Description
Policy Conditions
1. The quote is valid for 30 days, starting from the date the proposal is sent to the customer.
2. Waiting period of 2 weeks (14 days) – policy starts 14 days after payment is confirmed
3. The age limit on the plan is 60 years.
4. Maximum family size of 6 (principal, spouse, and max. of 4 children).
5. The premium is paid annually
6. Roaming is allowed within applicable networks on the plan
7. Plan upgrade is not allowed within the policy period and can be discussed at renewals based on utilization
8. Plan downgrade is not allowed during the policy period until policy renewals
9. All benefits are subject to their respective sectional limits which is described as: Inpatient Limit and Outpatient Limit. However, within the respective sectional limit, there are specific benefit limits as well. Consequently, in the event that any specific benefit limit under the sectional limit is exhausted, the remaining limit in that section will only cover other benefits within the section apart from the one that the specific benefit limit has been exhausted
10. Graded access to benefits:
• 9 months waiting period for chronic illness, related chronic diseases, surgeries and cancer care
• 12 months waiting period for Obstetrics & Gynaecology including antenatal, delivery and post-natal care
11. All pre-existing conditions is not covered
12. Final contract/negotiations are subject to IHMS’s terms and condition
Policy Exclusions
•Cosmetic surgery or treatment
•Pre-existing conditions
•Auto immune diseases
•Epidemic and Pandemic
•Domestic Violence
•Civil Disobedience
•Teeth whitening and Dental Prothesis
•Alternative /Un-orthodox medicine
•Domiciliary/Hospice care
•Neonatal care not listed under neonatal services
•Self inflicted injuries
•Congenital abnormalities
•Infertility – All investigations and treatment
•Orthodontics
•Infectious and contagious diseases in an epidemic
•Second opinion abroad/Refund of treatment abroad
•Services primarily for weight reduction or treatment of obesity
•Advanced and complex investigations (e.g. Marrow biopsy, skeletal survey)
•Prosthetic devices such as cardiac pacemaker, orthopedic implants.
•Management of Chronic Renal Failure (Dialysis and Transplant Surgery)
•Induced Abortion
•Laser Treatments and Transplants
•Professional Sports and willful exposure to needless danger
•All procedures, management and investigations not written/stated and covered by the plan
•Conditions caused by an act of war, an epidemic or enrollee participating in a riot
All types of dental or orthodontic cosmetic procedures including cost of consultation, examination, medication, procedures, follow-up visits
Teeth whitening, Braces,Veneers, Aligners, Crowns, Tooth replacement,Cosmetic dental surgical and non-surgical procedures
•Domiciliary/Hospice care
•Alternative /Un-orthodox medicine
•Services primarily for weight reduction or treatment of obesity
•Cosmetic treatments and procedures
•All investigations, consultations, medications, procedures, and treatments not covered by the plan
