IFCCO Tokio Individual Health Insurance – Krow

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A happy existence is built on a foundation of good health! With this in mind, we must all make the required efforts to maintain our health. However, there is a significant reason for concern given the rise in illnesses and the rising cost of healthcare every year. An Individual Health Insurance Plan might be quite beneficial in this situation.

A health insurance plan will step in and assist in paying for your medical costs in the event of an emergency. As a result, you may stop stressing about paying the hospital costs and concentrate on getting better. Additionally, these plans ensure you won’t have to sacrifice the standard of your care. It ensures you can recover fully and quickly and stand up again!

About IFFCO Tokio

The Indian Farmers Fertilizer Cooperative Limited (IFFCO) and Tokio Marine Group are partners in the IFFCO Tokio General Insurance Company. The former is the largest fertilizer producer in the world and owns 51% of the business, while the latter is one of the largest insurance groups in Japan and holds the remaining 49%. The company, founded in 2000, provides a variety of insurance products, including health insurance, auto insurance, motorcycle insurance, travel insurance, home insurance, and corporate policies like property insurance and liability insurance, to meet the diverse insurance needs of its clients.

Offering a range of complete health insurance options that may be purchased independently or as a floater to cover several relationships, IFFCO Tokio General Insurance Company is dedicated to giving you peace of mind. Numerous advantages are included in IFFCO Tokio health insurance policies, including coverage for pre-hospitalization and post-hospitalization costs, ambulance fees, and health checkups. Overall, the insurer’s specialized solutions meet a variety of needs from various societal segments.

IFFCO Tokio Health Insurance Overview

The IFFCO-Tokio General Insurance Company Limited provides IFFCO Tokio Health Insurance. As a joint venture between the Japan-based Tokio Marine Group and the India-based IFFCO, the business was founded in 2000. The organization wants to expand the number of people who have insurance nationwide and boost customer happiness by being open, equitable, and responsive. They are present all over India, especially in smaller cities and rural areas.

Why Choose IFFCO Tokio Health Insurance

  • A policy document that is immediately digitally signed and issued at any branch, POS location, or for online transactions

  • The exclusion of pre-existing conditions is only valid for three years, as opposed to the four years granted by most health insurance plans

  • The ability to automatically renew the sum Insured in the case of a health insurance claim

  • One of the rare businesses that, under its various plans, offer full reimbursement of the qualified claim amount

  • There is no participation from a third-party administrator, making the process easy and hassle-free

  • Widespread network of around 3000 connected hospitals in India with cashless services

  • Policyholders with active policies with any other insurer may change their plans to IFFCO-Tokio.

  • A dedicated, round-the-clock call center for help with claims and settlements

  • A reduction in the cost of any add-on coverage for enrolling relatives

IFFCO Tokio Health Insurance offers its plans in two different Segments, which are

  • The Individual Health Insurance Plans

  • The Group Health Insurance Plans

The Individual Health Insurance Plans by IFFCO TOKIO

IFFCO TOKIO Critical Health Insurance Policy

People and their families go through a mental tribulation when a severe illness or significant ailment is unexpectedly discovered in them. A protective strategy that shields the person from financial burdens associated with any serious disease is the IFFCO Tokio Critical Health Insurance Policy. The attributes are a comprehensive medical plan that covers all costs related to the diagnosis and treatment of serious illnesses and coverage for most life-threatening conditions, including cancer, kidney failure, coronary artery disease needing bypass surgery, major organ transplant, paralytic cerebral stroke, and accidental injuries leading to amputations.

Cashless facilities available at the Network Hospitals

Eligibility:

  • Employers protecting their employees and their dependents

  • Pre-identified segment/group where the State/Central Government pays the premium

  • Members of officially recognized service clubs

  • Owners of financial cards such as credit cards

  • Holders of certificates or deposits with banks or NBFCs

  • Shareholders of cooperative organizations, public limited firms, etc

  • Faculty and students at educational institutes

  • Members of any other group with a shared identity or interest

Exclusions:

  • Diseases that were already present when the policy was issued and had symptoms

  • Any medical expenses related to a sickness that was discovered within 120 days of the policy’s start date

  • The treatment of illnesses brought on by drug or alcohol abuse

  • Any critical sickness brought on by a suicide attempt or self-inflicted injury

  • In the event of a nuclear war or terrorist attack

Important Terms & Conditions:

  • Mandatory certification of the critical illness by any licensed medical professional

  • In addition, clinical, radiological, histological, and laboratory data should back up the confirmation

  • Only the insured person receives the one-time payment

  • The coverage will automatically expire once the payment for the expenses incurred is made
  • IFFCO TOKIO Individual Medishield Policy

A medical plan is created to cover a person’s or his family’s hospitalization costs.

The attributes of this policy include the following:

  • Costs related to the treatment of bodily ailments or accidents that occurred while the plan was in effect

  • Limited to medical expenses for treatment received in India

  • The plan is open to people from the age of three months to eighty

  • Minors between the ages of three months and five years are included, provided that both parents are covered

  • Up until the age of 45, applicants are exempt from medical examinations

  • For applicants over 45, a pre-acceptance medical examination that includes a blood sugar, urine, and ECG test is necessary for both new applicants and in situations where coverage has been interrupted

  • Additional tests (LP & KFT) are necessary for fresh/break coverage for applicants over the age of 55

  • A premium discount for including the family package covers the plan’s spouse, dependent children, and dependent parents

  • Dependent children must be recognized as single adults until they become 23

  • The term “hospitalization” shall only be used to describe situations in which the patient is receiving care in the specific facility identified in the plan for a minimum of 24 hours

  • A distinct list of 121 therapies has been included in the Individual Medishield Plan, and the costs associated with those treatments are also covered

Expenses covered under the medical plan:

  • Daily room rent at 1.0% of the basic sum insured

  • Daily ICU/ITU Rent at 2.5 percent of the Basic Sum Insured

  • The cost of registration, service fees, surcharges, and other hospital bill expenses, up to a maximum of 0.5% of the basic sum insured

  • Pre- and post-hospitalization nursing costs, contingent upon the attachment of licensed nurses at the doctor’s advice

  • Surgical, anesthesiological, or other consulting fees

  • Daily Allowance @0.1% of Basic Sum Insured for the duration of hospitalization, up to a maximum of Rs. 250 per day

  • Ambulance fees at 1% of the basic insurance amount or Rs. 1,500, whichever is greater

  • Costs associated with the purchase of medications, blood, oxygen, anesthesia, diagnostic and pathological tests, operating room fees, the price of chemotherapy, the price of dialysis, the price of pacemaker, the cost of artificial limbs, etc.

  • The costs for any treatment received at home rather than at a hospital with appropriate justifications will be covered for up to 3 days, up to a maximum of 20% of the base sum insured

  • If an insured person has an organ transplant, the hospitalization costs of the donor shall be paid by the overall and per-person limitations of the sum insured under the plan

  • Hospital-prescribed package fees for particular procedures, up to 80% of the sum Insured

  • The cost of a health examination, once every four claim-free years, which is equal to 1.0% of the average Basic Sum Insured

Exclusion:

  • Any medical expenses incurred within the first 30 days after the start of the plan

  • Any pre-existing conditions up to three years after the policy’s start date are not covered by the plan

  • Costs associated with the purchase of eyeglasses, contact lenses, hearing aids, or any dental work, unless hospitalization is necessary

  • Recovery, general senility, congenital disorders or diseases, sterility, or pregnancy-related conditions other than ectopic pregnancy

  • The plan will not provide coverage for any outpatient medical care

  • The price of extra medical supplies

  • Claiming any illness or accidentally sustained harm sustained while engaging in risky sports or activities

  • Costs associated with obesity treatment, hormone replacement therapy, gender modification, genetic problems, stem cell implantation, and surgery

  • Any costs associated with personal comfort and convenience items are considered non-medical expenses and are therefore not covered by the plan

  • Costs associated with naturopathy, alternative or experimental medicine, acupressure, acupuncture, magnetic therapy, and similar treatments
  • IFFCO TOKIO Individual Accident Insurance Policy

One must be ready for any unfavorable life events in this age of uncertainty. Huge costs burn a hole in the wallet regarding medical emergencies. Like its other plans, IFFCO Tokio’s Individual Accident Insurance Policy provides its customer protection in the case of such an occurrence. The attributes of this strategy are:

  • Individuals, families, and groups can all access the policy

  • Complete protection against any unintentional death or injury to anyone

  • The plan guarantees financial security to the applicant’s family in the case of death

  • Depending on the type of impairment, a reward ranging from 5% to 40% is awarded in the event of the loss of fingers or toes or any other permanent partial disability

  • In cases of temporary total incapacity, 1% of the insured amount or Rs. 6000 is paid per week, whichever is higher

  • The plan covers dependent children’s education in the unfortunate event of the insured’s death, loss of limbs or eyes, or total and irreversible disability

  • The Individual Accident Insurance Plan provides the insured individual with financial support if they lose their work as a result of losing limbs, eyes, or both due to an accident

  • Up to a certain amount, all costs associated with the use of ambulances in the case of an accident are covered

  • This plan includes supplemental benefits, including payment for clothing damaged in an accident and transportation costs for a deceased person

  • Individual and family plans’ sum assured automatically increases with each renewal

Exclusion:

  • Any cases of suicide or self-harm

  • Venereal disease and insanity

  • Mishaps or injuries brought on by alcohol or medications that are intoxicating.

  • Pregnancy or childbirth-related cases.

  • HIV or AIDS-related death or any other problems or disabilities

  • Nuclear and war risks

  • Members of the armed forces

  • Death or accident caused by participation in any risky sports, such as ballooning or aviation

How to File a Claim against IFFCO Tokio Health Insurance?

There are two ways to submit a health insurance claim at IIFCO Tokio

  • Cashless Claim

  • Reimbursement Claim

Cashless Claim:

Inform the insurance provider of the unplanned hospitalization as soon as possible by calling their toll-free customer service number. Inform the insurance provider at least three days before any anticipated hospitalization at any network hospital. You must present your health card and photographic identification at the hospital desk. The hospital will confirm your identity, and you must sign and return a fully completed pre-authorization request form to the insurance company’s TPA. The insurer’s TPA will send a letter of approval to the hospital if the request is granted. Your cashless treatment will start after the pre-authorization request has been verified. The approval for a cashless claim will be given out within 24 hours of receiving the appropriate paperwork.

Reimbursement Claim:

You will need to pay the medical bills out of your pocket if you are admitted to a non-network hospital or your cashless claim is denied at a network hospital. You must submit the claim form and the necessary medical documentation to the IIFCO Tokio branch closest to you. Within 20 days of receiving the documents, you will get the claim amount via check after the documents successfully undergo the verification process. You can ask for reimbursement within seven days of being released.

Lastly

For individuals and families, the IFFCO Tokio Health Insurance offers a wide range of plans with a maximum insured amount of INR 1 crore. Benefits of these plans include coverage for daycare procedures, immunization costs, ambulance costs, current treatment costs, covering for critical illnesses, the elimination of pre-health checkup hassles, and other hospitalization expenditures. However, many of these plans contain restrictions on co-payments, ICU costs, and room rental fees.