Reliance Life Easy Care Fixed Benefit Plan
Reliance Life Easy Care Fixed Benefit Plan
Reliance Life Easy Care Fixed Benefit Plan is a Non-Linked Non-Participating Health Plan. It is a Traditional Health Insurance Plan.
How it works – In this plan, premium is fixed for tenure of 5 years for which premium can be paid annually or single. There is Guaranteed Renewability in this plan, up to the age of 75 years of age. There are 5 options in this plan to choose Daily Hospitalization Cash Benefit of Rs 1000, Rs 2000, Rs 3000, Rs 4000 and Rs 5000. The Sum Assured under Plan Options I, II, III, IV and V are Rs 100,000, Rs 200,000, Rs 300,000, Rs 400,000 and Rs 500,000 respectively. All other benefits are paid as a percentage of the Sum Assured chosen.
In this plan, there is a fixed benefit of payment for the daily hospitalization expenses, additional Hospitalization Cash Benefit for ICU treatment, lump sum payment towards cost of multiple surgeries, benefit for 10 major surgeries, listed 10 major critical illness conditions, etc. This plan also pays for Recuperation Benefit for 7 or more days of hospitalization, irrespective of shift between hospitals
The Sum Insured is in this plan increases by 5% (up to a maximum limit of 20%) of basic sum insured without paying any extra premium, for every claim free year as No Claim Bonus and there is an additional 5% renewal discount provided at the time of term renewal at the end of 5 years.
Medical Benefit
Death Benefit
Income Tax Benefit
Compare this plan with other Health Plans
Key Features
It is a 5 year tenure Non-Linked Health Plan for which the premium is fixed in that tenure
In this plan, a fixed amount is paid towards hospitalization expenses for the number of days hospitalized
There is Guaranteed Renewability in this plan, up to the age of 75 years of age
There is an additional 100% of hospital cash benefit for each day of stay in case of ICU treatment also available in this plan
There is a Lump sum Benefit for 10 major listed surgeries in this plan and 10 mentioned critical illness conditions
This plan also pays for Recuperation Benefit for 7 or more days of hospitalization, irrespective of shift between hospitals
There is a 5% renewal discount provided at the time of term renewal
The Sum Insured is increased by 5% (up to a maximum limit of 20%) of basic sum insured without paying any extra premium, for every claim free year as No Claim Bonus
Plan options and premium paying frequency can be changed at every policy anniversary
Benefits
Medical Benefit
This plan basically covers:
- Daily Hospital Cash Benefit: 1% of the Sum Assured would be paid as Daily Hospitalization Cash Benefit from the 1st day of hospitalization subject to a minimum of 48 hours
- ICU Benefit: An additional amount of 1% of the Sum Assured would be paid for day of ICU hospitalization
- Recuperation Benefit: of 3% of the Sum Assured which is payable in case of 7 or more days of continuous hospitalization for the same injury or disease. The benefit is payable irrespective of whether the patient is admitted to one or more hospitals during one and the same episode
- Surgical Cash Benefit: is payable in case of Hospitalization for a minimum period of 24 hours for undergoing any valid and Medically Necessary Surgery except the mentioned major Surgeries in MSB, in India, a lump sum benefit equal to 10% of Sum Assured will be paid
- Major Surgical Benefit: is payable in case of Hospitalization for a minimum period of 24 hours for undergoing any one of the listed Major Surgeries a guaranteed amount equal to 100% of Sum Assured will be paid. The surgeries covered are:
- Hip or Knee joint replacement surgery necessitated due to an accident only
- Heart valve replacement surgery
- Excision of tissue of brain with craniotomy
- Transplantation of Heart
- Coronary artery bypass surgery
- Bone marrow transplant
- Liver transplantation (recipient)
- Renal transplantation (recipient)
- Total Excision of Esophagus and Stomach
- Transplantation of lung
Critical Illness Benefit:
- Critical Illness Benefit: is payable in diagnosis of any one of the listed critical illness a onetime fixed amount equal to 100% of Sum Assured will be paid and the benefit will cease to continue for lifetime. The illnesses covered would be:
- Cancer
- Heart Attack
- Stroke
- Major Burns
- Loss of Speech
- Loss of Hearing
- Alzheimer's Disease
- Parkinson's Disease
- Coma
- Terminal Illness
Death Benefit
Being a pure health plan, there is no Death Benefit payable in this plan
Maturity Benefit
Being a pure health plan, there is no Maturity Benefit payable in this plan
Income Tax Benefit
Health Insurance premiums paid up to Rs. 15,000 are allowed as a deduction from the taxable income each year under section 80D.
Premium remains fixed for a period of 5 years irrespective of increase in age, change in medical condition and number of the claims
There is Guaranteed Renewability in this plan, up to the age of 75 years
The Sum Insured is increased by 5% (up to a maximum limit of 20%) of basic sum insured without paying any extra premium, for every claim free year as No Claim Bonus
There is a 5% renewal discount provided at the time of term renewal
Pre-existing diseases are covered after 4 years of continuous renewal
Eligibility
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Minimum
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Maximum
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Sum Assured (in Rs.)
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1 lac
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5 lacs
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Policy Term (in years)
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5
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Premium Payment Term (in years)
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Single
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Equal to Policy Tenure
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Entry Age of Life Insured (in years)
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18
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65
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Age at Maturity (in years)
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-
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75
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Payment modes
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Single, Annual or Monthly
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Exclusions
There are certain exclusions in this plan
- Pre-existing diseases in the first 4 policy years
- Hospitalisation/Medical expenses not directly related to the specific illness or injury for which hospitalisation took place and the expenses which are not recommended by the attending doctor
- Any treatment not performed by a doctor or any treatment of a purely experimental nature
- Expenses which are not for actual, necessary and reasonable expenses incurred in the treatment of the Illness or Physical Injury, or any elective surgery or treatment which is not medically necessary
- Any diagnosis or treatment arising from or traceable to pregnancy, childbirth including caesarean section, medical termination of pregnancy and/or any treatment related to pre and post natal care of the mother or the new born ( excepting ectopic pregnancy)
- Sterility, treatment whether to effect or to treat infertility, any fertility, sub fertility or assisted conception procedure, surrogate or vicarious pregnancy, birth control, contraceptive supplies or services including complication arising due to supplying services
- Hospitalization for correction of birth defects or external congenital anomaly /internal congenital anomaly
- Any sexually transmitted diseases or any condition directly or indirectly caused to or associated with Human Immune Deficiency Virus (HIV) or any Syndrome or condition of a similar kind commonly referred to as AIDS (Acquired Immune Deficiency Syndrome}
- Dental treatment or surgery of any kind unless necessitated by accidental bodily injury
- Cost of spectacles contact lenses hearing aids and the cost of treatment for vision correction
- Self-afflicted injuries or conditions (attempted suicide) and or the treatment directly or indirectly arising from alcoholism or drug abuse and any Illness or Physical Injury which may be suffered after consumption of intoxication liquors or drugs
- Non-allopathic methods of surgery and treatment
- Hospitalisation and surgery for donation of an organ
- Medical or surgical treatment for weight reduction or weight improvement regardless of whether the same is caused (directly or indirectly) by a medical condition
- Psychiatric, mental disorders (including mental health treatments and, sleep-apnoea), Parkinson and Alzheimer’s disease, general debility or exhaustion (“run-down conditions”): congenital internal or external diseases, defects or anomalies, generic disorders: stem cell implantation or surgery, or growth hormone therapy
- Medical expenses relating to any Hospitalisation primarily for diagnostic, X-ray or any other investigations
- Any experimental or unproven procedures or treatments, devices or pharmacological regimens of any description (not recognized by Indian Medical Council)
- Stay in Hospital for domestic reason where no active regular treatment is given by a Doctor
- Charges for services received in convalescent home and nursing homes, nature cure clinics and similar establishments
- Circumcision unless necessary for treatment due to an accident
- Plastic surgery or cosmetic surgery unless necessary as a part of medically necessary treatment certified by the attending Medical Practitioner for reconstruction following an Accident or illness
- Any treatment related to sleep disorder or sleep Apnoea syndrome
- Medical Expenses incurred due to Ventral/Incisional
- Hernia unless the Company has paid the first operation
- Expenses for any routine or prescribed medical check-up or examination, external and or durable Medical / Non medical equipment of any kind used for diagnosis and/or treatment and/or treatment and/or monitoring and/or maintenance and/ or support including CPAP,CAPD,Infusion pump, oxygen concentrator etc, ambulatory devices that is walker, crutches, belts, collars, caps, splints, stings, braces, stockings, gloves, hand soaps etc. of any kind, Diabetic footwear, glucometer/ thermometer and similar related items and also any medical equipment, which are subsequently used at home
- Any kind of service charges, surcharges, admission fees, registration charges etc. levied by the Hospital
- Any natural peril (including but not limited to avalanche, earthquake, volcanic irruptions, or any kind of natural hazard). Nuclear disaster, radioactive contamination and/or release of nuclear or atomic energy\
- War, invasion, acts of foreign enemies, hostilities (whether war be declared or not), civil war, terrorism, rebellion, active participation in strikes, riots or civil commotion, revolution, insurrection or military or usurped power, and full-time service in any of the armed forces
- Naval or military operations ( including duties of peace time ) of the armed forces or air force and participation in operation requiring the use of arms or which are ordered by military authorities for combating terrorists, rebels and the like
- Participation in any hazardous activity or sports including but not limited to racing scuba dividing, aerial sports, bungee jumping or mountaineering, activities such as hang-gliding, ballooning, and any other hazardous activities or sports unless agreed by special endorsement
- Expenses incurred for procurement of a replacement organ, transportation costs of the replacement organ and associated administration costs and all costs incurred by the donor
- Any insured person committing or attempting to commit a criminal or illegal act with criminal intent, or intentional self-injury or attempted suicide while sane or insane
- Expenses for services or treatment which are paid for by any other party or which are claimable under workmen’s compensation insurance. In such case, the Company will reimburse the difference between the expenses that would have been reimbursable by the Company had there been no other insurer or workmen’s compensation insurance involved and the amount already reimbursed or reimbursable by other party or by workmen’s compensation insurance
- Non-Medical expenses including Personal comfort and convenience items or services such as telephone, television, personal attendant or barber or beauty services, diet charges, food , cosmetics, napkins, toiletry items, guest services and similar incidental expenses or services
- Any hospitalisation outside India
FAQs
Does Reliance Life Easy Care Fixed Benefit Plan cover Pre-existing Diseases?As mentioned under Exclusions, Reliance Life Easy Care Fixed Benefit Plan does cover Pre-existing Diseases and hospitalization from the same after a continuous renewal of 48 months and not before that
Is Maternity Benefit provided under Reliance Life Easy Care Fixed Benefit Plan? As mentioned under Exclusions, Reliance Life Easy Care Fixed Benefit Plan does not cover Maternity Benefit and hospitalization from the same. It is not even after continuous renewals as in other plans.
What happens if You want a loan against your policy ?Loan facility is not available in this plan.
What happens if You stop paying the premium?If the policy holder stops paying the premium within 30 days of the due date, the policy lapses and all benefits cease. If the lapsed policy is not revived within 90 days of the due date of the first unpaid premium then the policy will be terminated.
What happens if You want to surrender the policy ?Being a pure health plan; there are no Surrender Benefits under this plan.
Claim Process
You can make a cashless claim at the time of hospitalization through a network of 4000+ hospitals or at any time of the day in their 24 hour Customer Service desk.
For Network Hospitals:
- The Health ID Card and any photo ID needs to be presented to the TPA (Third Party Administrator) at the hospital and the they will submit the pre-authorisation form with signature
- The Claim Request will be checked
- The Claim Request will be authorised
- And the claim would be settled directly to the hospital
For non-Network Hospitals: The Claim Intimation must reach the company in writing within 7 days of hospitalization of the member. All claim under this plan needs to be made along with the following documents:
- The hospital bill needs to be settled initially by out-of-pocket payment
- Once discharged, the claim documents needs to be submitted
- Then the Claim Request will be checked and authorized and paid directly to the policyholder
All claims requests are to be sent to either the nearest Reliance Life Branch or for any claims/ product-related queries or servicing requests, please contact their Customer Care Toll- Free number at 1800 300 08181 or 3033 8181.
