AFFORDABLE FAMILY HEALTH

INSURANCE PLAN FOR CUSTOMERS IN

TIER 2 /TIER 3 CITIES
CLASSIC
 NO CLAIM BONUS
25% 25% 25% 25% 25% 25% 150%

Note
 Increase/decrease of SI will be on base SI.
 25% Increase in SI at renewal if NO CLAIM made in previous policy year
 25% Decrease in SI at Renewal if CLAIM made in previous policy year

#Internal Training and Circulation Only

 NCB ILLUSTRATION
Policy Total SI Available Claim Status in
No Claim Bonus
Year (at the Beginning of the Year) Policy Year
0 - 10,00,000 No

1 2,50,000 12,50,000 No

2 2,50,000 15,00,000 Yes

3 -2,50,000 12,50,000 No

4 2,50,000 15,00,000 No

5 2,50,000 17,50,000 No

6 2,50,000 20,00,000 No

7 2,50,000 22,50,000 No

8 2,50,000 25,00,000 No
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 UNLIMITED AUTOMATIC
RECHARGE
Covers hospitalisation related to same illness also

Note :
 There has to be a GAP of 45 Days between the date of Discharge and date of Re-admission for claim related to
same disease
 Unlimited Automatic Recharge does not cover claims related to Advanced Technology Methods

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 NEVER MISS JOY OF
PARENTING
Coverage of Assisted Reproductive Treatments (such as IVF) once in a block of
3 years.
Note :
 First Claim payable after 3 Years of initial Wait Period.
 Available for SI>5L.

#Internal Training and Circulation Only

 NEW AGE BENEFITS
 Unlimited E-Consultation with General Physicians
 Discount Connect for availing discounts on services at our network.

Note :
 Benefits will be serviced through CHIL customer Mobile Application

#Internal Training and Circulation Only

 COMPASSIONATE TRAVEL
Re-imbursement of travel expenses of an immediate family member by
Air/Travel, if an insured member hospitalized for a life threatening emergency
condition at a place 100 KM away from place of residence.

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 ZONAL PREMIUM
Zone 1 Zone 2 Zone 3
Mumbai, Thane, Delhi including
Faridabad, Gurgaon, Ghaziabad Bangalore, Pune, Nasik, Rest of
and Noida, Ahmedabad, Rest of India
Gujarat.
Baroda, Surat.

#Internal Training and Circulation Only

 PREMIUM
COMPARISON
Eldest Member Policy Care with Care Classic
Age Construct NCB Super Zone 3
39 Years 2A+1C 15,523/- 13,100/-

47 Years 2A+1C 26,666/- 19,357/-

62 Years 2A 43,831/- 34,126/-

Note :
 Premium are for 5 Lacs SI & Inclusive of GST Up to 30%
LOWER PREMIUM

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 PREMIUM
COMPARISON
Eldest Member Policy Care with Care Classic
Age Construct NCB Super Zone 2
47 Years 2A+1C 26,666/- 23,072/-

62 Years 2A 43,831/- 40,750/-

Note :
 Premium are for 5 Lacs SI & Inclusive of GST
BETTER
Coverage

#Internal Training and Circulation Only

 PREMIUM
COMPARISON
Eldest Member Policy Care with Care Classic
Age Construct NCB Super Zone 1
47 Years 2A+1C 26,666/- 25,857

Note :
 Premium are for 5 Lacs SI & Inclusive of GST
BETTER
Coverage
 PLAN DETAILS

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 PLAN BENEFITS
Sum Insured (SI) 5L \ 7L \ 10L \ 15L
Room rent Single Private A/C Room
ICU Charges No limit
In-Patient Care Up to SI
Day Care Treatment All Day Care Procedures
Pre-Hospitalization Medical
Up to 60 days
Expenses
Post Hospitalization Medical
Up to 90 days
Expenses
AYUSH Treatment up to 10% of SI; Max Rs.50,000/year
Up to SI if hospitalization exceeds 3 days
Domiciliary Hospitalization
AYUSH Treatment is part of Domiciliary Hospitalisation SI
Organ Donor Cover Up to 10% SI
Ambulance Cover Up to Rs.1,000 per policy year
Second Opinion Once per Policy Year per Insured Person for each Major illness/injury
Annual Health Check-up Once in a year for all Insured Members.

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 UNIQUE BENEFITS
Sum Insured (SI) 5L \ 7L \ 10L \ 15L
25% of SI for every claim free year,
No Claims Bonus
Max 150% of SI,
unlimited times in a Policy Year
Unlimited Automatic Recharge
Not applicable on Advanced Technology Methods

Unlimited E-Consultations Consultations with General Physicians

Available with SI>5 Lacs

Assisted Reproductive Treatment Once in every block of 3 years
Up to 2 Lac per policy year
Compassionate Travel Up to Rs.5,000 per policy year

Health Portal- Doctor on chat, Healthy tips reminder, etc.

Other Value Added Services
Discount Connect – Discounts on services at our network.

#Internal Training and Circulation Only

 BOUNDARY CONDITIONS
Entry Age – Minimum 91 Days with at least 1 member of age 18 years or above
Entry Age – Maximum Adult: 65 Years; Child: 24 Years
Exit Age Adult: Lifelong; Child: 25 Years
Cover Type Allowed Floater
Co-Payment 20% on each claim, If Insured Person age is >= 61 Years at policy inception
Tenure Options 1/2/3 Years
Zone 1: Mumbai, Thane, Delhi including Faridabad, Gurgaon, Ghaziabad and Noida,
Ahmedabad, Baroda, Surat.
Zonal Pricing
Zone 2: Bangalore, Pune, Nasik, Rest of Gujarat.
Zone 3: Rest of India.
Self, Legally married spouse, son, daughter or Parents(father, mother) or In Laws(
Allowed Relationship
mother-in-law, father-in law).

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 WAIT PERIODS
Initial Waiting Period 30 Days

Named Ailment Waiting Period 24 months

Pre-Existing Diseases Waiting Period 48 months

36 Months for First Claim

Assisted Reproductive Treatment
Subsequent claims allowed once in a block of 3
Waiting Period
Years

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 SUB LIMITS
ADVANCED TECHNOLOGY TREATMENTS
Treatment/Procedures Coverage
Amount
CATARACT Uterine Artery Embolization and HIFU 15% of SI
Balloon Sinuplasty 5% of SI
Sum Insured Limits per policy Year Deep Brain stimulation 25% of SI
Oral chemotherapy 15% of SI
Up to 25,000 per eye,
3 Lakhs Immunotherapy- Monoclonal Antibody to
Max 35,000 per policy year 25% of SI
be given as injection
Up to 40,000 per eye, Intra vitreal injections 5% of SI
5 Lakhs
Max 60,000 per policy year Robotic surgeries 25% of SI
Up to 50,000 per eye, Stereotactic radio surgeries 25% of SI
7-15 Lakhs Bronchical Thermoplasty Up to SI
Max 75,000 per policy year
Vaporisation of the prostrate (Green laser
Up to SI
treatment or holmium laser treatment)
IONM - (Intra Operative Neuro
Up to SI
Monitoring)
Stem cell therapy 25% of SI
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 OPTIONAL
BENEFITS

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 OPD CARE
 Option to choose OPD coverage up to Rs.10,000
 OPD Care covers
 OPD Consultation
 Max 3 Consultation allowed in a Year
 Prescribed Diagnostics
Note :
Max limit per consultation is Rs.500 for OPD Coverage up to Rs.5000.
Max Limit per consultation is Rs.1000 for OPD Coverage >Rs.5000.
One Claim in a quarter during Policy Year, as and when insured may deem fit.
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 WAIVER OF CO-PAYMENT
Mandatory Co-pay of 20% on Claims will be waived–off.

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#Internal Training and Circulation Only
 CARE CLASSIC CURRENTLY
NOT AVAILABLE FOR
POS AGENTS
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 OWN PORTABILITY
NOT ALLOWED

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 Incorrect
Address will lead
claim rejection
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