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Reliance Health Wise Policy

Introduction

Seeing your family in the pink of health ranks highest in priority for you. Yet, despite your best efforts, illnesses do occur. With the spiraling cost of health care, these unforeseen circumstances can take a toll on your savings. To ensure that you don’t need to spend your hard earned money on treatment of any such illness; we have a Policy that offers you all the financial support that you need.

Key Advantage

For the first time in India, Critical Illnesses are also covered as part of your Health Insurance Policy.

• A separate Double Sum Insured is automatically available as soon as any of the listed critical illnesses is diagnosed.
• 24 hours cashless facility at more than 3000 network hospitals.
• Income Tax benefits under Section 80 D.
• Options in duration of coverage – 1 year/2 year policies available.
• Family Floater benefit giving comprehensive protection to your family members under one single Policy.
• Discount on renewal premium for claim free policy.
• Coverage of pre-existing conditions after 2 years/4 years as per plan opted.

What does this Policy cover?

Depending on the Plan opted by you, your Reliance HealthWise Policy covers:

Hospitalisation Expenses - Expenses incurred towards-

• Hospital (room, boarding and operation theatre)
• Doctors & nurses
• Medical tests
• Medicines, blood, oxygen, appliances etc.

Day Care Treatment - Medical expenses towards specific technologically advanced day care treatments/surgeries where 24 hours of hospitalisation is not required.

Domiciliary Hospitalisation - All expenses related to a medical treatment, which is being administered at home, subject to specific conditions applicable.

Pre and Post Hospitalisation - Medical expenses related to your treatment before and after hospitalisation for a specified number of days.

Pre-Existing Diseases - Coverage of pre-existing diseases after two/four continuous renewals with us.

Critical Illness - Your Sum Insured is automatically doubled separately for treatment of Cancer, Coronary artery bypass surgery, First heart attack, Kidney failure, Multiple sclerosis, Major organ transplant, Stroke, Aorta graft surgery, Paralysis and Primary pulmonary arterial hypertension.

Donor Expenses - All hospitalisation expenses incurred by the Donor in case of major organ transplant are covered.

What are the value added benefits available?

Your Reliance HealthWise Policy offers a host of value added benefits, depending on the Plan opted by you. These include:

• Daily Hospitalisation Allowance for a maximum period of seven days.
• Nursing Allowance for a maximum period of five days, on recommendation of the treating Medical Practitioner.
• Reimbursement of charges towards Local Road Ambulance Services.
• Recovery Benefit of Rs. 10,000/- in case of hospitalisation for more than ten consecutive days.
• Expenses of an Accompanying Person at the Hospital/Nursing Home for a maximum of five days.
• Cost of Health Check up at the end of a block of four years, provided there were no claims reported.

What are the additional features of this Policy?

• Family Floater - Covers your family on a floater basis applicable to a maximum of four persons comprising of you, your spouse and two dependent children under the age of 21 years. Example- If Mr. Sharma and his family choose a regular health insurance plan with Rs. 1 lakh Sum Insured each; they would have to pay individual premiums for each member of the family. In addition, the cover for each Insured member would be only up to one lakh, even if the treatment costs beyond Rs. 1 lakh. But, if they take a Policy of Rs. 3 lakhs for the entire family under a floater Plan offered by Reliance HealthWise Policy, anyone from the family can claim up to Rs. 3 lakhs.
• Renewal Discounts - Equivalent to 5% of renewal premium, if there are no claims in the previous year.
• Income Tax Benefit - Premium eligible for deduction under Section 80 D of the Income Tax Act.

Who are covered under the Policy?

• Children above the age of three months and adults below the age of 65 years.
• Children between three months and five years can be covered only if one or both the parents are covered.
• Maximum age to enter the Plan is 65, 60 and 55 for Standard, Silver and Gold Plan respectively.

Policy Options

Choose your plan -You may choose any of the following plans

• Reliance HealthWise Policy - Standard
• Reliance HealthWise Policy - Silver
• Reliance HealthWise Policy - Gold

Two-Year Policy - Continuous coverage for two years without the hassles of annually renewing your Policy.

Wide range of Sum Insured

• Standard - 1 lakh to 5 lakhs
• Silver - 1 lakh to 5 lakhs
• Gold - 1 lakh to 5 lakhs

What does the Policy not cover?

At Reliance General Insurance, we would like our Policy to be as transparent as possible. To ensure that you do not face any unpleasant surprises when you make a claim, we would like you to know some of the major exclusions under the Policy.

• Certain ailments are not covered in the first year of the inception of the Policy. However, they are covered from the second year onwards. These are Cataract, Benign Prostatic Hypertrophy, Congenital Internal Diseases, Fistula in Anus, Piles, Hysterectomy for Menorrhagia or Fibromyoma, Hernia, Sinusitis and related disorders. This exclusion will not be applicable for roll over cases and renewals.
• Pre-existing illness will not be covered for the first two/four years, as per the Plan opted.
• Any disease contracted during the first 30 days of inception of Policy. This exclusion will not be applicable for roll over cases and renewals.
• Treatment of pregnancy & childbirth-related complications.
• Suicide, self inflicted injury or illness, mental disorder, anxiety, stress or depression, use of alcohol or drugs.
• Diseases such as HIV or AIDS.
• Cost of spectacles, contact lenses and hearing aids.
• Dental treatment or surgery of any kind unless requiring hospitalisation.
• Expenses on vitamins and tonics unless forming part of treatment for disease/injury.
• Naturopathy treatment or obesity related treatment.
• War, terrorism and nuclear weapons induced hospitalisation.

How can I get this Policy?

All you need to do is fill in the necessary details in the Proposal Form and hand it over along with your cheque to your Insurance Advisor. You will instantly get a Health Kit, containing among other things your Policy and Health Card.

How do I claim my insurance?

You can claim your insurance through the cashless and/or reimbursement facility.
To avail our cashless facility at more than 3000 of our network hospitals across the country, contact our Third Party Administrators (TPA) on the helpline numbers given on your health card. Once you submit the required documents, the TPA would arrange for cashless facility to be made available at the Hospital/Nursing Home, provided the disease/illness/injury, for which you are admitted in the hospital, is covered under your Policy. In case of an admission in a non-network hospital, inform the details to our TPA on the helpline numbers given on your health card. After you get discharged from the hospital, submit all your original bills to our TPA and claim for the reimbursement. To ensure that finances never interfere with your family’s healthcare, apply for the Reliance HealthWise Policy, today!