AEGON Life Health Plan

AEGON Life Health Plan is a comprehensive Health Insurance Plan from AEGON Life with exclusive benefits. This is a Traditional Plan without Bonus facility. 

How it works – This is a Health Insurance Plan which needs to be taken for at least 3 years. The premium is guaranteed for the period of 3 years, irrespective of any claim. This plan can be taken till 85 years of age and continued till 100 years of age with continuous renewals. This policy can be taken for spouse, upto 3 dependent children, dependent parents and also dependent siblings.

In this plan, the Insured person would get a fixed amount of money as Daily Hospitalization Benefit in case of hospitalization, irrespective of the actual amount spent. This plan also covers some exclusive additional benefits like Intensive Care Unit Benefit and Surgical Cash Benefit for specified surgeries.

There is an additional Critical Illness Rider Benefit in this plan. 

Since this is not a regular reimbursement policy, this policy can be claimed for a guaranteed amount in addition to the payment received from other health plans.

• This plan is a comprehensive Health Plan
• This plan covers all kinds of surgeries including 240 Day Care treatments
• This plan provides guaranteed coverage till 85 years of age
• This plan is for 3 years and hence the premium is guaranteed for the entire period of 3 years
• There is a No Claim Bonus available of 10% discount in premium
• This plan has a high non medical limit of Rs 3 lacs and 50 years of age, below which no medical tests are required.
• Spouse, 3 Children, dependent parents and also dependent siblings can be included in this plan under different options
• This plan provides a fixed amount of money for each day of Hospitalization and Intensive Care Unit admission, irrespective of the actual amount spent.
• There is an additional benefit for Surgeries are paid for 6 special types of surgeries
• This plan also covers 10 Critical Illnesses and Congenital Benefit
• There is an additional Critical Illness Rider Benefit in this plan
• The health coverage can be increased any time as well.

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• This plan Provides for Daily Hospitalization Benefit of Rs 2000 to Rs 5000 per day
• There is an additional benefit of Intensive Care Unit Benefit for admission into the ICU for more than 8 hours
• There is an additional Surgical Cash Benefit for 6 types of specified surgeries, over and above the Daily Hospitalization Benefit and the Intensive Care Unit Benefit.
• On diagnosis of any of the 10 mentioned Critical Illnesses, a fixed amount is paid as Critical Illness Benefit, irrespective of the actual amount spent. This benefit is provided as an additional rider benefit.
• This plan covers Congenital Benefit, i.e. Medically Necessary Surgical Procedures required to correct congenital defects in a child.

Death Benefit – There in no Death Benefit in this plan.

Maturity Benefit – This plan being a pure Health Insurance Plan has no Maturity Benefit as well.

Income Tax Benefit – Health Insurance Premiums paid up to Rs. 15,000 for normal residents and Rs 20,000 for Senior Citizen are allowed as a deduction from the taxable income each year under section 80D

• There is a discount of 10% in premium for inclusion of family members in the plan
• There is no requirement of medical tests till Rs 3 lacs and 50 years of age under this plan

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The below illustration is of the Sum Assured = Rs 5 lacs, Platinum Plan for an individual male of

Ages 30, 40 and 50 years respectively without rider benefit

Riders – There is 1 additional rider available in this policy

1. Critical Illness Benefit rider

You stop paying the premium - If the policy holder stops paying the premium, the policy cover and all its benefits will cease. No further benefit would be payable for illness diagnosed during the lapsed period even if the policy is subsequently revived.

The policy can however be revived within 1 year from the date of first unpaid premium.

You want to surrender the policy – This policy has no Surrender Benefits.

You want a loan against the policyholder policy - There is no loan available under this plan.

• There are certain exclusions under which claim would not be admitted. They are:
• Any claim occurring as a result of Pre-existing conditions or their resultant complications unless stated in the proposal form and specifically accepted by the Company and endorsed thereon
• AIDS, HIV related complications or any Sexually Transmitted Diseases
• Attempted suicide or self inflicted injury, irrespective of the mental condition
• Hazardous sports or activities included but not limited to bungee jumping, mountaineering etc.
• Any flying activity other than as a bonafide passenger
• Under the influence of alcohol, drugs or any substance not prescribed by a Registered Medical Practitioner
• War, riots, civil commotion, strikes, civil war or service in the military or paramilitary forces of a country at war
• Criminal, unlawful or illegal activity participation
• Exposure to radioactive or nuclear fuel
• Diagnosis or treatment taken outside India
• Psychiatric or mental illness
• Circumcision, any cosmetic procedures or Plastic Surgery
• Pregnancy, childbirth or their complications, Abortion, Medical Termination of Pregnancy, Infertility or sex change operation
• Organ donation (donor costs)
• Rehabilitation or convalescent care or length beyond customary length of stay
• Non-Allopathic treatment
• Purely investigative procedure not resulting in any treatment or unreasonable failure to seek medical advice
• Congenital conditions, genetic disorders or birth defects unless specifically covered

You can make a cashless claim at the time of hospitalization through a network of 3000+ hospitals or at any time of the day in their 24 hour Customer Service desk.

However, all claim under this plan needs to be made within 90 days of hospitalization along with the following documents:

1. AEGON Life Health Plan ID Card or current Policy Copy.
2. Claim form duly filled in bearing the signature of the Policyholder & attested by the hospital wherever requested.
3. The Doctor’s Certificate who did the treatment, duly filled and signed in original.
4. Copies of Medical records, Discharge Summary, Investigation reports, consultation papers, hospital bills.
5. If Package Treatment, break up of details of Package bill
6. Medico Legal Certificate (MLC) in accidental case
7. Copies of all investigations done with the respective bills & reports
8. Copies of all bills for medicines supported by relevant prescriptions
9. A copy of Age and Identity proof.

Without the above mentioned documents, the claim request would not get registered. The company may request for additional information or documents, which needs to be resolved as well.

All claims requests are to be sent to either the nearest AEGON Life Life Branch or for any claims/ product-related queries or servicing requests, please contact their Customer Care Toll- Free number at 1800 209 9090

Alternately you could contact the Third Party Administrator, Paramount.

Toll - free Number: 1800 22 6655

Help Line Number: 022 - 66620 808

Website: www.paramounttpa.com/AEGONreligare

Email id: contact.phs@paramounttpa.com

Address

Paramount Health Services Pvt. Ltd.

 Elite Auto House, A-54, 1st Floor, M. Vasanji Road, Off Andheri - Kurla Road,

 Chakala, Andheri (East), Mumbai - 400 093

Does AEGON Life Health Plan cover Pre-existing Diseases?

As mentioned under Exclusions, AEGON Life Health Plan does not cover Pre existing Diseases and hospitalization from the same. It is not even after continuous renewals as in other plans.
 

Do I need to get my Medicals done under AEGON Life Health Plan? 

As mentioned under Key Features, There is no requirement of Medical Tests in this plan till Rs 3 lacs of Sum Assured and 50 years of age. Only a declaration of Good Health is sufficient. However, if the medical underwriters feel necessary, they may call for medical tests but not under usual circumstances. Hence please mention all ailments in details.

However, for age at entry above 50 years or more than Rs 3 lacs of Sum Assured, Medical Tests would be required.
 

Is Maternity Benefit provided under AEGON Life Health Plan? 

As mentioned under Exclusions, AEGON Life Health Plan does not cover Maternity Benefit and hospitalization from the same. It is not even after continuous renewals as in other plans.