| BENEFIT STRUCTURE - SmartHealth Insurance- OPTIMUM | |||||||
| Section | Benefits | Option 1 | Option 2 | Option 3 | Option 4 | Option 5 | |
| 1 | a. Hospitalisation (Subject to room rent limit)* | Rs. 1,00,000 | Rs. 2,00,000 | Rs. 3,00,000 | Rs.
4,00,000 (No room rent limit) |
Rs.
5,00,000 (No room rent limit) |
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| b. Coverage of pre-existing diseases (Upto sum insured) |  |
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| c. Pre-Hospitalisation for a period of 60 days (Upto Sum Insured) | |
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| d. Post-Hospitalisation for a period of 90 days (Upto Sum Insured) | |
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| 2 | Day Care Treatment (Upto Sum Insured) | |
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| 3 | Domiciliary Treatment | Rs. 10,000 | Rs. 20,000 | Rs. 30,000 | Rs. 40,000 | Rs. 50,000 | |
| 4 | Critical Illness (Separate & Additional sum insured) |
Rs. 1,00,000 (On hospitalization of insured) |
Rs. 2,00,000 ( On hospitalization of insured) |
Rs. 3,00,000 (As lump sum amount) |
Rs. 4,00,000 (As lump sum amount) |
Rs. 5,00,000 ( As lump sum amount) |
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| 5 | Dread Disease Recuperation Benefit (Max of 60 days) |
Rs. 500 per day | Rs. 500 per day | ||||
| 6 | Transplantation of Organs | Rs. 20,000 | Rs. 40,000 | ||||
| 7 | Hospital Cash Allowance (For 30 days after first 3 days ) |
Rs. 500 per day | Rs. 500 per day | Rs. 750 per day | Rs. 1,000 per day | Rs. 1,000 per day | |
| 8 | Home Nursing (For 10 days after first 3 days ) |
Rs. 500 per day | Rs. 500 per day | Rs. 500 per day | Rs. 500 per day | Rs. 500 per day | |
| 9 | Ambulance Charges | Rs. 2,500 | Rs. 2,500 | Rs. 2,500 | Rs. 2,500 | Rs. 2,500 | |
| 10 | Inpatient Physiotherapy | Rs. 2,000 | Rs. 4,000 | Rs. 6,000 | Rs. 8,000 | Rs. 10,000 | |
| 11 | Recovery Grant | Rs. 12,500 | Rs. 12,500 | Rs. 12,500 | Rs. 12,500 | Rs. 12,500 | |
| 12 | Accompanying Person Expenses (For 10 days after frist 3 days) |
Rs. 250 per day | Rs. 250 per day | Rs. 250 per day | Rs. 250 per day | Rs. 250 per day | |
| 13 | Parent Accommodation as
Companion for Child (For 30 days after first 3 days) |
Rs. 250 per day | Rs. 250 per day | Rs. 250 per day | Rs. 250 per day | Rs. 250 per day | |
| 14 | Out-patient Dental Emergency Treatment (Accidents only) | Rs. 1,000 | Rs. 2,000 | Rs. 3,000 | Rs. 4,000 | Rs. 5,000 | |
| 15 | Out-patient Emergency Treatment for Accidents | Rs.2,000 | Rs.4,000 | Rs.6,000 | Rs.8,000 | Rs.10,000 | |
| 16 | Children's Education Fund | Rs. 1,000 | Rs. 2,000 | Rs. 3,000 | Rs. 4,000 | Rs. 5,000 | |
| 17 | Transportation of Mortal Remains | Rs. 1,000 | Rs. 2,000 | Rs. 3,000 | Rs. 4,000 | Rs. 5,000 | |
| * | Option 1- Normal hospitalisation - Rs 1,000 ; Intensive Care Unit(ICU)/Critical Care Unit (CCU) Rs. 2,500 per day | ||||||
| Option 2- Normal hospitalisation - Rs 2,000 ; Intensive Care Unit(ICU)/Critical Care Unit (CCU) Rs. 3,000 per day | |||||||
| Option 3- Normal hospitalisation - Rs 3,000 ; Intensive Care Unit(ICU)/Critical Care Unit (CCU) Rs 4,500 per day | |||||||