IFFCO Tokio Swasthya Kavach Wider offers health insurance coverage for the whole family. The plan provides both inbuilt coverage features as well as optional extensions which can be chosen to make the plan more exhaustive in its scope of coverage. There are also various value added services which increase the plan benefits.
Step 1 – the policyholder chooses the Sum Assured and the members covered.
Step 2 – the policyholder can also choose the critical illness extension by paying an additional premium.
Step 3- 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 4 – if the plan matures and no medical contingencies occur, cumulative bonus is paid which increases the Sum Insured without increasing the premium.
Harish buys the Wider plan for a Sum Insured of Rs.5 lakhs. He also opts for the critical illness rider.
Option 1 – Harish suffers kidney failure and is prescribed regular dialysis. His plan pays the critical illness benefit which he had opted for.
Option 2 – if the plan matures and there were no complications, the Sum Insured would increase by 5% and become Rs.5.1 lakhs.
|Room rent, boarding and nursing expenses||Up to 1.5% of Sum Insured|
|Registration, service charges or surcharges||At actuals|
|ICU room rent||Up to 2.5% 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.1500|
|Pre hospitalization||Up to 30 days|
|Post hospitalization||Up to 60 days|
|Daily cash for hospitalization||Rs.250/day|
|Organ donor expenses||Covered|
|Day care treatments||121 procedures covered|
|Health check-ups||Once every 4 claim-free years|
|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
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.
Pre health check-ups are covered up to 1% of the Sum Insured for all insured members together.
The plan provides an optional additional of Critical Illness rider which pays an additional Sum Insured in case the insured members suffer from any illness covered by the rider.
Some popular illnesses covered include stroke which results in permanent symptoms, cancer of specified severity, kidney failure which requires dialysis, open chest CABG, major organ transplant or bone marrow transplant, etc.
There is a period of 15 days from the date of policy issuance which is the free-look period under the plan. During this period the policyholder can choose to cancel the plan opted.
The plan is available for one year only after which it should be renewed.