claims will be made every quarter for actual expenses incurred, until the entire sum insured is exhausted.
  • Also if an insured is diagnosed as suffering from Cancer and reports a claim during the period of insurance, he/she can continue to receive benefits under the Policy up to the sum insured limit even after the expiry of Policy for up to 5 yrs from the inception of the Policy.
  • For policies continued without any break there will be no exit age.
  • For all claim-free policies subsequently renewed in accordance with the terms of the Policy, there will be an increase in the amount payable towards reasonable charges for medical expenses by 5% for the immediately following period of insurance provided that the cumulative bonus over all periods of insurance shall not exceed 25%. The earned cumulative bonus will not be lost if the policy is renewed within the 30 day grace period.

  
  Sum Insured Options
  Sum insured options starting from Rs.1 Lac and in multiples thereof subject to a maximum of Rs. 10 Lacs available under this policy.

• Pre Policy Medical Examination

  • All Insureds less than 50 years of age will be accepted for this insurance cover on the basis of the self declaration provided as well as certification of good health by a registered medical practitioner as given in the proposal form.

    Men	Clinical Examination, Prostate Specific Antigen Test, Stool examination -occult blood, Complete blood count, chest X-ray, Ultrasound of upper abdomen
    Women	Clinical Examination, CBC, Chest X-Ray, PAP Smear, Mammogram, Stool examination occult blood, Complete blood count, Ultra sound of Pelvis

  • All Insureds above the age of 50 years will be accepted for coverage after medical examination. Medical examinations required will be:
  • Reimbursement towards medical expenses for pre-policy medical examination will be limited to 50% of actual expenses.

• Exclusions of Raheja QBE Cancer insurance

  • First 30 days Waiting Period
    • No claim, however, shall be payable on any account whatsoever, if the Insured is diagnosed with Cancer within a period of thirty days from the commencement of the initial Period of Insurance specified in the Schedule.
    • This exclusion shall not, however, apply if the Insured Person has Continuous Coverage for more than twelve months.
  • Nuclear, chemical or biological attack as define below.
    • Nuclear attack or weapons means the use of any nuclear weapon or device or waste or combustion of nuclear fuel or the emission, discharge, dispersal, release or escape of fissile/ fusion material emitting a level of radioactivity capable of causing any Illness, incapacitating disablement or death.
    • Chemical attack or weapons means the emission, discharge, dispersal, release or escape of any solid, liquid or gaseous chemical compound which, when suitably distributed, is capable of causing any Illness, incapacitating disablement or death.
    • Biological attack or weapons means the emission, discharge, dispersal, release or escape of any pathogenic (disease producing) micro-organisms and/or biologically produced toxins (including genetically modified organisms and chemically synthesized toxins) which are capable of causing any Illness, incapacitating disablement or death.
  • Raheja QBE shall not be liable for making any payment under the Policy for any cancer or cancer related condition which is a Pre – Existing Disease. All Insureds above the age of 65 years to whom cover under this insurance is extended by Raheja QBE after medical examination and confirmation of no Cancer that is
    • a Pre – Existing Disease in the proposal form and are later on detected with Cancer in advanced stages will not be denied cover on the basis of the disease being a Pre – Existing Disease.
  • Raheja QBE shall not be liable to make any payment under the Policy for any costs or expenses incurred on AYUSH treatments.
  • No claim shall be payable under this Policy unless the diagnostic investigation reveals positive existence or presence of Cancer. Raheja QBE reserves its right to ask the Insured to present himself/herself for examination by a Medical Practitioner who is an oncologist for acceptance a claim under this Policy.