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IFFCO Tokio Swasthya Kavach Wider Plan

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.

Key features of the plan

  • No medical check-ups are required till 45 years of age.
  • Cashless claim facility is available at more than 4000 hospitals in India.
  • Expenses for vitamins and tonics are also covered under the plan.
  • Critical illness rider can be chosen with the plan.

How does the plan work?

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.

Example

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.

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 1.5% 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
  • No Claim Bonus – if no claim has been made by the policyholder in any policy year, a 5% increase in the Sum Insured is allowed up to a maximum of 50%
  • 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.
  • Critical illness rider – an optional Critical Illness Rider is available under the plan which pays an additional Sum Insured in case the insured is diagnosed with a critical illness.
  • 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

  Minimum Maximum
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

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

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.

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