IFFCO Tokio Swasthya Kavach Plan

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.

Key features of the plan

• No medical check-ups are required till 45 years of age.
• Various value added services are provided under the plan which is helpful in case of an emergency.
• Organ donor expenses are also covered by the plan.

How does the plan work?

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.

Example

Example

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.

Plan benefits

• Medical benefits – the list of medical expenses covered by the plan and their extent is as follows:

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

• Premium discounts – if the policyholder has an existing two-wheeler insurance plan from the company, a premium discount is allowed in the health insurance premium.
• Emergency Assistance Services – the plan provides value added emergency services if the insured is travelling at least 150 kms beyond his residential address. The services include:
• Medical consultation, evaluation and referral
• Emergency medical evacuation
• Medical repatriation
• Transportation to join patient
• Care and/or transportation of minor children
• Emergency message transmission
• Return of mortal remains
• Emergency cash co-ordination

Eligibility Criteria

What is not covered by the plan?

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.