L&T General Insurance Health Plans

1. My:Health Medisure Prime Insurance

My:health Medisure Prime Insurance ensures your family’s health against ever-spiralling medical cost. This health insurance plan caters your family’s unique health needs and help you bounce back from a medical emergency.

Key Features

• Grab premium discount on covering over 2 family members
• No pre-policy medical check-up up to 45 years with no medical adversity
• Avail lifetime renewability
• Personal case manager
• 24x7 claims assistance
• Assured claims service within 6 hours
• Premium calculation on the basis of zones

Policy Benefits

• In-patient hospitalization expenses are covered, for which the insured person requires hospitalization for a minimum period of 24 hours.
• Pre hospitalization expenses are covered for 60 days before hospitalization and post hospitalization expenses covered for 90 days after hospitalization.
• Day care procedures/surgeries are covered, for which the insured person requires hospitalization for less than 24 hours.
• Hospital cash allowance is payable from day 4 to day 10 of continuous hospitalization.
• Organ donor expenses are reimbursed, up to the limits mentioned in the policy schedule.
• Convalescence benefit is covered in case of hospitalization exceeds 10 days.
• Get additional cover equivalent to sum insured for medical expenses incurred against specified critical illnesses.
• Maternity & New Born Baby Cover is available. Coverage is applicable only towards the first two children. New born baby is covered for a period of 90 days from the date of birth.
• Accompanying person expenses are payable for a maximum period of 7 days, subject to hospitalization exceeding 3 days.

Value Added Benefits

• In case of occurrence of the second hospitalization due to accident in a policy period, the sum insured is reinstated, to the extent of the claim amount, up to the maximum of the sum insured.
• With Cumulative Bonus, the sum insured is increased by 5% on renewal of every claim-free policy year, up to a maximum of 50%.
• Comprehensive health check-up for insured persons above 45 years and this benefit is applicable upon completion of each block of two consecutive policy years.
• Ambulance Charges are covered towards insured’s transportation to the hospital for treatment of the disease/injury/illness.
• Avail tax benefits u/s 80D as per Income Tax Act, 1961 for premium paid for this plan.

Sub Limits

• No Room Rent Limit applicable under this plan.
• Maternity & New Born Baby Cover is available up to the maximum of 5% of the sum insured or Rs 25,000 for a normal delivery, 10% of Sum Insured or Rs 50,000 for a caesarean section or actual cost incurred, whichever is less.
• Hospital cash allowance up to Rs 1,000 per day.
• A lump sum amount of Rs 10,000 as a convalescence benefit.
• Accompanying person expenses are payable up to Rs 500 per day.
• Ambulance Charges of Rs 1500 are reimbursed.

Waiting Period Clause

• Initial Waiting Period: Claims arising during first 30 days of the policy start date, except accidental claims.
• Specific Waiting Period: 24 months Waiting Period will be applicable for specific illnesses.
• Pre existing Disease Waiting Period: Any pre-existing disease until 24 months of continuous policy coverage, from date of inception of the first policy.
• Pregnancy & Chilbirth Waiting Period: Treatment arising due to pregnancy and childbirth is covered after a waiting period of 48 months.

Exclusions

• Domiciliary hospitalization/treatment
• Genetic disorder
• Dental treatment/surgery
• Cost of spectacles, contact lenses, hearing aids, eye/ear examination
• War, invasion, or act of foreign enemy, etc.

2. My:Health Medisure Classic Insurance

My:health Medisure Classic Insurance is a carefully designed health insurance policy that caters to your family’s unique health care needs and ensures the complete well-being of the family. This health plan gives you a financial support and provides ease in paying off medical bills.

Key Features

• Health cover for your entire family
• Avail family discount on premium
• Cost of health check-up is reimbursed
• Lifetime renewability
• Claims Service Assurance

Policy Benefits

• In-patient hospitalization expenses are covered as mentioned in the Policy.
• Pre hospitalization expenses are covered up to 30 days before you are hospitalized and Post hospitalization expenses are covered up to 60 days after you are discharged.
• Day care procedures which need the insured to be hospitalized for less than 24 hours and are listed in the policy contract are covered.
• Domiciliary treatment expenses are covered under this plan.
• Domiciliary treatment expenses are covered under this plan.
• Convalescence benefit is covered in case of hospitalization exceeding 10 days.
• Maternity & New Born Baby Cover is available under this plan.
• Expenses incurred towards Ayurvedic treatment are covered.

Value Added Benefits

• In case of occurrence of the second hospitalization due to accident in a policy period, the sum insured is reinstated, to the extent of the claim amount, up to the maximum of the sum insured.
• With Cumulative Bonus, the sum insured is increased by 5% on renewal of every claim-free policy year, up to a maximum of 50%.
• Ambulance Charges are covered under this plan.
• Comprehensive health check-up for insured persons is reimbursed at the end of every 4 continuous claim-free policy years.
• Avail tax benefits u/s 80D as per Income Tax Act, 1961 for premium paid for this plan.

Sub Limits

• Room rent, Boarding, & Nursing Expenses are covered up to 1% of sum insured per day, up to a maximum of Rs 4,000 per day.
• ICU charges are covered up to 2% of sum insured per day, up to a maximum of Rs 6,000 per day.
• Co-pay of 10% applies for each claim for insured persons above 80 years.
• Hospital daily cash of up to Rs 500 per day is paid under this plan.
• Maximum of 10% of Sum Insured or Rs 20,000/- for a normal delivery and 20% of Sum Insured or Rs 40,000/- for a caesarean section or actual cost, whichever is less.
• Ayurvedic treatment is covered up to Rs 25,000 during a policy year.
• Ambulance charges are payable up to Rs 1,500 per hospitalization.
• A lump sum amount of Rs 5,000 is payable as convalescence benefit.
• Comprehensive health check-up is reimbursed up to 1% of average sum insured.

Waiting Period Clause

• Initial Waiting Period: A waiting period of 30 days from the inception date for all hospitalization claims except in case of accidents.
• Specific Waiting Period: 2 Years Waiting Period will be applicable for specific illnesses.
• Pre existing Disease Waiting Period: Any pre-existing ailment/injury that was diagnosed /acquired within 3 years from the issuance of the first policy.
• Pregnancy & Chilbirth Waiting Period: Treatment arising due to pregnancy and childbirth is covered after a waiting period of 48 months.

Exclusions

• Genetic disorder
• Dental treatment/surgery
• Mental illness/disease
• Cost of spectacles, contact lenses, hearing aids
• Routine medical and eye/ear examination,etc.

3. My:Health Medisure Super Top Up Insurance

With skyrocketing medical expenses, getting medical insurance is the need of the hour. With My:health Medisure Super Top Up Insurance Plan provides additional cover along with the current health policy. It is an affordable solution that provides adequate health cover.

Key Features

• Top up health cover Plan
• Flexible deductible options to choose from
• Higher sum insured at a lower premium
• Grab the premium discounts upon choosing this health cover
• 6 hours guaranteed response for cashless claim
• Guaranteed renewability for life

Policy Benefits

• In-patient hospitalization expenses are covered as mentioned in the Policy.
• Pre hospitalization expenses are covered up to 30 days before you are hospitalized and Post hospitalization expenses are covered up to 60 days after you are discharged.
• Day care procedures which need the insured to be hospitalized for less than 24 hours and are listed in the policy contract are covered.

Value Added Benefits

• No pre-policy medical check-up up to age of 55 years with no adverse medical history.
• No sub-limits on day care procedures and pre & post hospitalization.
• Avail tax benefits u/s 80D as per IT Act, 1961 for premium paid for this plan.

Sub Limits

• No Room rent limits are applicable under this plan.
• Co-pay of 10% applies for each claim for insured persons above 80 years.

Waiting Period Clause

• Initial Waiting Period: A waiting period of 30 days from the inception date for all hospitalization claims except in case of accidents.
• Specific Waiting Period: 2 Years Waiting Period will be applicable for specific illnesses.
• Pre existing Disease Waiting Period: Any pre-existing ailment/injury that was diagnosed /acquired within 3 years from the issuance of the first policy.