Description
Policy Conditions
1. The quote is valid for 30 days which is effective from the date proposal is sent to the customer.
2. Pricing is based on the assumptions of 30 principal lives and above.
3. The age limit on the plan is 65 years.
4. Maximum family size of 6 (principal, spouse, and max. of 4 children).
5. Discount is granted based on family size
6. The premium computed is paid annually and additional charges may apply for periodic premiums
7. Roaming is allowed within applicable networks on the plan
8. All individual and family members registered at onboarding are required to pay full premium regardless of when the dependents of the family registered during the policy period
9. New/Additional individual and family members can be added and deleted during the policy tenure and applicable prorated premiums and credit balances is shared with client.
10. Plan upgrade is allowed only within 30 days of policy commencement
11. Plan downgrade is not allowed during the policy period until policy renewals
12. Policy agreement must be executed on or before the policy start date.
13. 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
14. Final contract/negotiations are subject to IHMS’s terms and condition
POLICY EXCLUSIONS
•Conditions caused by an act of war, an epidemic or enrollee participating in a riot
•Domestic Violence
•Civil Disobedience
•Epidemic and Pandemic
•Allergy testing and treatments
•Auto Immune Diseases (Subsequent Investigations, Medication, and all forms of management)
•All form of immune therapy treatment
•Dental Prothesis
•Dental, Surgical and Orthopeadic Implants
•Spine surgery
•Heart and Brain Surgeries
•Neonatal care not listed under neonatal services
•Self inflicted injuries
•Congenital abnormalities for children not born on the plan
•Treatment of substance abuse or addiction
•Professional Sports and willful exposure to needless danger
•School admission test
•Stem cell transplant or bone marrow transplant
•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
•Hip replacement surgeries
•PET Scan
•In vitro fertilization (IVF)
•Epidural procedures for normal deliveries
•Laparoscopic Treatments
•Hormone replacement therapy
•Provision of hearing aids
•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
