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Reliance Life Care For You Advantage Plan

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Reliance Life Care For You Advantage Plan
 
Reliance Life Care For You Advantage Plan is a traditional, non-linked Health insurance Plan.
 
How it works – In this plan, premium is fixed for tenure of 3 years during which it does not change irrespective of age, health conditions or claims. There is guaranteed renewability in this plan up to the age of 75 years for adults and 21 years for children. In this Plan, self, spouse, children, parents as well as parents-in-law can be covered.
 
This plan covers Pre Hospitalization as well as Post hospitalization expenses and all admissible medical expenses under hospitalization like Room, boarding and nursing expenses, Surgeon, Anaesthetists, Medical Practitioner, Consultants, Specialists fee, Operation theatre charges, Anaesthesia, blood, oxygen, medicines and drugs etc. and Diagnostics and laboratory tests. Even 150 Day Care Treatment are covered in this plan. This plan also offers reimbursement of ambulance charges subject to a maximum of Rs 1,000 per policy year.
 
There is a feature of option to increase coverage, add members into the plan on every policy anniversary. And the premium paid towards this plan is tax free up to Rs 15000 every year under section 80D.
 
 
Key Features of Reliance Life Care For You Advantage Insurance Plan
 
  • It is a Non-Linked Health Plan
  • In this Plan, self, spouse, children, parents as well as parents-in-law can be covered
  • Premium remains fixed for a period of 3 years irrespective of increase in age, change in medical condition and number of the claims
  • There is a 15% renewal discount provided at the time of term renewal
  • The Sum Insured is increased by 5% (up to a maximum limit of 30%) of basic sum insured without paying any extra premium, for every claim free year as No Claim Bonus
  • 150 Day Care procedures are covered in this plan
  • Pre-existing diseases are also covered in this plan after a continuous renewal of 4 years
  • There is Guaranteed Renewability in this plan, up to the age of 75 years for adults and 21 years for the children
  • There is an option to increase coverage, add members into the plan on every policy anniversary
  • 95% of the claim is admissible in a network hospital and 90% in a non-network hospital
 
 
Key Benefits of Reliance Life Care For You Advantage Insurance Policy
 
Medical Benefit – This plan basically covers:
  • Pre & Post hospitalization expenses covered
  • All admissible medical expenses under hospitalization like:
    • Room, boarding and nursing expenses
    • Surgeon, Anaesthetists, Medical Practitioner, Consultants, Specialists fee
    • Operation theatre charges
    • Anaesthesia, blood, oxygen, medicines and drugs etc.
    • Diagnostics and laboratory tests
  • 150 Day Care Treatment
  • Reimbursement of ambulance charges subject to a maximum of Rs 1,000 per policy year
  • There are certain treatments that are admissible after the waiting period
 
 
Benefits you get from Reliance Life Care For You Advantage Policy
 
Death Benefit – Being a pure health plan, there is no Death Benefit payable in this plan
 
Maturity Benefit – Being a pure health plan, there is no Maturity Benefit payable in this plan
 
Income Tax Benefit - Health Insurance premiums paid up to Rs. 15,000 are allowed as a deduction from the taxable income each year under section 80D.
 
 
Additional Benefits from Reliance Life Care For You Advantage Policy
 
  • Premium remains fixed for a period of 3 years irrespective of increase in age, change in medical condition and number of the claims
  • There is Guaranteed Renewability in this plan, up to the age of 75 years for adults and 21 years for the children
  • The Sum Insured is increased by 5% (up to a maximum limit of 30%) of basic sum insured without paying any extra premium, for every claim free year as No Claim Bonus
  • There is a 15% renewal discount provided at the time of term renewal
  • Pre-existing diseases are also covered in this plan after a continuous renewal of 4 years
  • There is an option to increase coverage, add members into the plan on every policy anniversary
 
 
Eligibility conditions & other restrictions in Reliance Life Care For You Advantage  Policy
 

 

 
Minimum
Maximum
Sum Assured (in Rs.)
2 lacs
10 lacs
Policy Term (in years)
3
Premium Payment Term (in years)
Equal to Policy Tenure
Entry Age of Primary Life Insured (in years)
18
60 for new plan
72 for last renewal
Entry Age of Children (in years)
3 months
18
Entry Age of Parents (in years)
40
66 for new plan
72 for last renewal
Age at Maturity (in years)
-
75 for adults
21 for children
Payment modes
Annual or Monthly
 
Sample illustration of premium of Reliance Life Care For You Advantage Plan
 

The below illustration is for a healthy male of age 35, 45 and 55 years opting for a Sum Assured of Rs 2,00,000 and 5,00,000

 

Sample Premiums in Reliance Life Care for You Advantage Plan

 

Additional Features and Benefits of Reliance Life Care For You Advantage Plan
 
Riders – There are no additional riders in this plan
 
 
Policy Exclusions
 
  • There are certain exclusions in this plan
  • Pre-existing diseases in the first 4 policy years
  • Hospitalisation/Medical expenses not directly related to the specific illness or injury for which hospitalisation took place and the expenses which are not recommended by the attending doctor
  • Any treatment not performed by a doctor or any treatment of a purely experimental nature
  • Expenses which are not for actual, necessary and reasonable expenses incurred in the treatment of the Illness or Physical Injury, or any elective surgery or treatment which is not medically necessary
  • Any diagnosis or treatment arising from or traceable to pregnancy, childbirth including caesarean section, medical termination of pregnancy and/or any treatment related to pre and post natal care of the mother or the new born ( excepting ectopic pregnancy)
  • Sterility, treatment whether to effect or to treat infertility, any fertility, sub fertility or assisted conception procedure, surrogate or vicarious pregnancy, birth control, contraceptive supplies or services including complication arising due to supplying services
  • Hospitalization for correction of birth defects or external congenital anomaly /internal congenital anomaly
  • Any sexually transmitted diseases or any condition directly or indirectly caused to or associated with Human Immune Deficiency Virus (HIV) or any Syndrome or condition of a similar kind commonly referred to as AIDS (Acquired Immune Deficiency Syndrome}
  • Dental treatment or surgery of any kind unless necessitated by accidental bodily injury
  • Cost of spectacles contact lenses hearing aids and the cost of treatment for vision correction
  • Self-afflicted injuries or conditions (attempted suicide) and or the treatment directly or indirectly arising from alcoholism or drug abuse and any Illness or Physical Injury which may be suffered after consumption of intoxication liquors or drugs
  • Non-allopathic methods of surgery and treatment
  • Hospitalisation and surgery for donation of an organ
  • Medical or surgical treatment for weight reduction or weight improvement regardless of whether the same is caused (directly or indirectly) by a medical condition
  • Psychiatric, mental disorders (including mental health treatments and, sleep-apnoea), Parkinson and Alzheimer’s disease, general debility or exhaustion (“run-down conditions”): congenital internal or external diseases, defects or anomalies, generic disorders: stem cell implantation or surgery, or growth hormone therapy
  • Medical expenses relating to any Hospitalisation primarily for diagnostic, X-ray or any other investigations
  • Any experimental or unproven procedures or treatments, devices or pharmacological regimens of any description (not recognized by Indian Medical Council)
  • Stay in Hospital for domestic reason where no active regular treatment is given by a Doctor
  • Charges for services received in convalescent home and nursing homes, nature cure clinics and similar establishments
  • Circumcision unless necessary for treatment due to an accident
  • Plastic surgery or cosmetic surgery unless necessary as a part of medically necessary treatment certified by the attending Medical Practitioner for reconstruction following an Accident or illness
  • Any treatment related to sleep disorder or sleep Apnoea syndrome
  • Medical Expenses incurred due to Ventral/Incisional
  • Hernia unless the Company has paid the first operation
  • Expenses for any routine or prescribed medical check-up or examination, external and or durable Medical / Non medical equipment of any kind used for diagnosis and/or treatment and/or treatment and/or monitoring and/or maintenance and/ or support including CPAP,CAPD,Infusion pump, oxygen concentrator etc, ambulatory devices that is walker, crutches, belts, collars, caps, splints, stings, braces, stockings, gloves, hand soaps etc. of any kind, Diabetic footwear, glucometer/ thermometer and similar related items and also any medical equipment, which are subsequently used at home
  • Any kind of service charges, surcharges, admission fees, registration charges etc. levied by the Hospital
  • Any natural peril (including but not limited to avalanche, earthquake, volcanic irruptions, or any kind of natural hazard). Nuclear disaster, radioactive contamination and/or release of nuclear or atomic energy\
  • War, invasion, acts of foreign enemies, hostilities (whether war be declared or not), civil war, terrorism, rebellion, active participation in strikes, riots or civil commotion, revolution, insurrection or military or usurped power, and full-time service in any of the armed forces
  • Naval or military operations ( including duties of peace time ) of the armed forces or air force and participation in operation requiring the use of arms or which are ordered by military authorities for combating terrorists, rebels and the like
  • Participation in any hazardous activity or sports including but not limited to racing scuba dividing, aerial sports, bungee jumping or mountaineering, activities such as hang-gliding, ballooning, and any other hazardous activities or sports unless agreed by special endorsement
  • Expenses incurred for procurement of a replacement organ, transportation costs of the replacement organ and associated administration costs and all costs incurred by the donor
  • Any insured person committing or attempting to commit a criminal or illegal act with criminal intent, or intentional self-injury or attempted suicide while sane or insane
  • Expenses for services or treatment which are paid for by any other party or which are claimable under workmen’s compensation insurance. In such case, the Company will reimburse the difference between the expenses that would have been reimbursable by the Company had there been no other insurer or workmen’s compensation insurance involved and the amount already reimbursed or reimbursable by other party or by workmen’s compensation insurance
  • Non-Medical expenses including Personal comfort and convenience items or services such as telephone, television, personal attendant or barber or beauty services, diet charges, food , cosmetics, napkins, toiletry items, guest services and similar incidental expenses or services
  • Any hospitalisation outside India
 
 
How to Make a Claim?
 
You can make a cashless claim at the time of hospitalization through a network of 4000+ hospitals or at any time of the day in their 24 hour Customer Service desk.
 
For Network Hospitals:
  • The Health ID Card and any photo ID needs to be presented to the TPA (Third Party Administrator) at the hospital and the they will submit the pre-authorisation form with signature
  • The Claim Request will be checked
  • The Claim Request will be authorised
  • And the claim would be settled directly to the hospital
 
For non-Network Hospitals: The Claim Intimation must reach the company in writing within 7 days of hospitalization of the member. All claim under this plan needs to be made along with the following documents:
  • The hospital bill needs to be settled initially by out-of-pocket payment
  • Once discharged, the claim documents needs to be submitted
  • Then the Claim Request will be checked and authorized and paid directly to the policyholder
 
All claims requests are to be sent to either the nearest Reliance Life Branch or for any claims/ product-related queries or servicing requests, please contact their Customer Care Toll- Free number at 1800 300 08181 or 3033 8181.
 
 
Frequently Asked Questions about Reliance Life Care For You Advantage Plan
 
  • Does Reliance Life Care For You Advantage Plan cover Pre-existing Diseases?
 
As mentioned under Exclusions, Reliance Life Care For You Advantage Plan does cover Pre-existing Diseases and hospitalization from the same after a continuous renewal of 48 months and not before that
 
  • Is Maternity Benefit provided under Reliance Life Care For You Advantage Plan?
 
As mentioned under Exclusions, Reliance Life Care For You Advantage Plan does not cover Maternity Benefit and hospitalization from the same. It is not even after continuous renewals as in other plans.
 
 
What happens if?
 
You stop paying the premium - If the policy holder stops paying the premium within 30 days of the due date, the policy lapses and all benefits cease. If the lapsed policy is not revived within 90 days of the due date of the first unpaid premium then the policy will be terminated.
 
You want to surrender the policy – Being a pure health plan, there are no Surrender Benefits under this plan.
 
You want a loan against your policy – Loan facility is not available in this plan.

 
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