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IFFCO Tokio Individual Medishield Policy is a comprehensive health insurance plan that provides coverage against illnesses and injuries. This is an affordable health insurance plan that provides easy health insurance access to the lower and middle income segments of the country. In addition to the mediclaim coverage, it also comes with an optional critical illness extension that can be taken by paying a small additional premium amount. This policy comes with various flexible options to ensure that individuals and families are financially protected from various unexpected medical expenses.
Applicants must meet the following eligibility criteria set forth by the company in order to subscribe to IFFCO Tokio Individual Medishield Policy:
Some notable features of IFFCO Tokio Individual Medishield Policy are as follows:
The benefits available for policyholders under IFFCO Tokio Individual Medishield Policy are as follows:
Benefits | Extent of Coverage |
Inpatient hospitalisation | Actual expenses up to the sum insured limit |
Day care treatment | Coverage for up to 121 procedures that do not require 24 hours of hospitalisation |
Domiciliary treatment | Up to 20% of the sum insured amount |
Cumulative bonus | 5% of the sum insured amount per claim-free year subject to a maximum of 50% of the sum insured amount |
Ayurvedic and homeopathic hospitalisation | Up to 10% of the sum insured amount |
Daily cash allowance | 0.1% of the sum insured amount or Rs.250 per day (whichever is lower) for the duration of a hospital stay |
Ambulance charges | 1% of the sum insured amount subject to a maximum of Rs.1,500 per hospitalisation |
Health checkup | Available after every 4 claim-free years |
Critical illness cover (optional) | Up to the chosen sum insured limit for all medically necessary treatment procedures related to named critical illnesses |
Some of the major exclusions applicable to IFFCO Tokio Individual Medishield Policy are as follows:
In case of hospital admission, the company must be notified to initiate the claim proceedings. For planned hospitalisation, the company must be notified at least 72 hours before hospitalisation. Emergency hospitalisation can be notified within 48 hours after admission in a hospital.
Cashless treatment requires pre-authorisation from the company. The insured must fill up the authorisation form and send it to the insurer. The insurer will verify the policy details of the insured and provide approval for all valid claims.
Reimbursement claims can be initiated after discharge from the hospital by submitting various supporting documents. The insured must provide documents such as discharge summary, hospital main bills, prescriptions, pharmacy bills, diagnostic reports, physician certificate, etc. within a maximum of 30 days after discharge from the hospital. After the submission of these documents, the company will verify the claim and provide the reimbursement amount for all valid claims.
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