A NEW Innovative Subscription Offer With Medical Benefit

For all Shravak-Shravika members of JIO

( For all JAIN Sects, like Shwetamber, Digamber, Sthanakwasi, Terapanthi etc.)
 
JIO – Shravak Arogyam
Group Health  Subscription Offer
Khushhal  Pariwar
 
Health Subscription Terms KP-KENKO : (Nov 2022-2023):          

For October 2022 lot Members : Your cover benefit already expired on 30th October, 2022. Multiple mails & SMS were sent on your registered email id and on your registered contact number to pay on time to avail continuity benefit of cover during last two months. Your
enrolment will be considered now as fresh / new since payment not received within provided time limit. 1st year waiting period and 1st year exclusion clause will be applicable to you. Your cover benefit will start as fresh / new member from 15th January, 2023 to 14th January
2024.

For November 2022 lot Members : Your cover benefit already expired on 29th November, 2022. Multiple mails & SMS were sent on your registered email id and on your registered contact number to pay on time to avail continuity benefit of cover during last two month. Your
enrolment will be considered now as fresh / new since payment not received within provided time limit. 1st year waiting period and 1st year exclusion clause will be applicable to you. Your cover benefit will start as fresh / new member from 15th January, 2023 to 14th January
2024.

For January 2023 lot Members : Membership benefit will start from 15.01.2023.

For New Members : Membership benefit will start from 15.01.2023

Specialised Health Subscription in which member will get 25% discount on Prescribed Medicine, Doctor consultation, Diagnostic test order through Kenko Health app.

In case of hospitalisation eligible initial amount (Preauth) will be transferred in members account after uploading requisite documents in app. At the time of discharge final amount will be transferred in member’s account after uploading requisite documents.

1. Entry AGE is up to 90 Years and Renewal till LIFETIME

2. Family floater Subscription offer with medical benefit for 8 members. This includes Self, Spouse, 4 unmarried Dependent Children up to 25years, 2 Dependent Parents or Parents-In-Laws (No cross combination will be covered in the  Subscription). All covered members have
to be Jain only

3. Family floater  for 4 members. This includes Self, Spouse, 2 Dependent Unmarried Children up to 25years.

4. NO Health Check-Up Required prior to  Subscription.

5. Home care treatment for COVID allowed on reimbursement basis only. Maximum limit for home care COVID treatment is 25,000 per person on reimbursement basis only.

6. Hospital ROOM RENT & ICU CHARGES limitation (Per Day): 

Room, Boarding Expenses in Rs.
Sum Insured (including Nursing, RMO Expenses and all associated charges)
Normal Room ICU
2,00,000 2000 4000
5,00,000 5000 10000
10,00,000 7500 13000
In case, the insured person is admitted in a room with rent HIGHER than the eligible room rent limit, the
total hospitalization claim shall be deducted in proportion of eligible room rent limit.
e.g. If you are
admitted in 4000 Room and you are eligible for 2000 Room rent, then your all claim will get deducted
by 50%.
7. PRE-EXISTING DISEASE will cover after 1 year. (In 2nd year 75% of admissible claim amount & then after, 100% of admissible claim amount will be payable.)  subject to ailment capping , reasonable, customary and Medically Necessary charges***.

For Khushhal Pariwar policy member, renwable benefit will be given

Knee Replacement / Cataract / Other Chronic disease which are mainly Pre-Existing or the treatment for same can be delayed (the list given in point no. 30 cover starts after 1 year as per T & c even if they are diagnosed after Subscription inception.

Pre-Existing Disease Definition :

Any condition, ailment or injury or related condition(s) for which you had signs or symptoms, and / or were diagnosed, and / or received medical advice / treatment within 48 months to prior to the first  issued by the insurer.

8.
1st Year Exclusion Disease :
For New members 1st year exclusion applicable ,
For Renewal Member 2nd Year 75% and from 3rd Year 100% ( Except procedure mentioned in capping list )
The detail list of 1st Year exclusion disease is given under point no. 30

9. DAY CARE PROCEDURES: covered 

10. Internal Congenital diseases are covered maximum up to Rs. 50,000 per family.

11. Domiciliary Hospitalisation is NOT COVERED.

12. Emergency Ambulance Charges: up to Rs.2,500 or actuals whichever is less.

13. 90 Days Pre- Hospitalisation & 90 Days Post Hospitalisation expenses covered.

14. MATERNITY BENEFIT (for self & Spouse) : Maternity benefits, applicable ONLY AFTER 1 YEAR  for new members and for renewal members same is covered subject to overall limit of Rs.25,000/- for normal and Rs.35,000/- for caesarean delivery (for first 2 live
children). In case the member has already 2 or more living children, then they will not be eligible for Maternity Benefit. No Pre-post claim allowed in Maternity claims. No Maternity benefit for individual  Subscription.

15. NEW BORN BABY COVER: Request for addition of New Born Baby under the  shall be allowed provided birth intimation received in mail within 30 days from Date of birth of child on  service@jio.net.in email id with child birth proof, Any delay / request coming after 30
days from DOB for addition of New Borne baby, shall not be considered.

Any hospitalization within this period i.e. from DOB of baby to 30 days shall be considered subject to receipt of the timely intimation to Insurance Company

New born baby expenses related to Hospitalization shall be covered from Day One of the birth up to 90 days up to 35000 limit and thereafter up to Family Sum-Insured limit.

16. NEWLY MARRIED SPOUSE COVER: Request for addition of Newly married Spouse under the subscription shall be allowed within 30 days from marriage date provided written mail is received on  service@jio.net.in email id within 30 days from the date of marriage with
marriage proof, Any delay / request coming after 30 days from marriage date for addition of Newly married Spouse, shall not be considered.

17.  Subscription to be renewed as it is with same JIOJAC id and members who were covered in last year. If found any changes done, all covered members will be considered as a fresh members and all clause and terms applied for fresh member will be applied on all members.

Only new born baby or newly married spouse name can be added if new born birth or marriage is after 31.10.2021.

18. CASHLESS and REIMBURSEMENT both facility available in  subscription for Medical benefit.

19. As per INCOME TAX Act, Proposer will be not eligible for exemption under Sec 80D for Health Subscription amount.

20. Dental treatment covered if due to ROAD ACCIDENT ONLY and requiring 24 hours Hospitalisation. Police MLC / FIR is compulsory.

21. In all claim due to Accident (whatever cause, police MLC / FIR is compulsory)

22. MID-TERM ADDITIONS allowed only for newly married spouse and natural additions (new born baby) subject to intimation received within 30 days of marriage or birth (for newly married SPOUSE & new born BABY) in mail on service@jio.net.in. Any delay / request
coming after 30 days shall not be considered.

23. Any person CAN’T BE COVERED MORE THAN ONCE under whole group in JIO KP . If declared more than once, benefit would be payable under one Sum Insured only.

24. Member will be considered as fresh member if subscription amount received after expiry of current . No grace period will be considered as this is a group Subscription offer.  

25. All covered Member will be considered as fresh member if renewed using different JIOJAC ID or any changes in covered members name / relation detail of expiring , Continuity benefit will be lost for all covered members.

26. Kindly read Terms & Condition properly, if required then only call to call centre number 1800 1211 63177

27. REASONABLE AND CUSTOMARY CHARGES mean the charges for services or supplies, which are the standard charges for the specific provider and consistent with the prevailing charges in the geographical area for identical or similar services, taking into account the
nature of the Illness / Injury involved. Insurance company will process claim as per reasonably and Customarily and Medically Necessarily charges.

28. If proposer had died then please renew enrol for subscription offer as it is and informed  service@jio.net.in with death certificate of proposer within 5 days from payment. Respective team will get JIOJAC number transferred to Spouse of the deceased name. This will ensure
continuity under the . Your continuity under the  is tracked by JIOJAC number only.

Any claim in deceased proposer’s family, amount will be released in sequence covered Spouse, covered Elder child, father, mother name.

29. The insured can make a claim if her/his hospitalized stay is for over 24 hours. However, for certain treatments, such as dialysis, chemotherapy, cataract surgery, etc. the stay could be less than 24 hours.

30. CLAIM INTIMATION Require in each claim in advance

1. If Intimation given through Kenko App 7 days in advance, then Benefit Payable is 100% of Benefit.(Admissible Claim amount).
2. If Intimation given other than Kenko App (email, etc.) 7 days in advance, then Benefit Payable is 90% of Benefit.(Admissible Claim amount).
3. If member prefer Reimbursement through Kenko App, then Benefit Payable is 80% of Benefit.(Admissible Claim amount).
4. If member prefer Reimbursement other than Kenko App (email, etc.), then Benefit Payable is 70% of Benefit.(Admissible Claim amount).

 
 
 

a. Waiting period applicable for COVID claims for all newly covered members. Patient should be diagnosed COVID positive after 30 days from  subscription cover start date. All renewal member will not have waiting period.

e) In case of claim for Corona treatment, patient’s diagnosis report should be from Government approved laboratory is compulsory and patient’s report should be COVID POSITIVE. Also note that treatment should be only taken in Government approved hospital to treat
COVID Positive patient.
f) COVID treatment claims will be settled as per GIC guidelines or Govt. notification issued by the State Govt. where the hospital is situated.

31. Subscription Amount 
Khushhal Parivar  Annual subscription amount as per Highest Member’s age in the family per Year ##
Health Subscription for Kushhal Parivar – January 2023-2024 Total Subscription fees

Plan Policy Type Max. Person Max. Age Family Details Sum Insured Premium Without GST  GST Premium With GST

A 10 lacs 31,795 5,723 37,518

90 years Self + Spouse + 4 unmarried children +2 Parents / In Laws
B 5 lacs 25,244 4,544 29,788
8 members
C 10 lacs 26,720 4,810 31,530
Family Floater 60 years Self + Spouse + 4 unmarried children +2 Parents / In Laws
D 5 lacs 19,002 3,420 22,422
E 10 lacs 19,505 3,511 23,016
4 Members 45 years Self + Spouse + 2 unmarried children  
F 5 lacs 13,862 2,495 16,357
G 65 years Self 9,161 1,650 10,811
Individual 1 member       2 lacs
H 45 years Self 4,636 834 5,470

 
  

*Rs 2000/- + GST (non-refundable/non-transferrable) will be charged additional per financial year for JIO Membership fees, if not paid

Notes :

• Children in the  are defined as unmarried dependent children up to the age of 25 years.
• Either Parents or Parents-in-law covered (Cross combination not allowed)
• Single person can also opt for   subscription up to age of 65 years. Without maternity benefit.
• Family members to be covered as per acceptable age of specific plans only
• Individual   Subscription (Plan G & Plan H) is available only for members without any living spouse, children, Parents or parent in law (self-affidavit or certificate from JIO Director mandatory). No Maternity benefit for individual  Subscription.
• Subscription amount to be transferred to JIO account by members and JIO will subsequently make consolidated payment to Insurance Company. Hence, considering the time required for reconciliation and requisite processes, request members to pay subscription amount at the earliest
• subscription amount to be paid through Online Payment only. No changes or cancellation allowed after payment.
• Additional Payment Gateway fees shall be charged by Gateway Company for providing safe & secure online money transfer facility.
* For detail terms and condition, rejections and sub-limits refer JIO website.

https://jio.net.in/KPK22.php

**  Subscription terms and rates shall be reviewed annually and necessary corrective action shall be taken (if required) to keep the portfolio viable

• PARTNERS for  JIO-KENKO offer

• Insurance Company: Go Digit General Insurance Limited
 
32. GENERAL EXCLUSIONS (Not Payable )  JIO-KENKO Subscription with Medical benefit.

In Patient Hospitalisation (This exclusion is related to IPD - Hospitalisation benefit)

1. WAR like situation etc. :Treatment directly or indirectly arising from or consequent upon war or any act of war, invasion, act of foreign enemy, war like operations (whether war be declared or not or caused during service in the armed forces of any country), civil war, public
defence, rebellion, uprising, revolution, insurrection, military or usurped acts, nuclear weapons / materials, chemical and biological weapons, ionizing radiation, contamination by radioactive material or radiation of any kind, nuclear fuel, nuclear waste.

2. SUICIDE attempt, CRIME etc.: An Insured Person committing or attempting to commit a breach of law with criminal intent, intentional self-Injury or attempted suicide while sane or insane.

3. Risky Sports, Military :Wilful or deliberate exposure to danger , intentional self-Injury, participation or involvement in naval, military or air force operation, circus personnel, racing in wheels or horseback, diving, aviation, scuba diving, parachuting, hang-gliding, rock or
mountain climbing, bungee jumping, paragliding, parasailing, ballooning, skydiving, river rafting, polo, snow and ice sports in a professional or semi-professional nature.

4. Alcohol, Addiction etc.: Abuse or the consequences of the abuse of intoxicants or hallucinogenic substances such as intoxicating drugs and alcohol, including alcohol withdrawal, smoking cessation programs and the treatment of nicotine addiction or any other substance abuse
treatment or services, or supplies, impairment of Insured Person's intellectual faculties by abuse of stimulants or depressants

5. Weight management programs or treatment in relation to the same including vitamins and tonics, treatment of obesity (including morbid obesity).

6. Correction of eyesight: Treatment for correction of eyesight due to refractive error including routine examination.

7. Health check-ups: All routine examinations and preventive health check-ups, including corona virus when hosptizalation is not done

8. Cosmetic surgery, aesthetic and re-shaping treatments and Surgeries. Plastic Surgery or cosmetic Surgery or treatments to change appearance unless medically necessary and certified by the attending Medical Practitioner for reconstruction following an Accident, cancer or burns.

9. Circumcision (unless necessitated by Illness or Injury and forming part of treatment); aesthetic or change-of-life treatments of any description such as sex transformation operations.

10. Hospitalisation not required: Conditions for which treatment could have been done on an outpatient basiswithout any Hospitalization.

11. Experimental treatment: Investigational treatments, Unproven / Experimental treatment , or drugs yet under trial, devices and pharmacological regimens.

12. Diagnostic Only: Diagnostic tests/procedures/treatment/consumables not related to Illnessfor which Hospitalization has been done.

13. REST CURE :Convalescence, cure, rest cure, sanatorium treatment, rehabilitation measures, private duty nursing, respite care, long-term nursing care or custodial care, treatment taken in a clinic, rest home, convalescent home for the addicted, detoxification centre, home for
the aged, mentally disturbed remodelling clinic or any treatment taken in an establishment which is not a Hospital.

14. PREVENTIVE CARE/Vaccination including inoculation and immunizations (except in case of post-bite treatment); any physical, psychiatric or psychological examinations or testing.

15. Admission for enteral feedings (infusion formulas via a tube into the upper gastrointestinal tract) and other nutritional and electrolyte supplements unless certified to be required by the attending Medical Practitioner as a direct consequence of an otherwise covered claim.

16. Hearing aids & contact lenses or spectacles including optometric therapy, multifocal lens.

17. Baldness: Treatment for alopecia, baldness, wigs, or toupees, and all treatment related to the same.

18. Diabetic test strips etc.: Medical supplies including elastic stockings, diabetic test strips, and similar products.

19. External durable medical equipment: Any expenses incurred on prosthesis, corrective devices, external durable medical equipment of any kind, like wheelchairs crutches, instruments used in treatment of sleep-apnea syndrome or continuous ambulatory peritoneal dialysis
(C.A.P.D.), devices used for ambulatory monitoring of blood pressure, blood sugar, glucometers, nebulizers and oxygen concentrator for bronchial asthma/ COPD conditions. Cost of artificial limbs, crutches or any other external appliance and/or device used for diagnosis or
treatment (except when used intra-operatively). Sleep-apnea and other sleep disorders.

20. External Congenital Anomalies or diseases or defects.

21. Stem cell therapy etc. : Genetic disorders and stem cell implantation /Surgery, or growth hormone therapy.

22. Venereal disease, all sexually transmitted disease or Illness including but not limited to HPV, Genital Warts, Syphilis, Gonorrhoea, Genital Herpes, Chlamydia, Pubic Lice and Trichomoniasis.

23. "AIDS"(Acquired Immune Deficiency Syndrome) and/or infection with HIV (Human Immunodeficiency Virus) including Opportunistic infections but not limited to any conditions related to or arising out of HIV/AIDS such as ARC (AIDS Related Complex), Lymphomas in
brain, Kaposi's sarcoma, tuberculosis, Pneumocystis Carinii Pneumoniae etc.

24. Voluntary termination, miscarriage (except as a result of an Accident or Illness)

25. Infertility: Treatment for sterility, infertility, sub-fertility or other related conditions and complications arising out of the same, assisted conception, surrogate or vicarious pregnancy, birth control, and similar procedures; contraceptive supplies or services including
complications arising due to supplying services.

26. Organ donor screening: Expenses for organ donor

27. Illegal Organ Transplantation: Admission for Organ Transplant but not compliant under the Transplantation of Human Organs Act, 1994 (amended).

28. Spinal subluxation: Treatment and supplies for analysis and adjustments of spinal subluxation, diagnosis and treatment by manipulation of the skeletal structure; muscle stimulation by any means except treatment of fractures (excluding hairline fractures) and dislocations of the
mandible and extremities.

29. Dental Treatment: Dentures, implants and artificial teeth, Dental Treatment and Surgery of any kind, unless requiring Hospitalization due to an Accident.

30. Cost incurred for any health check-up or for the purpose of issuance of medical certificates and examinations required for employment or travel or any other such purpose.

31. Artificial life maintenance including life support machine use, where such treatment will not result in recovery or restoration of the previous state of health.

32. Treatment for developmental problems , learning difficulties eg. Dyslexia, behavioural problems including attention deficit hyperactivity disorder (ADHD).

33. Treatment for Age Related Macular Degeneration (ARMD), Rotational Field Quantum Magnetic Resonance (RFQMR), External Counter Pulsation (ECP), Enhanced External Counter Pulsation (EECP), Hyperbaric Oxygen Therapy, high intensity focused ultrasound, balloon
sinuplasty, Deep Brain Simulation,

34. Non-Medical Expenses (1):Expenses which are medically not necessary such as items of personal comfort and convenience including but not limited to television (if specifically charged), charges for access to telephone and telephone calls (if specifically charged), food stuffs
(save for patient's diet), cosmetics, hygiene articles, body care products and bath additives, barber expenses, beauty service, guest service as well as similar incidental services and supplies, vitamins and tonics unless certified to be required by the attending Medical Practitioner as a
direct consequence of an otherwise covered claim.

35. Treatment taken from a person not falling within the scope of definition of registered Medical Practitioner with any state medical council/ medical council of India.

36. Treatment charges or fees charged by any Medical Practitioner acting outside the scope of license or registration granted to him by any medical council.

37. Treatments rendered by a Medical Practitioner who is a member of the Insured Person's family or stays with him, except if pre- approved by Us.

38. Any treatment or part of a treatment that isnot of a reasonable charge, not medically necessary , drugs or treatments which are not supported by a prescription.

39. Non-Medical Expenses :(2) Administrative charges related to a Hospital stay not expressly mentioned as being covered, including but not limited to charges for admission, discharge, administration, registration, bio-medical, linen, documentation and filing, including MRD
charges (medical records department charges).

40. Non-Medical Expenses : (3)including but not limited to RMO, CMO, DMO charges, Bio-Medical waste charges , Infection Control Charges etc. surcharges, night charges, service charges levied by the Hospital under any head are not payable because they are part of Nursing
Charges and as specified in the Annexure for Non- Medical Expenses Click Here for more details 

41. Treatment taken outside India

42. Insured Person whilst flying or taking part in aerial activities except as a fare-paying passenger in a regular scheduled airline or air charter company.

43. Robotic surgery (whether invasive or non-invasive) and Any form of Laser Surgery

44. All forms of Bariatric surgery.

45. Use of Radio Frequency (RF) probe for ablation or other procedure.

46. Admission primarily for diagnostic purposes not consistent with the treatment taken.

47. Blacklisted Hospital, Doctor: Treatment in any Hospital or by any Medical Practitioner or any other provider of services that We have blacklisted as listed on Our website.

48. Treatment provided by anyone with the same residence as Insured Person or who is a member of the Insured Person's immediate family.

49. Holmium Laser Enucleation of Prostate, KTP Laser Surgeries, Femto laser surgeries, bio-absorbable stents, bioabsorbable valves, bioabsorbable implants, oral chemotherapy, Hormonal Chemotherapy, Adjuvant Chemotherapy, Neo-adjuvant Chemotherapy, Immuno-therapy,
use of Trastuzumab , Antibody cocktail , Infliximab, rituximab, avastin, lucentis group of drugs.

50. Domiciliary Hospitalisation, OPD treatment is not covered.

51.Consumables are not payable

OPD:  (This exclusion is related to OPD benefit only not for IPD Hospitalization Benefit )

Vision Corrections, Contact lens, and cost of spectacles

All Dental treatments

Mental health consultations

Any Cosmetic treatments

Non prescription medicines and diagnostic tests

Consultation, Medicines or diagnostic tests purchased out of network unless agreed in advance

Physiotherapy sessions

Medicines, diagnostic tests on prescriptions written before scheme start date

Cost of Insulin

Medicine, doctor consultation or diagnostic test cost covered by any insurance  of beneficiary are outside the scope

Cost of equipment for disabled people

Orthopaedic equipment cost

Cost of dialysis (excluded for OPD but is included in In Patient as Day Care)

Cost of Oral Cancer Drugs and cancer related diagnostics

Abortion, Mis-carriage, Termination of Pregnancy (Voluntary/Accidental)

Medicines administered at hospital or medical facility

33. Treatment not covered in 1st Year: Even if diagnosed after Subscription Inception.
For 2nd Year benefits capped at 75% of payable, except capped ailment which are paid up to capping limit mentioned below from 2nd year.

Sl No. Body System Illness Treatment/ Surgery

Cataract Cataract Surgery
1 Eye Glaucoma Glaucoma Surgery
Other Eye Surgeries Other Eye Surgeries
Serous Otitis Media  
Sinusitis Sinus Surgery
Rhinitis Surgery for the nose
Tonsillitis Tonsillectomy
Tympanitis Tympanoplasty
2 Ear Nose Throat (ENT)
Deviated Nasal Septum Surgery for Deviated Nasal Septum
Otitis Media Surgery or Treatment for Otitis Media
Adenoiditis Adenoidectomy
Mastoiditis Mastoidectomy
Cholesteatoma Resection of the Nasal Concha

All Cysts & Polyps of the female genito urinary system Dilatation & Curettage

Polycystic Ovarian Disease Myomectomy

Uterine Prolapse Uterine prolapsed Surgery
Fibroids (Fibromyoma) Hysterectomy unless necessitated by malignancy
3 Gynecology Breast lumps
Prolapse of the uterus
Dysfunctional Uterine Bleeding (DUB)
Any treatment for Menorrhagia
Endometriosis
Menorrhagia
Pelvic Inflammatory Disease
Gout Joint replacement Surgery
Rheumatism, Rheumatoid Arthritis Surgery for Prolapse of the intervertebral disc
Non infective arthritis  
4 Orthopedic / Rheumatological Osteoarthritis  
Osteoporosis  
Prolapse of the intervertebral disc  
Spondylopathies  
       
Stone in Gall Bladder and Bile duct Cholestectomy / Surgery for Gall Bladder
Cholecystitis
Pancreatitis

Fissure, Fistula in ano, hemorrhoids (piles), Pilonidal Sinus, Ano-rectal & Perianal Abscess

Rectal Prolapse
5 Gastroenterology (Alimentary Canal and related Organs)
Surgery for Ulcers (Gastric / Duodenal)
Gastric or Duodenal Erosions or Ulcers + Gastritis & Duodenitis

Gastro Esophageal Reflux Disease (GERD)

Cirrhosis

Acute & Chronic Appendicitis, Appendicular lump, Appendicular abscess

Stones in Urinary system (Stone in the Kidney, Ureter, Urinary Bladder)

Prostate Surgery
6 Urogenital (Urinary and Reproductive system Benign Hypertrophy / Enlargement of Prostate (BHP / BEP)

Hernia, Hydrocele, Surgery for Hydrocele, Rectocele and Hernia

Varicocoele / Spermatocoele Surgery for Varicocoele / Spermatocoele
Skin tumour (unless malignant)
7 Skin Removal of such tumour unless malignant
All skin diseases

Any swelling, tumour, cyst, nodule, ulcer, polyp anywhere in the body (unless malignant) Surgery for cyst, tumour, nodule, polyp unless malignant
8 General Surgery
Varicose veins, Varicose ulcers
Surgery for Varicose veins and Varicose ulcers
Congenital Internal Diseases or Anomalies
CABG
9 Cardiac Surgeries Angioplasty Thoraco Vascular / Cardiac Surgeries
Other Heart Surgeries / Thoraco Vascular Surgeries
Chemotherapy/ Cancer Surgeries Cancer treatment
10 Other Treatments Radiotherapy Cancer treatment
Dialysis kidney / Liver Failure

 
Maximum Amount payable per person for Ailments/
Sum Insured – 200000 Sum Insured - 500000 Sum Insured - 1000000
procedure. (INCL. Pre/post expenses)
Cataract per eye 15,000 21,000 25,000
All expenses related to CABG/ Angioplasty/ Stroke - Per
Ailments 1,20,000 2,20,000 2,80,000
Expenses related Radio therapy / chemotherapy & Dialysis -
Per Ailments 75,000 1,00,000 2,00,000
Expenses related to Prostate enlargement, Hysterectomy &
stone removal - Per Ailments 40,000 50,000 60,000
Joint & or Knee Replacement and implants (Maximum
payable - per family per year) 1,00,000 1,50,000 2,00,000

Co-pay not applicable on capped ailment.