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Surgery Permanent Partial Disablement Benefit

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Patients that undergo surgical procedures due to injury or illness can face serious financial troubles. Having an insurance policy to cover these procedures may help you save these expenses. FlexiCare Group Insurance Policy - The Surgery Permanent Total Disablement Benefit from Manipal Cigna Health Insurance offers a payout in case the policyholder undergoes a surgical procedure due to an illness or injury caused by an accident covered under the policy and suffers from permanent partial disablement.

Plan Details

Sum Insured up to

Premium Including GST 

Rs. 50,000

Rs. 64

Eligibility: You are eligible for the Surgery Permanent Partial Disablement Benefit between 18 and 65 years of age. The age is determined as per the last birthday.

Plan Validity: The plan is valid for a tenor of one year.

What's Covered

  • Money-in-bank

    Surgery Permanent Partial Disablement Benefit

    If the policyholder suffers from an illness or injury due to an accident covered under the policy and undergoes a surgical procedure covered under the policy and suffers permanent partial disablement of the nature specified below, a percentage of the sum insured will be payable. The illness or accident must occur within the policy year. The percentage of the sum insured is payable as per the Policy Schedule or Certificate of Insurance within 365 days from the date of the injury, if caused due to an accident. The percentage of the Sum Insured will be paid as specified in the table below, maximum up to the Sum Insured specified in the Policy Schedule or Certificate of Insurance.

    Nature of Permanent Partial Disablement

    Percentage of the Sum Insured payable unless specified otherwise

    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 toe great - any one foot

    5%

    v. Loss of toes other than great, if more than one toe 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 the 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 continues for a period of at least 180 days from its commencement. If at the expiry of the 180 days there is no reasonable medical hope of improvement, such disability is considered permanent at the end of this period.

    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 in lieu of this benefit, if opted.

    If the policyholder suffers a loss that is not of the nature of Permanent Partial Disablement specified above, then a disability certificate issued by a civil surgeon or the 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 a complete list of exclusions, please refer to the policy wordings.

Waiting Period

Name of the Waiting Period

Waiting Period

Initial Waiting Period

30 days

Specific Illness waiting period

24 months

Specified disease or procedure waiting period

A Waiting Period, since the Inception Date of the cover, specified in the Policy Schedule or Certificate of Insurance 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 an 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,
  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

any abscess related to the anal region.

  1. 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.

  1. i) Gastric and duodenal ulcer, any type of Cysts/Nodules/Polyps/internal tumours/

skin tumours, and any type of 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 Diseases, the Pre-Existing Disease Waiting Periods as mentioned in the Policy Schedule/ Certificate Of Insurance shall apply.

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

You can raise a claim by reaching out to the insurer via one of the following ways:
  • 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.

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