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HealthGain Health Insurance

HealthGain Health Insurance

Benefits

Reliance Health Insurance
No-Claim
Bonus Benefits
Cashless
Hospitalization
​5% Discount
for independent women
Auto ref​ill
of Sum Insured
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​ ​

Due to s​ky-rocketing inflation, even a small medical emergency can burn a hole in our savings. At this difficult situation- a health insurance policy comes as a saviour to you. It covers day care procedure, OPD charges, consultations, tests, and other such expenses that can put you in a financial crisis.

Beat the heat of inflation and avail the amazing benefits of this policy in 4 easy instalments. It's that simple! ​Click here to know more.​​​​

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Se​lect ​a Plan that Suits Your Needs

​From the below-mentioned options, you can select the right health insurance plan that secures your and your family's health.

CoverageIndividual Plan​Family Floater Plan
Who can buy this policy​This policy provides coverage to an individual.​It covers several members of a single family under the same plan by paying a single premium in a year.
What it offersThis policy offers benefits like cashless hospitalization, reimbursement, pre and post hospitalization expenses, and numerous other add-on features.
How it worksIn case of an illness, the entire sum insured covers only one individual.In case of multiple illnesses, the sum insured gets distributed among the members.


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What we offer in this plan-


​​​B​​enefit​s​​​​ Plan
​​Pre & Post Hospitalisation ExpensesUp ​to 60 Days
Hospitalisation Expenses​
​a. In-Patient Treatment
b. Day Care Treatments
Yes​
Domestic Road AmbulanceUp to Rs 1,500​
Donor Expenses​50% of SI up to max Rs 5 Lac
Domiciliary Hospitalisation​Up to 10% of SI, subject to a maximum of Rs 50,000.
Wellness​Yes​
Cumulative Bonus​33 1/3 % increase in Base SI for every claim free year; Max up to 100%.
33 1/3 % decrease in Base SI for every claim year; Max up to Cumulative Bonus earned.
Reinstatement of Base Sum Insured​One re-instatement up ​to 100% of Base Sum Insured, subject to sublimit of 20% for related illness/injury.
Call option​After every 4 claim free years up to maximum 4 times Base Sum Insured provided the total Sum Insured < = Rs 50 Lac. Can be exercised up to the age of 60 years.
Claim Service Guarantee ​Cashless Claims - 1% of claim amount for every delay of 6 hour​s beyond 6 hours of receipt of all information / documents.
Re-imbursement Claims - 1% of claim amount for every delay of 21 days beyond 21 days of receipt of all information / documents.
Maximum -​ 6% for a claim amount
Policy Service Guarantee​SI of Rs 10,000 for delay in policy issuance.
Accidental Death Cover for No Claim Renewal​NA
Insurance Renewal​NA​
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Why You Should Buy Health Insurance When You Are Young?​

  1. Low Premium-
    The premium of a health insurance policy is much lower when you are young. Let's understand this with an example- At the age of 25, you can have a cover of Rs. 3 lacs at a premium of just Rs. 5,546. As time passes by, our immune system weakens, a​nd we might need a cover of a greater sum insured. If you buy a cover of Rs. 9 lacs at the age of 50, then the premium amount gets almost tripled i.e. Rs. 14,856. Hence it is advised to buy a health insurance policy at a young age.​
    ​​
  2. Optimum health coverage-
    Due to a progressively sedentary lifestyle, unhealthy diet, environmental pollution and adulterated food, we are observing an increase in lifestyle diseases across age groups. The medical insurance offered by your employer is not enough. Even a regular hospitalization can cost you more than you can imagine. The fact is that medical exigencies in​crease as you get old and the need for medical insurance cannot be overlooked.

  3. Tax Benefits-
    Health insurance is one of the best ways to save tax under Section 80D of the Income Tax Act, 1961. You can avail tax benefits for a longer period if you buy a health insurance at a young age.

  4. Investment-
    If you buy health insurance policy at a young age, it's likely that you will get the best deal and your policy will be approved without any problem. ​The basic hospitalization costs have seen a spike of more than 10% in a decade.
    ​​
    Image Source:​Liv​emint ​(Findings of the sur​vey conducted by National Sample Survey Office in 2014​)​
    ​​


​Top 5 Factors That Affect Your Health Insurance Premium​

 

  1. Age: As mentioned earlier, the younger you are the less you have to pay to get yourself covered.

  2. Medical history: In case you have any pre-existing disease, your premium might increase or the insurer might not cover some particular disease in the policy.

  3. Body Mass Index: A high BMI may cause a surge in the premium amount. As high BMI is an indicative of obesity-related ailments like high blood pressure, heart attack, etc.

  4. Occupation: Your insurance premium is likely to increase if you work in hazardous environments or deal with harmful chemicals or radiations. Also, working at construction sites can surge your premium amount.

  5. Consumption of substances injurious to health: ​Your bad habits will never let you win any health situation. Hence, a smoker, alcoholic, or druggie may have a higher premium as compared to a person leading a healthy lifestyle.

     

    ​​​​​​​​​​​​Looking for a great taxing saving invest​ment?​​

     

    ​​Now as per section 80 D avail tax deductions of up to Rs 60,000*. ​​Take a look at this table to​ know more about the tax deductions:

    Description​​Medical Insurance Premium Paid forTotal deduction under section 80D
    Self, Spouse and Dependent ChildrenParents (Whether Dependent or Not)
    No one has attained the age of 60 Years ` 25,000 ` 25,000 ` 50,000
    Assessee and his family is less than 60 years and parents are above 60 years of age ` 25,000 ` 30,000 ` 55,000
    Assessee and his parents have attained the age of 60 ye​ars and above ` 25,000 ` 30,000 ` 55,000

     

    *Tax deductions are subject to provisions of Sec.80D of the Income Tax Act, 1961 and applicable amendments and are subject to change in the tax laws​. The tax rates/ benefits are subject to changes in tax laws. 

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​​​​What we cover-

This health insurance ​policy is a perfect foil for any unseen problems you might face during your treatment. Here's a quick look at what your policy covers.

Hospitalisation expenses in case of:

 

  • In-patient treatm​ent for covered illnesses /injuries, where the insured person is hospitalised for more than 24 consecutive hours.
  • ​Day-care treatment for surgeries /procedures, where the insured person requires less than 24 hours of hospitalisation due to advanced technology. For the list of Day care treatment. (Please refer to Annexure -I of the policy wordings)
Pre-hospitalisation coverage for:

 

Medical expenses incurred before hospitalisation. Under the HealthGain policy, you will get coverage for 60 days.

Post-hospitalisation coverage for:

Medical expenses incurred after hospitalisation. Under the HealthGain policy, you will get coverage for 60 days.

Domestic Road Ambulance:​​

 

Expenses for domestic-road ambulance services to the nearest hospital in case of life threatening emergencies. Under Plan A, your medical insurance policy would pay upto Rs 1,500 and upto Rs 3,000 under Plan B. (For more details on this mediclaim policy, please refer to the policy wordings)

​Donor expenses:

 

These are expenses incurred by the organ donor. We will cover up to 50% of the base sum insured, subject to a maximum of Rs. 5 lakh/- (For more details on this mediclaim policy, please refer to the policy wordings

Domiciliary hospitalisation:

 

  • Sometimes it is not possible to move the patient to a hospital because of their condition or lack of accommodation at the hospital. In such cases, the patient can be treated at home. This is called domiciliary hospitalisation.
  • Medical expenses for such cases will be covered if the treatment continues for a minimum of three days.

(For more details on this mediclaim policy, please refer to the policy wordings)

Re-instatement of base sum insured:

 

If you exhaust your entire sum insured & cumulative bonus (if any) and still require further hospitalisation for any related or unrelated illness, we will refill the full Sum Insured at no extra cost. (Please refer to Annexure -II of the policy wordings of this mediclaim policy)

Cumulative bonus:

 

  • This is a bonus awarded at the end of each claim free policy period. When you do make a claim in any given mediclaim policy period.
  • If you don’t make any claims on your policy for a year, you earn a cumulative bonus of 33.33% on your base sum insured, at no extra cost. However, the cumulative bonus can be accumulated equal to the amount of base sum insured. 
  • When you do make a claim in any given policy period, the bonus earned shall be decreased by 33.33% of the base sum insured, in the subsequent year. However, this will not reduce the initial base sum insured of your health insurance plan & your maximum reduction of cumulative bonus would be zero.
Call Option:

 

  • If you do not make any claim on your policy for 4 consecutive years, then by end of the 4th year your cumulative bonus will be equal to your base sum insured. In the 5th year, you can choose the “Call Option” to double your sum insured by adding this earned cumulative bonus.
  • Thereafter, you can accumulate the cumulative bonus again.

Please note that you can choose the Call Option only twice in your lifetime. (For more details, please refer to the policy wordings)

Claim service guarantee:

 

  • Cashless health insurance claims: If we’re unable to respond within 6 business hours, even after you have completed claim request with correct documentation and information, we will be liable to pay 1% of the claim amount to you, subject to a maximum liability of 6%.
  • Reimbursement of Claims: Similarly, if we’re unable to respond within 21 days, even after you have completed your claim request with correct documentation and information, we will be liable to pay 1% of the claim amount to you, subject to a maximum liability of 6%.

(For more details, please refer to the policy wordings​)

Policy service guarantee:
  • If, even after receiving all completed documents (including Medical reports, as applicable and premium), there is a delay of more than 10 working days from us in issuing your policy issuance, we will pay you onetime additional sum insured of Rs 10,000/- under Plan A and Rs 20,000/- under Plan B.
  • This will be applicable only for 1 year Policy Period and not for renewals/ auto-renewals.
Accidental death cover for no claim renewal:

 

  • Under Plan B, we will provide you an accidental death cover of Rs. 1 Lakh/- at the end of every claim-free policy year with our Company.
  • This cover will be valid for only one year.
  • This is applicable only if the policy holder is also the insured person in the policy.
Health Insurance Renewal:​

 

  • You can renew your medical insurance policy for free, under Plan B, if the person insured in the policy is diagnosed with a 'named critical illness
  • This benefit is provided once in the lifetime.
  • This is applicable only if the policy holder is also the insured person in the policy.

(Named critical illness can be referred in the policy wordings​)

​​​ Wellness Solutions:

 

Awes​ome discounts on various, value-added wellness services and choice of various online solutions through our wellness program.​​

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What we don't cover

 

​As much as we’d like for your policy to cover any and all types of situations, it isn’t possible.
Here are some of the exclusions in the HealthGain Policy.

  • Claims for any medical expenses that occur within 30 days of the mediclaim policy start day will not be covered, unless they occur due to an injury.
  • The following illnesses or surgeries will not be covered for the first two consecutive years from the policy start date:
    • Arthritis (non-infective)
    • Osteoarthritis and Osteoporosis
    • Gout
    • Rheumatism
    • All Vertebrae Disorders (including, but not limited to, Spondylitis, Spondylosis, Spondylolisthesis & Intervertebral Disc Prolapse)
    • Joint Replacement Surgery
    • Benign Ear, Nose and Throat (ENT) Disorders and Surgeries (including, but not limited to, Adenoidectomy, Mastoidectomy, Tonsillectomy and Tympanoplasty)
    • Nasal Septum Deviation, Sinusitis (and related disorders)
    • Benign Prostatic Hypertrophy
    • Cataract
    • Surgery of Genito-Urinary System (unless necessitated by malignancy)
    • Hernia, Hydrocele (all types)
    • Internal Tumours, Skin Tumours, Cysts, Nodules, Polyps, Breast lumps (each of any kind), unless malignant
    • Kidney Stone/ Ureteric Stone/ Lithotripsy / Gall Bladder Stone
  • Any conditions, ailments, injuries or related conditions, which you, the insured person, didn’t show any signs of, and /or which were diagnosed, and / or for which you received medical advice / treatment within 36 months, prior to the policy start date.
  • As per this policy a single room is defined as a room, where a single patient is accommodated and which has an attached toilet (lavatory and bath). The room may also provide provision for accommodating an attendant. Essentially, this type of room is the most basic and the most economical of all accommodations, available as a single room, in that hospital. Any room, beyond this description, is excluded from the health insurance policy coverage.
  • The following diseases or conditions are not covered in this plan, under permanent exclusions:
    • Intentional self-injury / injury under influence of alcohol, drugs / criminal acts
    • Outside India or Robotic or Stem Cells
    • War / nuclear / chemical / biological injuries
    • Diseases such as HIV / AIDS or STDs
    • Congenital diseases (diseases present from birth)
    • Maternity- or Fertility-related conditions
    • Cost of spectacles, contact lenses and hearing aids
    • Dental treatment or surgery
    • Treatment of mental illness
    • Cosmetic, aesthetic treatment
    • Non-allopathic, diagnostics , self-medication, unproven treatments​​

On purchase of the HealthGain policy, you get the R card! It's not just for claims, but it also gets you fabulous discounts and deals on a variety of health and lifestyle products and services.

Just download your​ ​R card here online, flash it at any of the places mentioned below (along with some photo ID) and get healthy! ​​​​

​​​​​

Health Gain Insurance FAQ

Benefits

Health Gain Insurance Reviews and Ratings

Average Rating:

4.4(Based on 131 ratings)

Showing 10 reviews

  • “Health Insurance for the Long Run”

    Now I see the use of buying health insurance when I am young. Auto refilling of the sum insured makes this a good policy.

    Sarosh C6 December 2018, Mumbai
  • “Liked health insurance on EMI”

    I purchased the health insurance on EMI for myself as I didn't want to spend in one go.

    Prasad S6 April 2018, Hyderabad
  • “got health insurance quote instantly”

    got an instant quote for health insurance depending on my needs.

    Suraj S15 March 2018, Kerala
  • “Premium calculator helped”

    Used the mediclaim policy premium calculator to calculate my premium and it helped me fasten the process of buying health insurance

    Shanaya F8 March 2018, Hyderabad
  • “best network oh hospitals”

    Got the healthgain policy as Reliance has a good network of hospitals for cashless service

    Anand L14 February 2018, Nellore
  • “Good healthgain policy”

    I have a healthgain policy of reliance and I am happy with the services they provide.

    Ujjwal B13 February 2018, Mumbai
  • “Family health insurance is good at a competitive rate.”

    The transactions are smooth and the customer service is helpful. The coverage provided by family health insurance is good at a competitive rate.

    Avinash S13 February 2017, Hubli
  • “Happy with Reliance Health Insurance!”

    Happy with the HealthGain product. Loving the added benefits provided by Reliance General Insurance.

    Ashutosh V13 February 2017, Jharkhand
  • “Good experience with Reliance General Insurance”

    Had a very good experience with Reliance. Easy and quick claim settlement for my HealthGain policy.

    Abhishek C10 February 2017, Mysore
  • “Helpful customer service”

    Helpful customer service who guided me about the health insurance policy that suited me best.

    Ayan A10 February 2017, Uttar Pradesh
  • See all reviews

On purchase of the HealthGain policy, you get the R card! It's not just for claims, but it also gets you fabulous discounts and deals on ​a variety of health and lifestyle products and services.

Just download your R card here online, flash it at any of the places mentioned below (along with some photo ID) and get healthy!

25% on
investigations

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25% on
OP consultation

15% on
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Online Wellness Solution

At Reliance General Insurance, it is our constant endeavor to deliver the best possible healthcare to our beneficiaries. We believe that health management can not be confined to the walls of a Hospital or Clinic. 

With your HealthGain Policy, we offer you various online services that give you access to health experts 24/7 as mentioned below. Click here to avail these services