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Aviva Heart Care Plan is a health insurance plan which is specially designed to cover cardiac related ailments and complications. The plan provides an exhaustive coverage by covering almost all heart-related problems. Furthermore, the plan comes with an option of covering the spouse under the same plan.
Step 1 – the policyholder chooses the Sum Assured and the coverage option. There are four coverage options which are as follows:
Step 2 – The policyholder also chooses the plan tenure and the premium paying frequency. Premiums are payable throughout the plan term.
Step 3- Heart-related ailments are categorized under three categories. If the life insured suffers any ailment, the payout would be made depending on the category of the ailment. Moreover, there is also a limit to the number of claims which can be made during the plan tenure. This limit also depends on the category of the ailment suffered.
Step 4 – If the plan matures and the life insured does not suffer any ailment, no maturity benefit is paid.
Rahul, a non-smoking male aged 30 years, buys Heart Care plan for a term of 20 years. The Sum Assured he chooses is Rs.10 lakhs.
Option 1 – Rahul chooses the ME option. He undergoes Pericardectomy which is categorized as a ‘Mild’ ailment. Thus, he gets Rs.2.5 lakhs payout. If he suffers a heart attack later in the policy tenure, it would be classified as ‘Severe’ ailment and he would get the remaining Sum Assured which is Rs.7.5 lakhs.
Option 2 – Rahul chooses ME+ option. He takes two ‘Moderate’ category treatments which pay his 50% of the Sum Assured in each instance. When his Sum Assured is exhausted, it is restored back to Rs.10 lakhs which would be available if he suffers any ‘Severe’ ailment.
Option 3 – Rahul takes WE option covering his wife too. Both the lives can claim the plan benefits. If Rahul suffers heart attack which is a ‘Severe’ condition, 100% of the Sum Assured is paid thus exhausting his cover amount. His policy would be terminated but his wife’s policy would continue and premiums would be waived off.
Option 4 – Rahul chooses WE+ option with restoration benefit. He takes two ‘Moderate’ category treatments which pay his 50% of the Sum Assured in each instance. When his Sum Assured is exhausted, it is restored back to Rs.10 lakhs. His wife’s Sum Assured can also be restored if it gets exhausted in treating any ‘Mild’ or ‘Moderate’ ailment. The restored Sum Assured would be applicable for ‘Severe’ ailments for both lives and the future premiums would be waived off.
|Category of ailments||Mild||Moderate||Severe|
|Benefit paid||25% of the Sum Assured per instance||50% of the Sum Assured per instance||100% of the Sum Assured per instance|
|Maximum number of claims||For ME and WE variant – 1 claim per life
For ME+ and WE+ variant – 2 claims per life for 2 different ailments
|2 claims per life||2 claims per life|
Moreover, in case of ME+ and WE+ plan variants, the premiums are waived off if the restoration benefit is activated and the Sum Assured is replenished.
Maturity Benefit – when the chosen tenure expires and the plan matures, no benefit is paid if the life insured does not suffer from any heart ailments.