Your physical health and those of your family members cannot be taken lightly. With the ever-increasing medical costs, providing quality health care to your loved ones can
prove to be a costly exercise. Having adequate financial protection for contingencies is the need of the hour. But now you can relax with the Smart Health – High Deductibles Insurance Policy. This policy acts as a top-up cover for any of your existing health insurance policy – It offers extended coverage for hospitalisation expenses incurred for treatment of disease, illness and injury after applying the deductible, that you have opted for.
What does this policy cover?
The policy provides the following coverage:
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Hospitalisation benefit
Covers hospitalisation expenses including doctor fees, room charges, expenses towards surgery and medicine costs, incurred for treatment of disease, illness or injury. The payment or reimbursement is subject to applying the deductibles agreed for.
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Pre and post hospitalisation expenses
Reimburses medical expenses related to disease or injury, requiring hospitalization,,for a period of 30 days prior to hospitalisation and for a period of 60 days post hospitalisation
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Pre-existing diseases
Covers expenses incurred for treatment relating to pre-existing diseases, illness or injury, after 4 continuous renewals with us.
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Transplantation of organs
Provides coverage for hospitalisation expenses incurred towards donor in case of major organ transplantation
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Ambulance charges
Provides reimbursement of expenses incurred for the transportation by ambulance to and from the hospital for treatment.
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In-patient physiotherapy charges
Provides for reimbursement of charges incurred towards physiotherapy in the hospital for the treatment of the disease, illness or injury.
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Accompanying person’s expenses
Provides an allowance towards expenses incurred on the accompanying person at the hospital.
What are the additional benefits offered?
Renewal discount
Discount equivalent to 5% of renewal premium every year will be given back to the Insured as Renewal Discount at the time of renewal for every claim-free year. This renewal discount on a progressive scale will be allowed upto 25%.
Income tax benefit
Premium paid under the policy shall be eligible for income tax deduction benefit under Sec. 80 D as per the Income Tax Act.
Eligibility
The policy is applicable for persons from the age group of 5 years to 70 years. However, children in the age below the age of 5 years can be covered if any one of the parents are also concurrently covered.
The policy can be issued to cover you, your spouse and two dependent children upto the age of 23 years.
What does this policy not cover?
The policy does not cover expenses relating to:
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Medical expenses incurred for treatment undertaken for disease or illness and/or for critical illness within the first 30 days of the inception date of the first policy.
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Pre-existing diseases / illness / injury / conditions. However, the same would be covered from the 5th year of the policy after four continuous renewals with the company without a break.
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Dental treatment or surgery of any kind unless requiring hospitalisation.
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Treatment of cataract, benign prostatic hypertrophy, dilation and curettage, hernia, hydrocele, congenital internal disease and other such treatments during the first year of the operation of the policy. However, this exclusion doesn’t apply for subsequent renewals with the company without a break.
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Birth control procedure, hormone replacement therapy or any expense related to pregnancy or child birth.
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Aesthetic treatment, cosmetic surgery and plastic surgery.
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AIDS and all diseases, illness and injury related to HIV.
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Vitamins and tonics unless forming part of treatment for disease, illness or injury.
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Sex change treatment.
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Treatment of mental disease / illness, stress, psychiatric or psychological disorders.
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Any criminal act.
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War, terrorism and nuclear group of perils.
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Naturopathy treatment.
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Any treatment received outside India.
This is not an exhaustive list. For a detailed list of exclusions, please read our policy terms and conditions.
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