• IFFCO Tokio Individual Medishield Policy

    Health Insurance
    • Premiums as low as Rs12/day for coverage of Rs.4 Lakhs*
    • 10,000+ hospitals for cashless treatment
    • Claim up to Rs. 55,000 deduction under section 80D**

    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.

    Eligibility for IFFCO Tokio Individual Medishield Policy

    Applicants must meet the following eligibility criteria set forth by the company in order to subscribe to IFFCO Tokio Individual Medishield Policy:

    • The proposer of the policy must be over 18 years of age.
    • The maximum entry age of this policy is capped at 80 years.
    • Dependents between the age of 3 months and 23 years can be enrolled in this policy alongside their parents.
    • For enrolling children below the age of 5 years, both parents must be concurrently covered in this policy.

    Features of IFFCO Tokio Individual Medishield Policy

    Some notable features of IFFCO Tokio Individual Medishield Policy are as follows:

    • This policy comes in multiple sum insured options ranging from Rs.1 lakh to Rs.5 lakh.
    • A family discount of 5% is available if two family members are covered under this policy on an individual sum insured basis. If more than two members are covered, a discount of 10% can be availed.
    • Pre-existing diseases have a waiting period of 36 months from the date of commencement of this policy cover.
    • The first 30 days of this policy will not provide any compensation for sickness hospitalisation. This waiting period is not applicable for renewals.
    • Medical examination is not required for people up to the entry age of 45 years.
    • Pre-hospitalisation and post-hospitalisation expenses are covered for up to 60 days each.
    • The policy provides the option of taking a critical illness plan as an add-on. The policyholder must pay an additional 30% premium to avail this coverage.
    • There is no co-pay option associated with this policy cover.
    • There is a free-look period of 15 days for policyholders to review the terms and conditions of this cover.
    • The premium amount paid for this policy is eligible for tax relief under Section 80D of the Income Tax Act.

    Benefits of IFFCO Tokio Individual Medishield Policy

    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

    Exclusions of IFFCO Tokio Individual Medishield Policy

    Some of the major exclusions applicable to IFFCO Tokio Individual Medishield Policy are as follows:

    • Cost of external medical equipment used as post-hospitalisation care
    • Cost of accessories such as spectacles, contact lens, hearing aids, crutches, etc.
    • Injuries attributable to suicide attempts
    • Dental surgery or treatment unless necessitated by an accident
    • Expenses incurred for naturopathy treatment
    • Illnesses or injuries attributable to drug or alcohol abuse
    • Injuries sustained while involved in criminal activities
    • Expenses related to childbirth, pregnancy, or related complications
    • Illnesses or injuries attributable to war or warlike activities
    • Illnesses or injuries attributable to exposure to nuclear materials
    • Expenses incurred for outpatient treatment
    • Expenses related to weight management or obesity treatment
    • Congenital diseases, anomalies, and birth defects
    • Any non-medical expenses incurred during a hospital stay

    Claim Procedure

    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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