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Arogya Sanjeevani Policy, Reliance General

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Arogya Sanjeevani Policy, Reliance General

Benefits

Arogya sanjeevani policy description
​​​​
​​Ayush
Hospitalisation Benefit
Cashless​
Inpatient Hospitalisation
Cataract
& Day Care Treatment

 

In the unprecedented times that we live in, covering oneself with a health insurance cover has become a necessity. Here’s an easy to buy plan with that covers all your inpatient hospitalisation needs with a wide range of sum-insured option ranging between ₹1 lac to ₹5 lacs, in multiplies of ₹50,000.


Take a detailed look at the benefits covered under Arogya Sanjeevani Policy, Reliance General:


Benefits Description

Section 1: Basic Benefits

Inpatient Care Covers medical expenses like room rent, ICU charges, medical practitioners fee, OT charges, nursing charges etc. incurred during hospitalization due to an illness or accident for period more than 24 hrs.
  • Room Rent, Boarding, Nursing Expenses as provided by the Hospital /Nursing Home, up to 2% of the sum insured subject to maximum of Rs.5000/- per day.
  • Intensive Care Unit (ICU) /Intensive Cardiac Care Unit (ICCU) expenses up to 5% of sum insured subject to maximum of Rs. 10,000/- per day.
  • Cost is included up to sum-insured for Anesthesia, blood, oxygen, operation theatre charges, surgical appliances, medicines and drugs, diagnostics, diagnostic imaging modalities and such similar other expenses.
  • Doctor/Surgeons fees is covered
Special Treatments Special treatments as listed below are covered with up to 50% of the sum-insured:
  • Uterine Artery Embolization and HIFU (High intensity focused ultrasound)
  • Balloon Sinuplasty
  • Deep Brain stimulation
  • Oral chemotherapy
  • Immunotherapy- Monoclonal Antibody to be given as injection
  • Intra vitreal injections
  • Robotic surgeries
  • Stereotactic radio surgeries
  • Bronchical Thermoplasty
  • Vaporisation of the prostrate (Green laser treatment or holmium laser treatment).
  • IONM - (Intra Operative Neuro Monitoring)
  • Stem cell therapy: Hematopoietic stem cells for bone marrow transplant for haematological conditions to be covered.
Day Care Procedures Medical expenses incurred for day care procedures taken at a hospital or day care centre. 24 hour mandatory hospitalization is not necessary in the day care procedure.
Cataract Treatment^Cataract treatment is covered op to 25% of Sum insured or Rs.40,000/-, whichever is lower, per eye, under one policy year
Ayush BenefitThe medical expenses for in-patient treatment taken under Ayurveda, Unani, siddha and homeopathy are covered without sublimits.
Pre- HospitalisationCovers medical expenses incurred 30 days prior to the date of hospitalisation.
Post- HospitalisationCovers medical expenses incurred up to 60 days from the date of discharge.
Emergency Road AmbulanceActual expenses incurred for utilizing road ambulance service for transporting the insured to the nearest hospital with adequate emergency facilities is covered upto ₹2000 per hospitalisation
Dental Treatment and Plastic SurgeryDental treatment & Plastic surgery necessitated due to any disease or accidental injury is covered

Section 2: Co-payment and Cumulative Bonus

Cumulative BonusIncrease in the sum insured by 5% in respect of each claim free year subject to a maximum of 50% of SI. In the event of claim the cumulative bonus shall be reduced at the same rate.
Co-payment5% for all claims
^ 24 Months waiting period is applicable for Cataract Treatment


Eligibility Criteria for Arogya Sanjeevani Policy, Reliance General-


ParametersEligibility
​Age

Child: 91 days to 25 years*

Adult: 18 years to 65 years*

​​
Policy Type​Individual and Family Floater​​
Policy Period​1 year​​
​Sum insured1 lac, 1.5 lacs, 2 Lacs, 2.5 lacs, 3 lacs, 3.5 lacs, 4 lacs, 4.5 lacs and 5 Lacs ​​

*Age based on completed years, No maximum cover ceasing age


Policy Cancellation-


Length of time Policy in forceRefund of premium
​Up to 15 daysPremium paid will be refunded (minus) any expenses incurred by the Company on medical examination of the insured person and the stamp duty charges​​

Waiting period for Arogya Sanjeevani Policy, Reliance General-


Waiting Period TypeDuration and Specifics​
​First Policy Waiting PeriodA waiting period of 30 days once the fresh policy is issued is applicable to all claims unless insured suffers an accident.​​
Pre-existing Diseases waiting periodPre-existing Diseases(PED) and it’s direct complications shall not be covered until the completion of 48 months of continuous coverage have elapsed, since inception of the policy provided that the PED is declared and/or accepted in the proposal​​.​​
Specific waiting periodA specific waiting period of 24/48 months is applicable on specific diseases as mentioned in policy as long as insured is in his/her third year of policy without break

24 months waiting period

  • Benign ENT disorders
  • Tonsillectomy
  • Adenoidectomy
  • Mastoidectomy
  • Tympanoplasty
  • Hysterectomy
  • All internal and external benign tumours, cysts, polyps of any kind, including benign breast lumps
  • Benign prostate hypertrophy
  • Cataract and age-related eye ailments
  • Gastric/ Duodenal Ulcer
  • Gout and Rheumatism
  • Hernia of all types
  • Hydrocele
  • Non-Infective Arthritis
  • Piles, Fissures and Fistula in anus
  • Pilonidal sinus, Sinusitis and related disorders
  • Prolapse inter Vertebral Disc and Spinal Diseases unless arising from accident
  • Calculi in urinary system, Gall Bladder and Bile duct, excluding malignancy.
  • Varicose Veins and Varicose Ulcers
  • Internal Congenital Anomalies

48 Months waiting period

  • Treatment for joint replacement unless arising from accident
  • Age-related Osteoarthritis & Osteoporosis
​​

What does the policy not cover?*


All permanent exclusions shall apply individually for each Insured Person under the Arogya Sanjeevani health policy and claims shall be assessed accordingly..

We will not make any payment for any claim in respect of any Insured Person directly or indirectly for, caused by, arising from or in any way attributable to any of the following unless expressly stated to the contrary in this Policy:

  • Domiciliary Hospitalization​​
  • Investigation & Evaluation
  • Rest Cure, rehabilitation and respite care​​
  • Obesity/Weight control
  • Change-of-Gender treatments​​
  • Cosmetic or Plastic surgery (unless due to accidental injury)
  • ​​Hazardous or Adventure sports
  • Breach of law
​​
​​​
  • ​​Excluded providers
  • Addictions, Drug / Substance Abuse
  • Alternate Therapy and Rejuvenation​​
  • Dietary Supplements & Substances
  • ​​Refractive Error
  • Unproven Teatments
  • Sterility and Infertility
  • Maternity​​
​​​
  • ​​Dental Treatment (unless due to accidental injury)
  • Non-medical expenses​​
  • Outpatient treatment (OPD)
  • Overseas treatment​​
  • War or similar situations​​
  • Nuclear, chemical or Biological attack

*All exclusions are subject to terms and conditions of the policy, please read complete policy wordings before concluding sales


Click here to read the policy wordings to know more about the exclusions of Arogya Sanjeevani Health Insurance Policy​








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