Reliance HealthGain Policy

Reliance HealthGain Policy

Reliance HealthGain is a health insurance policy which covers individual as well as the entire family against hospitalization and other medical treatment expenses. The policy offers reinstatement of Sum Insured if the total sum insured is exhausted during the same policy year. 

 

Key Features of Reliance HealthGain Policy

• Re-instatement of base sum insured, if the total sum insured has been exhausted
• Free auto-extension of policy for one-year in case of named critical illness
• Cover for extended family as well 
• Lifelong renewal for health insurance
• 5% premium discount for girl child or single woman
• Comprehensive cover - up to Rs. 18 lacs

 

What is covered in Reliance HealthGain Policy

The plan offer two variants of cover Plan A and Plan B, below are the benefits illustrated under each plan, which will be paid to the life insured.
 

Benefits	Plan A	Plan B
Sum Insured (in Rs.)	3 lacs, 6 lacs, 9 lacs	12 lacs, 15 lacs, 18 lacs
Domestic Road Ambulance	Rs. 1500	Rs. 3,000
Policy Service Guarantee	Sum insured of Rs. 10,000 for delay in policy issuance	Sum insured of Rs. 20,000 for delay in policy issuance
Accidental Cover for no claim renewal	No	Rs. 1 lac personal accident – death cover for – policyholder – insured
Insurance Renewal	No	One time premium waived, in case of listed illnesses
Benefits common across Plan A and Plan B
Pre and Post hospitalization expenses	Up to 60 days
Re-instatement of Base Sum Insured	Up to 100% of base sum insured and 20% of illness/injury
Hospitalization Expenses a. Inpatient treatment b. Day-care treatment	Yes
Donor Expenses	50% of base sum insured, maximum up to 5 lacs
Domiciliary Hospitalisation	10% of base sum insured, maximum up to 5 lacs
Wellness	Yes
Cumulative Bonus (every claim free year)	1/3% increase in base sum insured, maximum up to 100%
Call Option	After every 4 claim-free years up to maximum 4 times base sum insured

 

Eligibility conditions & other restrictions in Reliance HealthGain Policy

Particulars	Plan A	Plan B
Pre-Policy Issuance Medical Check-up	>=46 years	>= 18 years
Entry Age – Minimum	Individual/Floater – 5 years or above Children – between 91 days & up to 4 years can be covered under floater, with at least one member aged 21 years
Entry Age – Maximum	65 years, no entry age bar for an insured sum of Rs. 3 lacs	65 years
Exit Age	No Exit Age, the policy offers long time renewability
Tenure	1 or 2 years
Maximum Members	Individual – 6 Floater – 6 under the same floater = 4(children)+ 2 (members>=21 years of age)
Waiting period	Any illness – 30 days, Named Ailments – 2 years, Pre-existing diseases – 18 months
Co-payment	20% of assessed claim amount for those insured whose age at entry is 61 years or above

 

Additional Benefits/Features of Reliance HealthGain Policy

• Wellness Program – The program include a free health helpline, consultation with a medical practitioner, discounts from chemists, luxury spas etc.
• Double cover after 4 claim free years – option to increase the sum assured after 4 consecutive claim-free years
• Cashless Hospitalization – at more than 4000 hospitals
• Portability – in case policyholder wants to port the policy, can apply 45 days prior to the renewal date.
• Free look – in case, the policyholder is not convinced with the terms and conditions of the policy, s/he can cancel the same within 15 days from the date of receipt of policy document.

 

Exclusions - What is not covered in Reliance HealthGain Policy?

• Intentional self-injury /injury under influence of alcohol or drugs/criminal act
• Treatment received outside India or Robotic /Stem Cells surgery
• War/Nuclear/Chemical/Biological
• HIV/ADIS or Sexually Transmitted Disease (STD)
• Congenital diseases
• Maternity, Fertility excluding Ectopic Pregnancy
• Cost of spectacles, contact lenses and hearing aids
• Dental treatment or surgery
• Treatment of mental illness
• Cosmetic, Aesthetic, treatment
• Non-allopathic, Out-patient treatment
• Unproven /Experimental treatments
• Arthritis, Gout
• Benign ear, nose and throat (ENT) disorders
• Benign Prostatic Hypertrophy
• All types of Hernia, Hydrocele
• Internal tumors, skin tumors, cysts
• Kidney Stone / Ureteric Stone /Lithotripsy / Gall Bladder Stone