Reliance HealthGain Policy
Reliance HealthGain is a health insurance policy that covers individuals and the entire family against hospitalization and other medical treatment expenses. The policy offers reinstatement of the Sum Insured if the total sum insured is exhausted during the same policy year.
Key Features
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 a girl child or single woman.
Comprehensive cover - up to Rs. 18 lacs
Benefits
- Wellness Program – The program includes 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 the 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 the policy document.
Eligibility
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 |
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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 |
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Co-payment | 20% of the assessed claim amount for those insured whose age at entry is 61 years or above |
Exclusions
- 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
FAQs
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 |