Cover Period:

Principal Insured, Insured Spouse, Parents

[80 minus Age at entry]

[70 minus Age at entry], if AHC benefit is triggered and the policy is not continued by payment of premium after expiry of AHC period.

Insured Children
[25 minus Age at entry]

Initial Daily Benefit (i.e. the level of Hospital Cash Benefit (HCB) at inception):

Benefits paid for hospitalization as an inpatient throughout the Cover Period:

For any continuous period of 24 hours or part thereof (after having completed the 24 hours), provided that any such part stay exceeds a continuous period of 4 hours in a non-ICU ward/room of a hospital, an amount equal to the applicable daily benefit (ADB) available under the policy during that policy period will be paid to the insured.

Subject to the Benefit Limitations and Conditions specified, two times the Applicable Daily Benefit will be paid if any of the Insured(s) is(are) required to stay in a hospital's Intensive Care Unit. The Corporation shall pay benefits as if the admission was to the Intensive Care Unit during a period of 24 continuous hours (i.e., one day) of hospitalization if the hospitalization included stay in an intensive care unit as well as in any other inpatient (non-intensive care unit) ward of the hospital, provided that the period of hospitalisation in the intensive care unit was at least 4 continuous hours.

Major Surgical Benefit (MSB): If an insured person has one of the surgeries listed in the Major Surgical Benefit Annexure due to a medical necessity resulting from an accident-related illness or injury, the benefit percentage of the Major Surgical Benefit Sum Assured that is specified against each of the eligible surgeries listed in the Major Surgical Benefit Annexure will be paid, subject to the benefit limits and conditions mentioned. The Applicable Daily Benefit for that Insurance Year in respect of each Insured is multiplied by 100 (one hundred) to determine the Major Surgical Benefit Sum Guaranteed. Depending on how long the patient stays in the hospital, an additional $5 Hospital Cash Benefit will be given on top of the lump sum Major Surgical Benefit.

Moreover, the Major Surgical Benefit shall additionally include the following benefits:

Ambulance Benefit

Premium Waiver Benefit

Major Surgical Benefit Restoration: In the event that 100% of the Major Surgical Benefit Sum Assured is exhausted in a policy year in respect of an Insured due to the prior Major Surgical Benefit claims in that policy year, the subsequent Major Surgical Benefit claim in that policy year (i.e., in case of any specified surgeries as mentioned in the Major Surgical Benefit Annexure) will be covered, post-sum assured-assured-exhaustion, subject to:

Any additional Major Surgical Benefit claims made during that policy year must be for a different category or bucket (e.g., Cardiovascular System, Digestive System, etc.).
The following Major Surgical Benefit claim shouldn't be caused by, arising from, or be related to the prior Major Surgical Benefit claims in that policy year.
The subsequent Major Surgical Benefit claim must be for a different operation than any of the prior Major Surgical Benefit claims made during that coverage year (for example, a CABG, pancreatolithotomy, etc.).

Day Care Procedure Benefit:

Based on the length of stay in the hospital, a hospital cash benefit will be granted in addition to the medical management benefit for the following conditions:

1. Dengue
2. Malaria
3. Pneumonia
4. Pulmonary tuberculosis
5. Viral Hepatitis and
6. Pneumonia.

Extended Hospitalization Benefit: In the event that an insured individual experiences a single episode of continuous inpatient hospitalization lasting longer than 30 days as a result of an accidental bodily injury or illness, a lump sum equal to 10 times the applicable daily benefit shall be payable, subject to the previously mentioned benefit limits and conditions, regardless of the actual cost incurred. Any applicable Hospital Cash Benefit, Major Surgical Benefit, Other Surgical Benefit, or Day Care Benefit due for the same occurrence of inpatient hospitalization would be paid in addition to the Extended Hospitalization Benefit.

Other Benefits:

1. Auto Step-Up Benefit
2. No Claim Benefit
3. Health Check-up Benefit

Death Benefit:

1. On the death of an Insured person other than the Principal Insured
2. On the death of the Original Principal Insured

Auto Health Cover (AHC) Benefit

1. For Insured Child(ren)
2. For Insured Spouse/Insured Parent(s)

Maturity Benefit: At the conclusion of the Cover Period, no benefits are payable, and the Policy is deemed to have expired.