Manipal Cigna Lifestyle Protection – Critical/Accident Care Plan

Health emergencies arrive without any prior warning and often catch you off-guard causing a huge dent in your savings. For instance, a road accident or a critical illness diagnosis will not only affect your health but will drain your financial resources completely. Hence, it is a must to be prepared for such emergencies. Manipal Cigna Health insurance company offers Manipal Cigna Lifestyle Protection - Critical/Accident Care to protect you against any unforeseen medical emergency. These are two different plans:

• Manipal Cigna Lifestyle Protection – Critical Plan

• Manipal Cigna Lifestyle Protection - Accident Care Plan

In this article, we will talk about these two plans.

Manipal Cigna Lifestyle Protection Plans - Critical care plan and Accident care plan are two different plans offered by Manipal Cigna Health Insurance Company. Both plans prepare you for future health emergencies.

What is Manipal Cigna Lifestyle Protection Critical Care Plan?

The plan covers you against life-threatening diseases like cancer, heart diseases, kidney failure etc, and pays the entire sum insured upon diagnosis anywhere in the world. There is a list of 30 critical illnesses that are covered under the policy. Some of the major illnesses covered under the plan are cancer, open heart replacement, the first heart attack or even repair of heart valves, organ transplant, kidney failure etc. The plan allows you to choose a sum insured upto 10 times your annual income.

What is Manipal Cigna Lifestyle Protection Accident Care Plan?

The plan offers personal accident insurance cover that provides for unexpected expenses from death or injury due to an accident. This plan bridges the gap in coverage offered by other insurance plans such as life and disability. It offers complete protection on and off the job, which includes loss of income, death or disability. A sum insured upto 15 times your annual income is available.

Manipal Cigna Lifestyle Protection Critical/Accident Care plans are available in two variants: Basic, and Enhanced. While accident care plan has a 3rd variant also, called Comprehensive. Let us discuss the features of both plans in detail.

The coverage under the policy is available under two variants: Basic and Enhanced and following are the benefits available under the plan

• Critical illness cover - Basic Plan covers 15 critical illnesses and the Enhanced Plan covers 30 critical illnesses as listed in the policy document.

• Medical Second Opinion - The insured can seek a second medical opinion on the diagnosis of a critical illness from the company’s network of medical practitioners. This benefit is available once per insured person during the lifetime of the policy.

• Access to Online Wellness Program - Manipal Cigna Health Insurance offers customized health and wellness program to all customers through specified online tools like health risk assessment, lifestyle management programs and nutrition programs.

• Add-on Cover - Manipal Cigna Health 360 - OPD - The add-on cover provides coverage for doctor consultation on a cashless basis up to the OPD sum insured.

Waiting Period and Exclusions under the Policy

Given below is a list of the waiting period and exclusions for which no coverage is available under the policy.

• Initial waiting period of 90 days
• Benefit is payable subject to a survival period of 30 days after the first diagnosis of a critical illness.
• Permanent exclusions are
  • Any illness other than the listed critical illness
  • Any pre-existing disease
  • Suicide or drug abuse
  • Any inherited disorders

It is important to understand that every health insurance plan comes with specific waiting periods. Unless this time is served, a claim cannot be made.

• Accidental Death is covered upto 100% of sum insured in case of accidental death and upto 200% of sum insured in case death occurs while travelling in a common carrier as a fare-paying passenger.

• Permanent Total Disablement is covered upto 100% of the sum insured in case of an accident and upto 200% of the sum insured in case of an accident while travelling in a common carrier.

• Permanent Partial Disablement is covered up to 100% of the sum insured as per the nature of the disability.

• Emergency Ambulance Cover is available for upto ₹ 10,000.

• Orphan Benefit is paid to the legal guardian, as an amount equal to the sum insured towards the dependent child, in case both the insured and the spouse have died due to an accident.

• Loss of Employment due to permanent total or partial disability is covered for up to 3 months based on your last salary slip.

• Funeral expenses are covered upto a maximum of ₹ 10,000.

• Education Fund provides for child’s education in case of permanent disability by a one-time payment equal to 10% of the sum insured for 2 children.

Optional Covers

• Temporary Total Disablement is an optional cover that pays maximum upto ₹ 25,000 per week up to 100 weeks.
• Burns Benefit is paid in a range of 10% to 100% of the sum insured according to the degree of burns.
• Broken Bones Benefit is paid in a lump sum in case of a fracture due to an accident as per the policy terms.
• Coma Benefit is paid in lump sum upto 25% of the sum insured in case the insured goes into a comatose state due to an accident.

Following are the exclusions under the policy and no coverage is provided for these.

• Any disability arising due to a pre-existing condition
• Any act of self-destruction
• Hazardous activities
• Breach of law
• More than one claim during a policy period
• Disability due to warlike operation
• An increased risk due to change in the profession after the inception of the policy
• Death or disability caused due to substance abuse.

• Critical Care Plan - The insured should inform the call centre within ten days of the diagnosis of a critical illness and submit all the required documents within 60 days of the date of the first diagnosis. The following documents should be submitted in original to verify the claim request.

  • Duly filled claim form
  • Medical certificate confirming the diagnosis of critical illness
  • Certificate from attending doctor confirming that claim does not relate to any pre-existing disease or injury.
  • Discharge/ Death summary from the hospital.
  • Test reports confirming the diagnosis.
  • First consultation letter and subsequent prescriptions.
  • KYC documents
  • Any other required document

• Accident Care Plan - The insured should notify the company within ten days of the occurrence of an accident to request a claim. In event of a claim, the required documents should be submitted within 30 days of the occurrence of the accident. In addition to the claim form and KYC documents following documents will be required for the claim.

  • FIR copy duly attested by the concerned police station.
  • Medico-legal certificate copy duly attested by the concerned hospital
  • Income proof
  • In case of accidental death, original death certificate, death summary issued by the hospital, post-mortem report and id proof of the nominee is required.
  • In case of disability, a doctor’s certificate confirming the disability, an original discharge summary, a photograph of the insured reflecting the disability, a disability certificate issued by a civil surgeon and any other medical document asked by the insurer is required.

Accidents and critical illnesses can cause a lot of financial as well as emotional stress on families. Having a cover for critical illness and accident care can at least reduce the financial stress in such a difficult situation. Manipal Cigna Lifestyle Protection - Critical/Accident Care plans are worth considering if you have a family history of any critical illness or you are looking for an accident cover. In addition to separate plans for critical illness and accident care, Manipal Cigna Health Insurance also offers a Manipal Cigna Life Protection Group Policy that provides an umbrella group cover for personal accident and/or specified critical illnesses.