IFFCO Tokio Swasthya Kavach plan is a family health insurance plan which covers family members on a floater basis. The plan provides all the necessary coverage features at very low rates of premiums. Some coverage features of the plan include hospitalization including pre and post hospitalization, domiciliary treatments, etc.
Step 1 – the policyholder chooses the Sum Assured and the members covered.
Step 2- If the covered member (s) face any medical contingency and the related expenses are covered by the plan the expenses incurred are paid by the plan.
Step 3 – if the plan matures and no medical contingencies occur, cumulative bonus is paid which increases the Sum Insured without increasing the premium.
Kartik buys the base cover of Swasthya Kavach plan for a Sum Insured of Rs.4 lakhs covering himself and his wife.
Option 1 – His wife is hospitalized for a medical emergency faced. The plan would pay the ambulance costs up to Rs.750 and hospitalization expenses incurred.
Option 2 – if the plan matures and there were no complications, the Sum Insured would increase by 5% and become Rs.4.2 lakhs.
|Room rent, boarding and nursing expenses||Up to 1% of Sum Insured|
|Registration, service charges or surcharges||Up to 0.5% of Sum Insured|
|ICU room rent||Up to 2% of Sum Insured|
|In-patient hospitalization||Covered up to Sum Insured. In case of package treatment, the coverage would be limited to 80% of the Sum Insured|
|Domiciliary hospitalization||Up to 20% of Sum Insured|
|Ambulance cover||Up to Rs.750|
|Pre hospitalization||Up to 30 days|
|Post hospitalization||Up to 30 days|
|Daily cash for hospitalization||Rs.150/day|
|Organ donor expenses||Covered|
|Day care treatments||121 procedures covered|
|Age at entry (in completed years)||Dependent children - 3 months
Adults – 18 years
|Adults – 60 years
Dependent children – 23 years
|Premium paying options||Single pay|
|Sum Assured||Rs.2 lakhs||Rs.5 lakhs|
Illnesses suffered during the first 30 days of the plan commencement are not covered.
Pre-existing ailments are not covered in the first 4 years of the plan.
Specific illnesses have a 1 year and 2 year waiting period
Treatment of renal failure, heart disease and any type of cancer is not covered in the first two years of the plan.
Illnesses or accidents caused due to genetic disorder or stem cell surgery, substance abuse, participation in adventure sports or hazardous activities, criminal acts, attempted suicide, war and hazardous substances, etc. are not covered.
Treatments like dental treatments, cosmetic treatments, artificial life support, weight loss treatments, etc. are not covered.
Post hospitalization expenses are paid for up to 30 days after hospital discharge. The maximum expenses covered would be 7% of the hospitalization expenses up to Rs.7500 as the maximum limit.
No additional riders are available with the plan
Emergency Assistance Services have no sub-limits.
Treatment for cataract would be covered up to 7.5% of the Sum Insured up to a maximum of Rs.15, 000.
The plan covers the policyholder, spouse and up to a maximum of 3 dependent children who can be children, siblings, nephews or nieces.