Surgical Modification Allowance Cover Plan

Post Surgery Lifestyle Modification Expenses

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 suffers permanent total disablement, permanent partial disablement, critical illness or terminal illness, and post-surgery is disabled to an extent which necessarily requires to modify their vehicle or house to adjust to the disablement, the sum insured will be paid as specified in the policy schedule.

Waiting Period
The initial waiting period for this cover is 30 days, whereas the waiting period for specific illness is 24 months.
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.

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 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 diseases at the time of proposal or subsequently found to be pre-existing, the waiting periods mentioned in the policy schedule shall apply.