IFFCO Tokio-Swasthya Kavach Policy-Wider CI Plan

IFFCO Tokio-Swasthya Kavach Policy covers different members of your family under one floater Sum Insured, which results in substantial saving of premium, while ensuring that coverage is available for each member to the extent of the full Sum Insured under the Policy.There are two Plans available under the Policy – the cheaper Base Plan and the more comprehensive Wider Plan. The Wider Plan has two further options – Basic Cover only and Basic Cover with Critical Illness Extension.

Why you should choose ‘IFFCO Tokio-Swasthya Kavach Policy-Wider CI Plan?
  • Ambulance charges on actual basis, subject to maximum Rs 1,500.
  • Daily Allowance @ Rs. 250 per day, for the duration of hospitalisation.
  • Hospitalisation expenses of persons donating organs during organ transplantation of insured person, within the overall and individual limits of Sum Insured specified under Swasthya Kavach Policy
  • Domiciliary Hospitalisation expenses, up to a maximum sub-limit of 20% of Basic Sum Insured. This relates to expenses for medical treatment for a period of more than 3 days, which would normally require hospitalisation, but is actually taken at home for specified reasons, as stated in the Policy.
  • No medical checkup is required up to 45 years.
  • The optional Critical Illness Extension (for doubling of Sum Insured in respect of 10 listed major diseases) can be taken only under the Wider Plan (and not under the Base Plan), on payment of extra 30% on the basic premium.
Benefits
  • Room Rent @ 1.5% of Basic Sum Insured daily and ICU/ITU Rent @ 2.5% of Basic Sum Insured daily.
  • Registration, Service Charges, Surcharges etc. of hospital at actual, subject to a maximum of 0.5% of Basic Sum Insured.
  • Nursing expenses, including that incurred during pre and post hospitalisation periods.
  • Pre Hospitalisation expenses for a maximum period of 30 days prior to hospitalisation and Post Hospitalisation expenses for a period of 60 days after hospitalisation (without any monetary capping).
  • Cost of health check-up, once at the end of 4 claim free years block @ 1.0% of average Basic Sum Insured.
  • Prescribed package charges of hospital for specific treatments, subject to a maximum of 80% of Sum Insured or 80% of actual expenses, whichever is less.
  • A special premium discount scheme is available under Swasthya Kavach Policy, if the Insured has effected his Motor Two Wheeler Insurance Policy with Iffco Tokio, or if he is covered simultaneously as an employee/member under any Group Medical Policy issued by Iffco Tokio
  • Special provision is available for automatic reinstatement of Sum Insured in the event of a claim under Swasthya Kavach Policy, to the extent of the claim amount paid, except for some specified chronic diseases. The reinstatement premium is computed on short period basis, from date of hospitalisation till expiry of Policy and deducted from the claim amount itself. This ensures that the Insured does not have any worries about getting the benefit of full Sum Insured again, for a subsequent claim in respect of any family member covered under the Policy, unlike the standard Policies available in the market, where Sum Insured gets reduced by the claim amount for the balance period under the Policy.
Exclusions
  • Any pre-existing disease, for a period of 4 years of continuous coverage from inception of Insured’s first Medical Policy.
  • An initial 30 day waiting period for newly incurred diseases (not accidents).
  • One year and two year exclusion periods for certain specified diseases, as listed in the Policy.
  • Cost of spectacles, contact lens or hearing aids.
  • Dental treatment, unless requiring hospitalisation
  • Convalescence, general debility, congenital diseases/defects, sterility.
  • All claims arising from or related to pregnancy, other than ectopic pregnancy.
  • Any domiciliary or out-patient treatment.
  • Cost of external medical equipments.
  • Claims arising out of participation in dangerous sports/activities.
  • Claims arising from or related to HIV/AIDS.
  • War, terrorism and nuclear risks.
  • All non medical expenses, including personal comfort and convenience item services.
  • Treatment of obesity, hormone replacement therapy, sex change.
  • Genetic disorders, stem cell implantation and surgery.
  • Expenses on naturopathy, experimental or alternative medicine, acupressure, acupuncture, magnetic and similar therapies.
  • First 10% of any admissible claim, if insured person is suffering from either diabetes or hypertension and first 25% of claim, if he is suffering from both diabetes and hypertension. This provision is applicable for claims arising out of diabetes and/or hypertension only.