Hey!!! IFFCO Tokio’s Family Health Insurance policy (also known as Swasthya Kavach Policy) offers top-of-the-line cover against family health risks and potential financial instability.


Eligibility Criteria:

-18 years to 60 years of age of the proposer.

-Residents of India from any nationality.

-Coverage available for proposer and up to 3 dependants (children, siblings, nephews or nieces between 3 months to 23 years of age).


Sum insured options and plan options

Four floater sums insured options:

-Rs.2,00,000.

-Rs.3,00,000.

-Rs.4,00,000.

-Rs.5,00,000.

Two plans available – Base Plan and Wider Plan.


Policy covers

-Hospitalisation expenses incurred for treatment of physical disease or injury sustained/incepted during the Policy Period, although treatment can continue beyond Policy expiry date also. Following expenses would be included:
Room Rent @ 1.5% of Basic Sum Insured daily and ICU/ITU Rent @ 2.5% of Basic Sum Insured daily.
Registration, Service Charges, Surcharges etc. of hospital at actual, subject to a maximum of 0.5% of Basic Sum Insured.
Nursing expenses, including that incurred during pre and post hospitalisation periods.
All types of Medical Practitioner’s (Surgeon, Anesthetist, Consultant etc.) fees.
Cost of medicines, blood, oxygen, anesthesia, diagnostic and pathological tests, operation theatre charges, cost of chemotherapy, dialysis, pacemaker, artificial limbs etc.
Ambulance charges on actual basis, subject to maximum Rs 1,500.
Daily Allowance @ Rs. 250 per day, for the duration of hospitalisation.

-Domiciliary Hospitalisation expenses, up to a maximum sub-limit of 20% of Basic Sum Insured. This relates to expenses for medical treatment for a period of more than 3 days, which would normally require hospitalisation, but is actually taken at home for specified reasons, as stated in the Policy.

-Pre Hospitalisation expenses for a maximum period of 30 days prior to hospitalisation and Post Hospitalisation expenses for a period of 60 days after hospitalisation (without any monetary capping).

-Hospitalisation expenses of persons donating organs during organ transplantation of insured person, within the overall and individual limits of Sum Insured specified under the Policy

-Cost of health check-up, once at the end of 4 claim free years block @ 1.0% of average Basic Sum Insured.

-Prescribed package charges of hospital for specific treatments, subject to a maximum of 80% of Sum Insured or 80% of actual expenses, whichever is less.


Exclusions

Treatment arising from or traceable to:

-All medical conditions pre-existing at the time of policy issuance.

-All diseases contracted within the first 30 days from the policy commencement date.

-Intentional self-injury or attempted suicide.

-Cosmetic or aesthetic treatment.

-Alcohol or drug abuse.

-HIV / AIDS, STDs, Venereal diseases, congenital diseases.

-Cost of spectacles, contact lenses or hearing aids.

-Dental treatment not requiring hospitalization.

-Pregnancy or childbirth.

-Dangerous and hazardous sports and activities.

-Genetic disorders, stem cell implantation or surgery.

-Alternative medicine therapies like naturopathy, acupuncture, magnetic therapy, etc.

-First 10% of any admissible claim, if insured person is suffering from either diabetes or hypertension and first 25% of claim, if he is suffering from both diabetes and hypertension. This provision is applicable for claims arising out of diabetes and/or hypertension only.

-War, terrorism, nuclear radiation, etc.