We all work hard to make sure that we enjoy a financially secure life, but a sudden medical emergency can severely impact our financial planning and wellbeing.
Keeping this in mind Suryoday Small Finance Bank brings you an exclusive and comprehensive Group Health Insurance cover in partnership with ICICI Lombard General Insurance Co Ltd. This cover is designed to take care of your and your family’s health needs at a very affordable price.
Sum Insured Options –Rs. 3lacs |Rs. 5lacs |Rs.10 lacs.
Option to select Individual or Floater cover (2 Adults, 2 Adults & 1 Child, 2 Adults & 2 Children).
Group Personal Accident cover equivalent to the SI covering the Primary Proposer attached.
Higher entry age up to 70 years, starting from 91 days. Minimum age of primary member should be 21 years.
Single pricing slab for age band 21-60 years.
Pre-existing disease (PED) covered after 24 months waiting period.
Lifelong renewability subject to the policy holder continues to be a customer of the bank and the Bank continues to be the Corporate Agent and Master Policy Holder of ICICI Lombard General Insurance Co Ltd.
No underwriting till 45 years of age, tele underwriting from 45- 60 years age.
Convenient paperless digital onboarding via bitly link- Microsite.
Tax benefits on premium paid u/s 80D of the IT Act.
|Policy Conditions-Group Health Insurance|
|Age Band||91 day - 70 Years|
|Family Definition||Self, Spouse, 2 dependent children up to 20 yrs. of Age|
|Sum Insured||SI 3L / 5L / 10L|
|Room Rent||Room rent charges capped at 1% for normal hospitalization and 2% for ICU on Sum Insured. All all the other related charges such as Doctor Visiting Charges, Consulting Charges, Medical Tests etc which are a function of the Room Rent as per Hospital Rate Card – Will also get reduced Pro Rata as per Room Rent Capping – as part of Overall Claim Settlement|
|Pre-Existing Diseases||Pre-Existing Diseases that have been declared at the time of proposal and accepted by Us will be covered after 24 months of continuous cover|
|Pre - Post Hospitalization||Pre-hospitalization and Post hospitalization for 30 days & 60 days respectively are covered|
|Day Care Procedures||Day Care Procedures are Covered as per the standard list|
|Donor Expense||Covered upto Sum insured as per definition, provided organ used is for Insured person|
|Domiciliary Hospitalization||Covered up to Sum insured for Medical expenses for treatment taken when confined within one's home subject to completion of minimum 3 continuous days of such hospitalization|
|Alternate Treatment||Inpatient treatment for Alternate methods including Ayurveda, Unani, Siddha & Homeopathy treatment will be covered up to of Sum insured when taken in a Government recognized Hospital, on the prescription of a registered medical practitioner|
|Ambulance Service||Covers road ambulance expenses, incurred to transfer the Insured following an emergency to the nearest hospital per event of emergency hospitalization, provided we have accepted the in-patient claim up to a maximum limit of Rs. 1500|
|Pre-Policy Medicals||Tele UW above age of 45 years; Medicals above 60 years of age and in-case there is more than one PED|
|2 Years waiting period||
|Claim submission clause||Claim must be filed within 30 days from the date of completion of treatment. However, the Company may at its absolute discretion consider waiver, of this Condition in extreme cases of hardship where it is proved to the satisfaction of the Company that under the circumstances in which the insured was placed it was not possible for him or any other person to give such notice or file claim within the prescribed time-limit. The claim would invite additional 10% co-payment over and above payable amount as per policy terms and conditions|
|Mid-Term Inclusion||Premium to be charged as per fixed grid for addition endorsement|
|Reasonable and Customary Charges||Reasonable and Customary Charges will be applied on re-imbursement claims from non-network hospitals where medical treatment taken by the Insured Person during the Policy Period following an Illness or Injury that occurs during the Policy Period, subject to availability of the Sum Insured and any specific limits specified in the Schedule of Benefits and the terms, conditions and exclusions specified in the Policy document|
|Claim Intimation & Network clause||All Reimbursement Claims must be intimated to ILHC within 24 hrs of Admission, in case of non-intimation/Delayed intimation 10% Co-pay would be applicable except for Accidental claims. If the member is getting admitted in any network hospital and filing for reimbursement claims such claims will be settled to members with 15% co-pay|
|Add-Del of Lives||Premium to be charged as per fixed grid for addition endorsement. Premium to be refunded as per refund grid. No Refund for deletion if claim is under process or paid|
|Last year claim details||NA|
|Special Condition 1||Policy also covers hospitalization arising out of Psychiatric ailments within a limit of Rs. 30,000 when inpatient treatment has been availed in a Hospital|
|Special Condition 2||Cataract procedure is capped at Rs. 30,000|
|Special Condition 3||50% Co-Pay for cyberknife treatment/Stem Cell TransplantationCochlear Implant treatment shall be restricted to 50% of the SI|
|Portability||Portability is available on this product as per IRDA directive and product features|
|Termination||Policy will cease to be in effect from the date of termination of relationship with the organization|
|Disclaimer||Each policy issued under the Master Policy is valid for 1 year only|
|Policy Conditions-Group Personal Accident|
|Age of Entry: 21 – 65 years|
|Policy Tenure: 1 Year|
on the occurrence of death of the Insured Person, provided such death results solely and directly from an Injury, within twelve months from the date of Accident resulting in such Injury, provided that the date of occurrence of the Accident falls within the Policy Period/Policy Year.
|Permanent Total Disablement (PTD) resulting from Accident:
1) Loss of Sight of both eyes, or Physical Separation of two entire hands or two entire feet, or one entire hand and one entire foot, or of such Loss of sight of one eye and such Physical Separation/ Loss of one entire hand or one entire foot, then the Sum Insured as stated in the Schedule to this Policy hereto as applicable to such Insured Person.
2) Loss of Use of two hands or two feet, or of one hand and one foot, or of Loss of sight of one eye and Loss of Use of one hand or one foot, then the Sum Insured as stated in the Schedule to this Policy hereto as applicable to such Insured Person.
|For resolution of any query or grievance, Insured may contact the respective branch office of the company or may call the toll free no. 1800-2666 or may approach us at the sub-section “Grievance Redressal” on the website www.icicilombard.com (Customer Support Section). However, if the resolution provided by us is not satisfactory you may approach Insurance & Regulatory Development Authority (IRDA) through the integrated Grievance Management System (IGMS) or IRDA Grievance Call Centre (IGCC) at their toll free no. 155255.|
Suryoday Small Finance Bank is a Corporate Agent of ICICI Lombard General Insurance Company Limited Bearing License Number CA0491 and its Registered Office is at 1101, Sharda Terrace, Plot 65, Sector 11, CBD Belapur, Navi Mumbai- 400614. The insurance products are offered and underwritten by ICICI Lombard General Insurance Company Limited (IRDA registration no. 115)having its registered office at House 414, Veer Savarkar Marg, Prabhadevi Mumbai- 400 025 Servicing of the policy and adjudication of claims is sole responsibility of ICICI Lombard General Insurance Company Limited and Suryoday Bank cannot be held liable for the same.
To know more about the Product, please refer to Policy Wordings