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L&T Health Insurance

L&T General Insurance Co. Ltd. (IRDA Reg. No 146) is a company owned entirely by one of the largest Indian business enterprises Larsen & Toubro Ltd.

It is already an established global brand in sectors such as engineering, construction and technology. Banking on this brand value, it has forayed into the financial services sector with products such as loans and insurance for property, casualty, motor and health among others being added to its business portfolio.

L&T health insurance aims at being a customer-centric company and has developed assurance solutions for vast segment ranging from individuals to small and medium enterprises to large corporate. They are known particularly for their focus on the rural areas with products such as rural and micro insurance plans.

Backed by a strong financial advantage coupled with a stellar history in technology, the newly formed L and T Health Insurance Company has developed a huge spectrum of comprehensive plans that guarantee smooth and efficient experience for their customers.

Plans offered by L and T Health Insurance

my:health Medisure Classic Insurance

Individual Coverage

This is a basic health insurance plan offered by L&T which covers basic hospitalization expenses. Following are the details of coverage under this plan:

  • It offers basic health coverage in the range of INR 1,00,000 and INR 5,00,000 for individuals of any age above 3 months.
  • Pre and post hospitalization expenses, coverage for day care procedures, maternity coverage, health check up, no-claim bonus, etc. are the benefits provided in this plan.
  • The plan has two options which one can opt for in addition to the base plan.
  • Base plan + critical illness cover- This option can be added up to age 65 years and for people with sum insured of INR 2,00,000 and above. Addition of this option will provide double sum insured in case of critical illness.
  • Base plan + no sub-limits- This option can be added up separately. Addition of this option would remove all sub-limits over treatment like e.g. room rent limit, ICU rent, etc.

Family Floater Coverage

In case you want to cover your entire family under my:health Medisure Classic plan on a shared basis here are the details of the coverage are given below:

  • This is a basic family floater plan which covers health costs of the entire family in the range of INR 2,50,000 and INR 4,50,000. Policy holder, spouse and 2 dependent children (up to age 25 years) can be covered under the same policy.
  • Pre and post hospitalization expenses, coverage for day care procedures, maternity coverage, health check up, no-claim bonus, etc. are the benefits provided in this plan
  • The plan has two options which one can opt for in addition to the base plan.
  • Base plan + critical illness cover- This option can be added up to age 65 years and for people with sum insured of INR 2,00,000 and above. Addition of this option will provide double sum insured in case of critical illness.
  • Base plan + no sub-limits- This option can be added up separately. Addition of this option would not remove all sub-limits over treatment like e.g. room rent limit, ICU rent, etc).

Note: For both individual and family floater coverage,

  • the premium amount in this policy would change with different geographical regions.
  • co-pay (percentage expense to be paid out of pocket before claiming) of 10% is applicable above age 80 years.

To know more about the coverage offered under each section, please click here.

my:health Medisure Prime

Individual Coverage

This is health insurance plan covers basic hospitalization expenses along with additional benefit in case of critical illness. Details of coverage under this plan is as follows:

  • This plan offers coverage for health in the range of INR 3,00,000 and INR 10,00,000 for individuals between age 3 months and 65 years.
  • Pre and post hospitalization expenses, coverage for day care procedures, health check up (every two years), no-claim bonus, etc. are the benefits provided in this plan
  • Additionally, this plan has critical illness cover which will provide double sum insured in case of critical illness.

Family Floater Coverage

In case you want to cover your entire family under my:health Medisure Prime plan on a shared basis here are the details of the coverage are as follows:

  • This is a family floater plan which covers health costs of the entire family in the range of INR 3,00,000 and INR 10,00,000.
  • The floater can be opted for policy holder, spouse up to maximum age 65 years and 2 dependent children between age 3 months and age 18 years.
  • Pre and post hospitalization expenses, coverage for day care procedures, health check up (every two years), no-claim bonus, etc. are the benefits provided in this plan.
  • Additionally, this plan has critical illness cover which will provide double sum insured in case of critical illness.

If Medisure Prime suits your requirement for health insurance, please click here to know more about this plan.

my:health Medisure Plus

Individual Coverage

This plan has a unique feature wherein an individual can customize the coverage offered. Given below are the details of this plan:

  • This is a special plan which offers standard health coverage and an option to opt for custom health coverage for individuals between age 18 years and 65 years.
  • The coverage offered in this plan is in the range of INR 2,00,000 and INR 25,00,000.
  • The standard coverage option includes benefits like pre and post hospitalization expense cover, health check-up (every 2 years),coverage for ambulance charges, coverage for day care treatments, etc.
  • The custom coverage option allows customization of standard coverage by addition or deletion of certain benefits (e.g. deletion of pre and post hospitalization cover, addition of deductible option or critical illness cover, etc.)as per individual's requirement.
  • A minimum of 8 benefits are covered in this plan.

Family Floater Coverage

In case you want to get this plan for your entire family, here are is a brief overview of coverage offered:

  • This is a special family floater plan which offers standard health coverage and an option to opt for custom health coverage.
  • Proposer and spouse between age 18 years and 65 years and maximum of 3 dependent children between age 3 months and 25 years can be covered in the range of INR 2,00,000 and INR 25,00,000 under same policy.
  • The standard coverage option includes benefits like pre and post hospitalization expense cover, health check-up (every 2 years), coverage for ambulance charges, coverage for day care treatments, etc.
  • The custom coverage option allows customization of standard coverage by addition or deletion of certain benefits (e.g. deletion of pre and post hospitalization cover, addition of deductible option or critical illness cover, etc.) as per individual's requirement.
  • A minimum of 8 benefits are covered in this plan.

If this plan offers most suitable coverage as per your requirement, please click here to know more about the terms and conditions.

my:health Personal Accident Insurance

Individual Coverage

This is personal accident disability plan offered by L&T insurance. The details of coverage offered by this plan are as follows:

  • This plan provides accidental cover for individuals between age 5 years and 70 years.
  • The plan is divided into four tables:
  • Table A– provides compensation for accidental death
  • Table B- provides compensation for accidental death or permanent total disability
  • Table C– provides compensation for accidental death or permanent partial disability
  • Table D– provides compensation for accidental death or permanent partial or total disability or temporary total disability
  • This plan offers education coverage to cover education cost of dependent children post accidental death or disability of insured person.
  • The plan also covers for loss of employment, transportation cost of dead body, etc.

Family Floater Coverage

  • This is a family floater plan which covers accidental coverage for the entire family in the range of INR 3,00,000 and INR 10,00,000.
  • The floater can be opted for the policyholder, spouse and 2 dependent children (between age 5 years and 18 years) and dependent parents between age 5 years and 70 years can be covered under this policy.
  • The plan is divided into four tables:
  • Table A– provides compensation post accidental death
  • Table B- provides compensation post accidental death or permanent total disability
  • Table C– provides compensation post accidental death or permanent partial disability
  • Table D– provides compensation post accidental death or permanent partial or total disability or temporary total disability
  • This plan offers education coverage to cover education cost of dependent children post accidental death or disability of insured person.
  • The accident insurance policy also covers for loss of employment, transportation cost of dead body, etc.

Note:

  • In this plan there are three risk categories (based on the nature of job) which are used to calculate the premium.

In case you want to buy personal accident disability plan from L&T insurance, please click here to know more about this plan.

my:health Medisure Super Top-Up Insurance

Individual Coverage

This is a top-up plan which offers coverage after your medical expenses exceed the deductible value. Here are the details of coverage offered:

  • This is a top-up plan (these plans have an agreed upon deductible amount to be paid at the time of claim) for individuals between age 18 years and 65 years.
  • The coverage amount for this health insurance plan is in the range of INR 3,00,000 and INR 20,00,000 and the deductible amount is in range of INR 2,00,000 and INR 5,00,000.
  • Pre and post hospitalization expenses, coverage for day care procedures, etc. are benefits provided in this plan.

Family Floater Coverage

  • This is a top-up plan for families which offers coverage to all the family members in one plan.
  • The plan would cover adults between age 18 years and 65 years and children between age 3 months and 23 years.
  • The coverage amount for this plan is in the range of INR 3,00,000 and INR 20,00,000 and the deductible amount is in range of INR 2,00,000 and INR 5,00,000.
  • Pre and post hospitalization expenses, day care procedures, etc. are covered under this plan.

In case you wish to buy a top-up plan to cover your hospitalization expenses, know more about Medisure Super Top-up insurance click here.

my:jeevika Medisure Micro Insurance

Individual Coverage

This health insurance plan is available for rural population of India. The benefits offered are as follows:

  • This plan provides coverage of INR 30,000 specially for poor individuals between age 18 years and 65 years.
  • Pre and post hospitalization expenses, coverage for day care procedures, etc. are benefits provided in this plan.

Family Floater Coverage

If you want to buy this health insurance policy for your entire family on a shared basis here are the details of coverage offered:

  • This is a family floater which offers coverage of INR 30,000 specially to poor families.
  • Proposer and spouse between age 18 years and 65 years and 2 dependent children between age 6 months and 18 years can be covered under this policy.
  • Pre and post hospitalization expenses, day care procedures, etc. are covered under this plan.

In case you want to buy this plan for yourself and your family know more about this plan contact Coverfox.

my:jeevika Personal Accident Micro Insurance

Individual Coverage

This is personal accident disability plan for the poorer section of India. The benefits under this plan are as follows:

  • This plan offers accidental coverage of INR 50,000 for individuals between age 5 years and 70 years.
  • The plan offers compensation in case of accidental death, permanent total disability, etc.
  • Education fund, cumulative bonus, etc. are covered in this policy.

Family Floater Coverage

In case you want to buy a personal accident disability plan for your entire on a shared basis then here is a brief of coverage offered:

  • This is a family floater plan which offers accidental coverage of INR 50,000
  • Individuals between age 18 years and 70 years and children between age 5 years and 18 years can be covered under this policy.
  • This plan offers compensation in case of accidental death, permanent total disability, etc.
  • Education fund, cumulative bonus, etc. are covered in this policy.

If you want to buy this plan for yourself or your family, please contact Coverfox to know more about this plan.

my:jeevika Cash @ hospital Micro Insurance

Individual Coverage

This is a benefit plan which offers a lump-sum benefit on daily basis in case of hospitalization. With this plan, other expenses apart from the hospitalization expenses could be covered.

  • This plan offers certain amount of cash every day during hospitalization period only after hospitalization exceeds 24 hours.
  • Individuals between age 18 years and 65 years can be covered under this policy.
  • This plan has three variables:
  • Silver plan- provides maximum coverage of INR 7,500.
  • Gold plan- provides maximum coverage of INR 15,000.
  • Platinum plan- provides maximum coverage of INR 30,000.

Family Floater Coverage

In case you wish to have such coverage for your entire family on a shared basis. Then here are the details of the benefits offered:

  • This is a family floater plan which provides certain amount of cash every day during hospitalisation period (only after hospitalization exceeds 24 hours).
  • Individuals between age 18 years and 65 years and children between age 6 months and 18 years can be covered under this policy.
  • This plan has three variables:
  • Silver plan- provides maximum coverage of INR 7,500.
  • Gold plan- provides maximum coverage of INR 15,000.
  • Platinum plan- provides maximum coverage of INR 30,000.

Note:

  • The platinum plan cannot be opted for children.

Talk to a Health Insurance Advisor

Understand all the benefits of L&T; Health Plans

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Benefits

Larsen and Toubro or L&T general insurance company has a very good record and ratio for settling customer claims. Some of the benefits are listed below:

  • The company brings reliability, financial strength and proficiency, backed by a world class brand and seven decades of supreme leadership of the L&T Group
  • A personal case manager is allotted on request to explain policy benefits, resolve any doubts along with around the clock claim assistance services.
  • The company promises cashless claim settlement within 6 hours for requests made between 9am-9pm on working days and cash reimbursement within 6 working days.
  • Excellent record and ratio for claim settlement

Claim Process at L and T Insurance

There are two ways to make claim under a Health Insurance Policy: on cashless basis and on reimbursement basis. In simple terms, for making a claim on cashless basis, the treatment must be done only at a network hospital of the insurance company servicing your policy. For availing the treatment, you would have to first seek an authorization as per the procedures laid down and in the prescribed form. In case of claims on reimbursement basis, the insurance company has to be informed as per their prescribed procedures. The policyholder has to ensure that documents such as claim form, discharge summary, prescriptions and bills to be submitted for the claim on reimbursement are obtained after hospitalization.

L&T Health Insurance has a well-defined claim processing system.

Cashless Service: seeking Pre-Authorization

  • Complete the pre-authorization form available at the hospital’s insurance/TPA Desk.
  • Send the completed form via email or fax.
  • Approved letter will be sent by the claim management team. Remember that the claim management team could send an inquiry to the hospital or you before authorization.
  • In case the authorization is rejected, initiate the treatment and file for reimbursement claim.

Reimbursement Claim: Claim Submission

  • Complete the necessary form and submit along with required documents, as per the policy terms and conditions.
  • Necessary documents include discharge summary, prescriptions, bills etc.
  • Approved letter will be sent by the claim management team. Remember that you will be answerable to any queries raised by the claim management team before the letter is issued.
  • In case the claim is rejected, the reasons will be communicated by the team.

In case of any emergencies, you need to inform L&T within 24 hours of the admission. In case of planned emergencies, the notification has to reach the company 48 hours prior to the hospitalization. The claim intimation can be done via L&T's toll free number 1800-209-5846. The same could also be emailed to help@ltinsurance.com.

Note: If you are a Coverfox customer, you can directly reach out to us for all your claim-related issues and queries.

Frequently Asked Questions

What is the cover for Maternity in Medisure Prime Insurance Plan?

The policy provides cover for the hospitalization expenses related to childbirth. The sum insured for this particular cover is 5% of Sum Insured or Rs 25,000 for a normal delivery and 10% of Sum Insured or Rs 50,000 for a caesarean section or actual cost, whichever is lower. Coverage is applicable towards the first two children for Self and lawful Spouse who are covered under a single policy for a continuous period of 48 months. New born baby will be covered for a period of 90 days from date of birth (without intimation) within the maternity limits.

Does L&T Insurance offer the benefit of Double Sum Insured for critical illness?

Yes, L&T does provide the benefit of Double Sum Insured for critical illness. You can avail the feature on the payment of an additional premium. It provides an additional cover equivalent to the Sum Insured (which essentially doubles the Sum Insured) for treatment of a critical illness. The Sum Insured excludes the cumulative bonus. This includes cancer, coronary artery bypass surgery, first heart attack, kidney failure, multiple sclerosis, major organ transplant, stroke, aorta graft surgery and primary pulmonary arterial hypertension. This feature is available up to 65 years of entry age, for the Sum Insured of 2 Lakhs and above.

I am looking to buy a Personal Accident Insurance policy for my entire family. Do I get any discounts on the premium?

L&T offers Family Discount on Personal Accident Insurance policy. 10% will be available on the premium under the Family Package Cover as well as Individual Cover for a minimum of 3 members under the same family.

Which all hospitals are covered under L&T’s cashless network?

Cashless services are available at a network hospital. To locate a L&T’s network hospital near you, click here.

Review of L&T Health Insurance

Backed by the array of top notch insurance professionals and a trustworthy brand, L&T insurance delivers unbeatable services to their customers. Their commitments about stringent response times for service delivery and claims undeniably reserves one of the top slots for them in insurance domain in India. With an option of waiving the room rent sub-limits and the waiting period of only 3 yrs for Pre-Existing Diseases, L&T Health Insurance plans definitely scores the brownie points.