Key Highlights

Cashless Treatment at 4500+ Network Hospitals

You don’t have to pay even a single paisa from your own pocket in more than 4500+ network hospitals, for all the treatments that are covered by the policy. The Insurer shall pay for your treatment directly to the hospital, maximum up to Sum Insured.

Day Care Treatments

Insurance company will pay for more than 500 treatments that would require hospitalization for less than 24 hours. (Due to advancement in Technology). Please refer the terms for exact list of procedures.

Covers expenses related to childbirth

Policy covers upto R 15,000 for normal delivery and R 25,000 for C-Section per event, after a Waiting Period of 48 months. Waiting period can be reduced to 24 months with optional cover: Reduction in maternity waiting.

Key Product Benefits to Check

Worldwide Emergency Cover

You can get reimburserd for all the medical expenses incurred for emergency treatments for an illness or injury sustained or contracted outside of India which cannot be postponed until Insured Person has returned to India.

Expenses before and after Hospitalization

Get covered for all your claim related medical expenses 60 days before your hospitalization and upto 180 days after your discharge. This list may include follow-up visits, medication, diagnosis… etc.,

Ambulance Cover

You can claim upto Rs.3000 for necessary transportation fares by Ambulance required for rescuing your health condition.

Organ Donor Cover

Medical expenses of organ donor are covered upto Sum Insured, in case of organ transplant.

Expenses for the Treament taken at Home

You can cover the Medical Expenses, if you are bound to take treatment at home in case either if you are not in a condition to be moved to Hospitals or hospital room may not be available when you need the medical trea tment the most or even it involves medical treatment for a period exceeding 3 days.

Restoration of Sum Insured

The Insurance company shall restore your sum insured once in a policy year, if base sum insured and bonus is insufficient to settle a claim subject only if the Restored Sum Insured shall not be available for claims towards an Illness/ disease/ Injury (including its complications) for which a claim has been paid in the current Policy Year for the same Insured Person.

Exclusions to note

Pre exisiting diseases

In the first 4 years of subscription, Cigna will not pay for treating medical conditions that you may have been suffering from before purchasing the policy.

30 days waiting period

You can only claim for treatments of accidental injuries for the first 30 days after taking the policy

2 years waiting period

This policy covers some diseases/treatments like Cataract, Hysterectomy, Kidney Stone, Varicose veins, surgery of Tonsils and sinuses …etc., only after 2 years.

Additional Covers Available

Reduction in Maternity Waiting Period

This option helps you to reduce the mandatory waiting period on Maternity from 48 months to 24 months from the date of inception of first policy, depending upon the plan selected. In case of opting for this benefit, the new born baby cover and first year vaccinations will also follow reduction in waiting period under maternity cover and coverage under both the features will be capped as per the limits specified under Maternity Sum Insured as opted by the insured.

Critical Illness

This cover will provide lump sum amount equal to Sum Insured in case of first diagnosis of the covered critical illnesses. In case of a family floater policy, once a claim has been paid for a critical illness under this benefit Cigna will provide for 100% reinstatement of Sum Insured once during the lifetime of the policy for the other person covered.

Cumulative Bonus Booster

This cover helps to increase your Sum Insured by 25% for each claim free year up to a maximum of 100% when there are no claims paid or outstanding in the expiring Policy Year provided that the policy is renewed without a break.

FAQ’s

What is the maximum number of claims allowed over a year?

Any number of claims is allowed during the policy period. However the sum insured is the maximum limit under the policy.

What Identification proof do I have to carry for Hospitalisation?

You should carry thelHealth card provided by the company with this Policy, along with a valid photo identification proof (Voter ID card / Driving License / Passport / PAN Card / any other identity proof as approved by the Company).

What is Health Maintenance benefit ?

This benefit covers reimbursement of outpatient expenses incurred by Insured person upto the limits specified under the plan. It can be used to cover diagnostic tests, medical aids, drugs, prosthetics, dental treatments and alternative forms of medicines.

The list of hospitals change or remain the same ?

The Company - Cigna, at its sole discretion, reserves the right to modify, add or restrict any Network Hospital for Cashless services available under the Policy. Before availing the Cashless service, the Policyholder / Insured Person is required to check the applicable list of Network Hospital on the Company’s website.

What is the time limit to submit the claim in case I do not use cashless facility?

You should submit your claim within 15 days from date of discharge from the hospital

Is my claim payable in grace period?

Cigna will not be liable to pay for any claim arising out of an Injury/ Accident/ Condition that occurred during the Grace Period.