Visiting a healthcare clinic is typically an expensive proposition today. Everything is pricey, from medicines to small daycare treatment to major surgeries. But don't worry, Zuno (Edelweiss) General Insurance is here to ease the situation a little bit. You can quickly obtain the medical treatment you require with Zuno Arogya Sanjeevani policy for your and your family without worrying about the expenses.
The first unified health insurance program introduced in India is the Arogya Sanjeevani Policy. These days, every insurance provider offers similar protection benefits. An indemnity health plan is offered under Zuno Arogya Sanjeevani Policy, through which you can effectively protect your family and yourself.
The table below will help you understand the policy:
Read on to know what is covered in Zuno Arogya Sanjeevani Policy:
Hospitalisation charges: If you are in a hospital for a daycare procedure or are hospitalised for a covered treatment your hospital bills are covered.
Before and after Hospitalisation Expenses: The coverage is provided for related acquired hospital bills for thirty and sixty days before and after hospitalisation, respectively.
Ambulance Services: Roadside assistance ambulance fees are covered up to a maximum of INR 2000 for each hospitalisation.
Other Expenditures: If dental care or cosmetic surgery is required for curing a disease or harm due to an accident, the expenses are covered. Cataract surgery is also covered as per the specified limits.
Make sure you understand the conditions under which you cannot make a claim:
Preliminary Waiting Period: Except for accidents, medical care for illnesses is not compensated for the initial 30 days after the policy's start.
Pre-Existing Condition (PED) Waiting Duration: These diseases are treated after 48 months of uninterrupted insurance out from the policy's start date.
Particular Illness Waiting Duration: After twenty-four or forty-eight months of uninterrupted cover, Zuno (Edelweiss) health insurance allows for deferred coverage of certain conditions.
Before purchasing an Zuno Arogya Sanjeevani policy, it is important to consider the below points
This is a one-year insurance policy, and renewing before the term expires is required to continue coverage
Each claim has a co-payment provision. The sum is equal to 5% of the valid claim, mandatory throughout all age groups
Every year without a claim gives you a hike of 5 per cent on the sum insured through a compounding bonus, It can go up to 50% of the entire amount
As per Section 80D of the Income Tax Act of 1961, the policyholder gets benefits of tax concessions for the insurance premium paid in a financial year.
The reimbursement claims and the cash-free claim procedure must be understood before submitting any claim to Health Insurance Policies by Zuno. The steps to submit a claim are as follows:
Those hospitals approved in the network of Zuno Health Insurance offer the cashless treatment option. The insurance is affiliated with many hospitals across the country. Here is a simple how-to for submitting cashless medical claims:
First, decide which hospital in the city you live is part of the Zuno network to avail of cashless care. You can get a list on the insurer's website.
In case of a medical emergency, you must notify the insurance provider in 48 hours. For planned hospitalisations, you must notify them 72 hours in advance.
While visiting the hospital, carry your health card and an ID proof issued by the company
The pre-authorization application is then required to be completed and submitted to the hospital's helpdesk
The hospital submits the document to your insurance provider for validation after cross-checking every claim document
Once the insurance provider authorises the claim, the bills will be settled.
No matter if you have availed of the treatment from a network or non-network hospital, you can still fill out the reimbursement form and claim it. Submit the following paperwork to request a refund of your medical bills:
During a planned as well as unexpected hospitalisation, you need to notify Zuno Health Insurance. In case of a planned stay at the hospital, you must notify the company 72 hours in advance
Collect all invoices, discharge summaries, medical reports, etc., from the hospital. Remember the hospital's seal must be present on all the records
Fill out and sign the "Claim/Application Form", you can download it from the insurer's official website
Send all necessary paperwork to the address of Health Insurance Policies by Zuno or submit it online
The insurer then evaluates the claim/application form along with the supporting records. However, the acceptance is governed by the terms and circumstances of the policy.
If you do not currently have healthcare coverage and are unsure of which health plan is appropriate for you, Zuno Arogya Sanjeevani Policy is an option worth considering because it offers complete family coverage.
Ans: If the sum insured amount is less than INR 5,00,000, you may decide to raise your sum insured (in variations of INR 50,000) at the time of renewal. Your insured amount will grow by 5% automatically if you didn't file any claims in the preceding year as a cumulative bonus.
Ans: To receive cashless services, you need to get the treatment in a network hospital. Notify the company about the admission, display your healthcare card or any document of your insurance, and the facility will be processed.
Ans: The Edelweiss Arogya Sanjeevani Insurance typically has a one-year policy period. It does, however, provide lifelong renewal advantages.
