Finding the perfect health insurance is not an easy task. It requires time as well as an understanding of what type of and how much coverage will fulfil your medical needs in future. But it doesn’t necessarily have to be like this. To make health insurance simple and affordable, IRDAI has developed a standard health insurance policy which is the same across the industry, called Arogya Sanjeevani Policy. All health insurers are required to sell this standardized health insurance policy.
Raheja QBE Arogya Sanjeevani Policy is an inclusive protective health insurance plan that is pocket-friendly and covers all sorts of health and medical expenses, including expenses due to hospitalization, pre and post-hospitalizations, daycare procedures, and AYUSH treatment. The policy also covers specialized treatments up to 50% of the sum assured.
Hospitalisation | Expenses incurred due to more than 24 hours of hospitalisation. It includes - Hospital room rent expenses, doctor fees and other nursing charges upto 2% of the entire sum insured subject to a maximum amount of Rs 5000 per day. And Costs for ICU and ICCU are upto 5% of the sum insured, subject to a maximum of Rs. 10,000. |
Day Care Treatment | Expenses incurred due to less than 24 hours of hospitalisation. |
Pre Hospitalisation | Expenses up to 30 days before the hospitalisation. |
Post Hospitalisation | Expenses till 60 days from the hospital discharge date. |
Cataract Treatment | Expenses up to 25% of the sum insured or Rs. 40.000, which is lower, per eye during a policy year. |
AYUSH Treatment | Expenses incurred in treatment under the AYUSH system. |
Road Ambulance | Covered upto Rs.2000 per hospitalisation |
Cumulative Bonus | A 5% increase in the sum insured for each claim-free year upto a maximum of 50% of the sum insured. |
Co-payment | A 5% of co-payment is applicable for each claim. |
Advanced Treatments | The policy covers some listed technically advanced treatments like Uterine artery Embolization, Balloon sinuplasty, Deep brain stimulation, Oral chemotherapy, stem cell therapy, etc. |
Below is a list of salient features of Raheja QBE Arogya Sanjeevani Policy:
Cumulative Bonus - For every claim-free year, a policyholder gets a 5% increase in the sum insured up to a maximum of 50% of the sum insured.
Waiting Period -
Portability - The insured has the option to port the policy to other insurers as per IRDAI guidelines.
Following is a list of procedures excluded from the policy
There are several reasons why you should choose a Raheja QBE Arogya Sanjeevani policy:
The company processes claim requests in a quick and hassle-free manner:
A cashless facility is available only for policies serviced by Third Party Administrator (TPA) at network hospitals only.
Treatment should be availed at a network hospitals subject to pre-authorisation by the company.
A completed pre-authorization form is sent to the company/TPA for authorisation.
After the verification of the cashless treatment request, an authorization letter is issued by the company.
After discharge, the hospital sends the final bill with discharge details to the company/TPA, and the insurance company settles the claim.
For reimbursement, the insured should submit all the necessary documents within 30 days of discharge. These documents include a duly completed claim form, patient’s photo id proof, doctor’s prescription, original bills and receipts, discharge summary with all medical details, medical test reports, NEFT details and cancelled cheque, KYC details of the proposer, and any other relevant document required by the insurer.
If you are still considering getting health insurance for your family and looking for suitable plans, the Raheja QBE Arogya Sanjeevani policy can be your best choice offering complete protection against medical emergencies at a very reasonable cost. The policy has standard in-build benefits that rule out confusion regarding what to choose.
Ans: Yes, you can easily switch to the Arogya Sanjeevani policy from your existing health insurance plan.
Ans: Aarogya Sanjeevani Policy offers a sum insured starting from Rs. 50,000 upto Rs. 10 Lakhs in multiples of Rs. 50,000.
Ans: This policy offers only standard benefits and does not have any variants.
Ans: Yes. The policy covers any declared or listed pre-existing disease only after a waiting period of 48 months.