What's good here?
You most likely don't have to split the bill
The insurer will bear the entire cost of treatment (up to the sum insured) unless you explicitly opted to pay a portion of the bill. And if you’ve opted to co-pay a part of the bill, have you thought through it completely?
You can pick any room you like
Shared room, single room, deluxe room or any room that’s available. The insurer won’t nitpick on your choice of room since the policy has no restrictions on room rent.
You always have full cover irrespective of the disease
No funny business here. If your insurer hasn’t explicitly stated they won’t cover a certain illness, you can claim the full amount up to the sum insured, irrespective of the disease you’re dealing with. Meaning this policy doesn't impose the dreaded disease wise sub-limits.
Reasonable waiting period for pre-existing diseases
If you are already dealing with diabetes or hypertension, then the insurer will cover you from day 1. However, if you are dealing with other pre-existing diseases including thyroid and cardiovascular problems, then you’ll have to wait 3 years before they start covering these complications.
Pre & post hospitalization expenses covered
No worries if the doctor had to run a host of diagnostic tests before or after hospitalizing you. The insurer has your back. They will cover this amount in full for a pretty reasonable duration - 30 days before you are hospitalized and 60 days after discharge. This includes the cost of medication by the way.
Good Restoration Benefit
Even after you claim part of the cover on one occasion, you will have 100% of the cover restored, so that you can use this benefit in the event you have to endure multiple hospitalizations.
Day Care treatments covered
If you’re hospitalized for less than 24 hours in lieu of a minor procedure, then the insurer will cover these costs too. Think dialysis, chemotherapy or minor surgeries.
What's bad here?
No coverage if you are forced to hospitalize at home
The insurer will not cover the costs if you are forced to hospitalize at home due to a medical condition. In insurance lingo, they call this a policy with no domiciliary cover.
Special Bonus for being healthy and not claiming insurance
Your sum insured increases by 10% each year, so long as you make no claims during this period. But before you get too ahead of yourself, do note that they’ll stop offering you the bonus when your sum insured increases by 100%. Also, the bonus amount will reduce at same rate each time you make a claim. But hey, it's still a bonus.
What's lacking here?
Your insurer doesn’t provide free health check-ups
If you want to get a full-body checkup just to make sure you’re in fine working condition, be ready to pay for it yourself.
No Cover for Alternative Medicine
Think of getting Ayurvedic, Homeopathic or other alternative treatment to cure an illness. Tough Luck!!! Your insurer won’t cover this expense.
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