Sr. No |
Type of expense |
Expense limit (in Rs.) |
1. |
Medical Treatment with Room, Up to 1% of the Board & Nursing Expenses & Sum Insured per day Service Charges etc. |
Up to 1% of the sum assured (SI) per day |
2. |
Medical Treatment in Intensive Care Unit (ICU) |
Up to 2% of the SI per day |
3. |
All admissible claims under 1 & 2 during the policy period |
Up to 25% of the SI per illness/injury per claim |
4. |
Consultants & Specialists Fees |
Up to 40% of the SI per illness/injury per claim |
5. |
Anaesthesia, Blood, Oxygen, OT Charges, Surgical Appliances |
Up to 40% of the SI per illness/injury per claim |
6. |
Pre-hospitalisation |
Up to 10% of the eligible hospitalisation expenses incurred 30 days prior to date of admission into the hospital |
7. |
Post-hospitalisation |
Up to 10% of the eligible hospitalisation expenses incurred 60 days after the date of discharge from the hospital |
8. |
Ambulance charges |
1% of SI up to a max of Rs. 1500 |
9. |
Free Medical Check-up |
Free medical check-up - 1% of SI up to a max of Rs. 2500 for every 4 claim free year |
10. |
Parental Care: Attendant nursing charge to take care of you parents who are above 60 years of age |
Available for persons above 60 years old. Attendant nursing charges after discharge from the hospital for Rs. 500 or actual whichever is less per day up to a maximum 10 days per hospitalisation. The charges can be reimbursed for a period of 15 days during the entire Policy period. |
11. |
Child Care: Attendant escort charges to take care of child below 10 years of age |
Available for child below 10 years. Attendant escort charges of Rs 500 for each completed day of hospitalisation subject to maximum of 30 days during the Policy Period. |
12. |
Limit of Cataract |
15% of sum insured subject to maximum of 25000 per eye subject to first two years exclusion. |
13. |
Accidental Hospitalization |
SI under the policy shall increase by 25% of the balance sum insured available subject to max of Rs.1 Lac.in case of accidental hospitalisation. Payable only once under the Policy per person |
14. |
Alternative Treatment |
Reimbursement of Ayurvedic Treatment up to a maximum of15% of Sum Insured per Policy period up to a maximum of Rs. 20000 & Homeopathy and Unani Treatment up to a maximum 10% of Sum Insured per Policy period up to a maximum of Rs. 15000. |
15. |
Domiciliary Reasonable |
Reasonable and Customary Charges towards Domiciliary Hospitalisation as defined in Policy definition subject to 20% of the Sum Insured maximum up to Rs. 20000 whichever less is |
16 |
Convalescence Benefit (Benefit available for Insured above Insured 10 years & below 60 years |
Covers the convalescence expense up to an amount not exceeding Rs. 5,000/- per Insured, if the insured is hospitalised for any bodily injury or illness as covered under the Policy, for a period of 10 consecutive days or more. Admissible only once during the Period of Insurance. |
17. |
Co-Payment on all eligible admissible in non-network hospitals |
10% on all eligible admissible claims |
18. |
Cash Less facility |
Across SBI General Network hospitals |
19. |
Coverage for selected day care surgeries within 24 hours of hospitalization |
Covers select Day Surgery where less than 24 hours hospitalisation for specified procedures like Dialysis, Chemotherapy, Radio therapy, Eye Surgery, Dental Surgery (Due to accident), Tonsillectomy, etc are covered. |
Particulars |
Minimum |
Maximum |
Entry Age (in years) |
18 |
65 |
Sum Coverage (in Rs.) |
50,000 |
5,00,000 |