Manipal Cigna Pro-health Group Insurance Plan - Overview

The Manipal Cigna Prohealth Group Insurance Plan is a customized plan suited to meet the medical expenses of you and your family. Every person has different health needs, based on which they need varied health coverage plans. This plan is perfect for your needs and gives insurance protection helping you safeguard your most precious asset i.e your health. This comprehensive plan comes with suitable features and benefits helping you deal with unpredictable medical misfortunes.

 

Key Features & Benefits

The key features covered under Manipal Cigna Prohealth Group Insurance Plan are as follows:

  • Cashless claim facility

    The insurer can enjoy the cashless facility in times of medical emergencies under 6500+ network hospitals of Manipal Cigna.

  • In-patient Hospitalisation Expenses

    This plan covers the medical expenses for an illness or injury that requires hospitalisation for more than 24 hours.

  • Road Ambulance Cover

    This plan covers expenses on transportation by an ambulance service provider to the hospital.

  • Restoration of the sum insured

    It helps you to restore the base sum insured once in a policy year for unrelated illnesses in addition to the sum insured opted.

  • AYUSH Treatment

    The plan covers in-patient medical expenses for an insured for non-allopathic treatments such as Ayurveda, Unani, Sidha, Homeopathy, Yoga and Naturopathy arising from Accident or Illness.

  • Day Care Treatment

    The plan covers day-care procedures that need hospitalization, but not for more than 24-hours. All the costs incurred such treatments are also covered under the Manipal Cigna Pro-health Group Insurance.

  • Pre-hospitalization Expenses

    This policy covers medical costs incurred due to an illness or injury 60 days immediately before hospitalization.

  • Post-hospitalization Expenses

    The plan pays for the medical costs incurred due to an illness or injury 90 days immediately after hospitalization.

  • Domiciliary cover

    If in case, you are not hospitalized, and all your treatments are done at home then all those expenses are also covered in this plan. Some individuals prefer their treatment to be done at home rather than in a hospital. On the other hand, some doctors also advise staying at home for the treatment.

  • Organ Donor Expenses

    Medical Expenses incurred for an organ donor’s treatment for the harvesting of the organ donated will be covered under the policy.

  • Tax Benefits

    The health insurance plan offers tax exemptions under Section 80D of the Income Tax Act 1961.

Policy Details

Manipal Cigna Pro-health Group Insurance Plan
Policy Type Individual/ Family Floater (Only for Customers of Bajaj Finance Ltd.)
Entry Age Minimum Entry Age: 18 years
Maximum Entry Age: 65 years
Tenure One year
Sum Insured Rs. 15 lakh and Rs. 30 lakh
Renewal Lifetime Renewability
Starting Premium Rs. 6606
Number of members covered 6 members (2A+ 4C)

Plans Available

Health Insurance helps you to be stress-free while dealing with medical contingencies due to sickness and accidental injuries for you and your loved ones. The plans are available starting from Rs.6606, with maximum coverage of Rs. 30 lakh.

How to buy the policy

  • To apply for the Manipal Cigna Pro-health Group Insurance Plan, you can buy it easily online by filling in your basic and health details.
  • Ensure that the information given in the form is complete and accurate.
  • You may be required to undergo a pre-policy medical examination at our network diagnostic centres.
  • On buying this plan online, your policy will be generated instantly along with your policy kit and card. This is applicable for cases which do not require further underwriting or medical check-up.

List of Documents Required for purchasing the policy

The following mandatory documents will be needed to purchase the policy:

  • Photograph of the Applicant
  • Age proof such as birth certificate, Voter’s ID, PAN card, passport, etc.
  • Identity proof such as passport, Aadhaar card, PAN card, Voter’s ID, etc.
  • Income Proof such as Form 16, salary slips, employment certificate, etc.
  • Address proof such as telephone bill, electricity bill, passport, bank statement, Voter’s ID, etc.
  • Medical Test that the insurer requires you to undergo.

How to process claims

Cashless Claims

Documents needed to process cashless claim:

  • With the Manipal Cigna Pro-health Group Insurance Plan, you can avail the benefit of cashless treatment with our 3500+ network hospitals by following the following process:
    • Get admitted to any one of Manipal Cigna network hospitals.
    • Use your Manipal Cigna Pro-health Group Insurance card or share your policy number with the concerned team at a hospital along with your Passport/PAN card/ Voter’s ID as identification proof.
    • Now, the network hospital will verify your identity for validation and submit the pre-authorization request to the insurer
    • After validation, the insurer will review and provide their confirmation to the network hospital by fax and email. The insurer ensures you are also notified of the same through text message and email. The insurer will respond to your request within 30 minutes of filing the claim request.
    • The only activity left to do now is the final settlement of your claim (as per policy terms & conditions) with the hospital after completion of all the necessary formalities

 

Reimbursement Claims

Documents needed to process reimbursement claim:

  • If you get hospitalized, notify the insurer within 48 hours of admission in our network or non-network hospital. After getting admitted pay the amount directly to the hospital you are in.
  • After you are discharged from the hospital, make sure you have all the relevant documents, invoices, medical reports, and discharge certificate with you. The insurer would need the originals of all the mentioned documents to process your reimbursement.
  • Send all the documents to the insurer which should be filled and signed the claim form. Send your valid ID proof and age proof as well.
  • After receiving your documents, the insurer will review your claim request and accordingly will give our approval, raise a query or reject the same (as per policy terms & conditions)
  • Finally, the insurer will settle the claim (as per policy terms & conditions) and reimburse the approved amount.
  • Collect below mentioned relevant document in original from the hospital and submit them to us within 15 days of discharge from the hospital
  • Original investigation reports
  • Final hospital discharge summary FIR or post-mortem report if happened
  • Pharmacy bills along with the prescription
  • Cancelled cheque or NEFT details for payment
  • Original bills, receipts, and discharge report
  • Indoor case papers and duly filled claim form
  • Original hospital bills and a valid photo ID proof Treating doctor's report
  • Original consultation notes Nature of operation performed and surgeon's bill and receipt
  • Test reports along with attending doctor’s or surgeon’s report.

 

Major Policy Exclusions

  1. Dental treatments and cosmetic surgeries
  2. Ailments requiring treatment due to use or abuse of any substance, drug, or alcohol and treatment for de-addiction.
  3. Circumcision unless required for the treatment of Illness or accidental bodily injury.
  4. Breach of law with Criminal Intent, intentional self-injury.
  5. Cosmetic, aesthetic, and re-shaping treatments & surgeries.
  6. Psychiatric or psychological disorders, mental disorders.
  7. Ailment wise capping and ambulance charges
  8. Hearing aids, spectacles, or contact lenses including optometric therapy. Abuse or the consequences of the abuse of intoxicants or hallucinogenic substances.
  9. Miscarriage, Abortion, and C-section deliveries Sexually transmitted diseases such as AIDS and HIV.
  10. Refer to the policy document to know more exclusions in detail

Claim/Assistance Contact Details

Toll-free numbers: 08698010101/1800-209-0144 /1800-209-5858

Email: wecare@bajajfinserv.in

Mailing address: Ground Floor, Bajaj Finserv Corporate Office, Off Pune-Ahmednagar Road, Viman Nagar, Pune – 411014.

*For claim related issues please refer your policy document or certificate of insurance (COI).