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General Insurance

Cardiac Care Insurance Policy - Gold Plan

Eligibility Criteria

Minimum Entry Age 10 years
Maximum Entry Age 65 years
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For persons:

  • Who have undergone for first time Percutaneous Trans luminal Coronary Angioplasty (PTCA) / Coronary Artery Bypass Graft (CABG) within 7 years period prior to the commencement of the first policy under this insurance or
  • Who has Atrial Septal Defect (ASD) or Ventricular Septal Defect (VSD) that has been corrected or
  • With Patient Ductus Arteriosus (PDA) that has been treated or
  • Who had RF Ablation done to correct the underlying cardiac condition or
  • Who had an Angiogram done but no intervention was medically found necessary.
 

Highlights

Section 1:

Regular Hospitalization Cover (For Non Cardiac Ailments) 		Room, boarding, nursing expenses up to 2% of sum insured subject to a maximum of Rs. 5000/- per day
Section 2:

Regular Hospitalization Cover (For Cardiac Ailments) 		Hospital cover due to cardiac related complications which necessitate surgery/intervention and cardiac medical management.
Section 3:

Outpatient expenses 		Outpatient expenses of Rs. 500/- per event subject to a maximum of Rs. 1500/- per policy period.
Section 4:

Personal Accident 		Only death benefit is covered if an insured person meets with an accident.
 

Product Features

Key Features
Sum Insured

Sum Insured is the amount of cover provided by the insurance company. 		The plan provides a cover of Rs. 3 and 4 lacs
In-patient hospitalisation

This covers hospitalization expenses due to an illness or accident. 		The plan covers hospital accommodation, charges for stay in Intensive Care Unit, related hospitalization expenses such as surgeon’s fees, nursing, anesthesia, blood, oxygen, operation theater charges, surgical appliances, medicines, drugs and consumables up to the sum insured.
Pre-hospitalization

It covers the medical expenses due to an illness before the insured is hospitalized. 		The plan covers pre-hospitalization expenses of up to 30 days.
Post-hospitalisation

It covers the medical expenses due to an illness after the insured is discharged from hospitalization 		The plan covers post-hospitalization expenses up to 60 days in lump sum calculated at 7% of the hospitalization expenses (excluding room charges) subject to a maximum of Rs. 5,000/-.
Day Care Treatments

These are treatments that don’t require a 24-hr hospitalization and conducted in a hospital or day-care center.		 This plan covers the expenses of day care treatments up to Sum Insured.
Co-Payment

After a insured member turns a certain age, co-payment is applicable. Co-pay is that part of your claim amount, which you have to bear.		 This plan provides 10% co payment above the age of 60 years.
Waiting Period

If an insured person is suffering from any pre existing disease, he has to serve a specific waiting period wherein claim can be done only after completion of waiting period.		 Pre existing disease covered after:
Section 1 (Non cardiac ailments) Section 2 (Cardiac ailments) Section 3 & 4
48 Months 91th day No waiting period
 

Exclusions

  • Genetic Disorder.
  • Artificial Life Maintenance.
  • Mental disorders (including treatments for mental health).
  • Weight loss treatment.
  • Alternative Practice.
  • Recovery Benefit.
 
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