TERMS/PROD.

FHO COMPREHENSIVE WOMENS CARE STAR ASSURE

SUM INSURED 3,4,5,10,15,20,25 LAK 5,7.5,10,15,20,25,50,75,100 5,10,15,20,25,50,1Cr 5,10,15,20,25,50,75,1Cr,2Cr
TYPE OF COVER FLOATER INDIVIDUAL/FLOATER INDIVIDUAL/FLOATER INDIVIDUAL/FLOATER

Individual - 91 days to 17yrs Floater

AGE ENTRY 16DAYS - 65YRS 3M - 65YRS 3M - 75YRS
16Days To (17 Yrs Child)- 75YRS

3 Lac & 4 Lac - Rs.5000; 5 Lac & 1% of sum insured or maximum up to

1% of sum insured or maximum up to
ROOM RENT above SI - Single Standard A/C Private Single AC Room (Actuals) Rs 20,000 /-., 75L,1Cr,2Cr No limit
Rs 20,000 /-
Room (Any room)
PRE HOSPITALIZATION 60 DAYS ACTUALS 60 DAYS ACTUALS 60 DAYS ACTUALS 60 DAYS ACTUALS
POST HOSPITALIZATN 90DAYS ACTUALS 90 DAYS ACTUALS 90 DAYS ACTUALS 180 DAYS ACTUALS

Covered upto SI (i) for transportation Covered upto SI (i) for transportation Covered upto SI (i) for transportation
AMBULANCE Rs.750/MaX 1500 to hospital (ii) hospital to other to hospital (ii) hospital to other to hospital (ii) hospital to other
hospital (iii) from hospital to Home hospital (iii) from hospital to Home hospital (iii) from hospital to Home

SI of Rs 10 Lakhs & above only. Up to

10% of Basic Sum Insured – for Up to Rs.2,50,000/-per hospitalization Covered up to 10% of sum insured
Air Ambulance 10% of the sum insured per year is
5 Lac and above SI and maximum up to Rs.5,00,000/-PPP PPP
payable
All day care covered (Actuals)
CATARACT- 3 Lacs - 25,000/35T
All day care covered (CATARACT Also All day care covered (CATARACT Also All day care covered (CATARACT Also
DAY CARE, CATARACT/PPP ; 4 Lacs - 30,000/45T; 5 Lacs -
Actuals) Actuals) Actuals)
40,000/60T; 10 Lacs & Above -
50,000/75T
CO-PAY Above 60 years 20% Above 60 years 10% NA Above 60 years 10%
(Available immediately upon Unlimited number of times and
100% *3 (Available when the #100% (Can be utilized for illness/
partial/full utilization of the limit of maximum up to 100% each time,
AUTO.RESTORE Limit of Coverage (Basic SI + No disease for which claim/s was/ were
coverage) which can be utilized for a subsequent
claim Bonus) becomes zero) already made during the policy year)
hospitalization.
Up to 4 Lac - Rs. 10T; 5 Lac to 15
Covered - Actuals (Ayurveda, Unani, Covered - Actuals (Ayurveda, Unani,
AYUSH Lac - Rs. 15T; 20 Lac & 25 Lac - 15,000 to 30,000
Sidha & Homepathy) Sidha & Homepathy)
Rs. 20T

NCB-CLAIM FREE YEAR 25+10+10., Max 100% 1 YEAR -100% ( 5L - 50 +50%) 20% year Up to 100% of the Basic SI 25% year Up to 100% of the Basic SI
HOSPITAL CASH NIL AVAILABLE (500 -2500/DAY) NA NA
Based on age of the insured person Indi.,1500 to 8000 BasedonSI
HEALTH CHECK 750 to 3500 Based on SI 2000 to 5000 Based on SI
limits differ per policy year Floater 2500 To 15000 Based on SI
Specific Disease-Listed ALL 2 YRS ALL 2 YRS ALL 2 YRS ALL 2 YRS
P.E.D (WAITING) 48 MONTHS 36 MONTHS(BuyBack Option 1Yrs) 24 MONTHS 36 MONTHS(3Yrs Term 30Months)
WAITING PERIOD 30 DAYS FR NEW 30 DAYS FR NEW 30 DAYS FR NEW 30 DAYS FR NEW
AVAILABLE (Rs.300/VISIT) ONLY IN Rs.2.5K,3.5K, 5K Based On SI (Only for
OP BENEFIT (Dr. FEES) NA NA
NWH / N.O.T VARIES ON SI female insured person)
DENTAL/OPTTHAL NA EVERY 3 YRS -5k - 15k Based on SI NA NA
Long Term PREMIUM NA YES-(1,2,3Yrs) YES-(1,2,3Yrs) YES-(1,2,3Yrs) 10% Discount *
5 Lac - Rs. 100000; 10 Lac to 25 Lac -
Assisted Reproduction
Rs. 200000 WP of Every 36 months NA 3 Yrs After 50K TO 3L EVERY YEAR 2Yrs After 1 L To 4 L EVERY YEAR
Treatment
Based on SI
In Utero Fetal Covered (Actuals)* WP - 5L to 10L - Covered up to sum insured, Waiting
NA NA
surgery/Intervention 2yrs., 15L to 1Cr - 1yr period: 2 years
YES - 2 YRS WP., Normal 15K - 50K.,
YES - 1 Yrs (15L SI) WP / 25K, WP 2Yrs-Covered up-to 10% of the SI
DELIVERY BENEFIT NA Caesarean - 20k to 1L Based on S.I
50K,75K,1L Based on SI (Max 20L) Based on SI
2DELIVERIES COVERED
10% of SI (Max Rs. 50000)
1L-2L Based on SI., ONLY WHEN
New born baby cover Mother is covered under the Covered up to 25% of the sum insured 2Lakhs to 4 Lakhs
DELIVERY COVERED
policy for at least 1 year
RECHARGE 75K, 1L, 1.5L NA NA NA

Covered (Actuals) - Covered for Covered (Actuals) - Covered for the Covered (Actuals) - Covered for the
DOMICILIARY NA
the period exceeding three days period exceeding three days period exceeding three days

Covered (Actuals) Additional SI up to Covered (Actuals) Additional SI up to Covered upto SI. Additional SI up to
Basic SI for the Complications(if any) Basic SI for the Complications(if any) Basic SI for the Complications(if any)
DONOR EXPENSES 10 % SI MAX. 1 LAK
that necessitate a Redo Surgery/ICU that necessitate a Redo Surgery/ICU that necessitate a Redo Surgery/ICU
admission admission admission
FREE PA COVER NA EQUAL TO SI FOR 1 ADULT NA NA
AVAILABLE / 3YR WP / 2.5L To 5L AVAILABLE / 2Yrs WP / 2.5 L To 5L
BARIATRIC SURGERY NA NA
Based on SI-ONLY IN NWH Based on SI
SECOND MEDICAL OPINION AVAILABLE AVAILABLE AVAILABLE AVAILABLE
Treatment in VSPN Max of Rs.5,000/- PPP NA NA Max of Rs.5,000/- PPP
3 Lac to 15 Lac - Rs. 800; Rs 2000/- per day Maximum of 7 days
Shared Accommodation NA Rs.1,000/- per day
20 Lac & 25 Lac - Rs. 1000 (per hospitalization)
Modern treatments Covered* Covered* Covered* Covered up to sum insured
Compassionate Travel Air Travel Exp., Rs. 5000 NA NA Air Travel Exp., Rs. 10,000
Repatriation of Mortal
Up to Rs. 5000 reimbursed NA NA Up to Rs. 15,000 reimbursed
Remains
Home Care Treatment NA NA NA 10% of the SI subject Max of Rs 5 L
Rehabilitation and Pain Covered up to the sub-limit (or) Max Covered up to the sub-limit (or) Max
NA NA
Management 10% of the SI-NWH Only 20% of the SI
Based on the Sum insured chosen Based on the Sum insured chosen limits
Modern treatments limits differ, refer policy wording differ, refer policy wording for further Upto 50%,40%,30% Based on SI Covered up to SI
for further details details
K-Thousand / NA-NOT APPLICABLE / VSPN - Valuable Service Providers Network Hospital / WP - WAITING PERIOD /* Refer Brochure / PPP-Per Policy Period / L-Lakhs /Cr-Crore
/ N.O.T - NUMBER OF TIMES / NWH-Network Work Hospital /SI-Sum Insured / PED- Pre Existing Disease