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^* 20% Co-payment applicable on treatments taken on Non - Smart Select network hospitals

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Mediclaim Policy

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Super Saver

Care 3 ( 4 Lac )

Elite

Care 4 (5,7,10 Lacs)

Elite Plus

Care 5 (15,20,25,30,40 Lacs)

Global

Care 6 (50,60,75 Lacs)

Global Plus

Care 7 (1,2,3,6 Cr)

Features/ Plan (SI)	Care 3 ( 4 Lac ) Super Saver	Care 4 (5,7,10 Lacs) Elite
Deductible in policy period	Yes, Rs.10,000	No deductible
In patient hospitalization	Upto Sum Insured	Upto Sum Insured
Pre-hospitalization	30 days	30 days
Post-hospitalization	60 days	60 days
Day Care Treatments	Yes	Yes
Room Rent	1% of SI per day	Single Private Room
ICU charges	2% of SI per day	No Sub-Limit
Ambulance Cover	Rs.1,500/ hospitalization	Rs.2,000/ hospitalization
Daily Allowance	Rs.500/ day upto 5 days	-
Domicilliary hospitalization	Upto 10% of SI	Upto 10% of SI
Health Check-up	Yes, all members	Yes, all members
Recharge of SI	Yes	Yes
No Claim Bonus	Yes	Yes
Organ Donor Cover	Rs.50,000	Rs.100,000
Second opinion	Yes	Yes
Alternative Treatments	Upto 15,000	Upto 20,000

Features/ Plan (SI)	Care 4 (5,7,10 Lacs) Elite	Care 5 (15,20,25,30,40 Lacs) Elite Plus
In patient hospitalization	Upto Sum Insured	Upto Sum Insured
Pre-hospitalization	30 days	30 days
Post-hospitalization	60 days	60 days
Day Care Treatments	Yes	Yes
Room Rent	Single Private Room	Single Private Room (upgradable to next level)
ICU charges	No Limit	No Limit
Ambulance Cover	Rs.2,000/ hospitalization	Rs.2,500/ hospitalization
Domicilliary hospitalization	Upto 10% of SI	Upto 10% of SI
Health Check-up	Yes, all members	Yes, all members
Recharge of SI	Yes	Yes
No Claim Bonus	Yes	Yes
Organ Donor Cover	Rs.100,000	Rs.200,000
Second opinion	Yes	Yes
Alternative Treatments	Upto Rs.20,000	Upto Rs.30,000

Features/ Plan (SI)	Care 5 (15,20,25,30,40 Lacs) Elite Plus	Care 6 (50,60,75 Lacs) Global
In patient hospitalization	Upto Sum Insured	Upto Sum Insured
Pre-hospitalization	30 days	30 days
Post-hospitalization	60 days	60 days
Day Care Treatments	Yes	Yes
Room Rent	Single Private Room (upgradable to next level)	Single Private Room (upgradable to next level)
ICU charges	No Limit	No Limit
Ambulance Cover	Rs.2,500/ hospitalization	Rs.3,000/ hospitalization
Domicilliary hospitalization	Upto 10% of SI	Upto 10% of SI
Health Check-up	Yes, all members	Yes, all members
Recharge of SI	Yes	Yes
No Claim Bonus	Yes	Yes
Organ Donor Cover	Rs.200,000	Rs.300,000
Second opinion	Yes	Yes
Alternative Treatments	Upto Rs.30,000	Upto Rs.40,000
Care Anywhere	-	Yes
Maternity Cover	-	Upto 100,000

Features/ Plan (SI)	Care 6 (50,60,75 Lacs) Global	Care 7 (1,2,3,6 Cr) Global Plus
In patient hospitalization	Upto SI	Upto SI
Pre-hospitalization	Upto SI ,30 days	Upto SI , 30 days
Post-hospitalization	Upto SI ,60 days	Upto SI , 60 days
Day Care Treatments	Upto SI	Upto SI
Room Rent	Single Private Room (upgradable to next level)	Single Private Room (upgradable to next level)
ICU charges	No Limit
Ambulance Cover	Rs.3,000/ hospitalization	Rs.3,000/ hospitalization
Domicilliary hospitalization	Upto 10% of SI	Upto 10% of SI
Health Check-up	Yes, all members	Yes, all members
Recharge of SI	Yes, Up to SI (Once in a Policy Year)	Yes, Up to SI (Once in a Policy Year)
No Claim Bonus	Yes	Yes
Organ Donor Cover	Rs.300,000	Rs.500,000
Second opinion	Yes	Yes
Alternative Treatments	Upto Rs.40,000	Upto Rs.50,000
Care Anywhere	Yes	Yes
Maternity Cover	Upto 100,000	Upto 200,000
Vaccination Cover		Yes, Upto Rs. 10,000
Global Coverage: (excluding USA) Coverage outside India & USA - 45 continuous days in a single trip; Max. 90 days on a cumulative basis, in a Policy Year		Up to SI for Hospitalization Expenses & up to the limit specified under `Maternity Cover` towards Maternity expenses; With a 10% co-payment per Claim
Special Add on cover:
Global Coverage - Total Geographical scope of Benefit `Global Coverage (excluding USA)` is extended to USA also		Up to SI for Hospitalization Expenses & up to the limit specified under `Maternity Cover` towards Maternity expenses; With a 10% co-payment per Claim

Features/ Plan (SI)	Care 7 (1,2,3,6 Cr) Global Plus
In patient hospitalization	Upto SI
Pre-hospitalization	Upto SI , 30 days
Post-hospitalization	Upto SI , 60 days
Day Care Treatments	Upto SI
Room Rent	Single Private Room (upgradable to next level)
ICU charges
Ambulance Cover	Rs.3,000/ hospitalization
Domicilliary hospitalization	Upto 10% of SI
Health Check-up	Yes, all members
Recharge of SI	Yes, Up to SI (Once in a Policy Year)
No Claim Bonus	Yes
Organ Donor Cover	Rs.500,000
Second opinion	Yes
Alternative Treatments	Upto Rs.50,000
Care Anywhere	Yes
Maternity Cover	Upto 200,000
Vaccination Cover	Yes, Upto Rs. 10,000
Global Coverage: (excluding USA) Coverage outside India & USA - 45 continuous days in a single trip; Max. 90 days on a cumulative basis, in a Policy Year	Up to SI for Hospitalization Expenses & up to the limit specified under `Maternity Cover` towards Maternity expenses; With a 10% co-payment per Claim
Special Add on cover:
Global Coverage - Total Geographical scope of Benefit `Global Coverage (excluding USA)` is extended to USA also	Up to SI for Hospitalization Expenses & up to the limit specified under `Maternity Cover` towards Maternity expenses; With a 10% co-payment per Claim

Claim Process
Everyday Care

Claim Processing

Claim Intimation

In case of emergency, please intimate us within 48 hours of hospitalisation.
If planned hospitalisation, intimate us 48 hours prior to your admission.

1800-200-4488

1800-200-6677

customerfirst@religarehealthinsurance.com

Cashless
Request for Pre-Authorisation

Re-imbursement
Claim Form Submission

Complete the pre-authorisation form available at the hospital's insurance/TPA Desk and send us through email/fax. This form can also be downloaded from here.

Submission of claim form along with required documents, as per the policy terms & conditions. The form can be downloaded from here.

	Approved letter sent by the claim management team

	Hospital/Insurance to respond to any query raised by the claim management team

	You may initiate the treatment and file for reimbursement claim

	Approved letter sent by the claim management team

	Insured to respond to query, if any, raised by the claim management team

	We will communicate the reason in case of rejection

To see list of network hospitals for cashless treatment or for further information please click here. You may also call us on 1800-200-4488 or write to us at customerfirst@religarehealthinsurance.com

Why do I need health insurance?

Everyone is exposed to various health hazards. If you don’t have Health Insurance, you end up paying hefty medical bills in the event of hospitalization out of illness or injury from your own pockets. Effectively, this means that your savings would become nil. Or in case your do not have enough money for treatment; you may have to borrow and incur a debt for medical treatment.

In such circumstances, health insurance comes to your rescue. It is a means to shield you against unforeseen financial medical urgency due to illness of injury.

Health insurance covers the cost of private medical treatment for illness and injury that is curable.

Health insurance is necessary owing to increasing medical costs these days & uncertain environment.Therefore, insuring your family against Health Insurance is a must & should surely be a part of your regular financial planning.

What is the difference between a family floater and critical illness or hospital cash insurance?

The individual or family floater health insurance works on the principle of indemnity. This means that these insurance policies will pay you only what you have spent for medical treatment in hospital. On the other hand, the critical illness or the hospital cash insurance pays you the amount insured, irrespective of the amount spent for medical treatment. These are a benefit based policies.

How would I benefit by buying health insurance at a young age?

Health insurance premium tends to increase with age - more the age, higher the premium.
You can be covered for medical conditions that may be diagnosed over the years provided there is no break in the policy.
In addition, each 'no claim’ year would fetch you a discount on your premium or an increase in your sum insured amount at no extra cost. The treatment in case of ‘no-claim’ bonus varies from company to company.
Lastly, income tax benefit under Section 80 D of the Income Tax Act.

Why is it necessary for me to disclose my current health status correctly and accurately while I buy a health insurance policy?

Insurance is a contract of utmost good faith. It always pays to be honest. Declaring the correct and accurate health status at the time of buying health insurance ensures smooth processing of your application. This will also help us service you in a better manner.

What is beneficial for me - floater insurance or an individual insurance?

Buying an individual cover or a floater cover is an individual’s perception. However, as a general rule, at younger ages floater cover is advisable. As you grow older, you should go for an individual cover.

How does a Floater cover work?

For instance a person wants a health insurance for himself, his spouse & their children, the Family Floater plan offers insurance coverage to the entire family under one premium payment. Let’s take an example wherein the person insures himself, his spouse & the dependent children with the individual insurance plans with a sum insured of Rs. 1 lakh each, he ends up paying premium ranging between Rs. 1000 - Rs. 2000 for each family member. On the other hand if the person would have opted for the family floater plan with the sum insured of Rs. 3 lakhs, the total premium would surely be less than the separate premium payments in individual health insurance plans. Moreover the separate health plan holds the cover of only Rs. 1 lakh as against Rs. 3 lakh in case of the Floater plan thus helping the family in case the medical treatment costs go beyond that. This Rs. 3 Lac is available for each of the family members individually as well as collectively.

What is a No Claim Bonus?

This concept works on the same lines as the no-claim bonus on your car insurance. A Policyholder, who hasn’t made any claim in a year, can use the bonus to their benefit the following year.

Similarly, CARE offers a 10% increase in the policy sum insured for every claim-free year, with no change in premium. So, a policy with a sum insured of Rs 5 lakh, will get an extended cover of Rs 50,000 the following year at the same premium. A claim-free third year will see him earning another ten per cent extra cover on his base sum insured, taking the total to Rs 6 lakh. A maximum bonus of up to 50 per cent is permissible.

In case of claim, the accumulated bonus is reduced by 10%.

How does the Auto recharge work?

We will automatically recharge the sum insured, in case the sum insured and any no claim bonus accumulated is exhausted during the policy year. The sum insured will be recharged once in a policy year. Recharge Sum Insured can be used for future claims and not against an illness/disease (including its complications) for which a claim has already been made in the current policy year.

Do I need to undergo a medical check-up while buying a health insurance policy?

You may be required to undergo a medical check-up after you buy, incase any member to be insured is above 45 age or for sum insured Rs. 15 Lakhs or above. In most of the cases, the medical tests are done in your home, after taking appointment from you. No payment is required upfront for the same. Incase the policy is issued, you will not be charged anything. However, if the policy is declined/Canceled, medical charges will be deducted from the refundable premium amount. This will enable us a better understanding of your current and future health requirements. For further details, please refer to the prospectus or call 1800-200-4488 (Toll free).

How do I cancel my health insurance policy?

We offer a free look period to review your policy terms and conditions. In case you are not satisfied with these, you can request for cancellation of your policy during this period. You will be charged the pro-rated premium for the period during which your policy was in-force, the cost of pre-policy health check-up, if any, and the stamp duty. The balance premium would be refunded.

Also, you can request for cancellation of your policy at any time during the policy period. You will be refunded the premium amount as per the short scale grid. The grid is available in your Policy Terms and Conditions. However, in case you have reported any claim with us, you will not be entitled to any refund of premium on cancellation of the policy.

What is Co-payment?

Health Insurance companies use Co-Payment after insured member turns a certain age. Co-pay is that part of your claim amount, which you have to bear. Co-pay can be in % terms or an absolute amount. For example, in case of co-pay of 20% and claim of Rs. 10,000, we will pay you Rs. 8,000 (80% of 10K) and you will bear 20% (Rs. 2,000). In Religare Health Insurance policy there is No Co-payment ever, if insured with us before age of 61.

What are the documents required for portability?

You can apply for CARE under portability with following documents:

CARE proposal form
Portability form
Copy of expiring health insurance policy
Copy of renewal notice

Policy Terms
Minimum entry age	91 days
Maximum age	No age bar
Renewal	Lifelong Renewability. The Policy can be renewed under the then prevailing Health Insurance Product or its nearest substitute approved by IRDA.
Renewal premium	Premium payable on renewal and on subsequent continuation of cover arc subject to change with prior approval from IRDA.
Co-payment	No Co-payment in policy, if age of the eldest member insured with us at the time of first policy is below 61 years. 20% Co-payment will be applicable in policy, if age of the eldest member insured with us at the time of first policy is 61 years or above 61 years i.e. you will have to pay 20% of the claim amount under the policy, if any. We pay the rest.
Waiting period	30 days for any illness except injury
Waiting period for pre-existing illnesses	Four years of continuous coverage
Change in sum insured	You can enhance your sum insured under the policy only upon renewal
Grace period	30 days from the date of expiry to renew the policy

Self Help