With modern lifestyles, and uncertain times, health coverage has become extremely important. It provides protection against any sudden and unexpected medical emergency. A health insurance plan covers most of your hospitalisation expenses and offers many benefits. Similarly, IFFCO Tokio health insurance policies provide comprehensive coverage for hospitalisation expenses due to an injury or disease-related contingencies over and above the deductible opted by you.
IFFCO Tokio General Insurance Company is a joint venture company between Tokio Marine Group, one of Japan’s largest insurance providing groups and IFFCO, the largest manufacturer of fertiliser in the world. It is a reputed name in the insurance industry and gives you many reasons to choose it as your health insurer.
The company provides easy claim settlement with cashless claims through 7500+ network hospitals.
It has a wide presence with 20,000 agents across branches throughout the country.
The company has a claim settlement ratio of 99.71%.
It is known for its wide range of products and competitive pricing.
The company provides different types of health insurance plans for you and your families such as standard health insurance, top-up insurance, critical illness cover, personal accident cover, and tailor-made plans for rural locations and small towns.
This article presents an overview of the IFFCO Tokio Health Protector Plus Plan.
The policy is a supplemental insurance plan that provides coverage to you and your family, against high treatment costs, for hospitalisation, surgery, organ transplant, etc arising due to a disease or injury. It gives you an option to choose a deductible amount that you can bear through your existing base health coverage or through other sources. The policy offers coverage at an affordable price and addresses medical inflation at the same time as a top-up or super top-up plan. Let us look at the features of the policy.
IFFCO Tokio Health Protector Plus Policy offers the following key features and benefits.
Policy Term - The policy can be purchased for one year term.
Policy Type - The policy can be purchased as an individual plan or as a family floater plan. Also, it can be purchased without any basic health plan.
Family Coverage - Floater policy covers self, spouse, and dependent children up to the age of 25 years. The individual policy covers self, spouse, dependent children till 25 years, and parents.
Top up or Super Top up - The policy, also available as a top-up or super top-up plan, allows you to select how you want the deductible to be applied. You can apply it per claim or on the aggregate of all claims in a year.
Renewal - The policy can be renewed lifelong if renewed without a break. The sum insured can be increased at the time of renewal while the deductible can be reduced, but it requires a fresh proposal form and medical records to be submitted, and waiting periods will be applied afresh.
Entry Age - 18 to 65 years. Children above 3 months are covered if one of the parents is covered under the policy.
Pre Policy Medical Check-up - Not required till 45 years of age, subject to no medical history. In case it is required, the company bears the 50% cost of medical checkups.
Sum Insured Options - There are eight sum insured options available to choose from.
IFFCO Tokio Health Protector Plan covers hospitalisation expenses if the insured contracts any disease or is injured due to any accident (including any act of terrorism) and is hospitalised for treatment. Following are the expenses covered under the policy.
Room rent and nursing expenses
Fees for surgeons, anaesthetists, medical practitioners, specialists, and consultants, whether paid directly to the treating doctor or to the hospital.
Cost of anaesthesia, operation theatre, blood, surgical appliances, oxygen, drugs, and medicines, as well as materials for diagnosis, radiotherapy, chemotherapy, artificial limbs, pacemaker, transplant of any major organ, and other similar expenses.
AYUSH Hospitalisation expenses incurred in AYUSH hospitals.
Ambulance charges up to ₹ 3000 per claim.
Additional daily allowance equivalent to 0.1% of the sum insured for the duration of hospitalisation towards miscellaneous expenses.
In the case of organ transplant, donor hospitalisation expenses are also covered subject to the limit of the sum insured.
Pre and post-hospitalisation expenses for 60 and 90 days, respectively are also reimbursed along with hospitalisation expenses.
Specified modern treatments are covered as part of domiciliary hospitalisation or as day care treatments up to 50% of the sum insured.
Day Care treatments that require less than 24 hrs of hospitalisation are also covered as specified in the policy.
The above expenses, except for 5 and 6 are covered for domiciliary hospitalisation, also up to a maximum sub-limit of 20% of the sum insured.
The exclusions and the waiting period as per the policy include
Hospitalisation expenses for diagnostics and evaluation purposes.
Medical treatments related to childbirth and pregnancy.
Sterility and infertility treatments.
Treatment for substance abuse or any addictive condition.
Treatment consequent of the insured committing a breach of law.
Expenses related to admission for rest and personal care and not for any treatment.
Cost of spectacles, lenses or hearing aids.
Expenses related to cosmetic or plastic surgery except for reconstruction required after an accident, burn, or cancer.
Medical expenses due to a war-like occurrence.
OPD expenses
Treatments needed due to participation in an adventure sport.
Expenses related to the treatment of obesity
Expenses related to gender change treatments
Pre and post-natal expenses
Any service charges or surcharges levied by the hospital.
Expenses related to the treatment of any illness within 30 days from the commencement of the policy.
Expenses related to the treatment of a pre-existing disease and its direct complications till 48 months of continuous coverage after the inception of the policy.
Expenses for treatment of listed conditions till 24 months of continuous coverage.
The insured should register a claim as soon as possible. It should not be more than 7 days from the date of hospitalisation. At the time of claim registration, the insured should provide all original receipts and bills, discharge summary, test reports, prescriptions, certificates and evidence of all the medical expenses related to hospitalisation as asked by the company. Some important points you should know are.
The company will accept or reject a claim within 30 days of the receipt of all the necessary documents.
In case the claim payment is delayed, the company is liable to pay interest of 2% above the bank rate to the policyholder from the date of the receipt of all the documents till the date of payment of a claim.
In case the company requires an investigation, it is carried out and completed within 30 days of the receipt of the documents and the claim is settled or rejected within 45 days after receiving all the documents.
In case there is a delay beyond 45 days, an interest of 2% above the bank rate is applicable from the date of receipt of the document till the date of payment of the claim.
Health insurance plans offered by IFFCO Tokio are inclusive and suit every individual needs. The host of optional coverages available at low premiums helps in getting comprehensive health coverage at an affordable cost. To beat increasing medical costs, IFFCO Tokio offers IFFCO Tokio Health Protector Plus Plan that enhances your existing coverage and helps you receive the best medical care. It gives you complete freedom to choose the plan either as a top-up with your existing health plan or as health insurance without a base plan.
