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Arogya Sanjeevni health insurance

coverage



It is said that “Health is wealth”. With chaotic and hectic schedules, working up to late hours, increase in pollution, food contamination and fast-paced lifestyles among others, health has become a major concern like never before. As the overall life expectancy has increased in India, courtesy to advanced medical facilities, the number of diseases adversely affecting the people have also been on the rise in the past decade or so.
While the causes for a decline in the overall standard of health may be varied and debatable, there’s no denying the need for Health insurance across various age groups. With medical inflation, many citizens are increasingly turning to health insurance policies to avoid huge medical bills during emergencies.
Many Health Insurance Providers offer various plans with different terms and conditions creating confusion in the mind of the customer about which plan is appropriate for them. Hence IRDA has mandated all insurance companies to have ArogyaSanjeevni Policy with uniform coverage, Terms, conditions and exclusion.
It is Standard affordable health insurance policy indemnity plan which will cover basic hospitalization needs of policyholders with Pre Hospitalisation expenses for 30 days and post hospitalisation expenses for 60 days .
The Minimum Sum Insured isRs. 1 lakh and maximum sum Insured isRs. 5 lakh. The Policy could be procured in multiple of 50,000 above minim sum Insured of Rs 1,00,000/- maximum upto 5 lakhs
There are two options:
(a). Individual sum insured where Sum Insured will be available for an individual.
(b). Family Floater Policy where there will be overall Sum Insured available for members of family jointly.
Time and tide wait for no one, goes the old adage. The right time to buy a health insurance policy is the moment you realize that your health costs may only escalate in the future owing to the overall rise in the cost of living among other factors. The sooner you realize this, the better it is for you. In other words, you should buy a health insurance policy at a young age to avail of many benefits with lesser premium.
ArogyaSanjeevni Health policy covers persons in the age group 18 to 65 years. This Policy offers Life-long renewability.
  • Self, Spouse, Children below 25 years, parents, parents-in law
  • Age Criteria: from 18 to 65 years. Age of children: more than 91 days up to 25 years
  • In floater Policy: Maximum 6 adults can be covered. (No cap on number of children
  • Expenses of Hospitalization for a minimum period of 24 consecutive hours only shall be admissible. (Minimum period not applicable for Day Care procedures.
  • Pre / Post Hospitalisation : 30 days / 60 days
  • Cumulative bonus - Increase in the sum insured by 5% in respect of each claim free year (subject to a maximum of 50% of Sum Insured)
  • Co-Pay: 5% of claim amount must be paid by the policy holder
  • Room Rent: per day 2% of Sum Insured (Max Rs 5000) – For ICU 5% (Max 10,000)
  • Cataract: Up to 25% of Sum insured or Rs.40,000/-, whichever is lower.
  • Dental treatment, necessitated due to disease or injury only
  • Day Care treatment: Specified Day Care treatment requiring less than 24 hours hospitalisation are covered.
  • AYUSH Treatment covers hospitalisation (Ayurveda, Unnani, Siddha and Homeopathy)
  • Ambulance Expenses: subject to a maximum of Rs.2000/- per hospitalisation.
  • Uterine Artery Embolization and HIFU (High intensity focused ultrasound)
  • Balloon Sinoplasty
  • Deep Brain stimulation
  • Oral chemotherapy
  • Immunotherapy- Monoclonal Antibody to be given as injection,
  • Intra vitreal injections ,
  • Robotic surgeries ,
  • Stereotactic radio surgeries
  • Bronchial Thermoplasty
  • Vaporisation of the prostrate (Green laser treatment or holmium laser treatment)
  • IONM - (Intra Operative Neuro Monitoring)
  • Stem cell therapy: Hematopoietic stem cells for bone marrow transplant for haematological conditions to be covered.
  • Investigation & Evaluation- Expenses related to any admission primarily for diagnostics and evaluation purposes.
  • Rest Cure, rehabilitation and respite care.
  • Obesity/ Weight Control-Expenses related to the surgical treatment of obesity.
  • Change-of-Gender treatments
  • Cosmetic or plastic Surgery
  • Hazardous or Adventure sports
  • Breach of law
  • Excluded Providers-Expenses incurred towards treatment in any hospital or by any Medical Practitioner or any other provider specifically excluded by the Insurer and disclosed in its website / notified to the policyholders are not admissible.
  • Treatment for, Alcoholism, drug or substance abuse or any addictive condition and consequences thereof.
  • Dietary supplements and substances that can be purchased without prescription.
  • Refractive Errors related treatment expenses, Unproven treatments, Sterility & Infertility
  • Maternity Expenses
  • War(whether declared or not )Nuclear ,chemical or biological attack or weapons etc.
  • Any expenses incurred on Domiciliary Hospitalization and OPD treatment
  • Treatment taken outside the geographical limits of India
  • In respect of the existing diseases, disclosed by the insured and mentioned in the policy schedule
  • Pre-Existing Diseases: Expenses related to the treatment of a pre-existing Disease (PED) and its direct complications shall be excluded until the expiry of 48 months of continuous coverage after the date of inception of the first policy with Insurer.
  • First Thirty Days Waiting Period: Expenses related to the treatment of any illness within 30 days from the first policy commencement date shall be excluded except claims arising due to an accident.
  • Specific Waiting Period : Expenses related to the treatment of the listed conditions, shall be excluded until the expiry of 24/48 months (as mentioned in policy) of continuous coverage, as may be the case after the date of inception of the first policy with the insurer.
  • MORATORIUM PERIOD: After completion of eight continuous years under this policy no look back would be applied. This period of eight years is called as moratorium period. After the expiry of Moratorium Period no claim under this policy shall be contestable
Yes. Option for monthly, quarterly and half yearly
If you are insured continuously and without interruption under a plan issued by an Indian general insurer and you want to shift to any other Insurance Company on renewal of Health policy then there will be transfer of accrued benefits and make due allowances for waiting period etc., as per regulations & guidelines on portability issued by IRDA. If the insured person transfers from any other insurer and enhances coverage, then the portability benefits will be offered only in respect of the previous sum Insured.
The premium amount paid under this policy qualifies for deduction under Section 80D of the Income Tax Act.
  • Sum Insured by the policy
  • Premium to be paid for the coverage
  • List of network hospitals and Claim Settlement Ratio
  • Sub-limits (if any) and Waiting Period (for PEDs)
  • Co-pay
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ARRON INSURANCE BROKERS PRIVATE LIMITED, CIN : U67100GJ2016PTC093877
DIRECT INSURANCE BROKERS FOR LIFE AND NON LIFE
Reg. Office : B-711, Mondeal Heights, Next to Hotel Novotel, S.G. Highway, Satellite, Ahmedabad 380015 Gujarat -India
IRDAI Direct Insurance Registration No. 639 - Valid till 06th March, 2024
Contact No. +91 9727227797 ; E mail: info@arron.in
Tollfree : 1800123000044
Principal Officer : Mr. Ramesh K. Patel ; E mail : rameshpatel@arron.in
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