Page 158 - IC38 GENERAL INSURANCE

 Critical illness cover: Available as an option under the high end version
products for certain ailments which are life threatening and entail
expensive treatment.

 Reinstatement of sum insured: After payment of claim, the sum insured
(which gets reduced on payment of a claim) can be restored to the
original limit by paying extra premium.

 Coverage for AYUSH – Ayurvedic – Yoga - Unani – Siddha – Homeopath:
Few policies cover expenses towards AYUSH treatment up to a certain
percentage of the hospitalization expenses.

xii. Value added covers

Few indemnity products include value added covers as listed below. The
benefits are payable up to the limit of sum insured specified against each
cover in the schedule of the policy, not exceeding the overall sum insured.

 Outpatient cover: As we know health insurance products in India mostly
cover only in-patient hospitalization expenses. Few companies now
offer limited cover for out-patient expenses under some of the high-end
plans.

 Hospital cash: This provides for fixed lump sum payment for each day of
hospitalization for a specified period. Normally the period is granted for
7 days excluding the policies deductible of 2/3 days. Thus, the benefit
would trigger only if hospitalization period is beyond the deductible
period. This is in addition to the hospitalization claim but within the
overall sum insured of the policy or may be with a separate sub-limit.

 Recovery benefit: Lump sum benefit is paid if the total period of stay in
hospital due to sickness and/or accident is not less than 10 days.

 Donor‘s expenses: The policy provides for reimbursement of expenses
towards donor in case of major organ transplant as per the terms and
condition defined in the policy.

 Reimbursement of ambulance: Expenses incurred towards ambulance
by Insured/insured person are reimbursed up to a certain limit specified
in the schedule of the policy.

 Expenses for accompanying person: This is intended to cover the
expenses incurred by accompanying person towards food, transportation
whilst attending to insured patient during the period of hospitalization.
Lump sum payment or reimbursement payment as per the policy terms is
paid, up to the limit specified in the schedule of the policy.

 Family definition: Definition of family has undergone changes in few
health products. Earlier, primary insured, spouse, dependent children

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