A medical trip is a necessity for many patients who can benefit from the opinion of a medical expert. However, many patients find themselves struggling to meet the expenses incurred during such a trip.
FlexiCare Group Insurance Policy - Comprehensive Surgical Hospitalisation and Family Transport Cover from Manipal Cigna Health Insurance Co. Ltd. plan covers any expenses incurred during in, pre, and post-hospitalization and the traveling expenses of the policyholder and an immediate family member for a medical trip. There is also a hospitalization cover under this policy.
Plan Details
|
Sum insured up to (surgical hospitalization) |
Sum insured up to(follow up trip) |
Premium (including GST) |
|
Rs. 1 lakh |
Rs. 5,000 |
Rs. 2,074 |
|
Rs. 2 lakh |
Rs. 5,000 |
Rs. 2,389 |
|
Rs. 5 lakh |
Rs. 5,000 |
Rs. 3,539 |
Eligibility: Individuals between the age of 18 and 65 years can avail this plan. The age is taken as on the last birthday.
Plan Validity: The plan is valid for a tenor of one year.
What's Covered
-
In-patient Hospitalisation
If during the policy year, the policyholder suffers an injury due to an accident caused by an event covered under the policy and directly results in hospitalization, the reasonable and customary charges will be paid. The payout is for hospitalization to avail medically necessary treatment of the policyholder, and the admission date is within the policy year.
- Room charges up to the category specified in the policy schedule.
- Charges for accommodation in ICU/CCU/HDU.
- Operation theatre cost.
- Medical practitioner’s fees.
- Specialist’s fee.
- Surgeon’s fee.
- Anaesthetist’s fee.
- Radiologist’s fee.
- Pathologist’s fee.
- Assistant surgeon’s fee.
- Qualified nurses’ fee.
- Medication.
- Cost of diagnostic tests as an in-patient.
- Surgical appliance or medical appliance.
If the policyholder is admitted in a room where the room rent incurred is higher than that which is specified in the policy schedule, then the policyholder shall bear a ratable proportion of the total associated medical expenses (including surcharge or taxes thereon). The expenses should be in proportion to the difference between the room rent of the entitled or eligible room rent to the room rent actually incurred, unless specified otherwise.
Artificial life maintenance will be covered, including life support machine use, where such treatment will not result in recovery or restoration of the previous state of health under any circumstances unless in a vegetative state as certified by the treating medical practitioner.
Day Care will be covered under the coverage if opted and as specified under the policy schedule.
The cover is payable up to the limit as specified in the policy schedule.
-
Surgical Pre-hospitalization (5 days)
The pre-hospitalization Medical Expenses will be paid immediately before the policyholder's date of hospitalization or daycare (if opted) up to the limits as specified in the policy schedule. The claim must be admissible under ‘surgical hospitalization cover,’ and the pre-hospitalization medical expenses are related to the same injury. The date of admission to the hospital for this coverage shall be the date of the policyholder's first admission in relation to any injury.
-
Surgical Post-hospitalization (10 days)
The post-hospitalization medical expenses will be paid post-discharge of the policyholder immediately from the hospital or daycare (if opted) up to the limits as specified in the policy schedule. The payout is eligible provided that a claim is admissible under ‘surgical hospitalization cover’ and the post-hospitalization medical expenses are related to the same injury.
The date of discharge from the hospital for this cover shall be the date of the policyholder's last discharge from the hospital concerning any one injury.
-
Surgery Family Transportation Allowance
If during the policy year, the policyholder suffers an injury due to an accident, covered under the policy and needs hospitalization in a hospital situated at a distance of at least 100 kilometre from their actual place of residence and the attending medical practitioner recommends the personal attendance of an immediate family member, the sum insured will be paid as specified in the policy schedule. This payout is towards the transportation of any one immediate family member to the place of hospitalization of the policyholder.
Room Rent Caping
For SI, 1Lakh and 2 Lakhs, the room rent limit is capped at Rs. 2000 per day for a normal room and Rs. 4000 per day for ICU. For SI, 5 Lacs, the room rent is limited to a single private room and there is no limit for ICU.
What is Not Covered / Exclusions
- Medical treatment for any pre-existing diseases
- Hospitalization for less than 48 hours
- Treatment that is not medically necessary
- Trips taken for leisure or business purposes
- Charges related to separate room cost in case an immediate family member is accompanying the policyholder
Waiting Period
The initial waiting period for this cover is 30 days, whereas the waiting period for specific illness is 24 months.
Specified disease or procedure waiting period
Since the inception date of the cover, a waiting period specified in the policy schedule shall apply to all treatments. The following treatments, medical or surgical, for all medical expenses along with their complications, are not covered:
- Cataract.
- Hysterectomy for Menorrhagia or Fibromyoma or prolapse of uterus unless necessitated by malignancy myomectomy for fibroids.
- Knee replacement surgery (other than caused by accident), non-infectious Arthritis, Gout, Rheumatism, Osteoarthritis and Osteoporosis, Joint Replacement Surgery (other than caused by accident), prolapse of intervertebral discs (other than caused by accident), all Vertebrae Disorders, including but not limited to Spondylitis, Spondylosis, Spondylolisthesis, Congenital Internal.
- Varicose Veins and Varicose Ulcers.
- Stones in the urinary urogenital and biliary systems, including calculus diseases.
- Benign Prostate Hypertrophy, all types of Hydrocele.
- Fissure, Fistula in the anus, Piles, all types of Hernia, Pilonidal sinus, Hemorrhoids, and an abscess related to the anal region.
- Chronic Suppurative Otitis Media (CSOM), Deviated Nasal Septum, Sinusitis, and related disorders, surgery on tonsils/Adenoids, Tympanoplasty, and any other benign ear, nose, and throat disorder or surgery.
- Gastric and duodenal ulcer, any Cysts/Nodules/Polyps/internal tumors/ skin tumors, and any Breast lumps (unless malignant), Polycystic Ovarian diseases.
- Any Surgery of the Genito-urinary system unless necessitated by malignancy.
If these diseases are pre-existing diseases at the time of proposal or subsequently found to be pre-existing, the waiting periods mentioned in the policy schedule shall apply.
*For a complete list of exclusions, please refer to the policy wordings.
How to Apply
Click on ‘Apply Now’ button and share your basic details in the online application form
Check and confirm your application by entering the OTP received on your mobile number
Pay the premium via credit/debit card, UPI, mobile wallet, or any other available online payment mode
You will receive the details of your membership via email/WhatsApp
Claim process
- Insurer’s Email: servicesupport@manipalcigna.com
- Insurer’s Toll free number: 1800-102-4462
Contact Us
In case you have any queries about coverage, exclusions, or claims, please write to us at wecareinsurance@bizsupportc.com.
Disclaimer - Conditions apply. This product is offered under the Group Insurance scheme wherein Bajaj Finance Limited is the Master policyholder. The insurance coverage is provided by our partner Insurance Company. Bajaj Finance Limited does not underwrite the risk. IRDAI Corporate Agency Registration Number CA0101. The above-mentioned benefits and premium amount are subject to various factors such as age of insured, lifestyle habits, health, etc (if applicable). BFL does NOT hold any responsibility for the issuance, quality, serviceability, maintenance and any claims post sale. This product provides insurance coverage under ManipalCignaFlexiCare Group Insurance Policy, UIN: MCIHLGP20120V011920. Purchase of this product is purely voluntary in nature. BFL does not compel any of its customers to mandatorily purchase any third-party products.