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Surgery can be life-saving for some kinds of accidental injuries and illnesses but is often very expensive. It is thus wise to have an insurance policy that covers surgical procedures. FlexiCare Group Insurance Policy - Surgery Permanent Partial Disablement Benefit from Manipal Cigna Health Insurance offers a payout if an insured person undergoes surgery for an illness or injury caused in an accident that causes permanent partial disablement.

Plan details

Sum insured

Premium including GST 

Rs. 50,000

Rs. 64

Eligibility: Those aged between 18 and 65 are eligible for the permanent disablement benefit.

Validity: 1 year

What's covered

  • Money-in-bank

    Surgery benefit

    If an injury or illness because of an accident leads to permanent partial disablement and requires surgery, a percentage of the sum insured will be payable. The accident must occur during the policy period and be of a nature covered in the policy. The disablement or illness must happen within 365 days of the accident.

    The table below details the types of disabilities covered in the permanent partial disablement cover and the percentage of the sum insured that is payable:

    Nature of permanent partial disablement

    Percentage of sum insured payable

    i. Total and irrecoverable loss of sight in one eye

    50%

    ii. Loss of one hand or one foot

    50%

    iii. Loss of all toes – any one foot

    10%

    iv. Loss of great toe – any one foot

    5%

    v. Loss of toes other than the great toe, if more than one toe is lost, each

    2%

    vi. Total and irrecoverable loss of hearing in both ears

    50%

    vii. Total and irrecoverable loss of hearing in one ear

    15%

    viii. Total and irrecoverable loss of speech

    50%

    ix. Loss of four fingers and thumb of one hand

    40%

    x. Loss of four fingers

    35%

    xi. Loss of thumb - both phalanges

    25%

    xii. Loss of thumb - one phalanx

    10%

    xiii. Loss of index finger - three phalanges

    10%

     xiv. Loss of index finger - two phalanges

    8%

    xv. Loss of index finger - one phalanx

    4%

     xvi. Loss of middle/ring/little finger - three phalanges

    6%

    xvii. Loss of middle/ring/little finger - two phalanges

    4%

    xviii. Loss of middle/ring/little finger - one phalanx

    2%

    The benefit specified above will be payable if:

    The permanent partial disablement is proved. A disability certificate issued by a civil surgeon or an equivalent appointed by the district, state or government Board needs to be submitted.

    For disablement other than physical separation of limb/s, digit/s, the permanent partial disablement must continue for at least 180 days from its commencement. If at the end of 180 days there is no reasonable medical hope of improvement, such disability is considered permanent.

    If the policyholder passes away before the claim is admitted, no amount will be payable under this benefit. However, coverage under accidental death shall become payable instead of this benefit if opted for.

    If the policyholder suffers a loss, not of the nature of permanent partial disablement specified above, a disability certificate issued by a civil surgeon or an equivalent appointed by the district, state or government board will determine the degree of disablement and the amount payable, if any.

What's not covered

  • Any pre-existing disease

*For the complete list of exclusions, please refer to the policy wordings.

Waiting Period

Type

Duration

Initial Waiting period

30 days

Specific Illness waiting period

24 months

Waiting period for specific diseases and procedures

A waiting period from the date of inception specified in the policy schedule or insurance certificate shall be considered for any treatments, medical or surgical expenses, or other complications resulting during treatment. The waiting periods shall apply to the following diseases as per the durations mentioned in the policy schedule or insurance certificate:

  1. a) Cataract
  2. b) Hysterectomy for menorrhagia, fibromyoma or prolapse of uterus unless necessitated by malignancy myomectomy for fibroids
  3. c) Knee replacement surgery (other than that caused in an accident), non-infectious arthritis, gout, rheumatism, osteoarthritis and osteoporosis, joint replacement surgery (other than that caused in an accident), prolapse of intervertebral discs (other than that caused in an accident), all vertebrae disorders, including but not limited to spondylitis, spondylosis, spondylolisthesis, 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 anus, piles, all types of hernia, pilonidal sinus, haemorrhoids and

an abscess related to the anal region

  1. h) Chronic suppurative otitis media, deviated nasal septum, sinusitis and

related disorders, surgery on tonsils/adenoids, tympanoplasty and any other benign

ear, nose and throat disorder or surgery.

  1. i) Gastric and duodenal ulcer, any cysts/nodules/polyps/internal tumours/

skin tumours 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 at the time of the proposal or subsequently found to be pre-existing, the pre-existing disease waiting periods as mentioned in the policy schedule or certificate of insurance shall apply.

How to apply

1

Click on the ‘Buy Now’ button on this page and share your basic details in the online application form.

2

Check and confirm your application by entering the OTP received on your mobile number.

3

Pay the premium via credit/debit card, UPI, mobile wallet, or any other available online payment mode.

4

You will receive the details of your membership via email.

Claim process

You can raise a claim by contacting the insurer in one of the following ways:

Contact us

For queries related to coverage, exclusions, or claims, please write to us at wecare@bajajfinserv.in

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.

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