Future Generali Insurance plans

Future Generali Health Insurance

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Plan Type
Coverage type
Coverage amount
Date of birth
  OR age    years
Policy duration
Start date
End date
* Name, Email Id & Mobile No. are required 

Key highlights of Health Insurance

  • Room, Board & Nursing Expenses as provided by the hospital/nursing home including registration and service charges
  • Surgeon, Anaesthetist, Medical Practitioner, Consultants, Specialists Fees
  • Anaesthesia, Blood, Oxygen, Operation Theatre Charges, Surgical Appliances, Medicines & Drugs, Diagnostic Materials and X-ray, Cost of Pacemaker, prosthesis/internal implants and any medical expenses incurred which is integral part of the operation

Future Generali Health Insurance Review

Future Generali Health Insurance
Future Generali Health Insurance sum insured
3 lacs − 100 lacs options available
Incurred Claims Ratio *
Health Insurance tenure options
Policy extends from 10 yrs to 30 yrs
Claims Settlement Ratio **
List of network hospitals
6,300+ hospitals
Number of policies issued *
Maximum family floater coverage
Self, Spouse + dependent (children + parents)
Number of lives covered *
* As per IRDAI report for 2020-21   |   ** As per NL25 data published on the Insurance Company website

Future Generali Health insurance products

Key Features:
Health Total is a Comprehensive Retail Health Product with wider and long term coverage.
Key Features:
Future Hospicash is a cover that provides cash benefit in case of hospitalisation to avoid eating one’s savings.
Key Features:
Future Vector Care is a health insurance product that provides a lump sum benefit in case the insured is diagnosed and hospitalised due to serious diseases caused by vectors
Key Features:
The Criti Care policy will pay a lump sum benefit in the event of a diagnosis or procedures for any of the critical illnesses listed below. This is subject to a waiting period of 90 days from the date of commencement of the policy and 28 days from the date of diagnosis or procedure for the survival of the insured.
Future Advantage Top Up plan supplements your existing health insurance where you can go above and beyond a deductible limit for higher insured sums.
Future Health Surplus Insurance plan supplements your existing health insurance where you can go for higher sum insured over and above a deductible limit.
Future Aarogya Bima is an affordable health insurance policy that covers entire family. It provides cover to anyone from day 1 to 70 years thereafter till lifetime. Available on Individual & Family floater basis.
Future Varishta Bima is a health insurance plan designed just for senior citizens. It provides cover to anyone from age of 60 years and above with continuous cover thereafter till lifetime.
There are 4 different plans: Gold, Platinum, Topaz and Ruby. All plans are available with individual and floater option and with Lifelong renewal facility.
Arogya Sanjeevani Policy, Future Generali India Insurance Company Limited is a standard Retail Health Product with wider coverage for the whole family.
Key Features:
  • Policy can be availed by persons between the age of 18 years and 65 years. Proposer with higher age can obtain policy for adult members of the family, without covering self.

Key Features:
  • Policy can be availed by persons between the age of 18 years up to 65 years as Proposer. Proposer with higher age can obtain policy for family,without covering self.

Future Generali India Insurance Company Limited is a joint venture between Future Group – the game changers in Retail Trade in India and Generali – a 187 years old global insurance group featuring among the world’s 60 largest companies, as per Fortune Global 500 Ranking (2017). The company was incorporated in September 2007 with the objective of providing retail, commercial, personal and rural insurance solutions to individuals and corporates to help them manage and mitigate risks. Future Generali India has been serving the customers by leveraging upon its global Insurance expertise in diverse classes of products of Generali Group and the Indian retail game changers Future Group. Having firmly established its credentials in this segment and effectively leveraging on the skill set of both its JV partners, Future Generali India has evolved to become a Total Insurance Solutions Company.

Future Generali offers their health insurance insureds the option of availing quality treatment at more than 6500+ leading hospitals across the country. They have an incurred claims ratio of 62.00%, and also covered 11.01 lac lives during the same year 2018-19, as per the data provided by IRDAI.

Why Should One insure themselves through Future Generali Health Insurance plans?

  • Have serviced Over 16 lac customers since inception of the company
  • Future Generali settles on an average 2,10,000 claims every year
  • Presence in 125+ locations across India with around 2,000+ active corporate clients
  • Future Generali’s Health in-house servicing arm provides fast and easy claims settlement
  • Around 5,100+ cashless hospitals for Health Insurance and over 2,500+ cashless garages for Motor Insurance claims
  • Committed to providing value added features such as Future Xpress and Future Xpress+
  • We are an ISO 9001:2008 certified for quality excellence and ISO/IEC 27001:2013 an information security management system standard
  • Wide Range Of Health Insurance Products From Individual Plans to Family Floater Schemes with Sum Insureds ranging from ₹3 lacs to ₹100 lacs (₹1 cr)
  • Covers Hospitalisation Treatment including coverage for Covid 19 Expenses
  • Floater Discount: Premium applicable for the primary insured will be the standard individual premiums. For remaining dependant members, floater discounts will be applicable on their respective premium as per their age.
  • Voluntary deductible discount: Discount of 10% to 25% on premium as per the voluntary deductible and plan opted.
  • Long-term discount upto 10% applicable in case of upfront premium payment for long term policy.
  • Instalment Facility : In case of policies which are on long term basis, facility of instalment payment is available monthly, quarterly and half yearly. Loadings maximum of 5% will be applicable on standard premiums as per the instalment frequency opted.
  • Tax benefit: Premium paid by any mode other than cash is eligible for tax relief as provided under Section 80-D of the Income Tax Act.
Future Generali Health Insurance is today one of the fastest growing insurance players in India with a lot of focus on both retail and group insurance products. Today the Future Generali health insurance premium is one of the most competitive in the market across all their plans apart from being competitive in their benefit structure. They are also one of the players who have built a strong hospital network across India with a current strength of 5,100+ and growing. Most of the customer’s Future Generali health insurance reviews have been positively influencing the growth of their business year on year. One can also follow the Future Generali health insurance renewal link on eindiainsurance for renewal of their existing policies and if one needs to file a claim, all they need to do is to fill in the Future Generali health insurance claim form available on the same website.

Future Generali Health insurance benefits

  • Features
  • Eligibility
  • Benefits
  • Claims
  • Exclusions

Features of Future Generali Health insurance

  • Room Rent : NIL cap on room rent across all plans
  • Co-pay : No co-pay if entry age < 60 yrs / 20% to 40% co-pay for ages > 60 years
  • Restoration : 100% of base sum insured for all types of illnesses
  • Pre-hospitalisation expenses - We shall pay for expenses incurred 60 days prior to date of admission into the hospital.
  • Post-hospitalisation expenses - We shall pay for expenses incurred 90 days after the date of discharge from the hospital.
  • Day Care Expenses - We shall pay for Day Care expenses incurred on advanced technological surgeries and procedures requiring less than 24 hours of hospitalisation as per the attached day care list.
  • Ambulance charges - up to a maximum of Rs. 1500 per hospitalisation will be reimbursed to You on producing the bills in original.
  • Free medical check-up - At the end of every continuous period of 4 years during which You/Your family have held Our Health Suraksha policy without making a claim You/ Your family may apply to Us for a free medical check-up (Physician Consultation, ECG, Complete Blood Count, Urine Routine, Fasting blood Sugar, Post Prandial Blood Sugar, Lipid Profile, Sr. Creatinine, SGOT, SGPT, GGTP) at our Diagnostic Centre the location of which We will specify at the time of Your application. For the avoidance of doubt, We shall not be liable for any other ancillary or peripheral costs or expenses (including but not limited to those for transportation, accommodation or sustenance). The above benefit would be available for any two of the insured family members.

Eligibility of Future Generali Health insurance

  • Eligibility period - 90 days to 70 years
  • Policy can be purchased by minimum 2 adults
  • Life long renewal.
  • Above 45 years customers should get medical check up done.
  • For those within 45 years, the value of sum insured accepted will be up to 10 lakhs without medical tests. Subject to claim proposal.
  • For person above 55 years maximum sum insured will be Rs 5 lacs.

Benefits under Future Generali Health Insurance plans include :

  • Medical Expenses covered - Hospitalization Medical Expenses, Day Care Treatment expenses, Pre-hospitalization Medical Expenses, Post-hospitalization Medical Expenses, Organ Donor Expenses, Domiciliary Hospitalisation Expenses
  • Restoration of the Sum Insured - If the Sum Insured and Cumulative Bonus (if any) is exhausted due to claims payable, Restore Sum Insured (equal to 100% of the Sum Insured) will be automatically available for the particular Policy Year subject to Terms & Conditions
  • Maternity Expenses - Maternity benefit with only two years of waiting period when both husband and wife are covered together
  • Miscellaneous Coverages - Patient Care, Accompanying Person, Road Ambulance Charges, Wellness Care, E-Opinion in respect of an Illness or Injury and Alternative Treatment
  • Accidental Hospitalization - Increase in the Sum Insured by 25% of the available balance Sum Insured subject to maximum 10 lakhs in case of Accidental Hospitalisation.
  • Emergency Medical Evacuation (applicable for Superior Plan and Premiere Plan) - We will reimburse expenses under this Benefit incurred for medical evacuation from the place of local Hospitalisation /Accident to any other Hospital within India.
  • Out Patient Medical Expenses - (applicable for Superior Plan and Premiere Plan)
  • Reimburse Expenses - We shall reimburse expenses towards consultation, diagnostic tests and medications prescribed as per plan opted.
  • Child Vaccination Benefits (applicable for Premiere Plan) - We will cover charges for vaccinations for child less than 12 years of age.
  • New Born Baby - (applicable for Superior Plan and Premiere Plan)
  • Medical Treatment Abroad for listed conditions - (applicable for Premiere Plan)
  • Additional covers - Patient care, Accompanying Person, Road Ambulance Charges, E-Opinion in respect of an Illness or Injury, Alternative Treatment, Wellness Care
  • Cumulative Bonus - 50% for every claims free year to a maximum of 100% * Product coverage’s applicable would be as per plan opted
  • With Health Suraksha, the member has access to cashless facility at our empanelled hospitals across India.
  • Pre and Post hospitalization expenses incurred from 60 days prior up to 90 days after hospitalization.
  • 130 Day-care procedures.
  • Hospital cash benefit for platinum plan.
  • Pre-existing disease covered after four years of consecutive renewal.
  • Free Medical check-up in our empanelled diagnostic centres after every four claim free years.
  • Patient care expenses up to maximum of Rs 350 per day forpersons above 60 years.
  • Accompanying person expenses up to Rs 500 per day.
  • Additional accidental hospitalization limit enhanceed by 25% of balance sum insured, subject to a maximum of Rs.1 lakh.
  • Grace period of 30days from date of exipry of renewal.
  • Please note that Rs 50,000 sum insured would be available for dependent children only.
  • Loading of maximum 50% would be applicable for adverse claims experience.
  • Porting of similar health policy to Future Health Suraksha as per portability guidelines.

Claim Process

Assistance Contact Numbers :
For Health Claims
Call at : Toll Free 1800 103 8889
Call at : Toll Free 1800 209 1016
Email ID : fgh@futuregenerali.in

The indicative list of documents required is mentioned below :
  • Future Generali Claim Form properly filled in and signed by the claimant along with Medical Certificate Form filled, signed and stamped by the treating doctor.
  • Original Discharge Card / Summary from the hospital / nursing home.
  • Doctor's consultation reports / history.
  • Hospitalization and other medical Bills, Receipts in original.
  • Cash Memos from hospital / pharmacies supported by proper prescription.
  • Investigation reports.
  • Medico Legal Certificate (MLC) for accident cases.
The list given is indicative in nature. Further additional documents may be called for depending on the nature of the claim.
Cashless Claims Process
Step 1 Get admitted to any one of Future Generali network hospitals, currently they have 5100+ hospitals across India…hospital list at Future Generali Health Insurance
Call at : Toll Free 1800 103 8889
Call at : Toll Free 1800 209 1016

Before you seek medical treatment we request that you contact us 2-3 days in advance. This will allow our team to help you follow the next few steps. In case of emergency, you can contact us within 24 hours of admission to the hospital.
Step 2 Your Identification : At the network hospital you will need to show your Future Generali Health Insurance health card and valid photo ID*, along with your policy number, to be able to use your insurance. This will give the network hospital the details they need to contact us for the cashless hospitalization process.
* - Passport / PAN card / voter’s ID for identification purposes
Step 3 Hospital sends cashless hospitalization request form : The network hospital will send us the preauthorization request form which has details of medical history, line of treatment and estimated treatment cost.
Step 4 Future Generali Health Insurance contacts Hospital : Wherever the information provided in the request is sufficient to ascertain the authorization, we will issue the authorization Letter to the network hospital. Wherever additional information or documents are required we will call for the same from the Network hospital and upon satisfactory receipt of last necessary documents the authorization will be issued.
Step 5 At the time of Discharge : Hospital will send us the final request for authorization of any residual amount along with final hospital bill and discharge summary. You will be discharged from the hospital upon receipt of final authorization letter from us. Any inadmissible expenses, copayments, deductions will have to be paid by you.
Step 6 Payment to the network hospital made by Future Generali Health Insurance : Once the Hospitalization is done, hospital will send the original claim documents to us. The claim will be assessed by us and payment will be made to the network hospital

Reimbursement Claims Process
Step 1 Call at : Toll Free 1800 103 8889
Call at : Toll Free 1800 209 1016

Before you seek medical treatment we request that you contact us 2-3 days in advance. This will allow our claims service associate to help you follow the next few steps. In case of emergency, you can contact us within 24 hours of admission to the hospital.
Step 2 Avail treatment at the hospital : You can avail treatment at hospital and settle all hospitalization expenses. Collect original hospital bill, receipts, discharge summary, investigation reports, pharmacy bills and other documents from hospital at the time of discharge from hospital.
Step 3 Submit the claim documents : You have to download the claim form from our website. Copy of this form is also included in the policy kit provided to you. Alternatively, you can contact your Health advisor or visit nearest Future Generali Health Insurance branch. Submit the claim documents at nearest Future Generali Health Insurance branch or Corporate office. The documents should be submitted within 15 days from discharge from the hospital.
Step 4 We assess the claim : Wherever the information provided in the claim documents is sufficient to ascertain the admissibility of claim, we will approve the claim. Wherever additional information or documents are required we will call for the same from you and upon satisfactory receipt of last necessary documents the claim will be settled by us.
Step 5 Settlement of claim : Upon approval of claim by us, payment of the reimbursement claim will be made to the policy holder either through EFT or through cheque/DD.

Exclusions of Future Generali Health insurance

Some of the permanent exclusions under the Future Generali Health Insurance Plans are below, kindly review the policy wordings which are available with your policy kit for the entire list of exclusions under your opted plan. The exclusions include:
  • Injury or Illness directly or indirectly caused by or arising from or attributable to war, invasion, act of foreign enemy, war like operations (whether war be declared or not)
  • Circumcision, unless necessary for treatment of an Illness not excluded hereunder or as may be necessitated due to an Accident
  • Vaccination/inoculation (except as post bite treatment)
  • Cosmetic treatments (for change of life or cosmetic or aesthetic treatment of any description), plastic surgery other than as may be necessitated due to an Accident or as a part of any Illness, refractive error corrective procedures, experimental, investigational or Unproven/Experimental Treatment, devices and pharmacological regimens of any description.
  • Charges incurred in connection with cost of spectacles and contact lenses, hearing aids, durable medical equipment (including but not limited to cost of instrument used in the treatment of Sleep Apnea Syndrome (C.P.A.P), Continuous Peritoneal Ambulatory Dialysis (C.P.A.D) and oxygen concentrator for asthmatic condition, wheel chair, crutches, artificial limbs, belts, braces, stocking, Glucometer and the like), namely that equipment used externally for the human body which can withstand repeated use; is not designed to be disposable; is used to serve a medical purpose, such cost of all appliances/devices whether for diagnosis or treatment after discharge from the Hospital
  • The treatment of obesity (including morbid obesity) and other weight control programs, services and supplies
  • Expenses incurred towards treatment of Illness or Injury arising out of alcohol use/misuse or abuse of alcohol, narcotic substance or drugs (whether prescribed or not)
  • In-Vitro Fertilization (IVF), Gamete Intra Fallopian Transfer (GIFT) procedures, and Zygote Intra Fallopian Transfer (ZIFT) procedures, and any related prescription medication treatment; embryo transport; donor ovum and semen and related costs, including collection and preparation; voluntary medical termination of pregnancy; any treatment related to infertility, impotence and sterilization
  • External Congenital Anomaly and related Illness/ defect.
  • Vitamins, tonics, nutritional supplements unless forming part of the treatment for Injury or Illness as certified by the attending Medical Practitioner
  • Injury or Illness directly or indirectly caused by or contributed to by nuclear weapons/materials
  • Genetic disorders and stem cell implantation/Surgery/storage
  • Any treatment required arising from Insured participation in any hazardous activity including but not limited to scuba diving, motor racing, parachuting, hang gliding, rock or mountain climbing unless specifically agreed by Us.
  • Any treatment received in convalescent home, rehabilitation centre, convalescent hospital, health hydro, nature care clinic or similar establishments
  • Non-prescribed drugs and medical supplies, hormone replacement therapy, sex change or treatment which results from or is in any way related to sex change
  • Treatment for any mental illness or psychiatric illness
  • Personal comfort and convenience items or services such as television, telephone, barber or guest service and similar incidental services and supplies

Future Generali Health Insurance FAQ’s

Future Generali has an extensive network of 5,100+ network hospitals across India. One must get admitted to a network hospital in order to avail cashless treatment for their illness. One can get the Future Generali Health Insurance network hospital list which is available "Hospital list link"

There is no upper limit on the number of claims during the policy period. However, the total cumulative claim amount cannot exceed the Policy Sum Insured, unless the chosen plan has a Sum Insured Refill benefit, which provides additional coverage even after filing a claim.

The minimum age required for entry is 1 day. There is no limit of Maximum age for entry. Children will be covered as dependents up to 25 years of age. There is no exit age in this policy.

In case of an Individual policy, each Insured person under the policy will have a separate sum insured for them. Individual plan can be bought for self, lawfully wedded spouse, children, parents, siblings, parent in laws, grandparents and grandchildren, son in-law and daughter in-law, uncle, aunty, nephew & niece.

  • Vital Plan : Self, spouse, dependent children and dependent parents.Children will be covered as dependents up to 25 years of age.
  • Superior and Premiere Plan : Self, spouse, dependant or non-dependent children, dependent or non-dependent parents, Dependent Siblings, daughter in law, son in law, parents in law, grandparents and grandchildren.

When an insured is hospitalized and stays in hospital for more than 24 hours solely for receiving treatment it is termed as inpatient treatment. Out-patient treatment is when insured visits a clinic/hospital or a consultation room for diagnosis and treatment based on the advice of medical practitioner. In out-patient hospitalization patient is not admitted under a day care or as an in-patient.

Hospitalization under Ayurveda, Unani, Siddha, or Homeopathy (AYUSH ) are covered provided that the treatment has been undergone in a government hospital or in any institute recognized by government and / or accredited by Quality Council of India / National Accreditation Board on Health for that Alternative treatment.

Future Generali under this policy will pay the Reasonable and Customary Charges incurred for an organ donor’s treatment for the harvesting of the organ donated provided that :

  • The organ donor is any person whose organ has been made available in accordance and in compliance with the Transplantation of Human Organs Act, 1994 and the organ donated is for the use of the Insured Person;
  • We will not pay the donor’s screening expenses or pre and post hospitalisation expenses or for any other medical treatment for the donor consequent on the harvesting;
  • We have accepted claim under Hospitalisation medical expenses for the Insured Person and the Insured Person has been Medically Advised to undergo an organ transplant;
  • Costs directly or indirectly associated with the acquisition of the donor’s organ will not be covered.

If an Insured Person suffers an Illness or Injury during the Policy Period in respect of which a claim has been admitted under Hospitalisation medical expenses then at the Insured Person’s request We will arrange a maximum of two e-opinions (in a Policy Year) from a Medical Practitioner selected by the Insured Person from Our panel. The e-opinion will be based only on the information and documentation provided to the Medical Practitioner by or on behalf of the Insured Person.

If the Sum Insured and Cumulative Bonus (if any) is exhausted due to claims incurred and paid during the Policy Year or incurred during the Policy Year and accepted as payable, then it is agreed that a Restore Sum Insured (equal to 100% of the Sum Insured) will be automatically available for the particular Policy Year, provided that:

  • The Restore Sum Insured will be enforceable only after the Sum Insured and the Cumulative Bonus have been completely exhausted in that Policy Year;
  • The Restore Sum Insured can only be used for claims made by the Insured Person in respect of Benefits 1-4 (refer policy wordings).
  • The Restore Sum Insured cannot be used for claims based on Maternity Expenses/Treatment;
  • The Restore Sum Insured can be used for only future claims made by the Insured Person and not against any claim for an Illness (including its complications) for which a claim has been paid in the current Policy Year under Benefits 1-4(refer policy wordings).
  • Only the Sum Insured (excluding Cumulative Bonus) will be considered as Restore Sum Insured;
  • The Restore Sum Insured will only be applied once for the Insured Person during a Policy Year;
  • If the Restore Sum Insured is not utilised in a Policy Year, it shall not be carried forward to any subsequent Policy Year.
  • If the Policy is opted by You on a ‘Family Floater’ basis as specified in the Schedule, then the Restore Sum Insured will only be available in respect of claims made by those Insured Persons who were Insured Persons under the Policy before the Sum Insured and Cumulative Bonus was exhausted.

  • 24 months waiting period for: Pre existing conditions, Internal Congenital Anomalies, Cataracts, Benign Prostatic Hypertrophy Hernia of all types, Deviated Nasal Septum, Hypertrophied Turbinate, Hydrocele, All types of sinuses Fistulae, haemorrhoids, fissure in ano, Dysfunctional uterine bleeding, Fibromyoma, Endometriosis, Hysterectomy, All internal or external tumors/cysts/nodules/polyps of any kind including breast lumps with exception of malignant tumor or growth. Surgery for prolapsed inter vertebral disc unless arising from Accident, Surgery of varicose veins and varicose ulcers, any types of gastric or duodenal ulcers, stones in the urinary and biliary systems, Surgery on ears and tonsils.
  • 48 months waiting period for Organ transplant, Rheumatoid Arthritis, Gout, Joint replacement due to degenerative condition age related osteoarthritis, Osteoporosis , unless such joint replacement surgery is medically necessary due to injury
  • First 30 days waiting period for medical expenses incurred for any illness diagnosed or diagnosable except those incurred as a result of Injury.

The PPC details are as per the table below :

Plans Vital Superior Premiere
Age Band Upto 50 years Above 50 years From 18 years to 50 years Above 50 years From 18 years to 50 years Above 50 years
Medical tests Not Required Required Required Required Required Required

Proposals with health declarations may also be advised Pre policy medical examinations irrespective of age. Pre policy tests need to be done in the empanelled diagnostic centers only. The test would be valid for a period of one month from the date the tests have been conducted.

You can port your existing health insurance policy to Future Generali’s Health plan. The below supporting documents will be required:

  • Portability Form
  • Proposal Form
  • Previous insurance policy copies of last 4 years

Change in Sum Insured /Plan can be done at renewals only. No increase/decrease in Sum Insured/Plan is allowed during the currency of the policy. Increase in Sum Insured can be allowed up to two slabs higher, whereas increase in Plan can be allowed up to one plan higher. For age group above 60 years, increase in Plan would not be allowed. For age group up to 50 years increase in sum insured up to Rs 10Lacs (within Vital Plan) can be allowed without medical examination (in case of no claim / no health declaration). For Superior/Premiere Plan (Sum Insured above 10 lakhs), medical examination is required irrespective of age. For age group above 50 years increase in sum insured can be allowed with medical examination. Decrease in Sum Insured allowed up to one slab lower only, in case of no claim in any preceding Health Total policies.

A pre-existing disease is any condition, ailment or injury or related condition(s), for which the insured person had signs or symptoms, and /or were diagnosed, and / or received medical advice / treatment within 36/48 months prior to 1st health insurance policy issued by Us under which the insured person was covered.

Under cashless hospitalization, the insured person does not settle the hospitalization expenses at the time of discharge from hospital. The settlement is done directly by us for treatment that the insured person is eligible to receive under the terms of his/her policy. This is for your convenience. However, it is important to note here that prior approval is required from us before admission into the hospital. In some cases, you may have to pay for all or part of the treatment if it is not fully covered under the terms of the policy. However, in case of emergency hospitalization, you can obtain approval post-admission. Please note that the cashless facility is available only at our Network Hospitals.

The premium paid on a health insurance policy is eligible for deduction under Section 80D of the Income Tax Act. So save with your policy now!

A waiting period is the length of time you, the insured, will have to wait before the benefits under the health policy can be utilised.

The following KYC documents are required from the insured person/proposer in cases of reimbursement -

  • If claim amount is below 1 lakh- Photo Id proof & address proof
  • If claim amount is above 1 lakh- Photo Id proof, address proof and a recent photograph

A deductible is a cost-sharing requirement. It states that the insurer will not be liable for a specified amount in case of indemnity policies. This is applicable for a specified number of days/hours in case of hospital cash policies which apply before any benefits are payable by the insurer. Remember that a deductible does not reduce your sum insured.

The following details are to be provided to the company at the time of intimation of claim: • Policy number • Name of the policyholder • Name of the insured person in whose relation the claim is being lodged • Nature of illness / injury • Name and address of the attending medical practitioner and hospital • Date of admission • Any other information as requested by us

In planned hospitalization the treatment is planned well in advance. The intimation of such hospitalization and authorization from us has to be taken minimum 3 days prior to the date of hospitalization. E.g. Cataract, pace maker implantation, total knee replacement etc are examples for which the hospitalisation can be planned.The insured person should at least 3 days prior to admission to the hospital approach the network provider for hospitalization for medical treatment.

In emergency hospitalization the patient is admitted to the hospital in an emergency situation, for e.g. Severe abdominal pain, accident, heart attack etc. In such event, we should be intimated within 48 hours of admission to the hospital.

We will not be liable to pay for any claim arising out of an injury/ accident/ condition that occurred during the grace period.

You should carry the health 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).

We may investigate claims at our own discretion to examine validity of claim. Such investigation shall be concluded within 15 days from the date of assigning the claim for investigation and not later than 6 months from the date of receipt of claim intimation. Verification carried out, if any, will be done by individuals or entities authorised by us to carry out such verification / investigation(s) and the costs for such verification / investigation shall be borne by the us.

We shall settle claims, including its rejection, within 7 (seven) working days of the receipt of the last ‘necessary’ document but not later than 30 days.

You should submit the post-hospitalization claim documents at your own expense within 15 days of completion of post-hospitalization treatment or period, whichever is earlier. We shall receive pre and post- hospitalization claim documents either along with the inpatient hospitalization papers or separately and process the same based on merit of the claim derived on the basis of documents received.

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How to buy online?

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Portability Information for Mediclaim Insurance in India.

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CIN: U66000KA2018PTC117713 | IRDAI Web aggregator License Code Number: IRDAI / INT / WBA /53/ 2018, Valid till 07/08/2025