IFFCO Tokio is one of the private general insurance service providers operating in India. The company offers insurance service in multiple domains including motor, health, travel, home, etc. In the health insurance domain, the company offers a lot of products suitable for people with different requirements. Swasthya Kavach Policy by IFFCO Tokio is a comprehensive family health insurance plan that offers complete protection against various health ailments. This policy offers a range of benefits and ensures that a family does not face financial distress during a medical emergency.
People who wish to subscribe to IFFCO Tokio Swasthya Kavach Policy must belong to the following criteria.
Some of the key features of IFFCO Tokio Swasthya Kavach Policy can be listed as follows.
This policy offers a range of benefits for its policyholders. The benefits offered by IFFCO Tokio Swasthya Kavach Policy along with their sub limits can be given in the following table.
|Benefits||Base Plan||Wider Plan|
|Room rent||1% of the sum insured||1.5% of the sum insured|
|Intensive care unit charges||2% of the sum insured||2.5% of the sum insured|
|Ambulance charges||Up to Rs.750 per hospitalisation||Up to Rs.1,500 per hospitalisation|
|Cumulative bonus||nil||5% per claim-free year subject to a maximum of 50% of the sum insured|
|Daily allowance||Rs.150 per day||Rs.250 per day|
|Health checkup expenses||nil||Up to 1% of the sum insured after 4 years of continuous policy coverage|
|Critical illness cover (optional)||Not available||Available for up to 10 major illnesses named in the policy policy document upon payment of 30% additional premium|
|Pre hospitalisation expenses||Covered for up to 30 days before admission in a hospital||Covered for up to 30 days before admission in a hospital|
|Post hospitalisation expenses||Covered for up to 30 days after discharge from a hospital (capped at 7% of the hospitalisation expenses)||Covered for up to 60 days after discharge from a hospital (no monetary capping)|
|Domiciliary hospitalisation||Up to 20% of the sum insured limit (treatment period must be at least 3 days)||Up to 20% of the sum insured limit (treatment period must be at least 3 days)|
Though the coverage offered is extensive, the company is not liable to compensate the insured for all injuries or illnesses. Some of the exclusions under IFFCO Tokio Swasthya Kavach Policy can be given as follows.
The claim procedure under IFFCO Tokio Swasthya Kavach Policy begins soon after the company is intimated about the hospitalisation. For planned hospitalisation, the policyholder must intimate the company or TPA at least 3 days before the date of admission. Emergency admissions must be intimated within 24 hours of hospitalisation.
Cashless treatment: For cashless treatment, the pre-authorisation form must be filled and submitted to the company during the time of admission. Upon receival of the request through fax, the company will provide authorisation for treatment. All bills, except for non-medical expenses, will be sent directly to the insurer. The insured must bear the cost of convenience and other non-medical expenses.
Reimbursement claims: For reimbursement claims, all bills related to the medical treatment must be submitted to the insurer within 7 days after discharge from the hospital. Some of the documents required for the claim include discharge summary, medical bills, cash memo, prescriptions, diagnostic reports, physician certificates, etc. Once the documents are received, the company will process the claim and provide the settlement amount within a maximum of 20 days.
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