Any individual between the age of 5 and 70 years can be covered by this policy. Children aged between 3 months and 5 years can also be covered by this policy, provided either or both of their parents are also covered. This policy is meant to give respite to people from lower income strata from high outlay of hospitalization. It is meant for common masses.
The policy covers expenses incurred due to domiciliary hospitalization or hospitalization for medication wherein the insured person is put up in a nursing home. The cause of hospitalization can be any injury or disease or illness as specified in the terms of the policy. The maximum liability is Rs. 5000 annually per person.
The risks covered
The policy provides insurance against sudden diseases like food poisoning, heart attack, pneumonia, jaundice and appendicitis etc. even accidents that require hospitalization are also covered.
- But to claim, the insured person must be hospitalized or domiciliary hospitalized.
- The disease must be contracted after 30 days from initiation of the policy.
The diseases that are covered by the policy are very specific which excludes the following cases.
- Dental treatments which do not require hospitalization are not covered.
- Diseases which can be traced to pregnancy or child birth including caesarian section are not covered.
- Regular eye treatments are not covered.
- Circumcision is out of scope of this policy.
- Expenditure on tonics and vitamins.
- Illness or injury caused by war or nuclear perils.