Reliance HealthGain insurance

Reliance Health Gain insurance plans details

• Advantages of Health Gain Insurance

  • As low as 91 days of entry age and There is NO maximum entry age for sum insured of Rs, 300,000
  • After 36 months of continuous coverage you can get coverage for pre –existing diseases.
  • “Claim & Policy Service Guarantee” available.
  • Special benefits like “Call Option” & “Re-instatement of Base Sum Insured”.
  • Wellness Services.
  • Entire family coverage along with Spouse, Children , Parents, Parent in law, Brothers, Sisters, Grand Parents, Grand Children, Daughter-in-law and Son-in-Law.

• Benefits of Health Gain insurance

  Coverage Benefits in US	Plan A	Plan B
  Sum Insured - on annual basis	3Lacs, 6Lacs , 9Lacs	12Lacs, 15Lacs & 18Lacs
  In-Patient Treatment	Yes	Yes
  Day Care Treatments	Yes	Yes
  Pre-hospitalisation	60 days	60 days
  Post hospitalisation	60 days	60 days
  Domestic Road Ambulance	Upto 1500	Upto 3000
  Domiciliary Hospitalization	Up to 10% of SI, subject to a maximum of Rs 50,000	Up to 10% of SI, subject to a maximum of Rs 50,000
  Donor Expenses	50% of SI upto max 5 lacs	50% of SI upto max 5 lacs
  Initial Wait Period	30 Days	30 Days
  Named ailments	24 months	24 months
  Pre-existing Diseases	36 months	36 months
  Room Eligibility	Single Private	Single Private
  Co-payment	@ 20% per claim In Floater policy : for all insured if the age of eldest member at entry is 61 years or above In Individual policy : for those insured whose age at entry is 61 years or above	@ 20% per claim In Floater policy : for all insured if the age of eldest member at entry is 61 years or above In Individual policy : for those insured whose age at entry is 61 years or above
  Tenure	1 Year	1 Year
  Wellness	Yes	Yes
  Cumulative Bonus	33 1/3 % increase in Base SI for every claim free year ; Max up to 100% 33 1/3 % decrease in Base SI for every claim year ; Max up to Cumulative Bonus earned	33 1/3 % increase in Base SI for every claim free year ; Max up to 100% 33 1/3 % decrease in Base SI for every claim year ; Max up to Cumulative Bonus earned
  Call option	After every 4 claim free years. Upto maximum 4 times Base Sum Insured provided the enhanced Sum Insured <= 50lacs . Can be exercised upto the age of 60 years (under floater policy as per the age of senior most member and under individual policy as per the age of respective member)	After every 4 claim free years. Upto maximum 4 times Base Sum Insured provided the enhanced Sum Insured <= 50lacs . Can be exercised upto the age of 60 years (under floater policy as per the age of senior most member and under individual policy as per the age of respective member)
  Reinstatement of Base Sum Insured	One re-instatement upto 100% of Base Sum Insured, subject to sublimit of 20% for related illness/ injury	One re-instatement upto 100% of Base Sum Insured, subject to sublimit of 20% for related illness/ injury
  Claim Service Guarantee	Cashless Claims 1% for every delay of 6 hours beyond 6 hours of receipt of all information/documents Re-imbursement Claims - 1% for every delay of 21 days beyond 21 days of receipt of all information/documents Maximum - 6% for a claim	Cashless Claims 1% for every delay of 6 hours beyond 6 hours of receipt of all information/documents Re-imbursement Claims - 1% for every delay of 21 days beyond 21 days of receipt of all information/documents Maximum - 6% for a claim
  Policy Service Guarantee	SI of Rs 10000	SI of Rs 20000
  Accidental Death Cover for No Claim Renewal	No	1 Lac PA-Death cover for Policyholder-Insured
  Insurance Renewal	No	One time Renewal premium waiver if the Policyholder- Insured suffers from named Critical Illness

• Medical test require for above 45 years of age

  • MER ( Medical Examination Report) MER ( Medical Examination Report)
  • CBC with ESR CBC with ESR
  • Urine Routine Urine Routine
  • Fast Blood Sugar HBA1C
  • Sr.Cholesterol Total Lipid Profile
  • SGPT LFT with GGT
  • Sr.Creatinine Sr.Creatinine
  • ECG HBsAG
  • TMT
  • X ray Knee Joint AP & Lateral -Both Knees

• Waiting Period of Healthgain Insurance

  30-Day waiting period: Claim for any Medical Expenses incurred for treatment of any Illness which began within 30 days of Policy Period Start Date shall not be admissible, except those incurred as a result of an Injury.

  2 year waiting period: In case of Pre-existing disease at the time of commencement of first policy with the Company, these shall not be covered until 36 months of continuous coverage has elapsed, since the first Policy Period Start Date with the Company.

  
  

  • Intentional self-injury / injury under influence of alcohol or drugs / criminal act
  • Treatment received outside India / Stem Cells surgery
  • War / Nuclear / Chemical / Biological
  • Diseases such as HIV or AIDS or STD
  • Diseases existing from the time of birth (Congenital diseases)
  • Maternity, fertility excluding Ectopic pregnancy
  • Cost of spectacles, contact lenses and hearing aids
  • Dental treatment or surgery
  • Treatment of mental illness
  • Cosmetic, aesthetic treatment
  • Non-allopathic, Out-patient treatment
  • Unproven / Experimental treatments