Religare Joy
Religare Joy Health Insurance is a unique policy which covers hospitalization expenses during pregnancy and also addresses maternity and health needs.
Key Features
Blend of Maternity and Hospitalisation cover
Industry’s lowest ‘Waiting period’ of only 9 months for maternity related claims
New born baby cover
100% increase in sum insured with no claim bonanza
Benefits
Hospitalisation expenses such as room rent, nursing expenses, ICU charges, surgeon’s fees, doctor’s fees, anaesthesia, blood, oxygen, operation theater charges, etc. The policy offers Single Private Room with AC.
Medical expenses incurred if hospitalisation is less than 24 hours,
Covers maternity-related expenses incurred with respect to hospitalisation for the delivery of the child. Policy also covers pre and post-natal expenses. Cover under this benefit is available only up to 45 years of age.
Covers the medical expenses of newborn from birth till the completion of 90 days. After 90 days, your baby would be covered under the regular policy upon payment of additional premium.
Policy will pay a lumpsum amount in case the new born baby is diagnosed with Down’s Syndrome or Cerebral Palsy provided that no claim under Benefit – ‘New Born Baby Cover’ shall be made with respect to Down’s Syndrome or Cerebral Palsy.
Religare JOY comes with the No Claim Bonanza feature, wherein, if there are no claims during the policy tenure of 3 years, you receive a bonus of 100% of your sum insured.
Medical expenses incurred 30 days immediately before hospitalisation will be covered. Expenses incurred up to 60 days after being discharged from the hospital such as follow-up visits to medical practitioner, medication, etc will be covered.
Charges of Ambulance provided by the hospital or any service provider will be reimbursed
Tax benefits as a deduction from the taxable income each year under section 80D of the Income Tax under the existing tax laws of the Income Tax, 1961, on premiums paid up to Rs. 15,000 in case of individuals and Rs 20,000 for senior citizens
How it works
| Sum Insured – On annual basis | Rs. 3 Lakh | Rs. 5 Lakh |
| Hospitalisation Expenses | Yes, up to Sum Insured | Yes, up to Sum Insured |
| Room Category | Single Private Room with AC | Single Private Room with AC |
| Pre-Hospitalisation Medical Expenses | Up to 30 days | Up to 30 days |
| Post-Hospitalisation Medical Expenses | Up to 60 days | Up to 60 days |
| Ambulance Cover | Up to Rs. 1,000 per Claim | Up to Rs. 1,000 per Claim |
| Maternity Cover (including Pre-natal & Post-Natal expenses) | Up to Rs. 35,000 | Up to Rs. 50,000 |
| Newborn Baby Cover | Up to Rs. 30,000 | Up to Rs. 50,000 |
| No Claim Bonanza (Optional Benefit) | Yes | Yes |
Eligibility
| Minimum | Maximum | |
| Sum Assured (in Rs) | 3,00,000 | 5,00,000 |
| Policy Term (in years) | 3 | |
| Entry age (Adult) | 18 years | 65 years |
| Entry age (Child) | 1 day | 24 years |
| Entry age (New born) | 1 day | 90 days |
| Renewal age | - | Lifelong Renewability |
| Co-payment | If anyone enrols at the age of 61 years or above, then they will have to pay 20% of the claim amount | |
| Waiting period for maternity claim | 9 months | |
| Grace period | 30 days from the date of expiry to renew the policy | |
Exclusions
The standard policy exclusions are -
Any pre-existing ailment/injury that was diagnosed/acquired within 48 months prior to issuance of the first policy
Any diseases contracted during first 30 days of the policy start date except those arising out of accidents
Non-allopathic treatment
Expenses attributable to self-inflicted injury (resulting from suicide, attempted suicide)
Expenses arising out of or attributable to alcohol or drug use/misuse/abuse
Cost of spectacles/contact lenses, dental treatment
Medical expenses incurred for treatment of AIDS
Congenital disease
Tests and treatment relating to infertility and in-vitro fertilisation
FAQs
The individual or family floater health insurance works on the principle of indemnity. This means that these insurance policies will pay you only what you have spent for medical treatment in hospital. On the other hand, the critical illness or the hospital cash insurance pays you the amount insured, irrespective of the amount spent for medical treatment. These are a benefit based policies.
You may be required to undergo a medical check-up after you buy, in case any member to be insured is above 45 age.
Buying an individual cover or a floater cover is an individual’s perception. However, as a general rule, at younger ages floater cover is advisable. As you grow older, you should go for an individual cover.
Co-pay is that part of your claim amount, which you have to bear. Co-pay can be in % terms or an absolute amount. For example, in case of co-pay of 20% and claim of Rs. 10,000, insurance company will pay Rs. 8,000 (80% of 10K) and you will bear 20% (Rs. 2,000).
