Frequently Asked Questions

  • General
  • Service

Load More

Yes, there will be a 30 days waiting period except for accidental hospitalization.

Hospital cash insurance is a benefit plan where you get a fixed lump sum amount for each day of hospitalization. The amount paid is irrespective of your actual hospital bill. You can use this amount for medicines, diagnostics tests any other expenses which customer may incur.

All existing customers of PayNearby and the new ones (by registering themselves on our platform) are eligible to get the benefit of the plan.

Comment on this FAQ

Your email address will not be published. Required fields are marked *

Health insurance covers majority of medical expenses but there could be other non-payables expenses or incidental expenses such as ambulance expenses, attendant charges etc. that could burn a hole in your pocket. The lump sum paid out from this plan can be used for all such expenses.

Comment on this FAQ

Your email address will not be published. Required fields are marked *

Mediclaim is an indemnity health insurance product which is a reimbursement of expenses while Hospicash is a defined benefit product paying for each day of hospitalization irrespective of the actual bills.

 

Particulars Details
Cover Type Individual
Type of Plan GFB – Group Hospicash
Frequency of payment Annual in advance
Policy Period 1 Year
Age Group 18 – 60  Years
Daily cash benefit Rs.1500 per day or Rs.2000 per day
Premium Rs.885 per year Or Rs.1180 per year respectively
Limit per policy year 30 days
Deductible 1 day per hospitalization
Waiting Period 30 days
1 Year waiting period (Specified illness) Not Applicable
Pre-existing diseases waiting period Not Applicable

There is a 1-day deductible per hospitalization.

Mr. Anand opted for Rs.1500 per day & got hospitalised for Dengue fever for 5 days in the second month after taking the policy. Mr. Anand will receive Rs.1500 X 4 days

(5 days – 1-day deductible) = Rs.6000/-

 

 

Mr. Anand is again hospitalised for fever the next month for 5 more days.

Mr. Anand will receive Rs.1500 X 4 days

(5 days – 1-day deductible) = Rs.6000/-

1 day deductible will be applicable for every hospitalization.

This plan provides Daily cash benefit options which are payable on each day of hospitalization.

Yes, 30 days. Which means you will be able to claim until the number of days opted as the policy year limit.  In a year maximum claim cannot be for more than 30 days.

Multiple claims for medically necessary treatment of same illness or injury will be covered up to a maximum of 30-days per policy year.

Critical pre-existing conditions are not covered as part of the policy. The insured will need to agree to the below mentioned declaration displayed on the app/portal at the time of policy registration.

“I hereby declare that I perform all my routine activities independently and that I have never suffered from, am not currently suffering from any of the mentioned critical illnesses namely Cancer, Major Organ disease / transplant, Stroke /Paralysis, Nervous disorders, HIV, etc.”

You can purchase the policy for yourself only.

Comment on this FAQ

Your email address will not be published. Required fields are marked *

The minimum entry age is 18 years and the maximum entry age is 60 years.

No. You cannot cover all members of your family in one policy as each policy will cover only one person. Each family member can buy a separate policy if they are within the age group of 18 to 60 years.

Your policy is valid for 1 year. You can renew your policy at the end of policy term.

 

Life-Long renewability is available provided the policy is purchased within the age group of 18-60 years.

Hospitalization at all allopathic hospitals and government approved non-allopathic hospitals are approved for coverage.

Comment on this FAQ

Your email address will not be published. Required fields are marked *

No. Policy will not cover suicide cases.

No. Hospitalisation for pregnancy is not covered under the policy.

Comment on this FAQ

Your email address will not be published. Required fields are marked *

All diagnostic procedures are excluded from coverage. Angioplasty is covered if hospitalisation is for more than 24 hours.

Organ transplant will be covered only if the procedure is compliant under Human Organs Act, 1994 (amended).

Hospitalization for life support is not covered if such treatment will not result in recovery or restoration of the previous state of health.

No. Hospitalization is not covered for AIDS/HIV or any Sexually Transmitted Diseases.

No, you cannot request for enhancement of sum insured.

Customer has to raise request with Aditya Birla Health Insurance Co. Ltd.  Customer can call on 1800 270 7000 or write at care.healthinsurance@adityabirlacaptial.com .

The below documents needs to be submitted within 30 days from the date of hospitalization or within 30 days from the date of discharge

  • Duly filled claim form
  • Certificate of Insurance
  • Copy of Discharge Summary detailing the period and reason for admission plus the line of treatment
  • Copy of the final bill or payment receipt
  • KYC documents – Photo ID, Address and Age proof
  • In case of Accident Cases – Certificate from the doctor stating Details of Accident/trauma & Whether the patient was under the influence of alcohol or any intoxicating substance during incident / accident.
  • Any other documents which the Insurer will ask in case the submitted claim has to be further investigated

Comment on this FAQ

Your email address will not be published. Required fields are marked *

To do so, customer has to raise request with Aditya Birla Health Insurance Co. Ltd.  Customer can call on 1800 270 7000 or write at care.healthinsurance@adityabirlacaptial.com .

Load More