Tensed? For what? Oh for protection and well being of you and your family members well Then, keep your tension aside as, we are here the Care Group Health Insurance Policy Plan for your rescue.
What is Care Group Health Insurance
The Care Health Insurance Company which is commonly known as the Religare Health Insurance which offers Health Insurance Policy Plan. The Care Health Insurance Policy provides an individual Health Insurance, Group Health Insurance as well as Family Health Insurance Policy Plans. The company is standing tall with the establishments in around 1700 locations in PAN India. The Care Group Health Insurance Policy Plans offers liquidity in plans as per the customer’s needs, pre-existing diseases are under the coverage from day 1 of the enrollment, newborn baby is under the protection from day 1, claim settlement process is easy and direct, and much more.
Benefits of Care Group Health Insurance
The major features and benefits of the Care Group Health Insurance Policy Plan are all listed below:-
1. The Care Group Health Insurance Policy Plan tends to provides the best healthcare amenities to all the employees of a firm which have choosen the plan.
2. This policy believes in hassle free procedures especially in the case of medical emergencies, so they offers cashless claim settlement in all the registered network hospitals.
3. With the affordable and economical premium amounts, the Care Group Health Insurance Policy Plan offers the comprehensive healthcare services as well.
4. The customer care support is active and live for 24×7.
5. The Care Health Insurance Company has its own staff settled for the Health Administration Team which aims at providing and serving extremely quick disbursement of claims.
6. This policy plan are flexible enough and be switched to the family floater plan to the individual cover.
7. The policy provides income tax benefits U/S 800 of the IT Act as well.
Inclusions of Care Group Health Insurance
In case the policy owner is diagnosed with illness or disease or an injury during the policy period. Then the policy will offer coverage for the below mentioned:
1. In-patient Care: The medical bills that have gone up during the hospitalization of the policy owner on the written advice of a medical professional are taken care by the health insurance policy plan.
2. Day Care Treatment: The medical costs that are incurred during the daycare treatment at a daycare centre or hospital on the written advice of a medical professional is also under the coverage. The maximum amount of liability for the policy owner while being enrolled in the plan period should not go beyond the sum insured amount.
3. Sum-limit on Room Rent: In case of the room rent being higher than the 1% of the SI on a daily basis then the amount ranges beyond that percentage will be in the part of the individual.
4. Sub-Limit on ICU Charges: In case of the ICU charges being higher than the 2% of the SI on a daily basis then the amount ranges beyond that percentage will be in the part of the individual.
Exclusions of Care Group Health Insurance
1. Waiting Period: Claim initiated for any Medical Expenditure which is incurred for the treatment of any sort of illness in the initial 30 days of the policy tenure will not be taken care by the insurance company. But the cost of treatment of any kind of injury will be covered.
2. Specified Waiting Period: In the first 24 months, no claims initiated by the policy owner will be accepted for the below mentioned illnesses or surgical procedures.
1. The non infective diseases like Arthritis, Osteoarthritis and Osteoporosis are not covered under the plan.
2. The policy does not provide coverage for Gout and Rheumatism as well.
3. Disorders related to spine are not covered.
4. Joint Replacement Surgeries are also not covered under the policy.
5. ENT disorders and surgeries are also not provided protection.
6. Sinusitis and other resembling disorders are not covered.
7. Benign Prostatic Hypertrophy is not covered under the plan.
8. Cataract, Dilatation and Curettage have also failed to be part of protection.
9. The policy do not cover the Fissure/Fistula and Hemorrhoids/Piles in anus.
10. The policy also do not cover Pilonidal Sinus.
11. Gastric and Duodenal Ulcers are also not covered.
12. Genito urinary system surgery is not covered.
13. The policy does not cover any kind of Hernia or Hydrocele.
14. The policy does not cover for Hysterectomy for menorrhagia, Fibromyoma.
15. The policy does not provide cover for any Internal tumors and skin tumours.
16. The policy does not provide cover for cysts and nodules.
17. Polyps and Breast lump, unless and until it is malignant are not included under the policy.
18. Kidney Stone, Gall bladder Stone and Ureteric Stone are not included in the protection list of the policy.
19. Varicose veins and varicose ulcers
are also not covered under in this policy.
3. Pre-existing Disease:
If the policy owner experiences any sort of illnesses that are mentioned above, then the individual will not be provided help and protection under the policy.
Care Group Health Insurance Claim Procedure
To be eligible of the cashless claim, the policy owner has to follow the below mentioned procedure:-
1. Cashless Claim: The policy plan have the facility of cashless claim settlement only at the network hospitals. The policy owner is required to show a valid photo identification document which can either be: Voter ID card, Driving License, Passport, PAN Card or any other identity proof that is approved by the insurance company prior.
2. Reimbursement: In case of a planned hospitalisation, an individual is required to initiate the claim settlement process at least 48 hours before hand. The insurance company should be made aware about the admission in the hospital within 24 hours. All the necessary documents and information should be shared with the insurance company within the time span of 15 days of the discharge of the policy owner.
Document Required During Claim
The list of documents required to apply for the claim are:-
1. Duly filled claim settlement form.
2. The necessity of hospitalization show by the doctor in a written manner.
3. Medicines and tests prescribed by th doctor.
4. Bills issued by the hospital and the medical store along with the discharge card.
5. Original copy of test reports and payment receipts.
6. FIR or final police report, if it is needed.
7. In case post mortem is conducted in an event of unusual death.
8. Any other document as asked by the required TPA desk to help you settle the Claim.
A. The insurance company will consider fully verified photocopies of the documents which is attested by insurance company and which is submitted with the original payment certificate.
B. The insurance company is liable to consider all the bills or invoices that are made in the name of the policy owner.
C. The insurance company will can only bear the delay only and only when the reason behind the delay is genuine and seems out of control of the policy owner.
Q1. How much cover is provided for the ambulance cover?
Ans – For the ambulance cover the amount ranging from Rs.1000 to Rs.2500 is provided.
Q2. Does Care Group Health Insurance provide day care Treatment cover?
Ans – No, the Care Group Health Insurance Policy do not provide coverage for any STDs. Yes, the day care treatment is available under the Care Group Health Insurance Policy Plan.
Q3. What is the ICU charges limit in Care Group Health Insurance?
Ans – Care Group Health Insurance Policy Plan offers 2% of the sum insured on a daily basis for the ICU charges.
Q4. Does Care Group Health Insurance provide cover for in Patients care?
Ans – Yes, Care Group Health Insurance Policy Plan serves protection for the in-patient care.
Q5. What is the room rent limit in Care Group Health Insurance Policy?
Ans – The Care Group Health Insurance Policy Plan provides room rent being higher than the 1% of the SI on a daily basis then the amount ranges beyond that percentage will be in the part of the individual.
Q6. Does Care Group Health Insurance provide a cashless claim feature?
Ans – Yes, the cashless claim settlement feature is also provided in the Care Group Health Insurance Policy Plan.
Q7. Does Care Group Health Insurance Provide cover for STDs?
Ans – No, the Care Group Health Insurance Policy do not provide coverage for any STDs.