Surgery - Loss of Family Earning Cover Plan

Surgery Loss of Family Earning Cash

The policy offers Rs. 25000 per month for 90 days

If during the policy year, the policyholder suffers an illness or injury due to an accident and needs to undergo a surgical procedure, covered under the policy and post-surgery suffers from permanent total disablement, permanent partial disablement, temporary total disablement or coma, and is disabled from engaging in their primary occupation and loses the primary source of income generation, the cash coverage will be paid up to the limit as specified in the policy schedule. The payout is in respect of a dependent child (children) under the age of 25 years as on the date of occurrence (unless specified otherwise), dependent spouse, dependent parent irrespective of whether they are insured under this policy. 

Any claim towards this cover that becomes admissible where the dependent child (children) is a minor, shall be payable to the legal guardian. If the policyholder has more than one dependent, the sum insured as specified under this cover shall be divided equally among all eligible dependents. Note: For definitions of permanent total disablement, permanent partial disablement, temporary total disablement, or coma, please refer to the product brochure before concluding a sale.

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: 

1. a) Cataract.
2. b) Hysterectomy for Menorrhagia or Fibromyoma or prolapse of uterus unless necessitated by malignancy myomectomy for fibroids.
3. c) 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, or Congenital Internal. 
4. d) Varicose Veins and Varicose Ulcers.
5. e) Stones in the urinary urogenital and biliary systems, including calculus diseases. 
6. f) Benign Prostate Hypertrophy, all types of Hydrocele. 
7. g) Fissure, Fistula in the anus, Piles, all types of Hernia, Pilonidal sinus, Hemorrhoids, and an abscess related to the anal region. 
8. h) 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.
9. i) Gastric and duodenal ulcer, any Cysts/Nodules/Polyps/internal tumors/ 

skin tumors, and any Breast lumps (unless malignant), Polycystic Ovarian diseases. 

1. j) 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.