General

Tokio Swasthya Kavach Policy of Iffco

Tokio Swasthya Kavach Policy of Iffco: The policy provides coverage for you and your relatives in the event of an accident or illness, such as hospitalization, medical costs, surgical expenses, organ transplantation, and so on. On a floater basis, the Policy protects the members of the Family, which includes you, your partner, and any minor children under the age of 23. Coverage is provided under a single Sum Insured, with no need for a separate Sum Insured for each family member.

As a result, each member of the Family has a claim against the single Limit of Indemnity. A critical illness alternative is also available to the family under a single amount insured on a floater basis. ITGI provides you with the policy at a reasonable cost. Without the use of a third-party administrator, IFFCO TOKIO handles the claim directly. We also have the opportunity to switch to any appropriate health insurance policy while maintaining coverage flexibility in terms of the waiting period. The policy covers you for a year and is available in two different plans: Base Plan and Wider Plan.

Mr. S Narayanan, Managing Director and Chief Executive Officer, IFFCO Tokio General Insurance, said at the launch of Swasthya Kavach, “IFFCO Tokio has consistently designed products that efficiently take care of its customers’ health insurance needs.” Swasthya Kavach provides advantages that are suitable for health-related emergencies.

Swasthya Kavach is available in two plans: Base Plan and Wider Plan. Both plans have the following key coverage:

  • Expenses for hospitalization include doctor’s fees, operation fees, room and nursing fees, medicine costs, medical tests, and so on.
  • There are 121 specified daycare surgeries that provide coverage for treatments that require less than 24 hours in the hospital.
  • After 4 years of continuous coverage with IFFCO TOKIO, pre-existing disease coverage is available.
  • Allowance per day.
  • Medical support in an emergency.

The following items are included in the Wider Plan’s extra coverage:

  • The additional coverage under the Wider plan are:10 specified critical illness cover available as an optional extension for the entire family (The 10 named critical illnesses under this policy are: Paralytic Stroke, Cancer, Renal failure, Coronary artery disease, Major organ transplant, Major injuries. End-stage liver disease, Major burns, Coma, Multiple sclerosis).
  • Cumulative bonus of 5 percent on every.
  • After every block of four claim-free years, a family health check-up is required.

On payment of an extra premium over and above the basic Cover premium, Hospitalization for Critical Illness, an Optional Extension, provides additional coverage for significant diseases such as Coronary Artery Disease, Renal Failure, Paralytic Stroke, Cancer, Major Organ Transplantation, and Injuries leading to loss of limb(s). The coverage is once again floater, and claims are resolved via reimbursement.

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Limitation on Age:

Individuals between the ages of 18 and 65 may purchase this insurance. Children aged 91 days to 23 years old will be covered as long as one or both parents are covered at the same time. Persons over the age of 65 are not eligible for first-time coverage. Persons over the age of 65 are not eligible for first-time coverage. Renewals, on the other hand, are permitted at any age.

Swasthya Kavach Policy by IFFCO TOKIO: Main Benefits

There are many advantages of purchasing Family Floater Health Insurance. Here are a few instances.

Amount Insured is automatically reinstated

Except for certain listed chronic conditions, a special provision is available for automatic reinstatement of Sum Insured in the event of a claim under the Policy, to the extent of the claim amount charged. The reinstatement premium is calculated over a brief time span, from the date of hospitalization to the policy’s expiration date, and deducted from the claim number.

Unlike regular insurance available on the market, where Sum Insured is decreased by the claim amount for the balance period under the policy, this means that the Insured does not have to worry about receiving the full Sum Insured payout for a subsequent claim in respect of any family member protected under the Policy.

A large number of hospitals are part of the network-

IFFCO Tokio has a large number of network hospitals (over 4600+) across the country where cashless claim settlement is possible. There is also a customer support service available 24 hours a day, 7 days a week for any claims-related issues.

Add-on covers with a twist-

On payment of a small additional fee, the Critical Illness Extension under the Wider Plan option of this Policy offers a unique add-on cover.

Facility for portability-

The Wider Plan option includes a portability option for those who choose to move from other insurers’ policies.

Health and personal support in an emergency-

Through the Value Added Services provided under both the Plan options of this Policy, all covered individuals performing domestic travel will receive unique emergency medical and personal assistance.

Bonuses Added Together-

On renewal, a cumulative bonus (i.e., a free increase in Sum Insured) of 5% is provided per claim-free year, up to a maximum of 50% of the Basic Sum Insured. In the case that any family member protected by the Policy makes a claim, the existing Cumulative Bonus is not completely withdrawn; instead, it is decreased by 10% at the next renewal, subject to the condition that the expiring Basic Sum Insured is retained.

Premium discount scheme with a twist-

If the Insured has affected his Motor Insurance Policy with IFFCO Tokio, or if he is protected concurrently as an employee/member of any IFFCO Tokio Group Medical Policy, a separate premium discount scheme is available under this Policy.

Re-Establishment of the Amount Insured

If the insured individual is sick and a claim is made, the value of the claim is deducted from the amounts insured. As a result, if the insured wishes to reinstate the amount insured, he will do so at the time of claim.

Following the incidence of a claim under the scheme, the basic sum insured will be reinstated by the amount of the claim, after charging the required premium, in accordance with the following formula for reinstatement of the basic sum insured, ensuring that the full basic sum insured is available for the policy period:

  • The basic sum insured will be reinstated to the degree that the claim amount is charged.
  • The claim sum would be reduced by the reinstatement premium.
  • The policy will be reinstated for the duration beginning with the first day of hospitalization and ending with the policy’s expiration date.
  • The hospitalization care costs of the illness, disease, or accident for which the insured person(s) was/were hospitalized would not be covered by this restored simple amount insured.
  • Though the basic sum insured will be restored as soon as the insured person(s) is hospitalized, the premium will be deducted from the claim settlement amount.

Documents available for claim settlement:

  • Claim Form.
  • Discharge Summary, Bills and Receipts of Hospital/Nursing Home Attending Doctor’s Report and Bills, as well as cash memos of medications and pathological tests with correct prescriptions.
  • In the event of an accident, there will be an F.I.R, a Post Mortem Report, a Final Investigation Report, and so on.

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