Iffco Tokio Swasthya Kavach Family Health Insurance Plan
Product Review
Iffco Tokio- Swasthya Kavach Family Health Plan is a hospitalization policy, which covers inpatient treatment for a minimum period of 24hrs, along with other benefits like day care treatments, Ayurvedic treatment, etc.
Unique Features of Iffco Tokio Swasthya Kavach Family Health Insurance Plan
- Cumulative Bonus of 5% on every claim free renewal, subject to max of 50% (Available on Wider Plan)
- Non-Allopathic Treatment like - Ayurvedic/ Homeopathic treatments are covered under this policy
- Some Organ Specific are Covered after 1 year like Tonsillitis/ Adenoids Gastric etc
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Critical features of Iffco Tokio - Swasthya Kavach - Family Health Insurance Plan
Room rent:
Limits imposed towards room and ICU rent expenses
- This Plans has 2 variants Base and Wider plan
- Room Rent-1% of the Sum Insured in Base plan and 1.5% of the Sum Insured in Wider Plan.
- ICU-2% of the Sum Insured in Base plan and 2.5% of the Sum Insured in Wider Plan.
- *This plan provides coverage for registration, service charges, surcharges, etc. up to 0.5% of sum insured.
No Claim Bonus:
Health Insurance policies may offer Cumulative Bonus wherein for every claim free year, the Sum Insured is increased by a certain percentage at the time of renewal
5% of basic sum insured up to a maximum of 50 % for each unclaimed year in case opted for(The cumulative bonus will reduced by 10% of the Sum insured once a claim is made)
Co-Pay:
Specific % of admissible claim amount to be borne by Insured
- 10% or 25 % is applicable for the first claim of individuals with diabetes and/or hypertension
- For packaged treatments, only 80% of the sum insured is available for the coverage
- The below mentioned list of treatments has specified expenses limit per claim in Base Plan:-
- Cataract: 7.5% of the Sum Insured subject to maximum of Rs. 15000/-
- Piles, Fistula,Fissure, Tonsillitis,Sinusitis: 10% of the Sum Insured subject to maximum of Rs. 30000/-
- Benign Prostatic,Hypertrophy, Hernia: 20% of the Sum Insured subject to maximum of Rs. 50000/-
- Knee/ Hip Joint,Replacement, All Cancer, Renal Failure: 50% of the Sum Insured subject to maximum of Rs. 200000/-
- Appendicitis, GallBladder stones and Hysterectomy: 15% of the Sum Insured subject to maximum of Rs. 40000/-
Pre-Existing Diseases:
Means any condition, ailment or injury or related condition(s) for which you had signs or symptoms, and / or were diagnosed, and / or received medical advice/ treatment, within 48 months prior to the first policy issued by the insurer
This Plan has a waiting period of 4 years is case of pre-existing diseases
Eligibility Criteria
- Minimum Age of Entry:- Children-91 days to 23 years/Adults-18 years
- Maximum age of Entry:- 60 years
- Sum Insured:-
Base Plan- 2,3,4,5 Lacs
Wider Plan- 2,3,4,5 Lacs - Policy Tenure:- 1 yr
- Premium Calculated on Basis of:- Age (i.e. sum Insured Chosen)
Add-ons
- Critical illnesses (Option in Wider Plan):-
Critical Illness means any Disease or Major Injuries, which the Insured Person is diagnosed to have suffered from and which requires Hospitalisation: Defined Illness are: Stroke, Cancer, Kidney Failure, Open Chest CABG, Major Organ/ Bone Marrow Transplant, Major Illness, Major Burns, Coma of Specified Severity, Multiple Sclerosis, etc. - Emergency Assistance Services (Available with Base & Wider Plan):-
Value added Emergency Medical Assistance and Emergency Personal Services as described below: (No Additional Cost)
- Medical Consultation, Evaluation and Referral
- Emergency Medical Evacuation
- Transportation to Joint Patient
- Care and/ or Transportation of Minor Children
- Emergency Message Transmission
- Return of Mortal Remains
- Emergency Cash Coordinate
Waiting Period
- Covered from Day 1 : Accidental Injuries
- Covered after 30 Days : All incidences apart from specified surgeries, Permanent exclusion & Pre-existing diseases (if any)
- Covered after 1 Year : Tonsillitis/ Adenoids Gastric or Duodenal Ulcer Any type of Cyst/ Nodules/ Polyps Any type of Breast lumps
- Covered after 2 Years : Cataract, Benign Prostatic Hypertrophy, Hysterectomy for Menorrhagia or Fibromyoma Hernia, Hydrocele Fistula in anus, Piles, Sinusitis Choletithiasis and Cholecystectomy Spondylosis / Spondilitis – any type Inter- vertebral Disc Prolapse (other than caused by an accident) Knee replacement/ Joint Replacement/ Hip replacement (other than caused by an accident) Osteoarthritis Chronic Renal failure or End Stage Renal Failure. Heart Disease Any type of Carcinoma / Sarcoma/ Blood Cancer Varicose Veins / Varicose Ulcers(Only for Base plan-Renal Failure, Cancer and Heart Disease)
Exclusions
- Cost of spectacles, contact lens or hearing aids.
- Dental treatment, unless requiring hospitalisation.
- Convalescence, general debility, congenital diseases/defects, sterility.
- All claims arising from or related to pregnancy, other than ectopic pregnancy.
- Any domiciliary or out-patient treatment.
- Cost of external medical equipments.
- Claims arising out of participation in dangerous sports/activities.
- Claims arising from or related to HIV/AIDS.
- War, terrorism and nuclear risks.
- All non medical expenses, including personal comfort and convenience item services.
- Treatment of obesity, hormone replacement therapy, sex change.
- Genetic disorders, stem cell implantation and surgery.
- Treatment of mental illness,cosmetic surgery/implants or plastic surgery
- Expenses on naturopathy, experimental or alternative medicine, acupressure, acupuncture, magnetic and similar therapies.
Note:- Any claims arising out of or attributable to any of the following is not covered
Tax Benefits
The premium paid for health insurance policy is liable to get a tax rebate under section 80D of the Income Tax Act, 1961.
Claim Process
In case you would like to know about the Claim Process or would like to register a Claim please click the link below
