• High Sum Insured up to Rs.25 Crore ^
• Double benefit in case of Accidental Death**
• Weekly coverage up to 100 weeks in case of TTD (Optional Cover)***
• Triple the amount of Sum Insured in case of PTD while travelling in common carrier*
• Loyalty benefit increases SI by 5% every year max. up to 50% in case of renewal
• Coverage for Burns, Fractures, Reconstructive surgery & Domestic Road Ambulance
• Coverage for Child education
• Nursing care
• Mobility cover

^{^Other Plans/Sum Insured are also available. ** Considering 200% of SI payable in case of Accidental Death due to Common carrier mishap (Optional cover). *** Optional Cover is available on payment of additional premium. Benefits might vary as per the plan chosen. * Considering 100% of SI payable each in case of Permanent Total Disability (PTD), PTD improvement (Optional cover - Coverage amount is equivalent to base Sum Insured) and Common carrier mishap cover (Optional cover).}

• Minimum entry age - 91 days
• Maximum entry age - Adult 70 years and Child 24 years
• Age of proposer - 18 years or above
• Policy Tenure - 1, 2 or 3 years
• Lifelong Renewability

Key Exclusions

• Any pre-existing injury or disability;
• Any intentional self-inflicted injury, suicide or attempted suicide, sexually transmitted conditions, mental or nervous conditions, insanity, disorder or depression.
• The Insured Person flying in an aircraft other than as a fare paying passenger in a Scheduled Airline.
• The Insured Person engaging in sporting activities in so far as they involve the training for or participation in competitions of professional sports, unless declared beforehand and agreed by the Company in writing subject to additional premium being received and incorporated accordingly in the Policy.
• Insured Person serving in any branch of the military, navy or air-force or any branch of armed Forces or any paramilitary forces.
• Any claim related to Hazardous Activities.
• Persons whilst working with in underground mines, explosives, press, activities like racing on wheels or horseback, winter sports, canoeing involving white water rapids, any bodily contact sport.
• Claim arising out of mental illness, psychiatric or psychological disorders.

For complete exclusions please refer to the product Policy Terms and Conditions.

Re-imbursement Claim Process

• You can register your claim online by scanning & uploading the claim documents at the Care Health Insurance ‘Self-Help Portal’ Link- https://www.careinsurance.com/self-help-portal.html or download the Care Health-Customer App to be able to do the same.
• As per the product you are insured with, download the re-imbursement claim form & submit online- https://www.careinsurance.com/health-insurance-claim-forms.html or download the Care Health-Customer App to be able to do the same.
• Upload a personalized name printed cancelled cheque in name of employee for corporate policy and in name of proposer for individual policy.
• In event of employee’s/proposer’s demise – cancelled personalized cheque (name printed) of nominee, ID proof of nominee & legal heir certificate.
• You are requested to scan & upload the following documents received from your hospital. Also submit additional documents, if any.
  • Original discharge summary
  • Original final hospital bill with item wise break-up
  • Original paid receipt against the final hospital bill
  • For Accidental cases
    1. MLC/FIR copy (if applicable)
    2. Alcohol history (if applicable)
  • Investigation reports (like X-Ray/MRI/CT Scan etc)
  • Attested copy of indoor case papers
  • In case of implant surgery, invoice & sticker
  • For all claims amounting Rs.1 lakh or above please provide copy of any one of these KYC documents (Aadhaar Card, Passport, Driving Licence Voter ID, etc). Please ensure that the address on KYC documents is matching with the Policy address.

Cashless Claim Process

1. To locate the nearest cashless network visit https://www.careinsurance.com/health-plan-certified-network-hospitals.html or download the Care Health-Customer App by clicking here https://bit.ly/3iI2ZfJ.
2. Contact hospital insurance help-desk or billing counter with a copy of patient’s medical ID card, e-health card, pre-authorization form along with valid Govt. ID proof. You can easily access your e-card anytime, anywhere by downloading the Care Health-Customer App.
3. Submitted documents are shared by the billing counter/TPA desk with us, seeking pre-authorization approval.
4. In case any information is incomplete/ missing; we may contact hospital for the same.
5. Pre-authorization decision will be given by us post review as per policy terms and conditions.
6. Post treatment discharge summary and other related documents are submitted by the hospital/TPA to us for final approval.
7. We assess the bills basis the sum insured and plan terms & conditions to settle the bill directly with the hospital.