HealthGain is a comprehensive health insurance cover offered by the general insurance wing of Reliance. The company offers a range of health insurance plans for its customers and ensures that adequate coverage is provided for everyone. This policy comes with multiple options, and it can be taken either as an individual cover or a family floater cover.
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**
Eligibility for Reliance HealthGain
The eligibility criteria outlined by the company for enrolling in Reliance HealthGain can be listed as follows:
Anyone over the age of 5 years can be enrolled in the individual or family floater plan.
Children between the age of 91 days and 5 years can be enrolled in the policy provided at least one adult over the age of 21 is covered simultaneously.
There is no maximum entry age for the sum insured option Rs.3 lakh (lowest). For all other sum insured options, the entry age is capped at 65.
Once entered, lifetime renewability option is available for this policy cover.
A maximum of 6 family members can be enrolled in this policy cover.
Features of Reliance HealthGain
The key features of Reliance HealthGain can be listed as follows:
This policy is available in 6 different sum insured options - Rs.3 lakh, Rs.6 lakh, Rs.9 lakh, Rs.12 lakh, Rs.15 lakh, and Rs.18 lakh.
All pre-existing conditions can be covered after 3 years of continuous policy coverage.
For plan A (Rs. 3 lakh, Rs.6 lakh and Rs.9 lakh), pre-insurance medical checkup is required for people above 46 years of age.
For Plan B (Rs.12 lakh, Rs.15 lakh, and Rs.18 lakh), pre-insurance medical checkup is required for people above 18 years of age.
There is an initial waiting period of 30 days for all illnesses. For accidental hospitalisation, this waiting period does not apply.
Pre and post hospitalisation expenses are covered for up to a period of 60 days.
For certain conditions like arthritis, cataract, hernia, kidney stone, etc., there is a waiting period of 2 years.
There is a mandatory copayment requirement of 20% for people entering this policy cover after 61 years of age.
There are various policy discounts available with this cover: 5% for girl child or single woman, 5% discount for existing Reliance car insurance customers, and 5% or 10% discount depending upon family size.
Free auto extension of the policy is available if the insured is diagnosed with any of the named critical illness.
The sum insured amount for the policy will be doubled after 4 continuous claim-free years.
This policy can be ported to other insurance service providers in the market. The company must be notified at least 45 years before the date of renewability.
Tax benefit is available as per Section 80D of the Income Tax Act for people enrolling in this policy.
Benefits of Reliance HealthGain
In-patient hospitalisation expenses
Covered up to the sum insured limit
Day care treatment
Covered up to the sum insured limit
Organ donor cover
50% of the base sum insured subject to a maximum of Rs.5 lakh
Domiciliary hospitalisation
10% of the sum insured subject to a maximum of Rs.50,000
Reinstatement of sum insured
100% reinstatement upon exhaustion (once a policy year)
Cumulative bonus
33.33% after every claim-free year subject to a maximum of 100%
Domestic road ambulance
Plan A - Rs.1,500
Plan B - Rs.3,000
Accidental death cover (only for Plan B)
Rs.1 lakh following the death of the insured
Exclusions of Reliance HealthGain
Some of the permanent exclusions applicable to Reliance HealthGain policyholders can be listed as follows:
Intentional self-injuries or suicide attempt
Injuries or illnesses that can be related to drug use or alcohol
Injuries or illnesses attributable to war, nuclear weapons, chemical weapons, biological weapons, etc.
Any kinds of stem cell treatment
Any kinds of congenital diseases
Expenses related to the treatment of HIV, AIDS, and sexually transmitted diseases
Expenses related to the treatment of mental disorders
Any kinds of dental treatment unless arising out of accident
All kinds of non-allopathic treatments including unproven or experimental treatments
Cosmetic or aesthetic treatments of all kinds
Maternity expenses except for ectopic pregnancy
Cost of accessories such as hearing aids, spectacles, contact lenses, etc.
Claim Procedure
The claim process for Reliance HealthGain begins with intimation to the company about the hospitalisation. For cashless claims, the authorisation form and other relevant documents must be submitted immediately following hospitalisation. For reimbursement claims, all necessary documents must be submitted after discharge from the hospital.
For cashless claims, the company promises approval within 6 hours. Beyond the 6-hour limit, the company offers 1% of the claim amount extra for every delay of 6 hours. The same is applicable for reimbursement claims too. For every delay of 21 days after the initial 21 days, the company offers 1% of the claim claim subject to a maximum of 6%.
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They reject all claims without proper reason. I personally experienced it. My claim of hospital bill was rejected giving any wrong reason. I urge all people, never take any policy of apollo munich. claim ID: 948912 case ID:5208987. Anyone can check my claim. Fraud apollo munich company, Playing with people money.
I have taken the health insurance policy with the STAR HEALTH & ALLIED INSURANCE where i been using the policy since from last few years. The premium i have paid is 11K for this policy, the medical coverage is for 2L 50K for this policy where the coverage is for self.
I have been using the health insurance policy with the ROYAL SUNDARAM GENERAL INSURANCE since from last 4-5 years where i had claim once with this policy. The medical coverage is for 4L for complete family. The premium is nominal with this insurance policy.
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6
DR AMIT KUMAR TIWARI
, bilaspur
Reviewed on Jan 29, 2019
The reason for taking the HDFC ERGO GENERAL INSURANCE health insurance is because i wanted to enhance the medical coverage of this policy. It is a top up plan where i the coverage is for 6L for family. It also includes the pre existing disease coverage.
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2
DR AMIT KUMAR TIWARI
, bilaspur
Reviewed on Jan 29, 2019
The reason for taking the health insurance policy with the NATIONAL INSURANCE is because the service is very good. The premium is nominal also the medical coverage what they have offered is 1L for self coverage. It has the disease coverage also the accidental coverage.
The reason for taking the health insurance policy with the HDFC ERGO GENERAL INSURANCE is because i am an existing customer of life insurance with this HDFC. I had no claim experience with this policy but the medical coverage is for 5L for self.
I am using with the health insurance policy with the BAJAJ ALLIANZ GENERAL INSURANCE from last two years which is a corporate policy where i had no claim experience but the premium i am paying for yearly where half of the amount has been paid by the company. The medical coverage they are providing is for 2L for family.
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1
KARTHIK RAMESH
, kumarakom
Reviewed on Jan 27, 2019
The premium is nominal when compared to the other health insurances with the APOLLO MUNICH so i have taken this health insurance policy. The claim settlement is very good and the customer service is very helpful. I had no claim experience but the medical coverage is for 10L with this policy.
I have been using the health insurance policy with the ICICI LOMBARD GENERAL INSURANCE since from last 10 years where i have paid the premium for 7 years. The customer support is very helpful for getting the claim where i got 60K of claim with this policy. Medical coverage is for 5L for family.
The benefits are good with the UNIVERSAL SOMPO GENERAL INSURANCE health insurance so i have taken this insurance. I had no claim experience with this insurance policy but the premium is nominal and the medical coverage is for 10L and the policy coverage is family.
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1
TAUSEEF ALI SAYYED
, mumbai
Reviewed on Jan 23, 2019
It is the better plan when compared to the others so i have taken the health insurance policy with the HDFC ERGO GENERAL INSURANCE. Premium is nominal and also the medical coverage is satisfactory which gives the medical coverage is for family.
I have taken the HDFC ERGO GENERAL INSURANCE health insurance policy with the where i have paid the premium 4187 and the medical coverage is satisfactory with this policy. I had no claim experience with this policy. I have not got the soft copy as well as the hard copy.
The service is better than others so i have taken this HDFC ERGO GENERAL INSURANCE health insurance policy. I had no claim experience but the medical coverage is for 3L for self. I have not received the soft copy and the hard copy. There is no proper customer followup. The premium i have paid is 8,035.
There is no particular reason for taking the health insurance policy with the CIGNA TTK HEALTH INSURANCE but i had no claim experience with this policy also the medical coverage is satisfactory but i have no idea. Policy coverage is for self.
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2
PAVAN MANIKANTA
, nellore
Reviewed on Jan 23, 2019
I have taken the health insurance policy with the BAJAJ ALLIANZ GENERAL INSURANCE wheeler i have been using it since from last few months where i have paid the premium which is nominal also the medical coverage is for 5L which covers self and my mother.
The reason for taking the STAR HEALTH & ALLIED INSURANCE health insurance policy is because friends suggested. The medical coverage is for 5K where it gives the coverage for 2 persons. It also includes the critical illness, disease coverage.
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4
MAHIPATHI JAYALAKSHMI
, guntur
Reviewed on Jan 22, 2019
I have been using the health insurance policy with the APOLLO MUNICH where i am using it from last few months. I have experienced with no claim experience but the medical coverage they have offered is satisfactory. It gives the coverage for family.
There is no particular reason for taking the health insurance policy with the BHARTI AXA GENERAL INSURANCE where i had no claim experience. The premium i have paid is 3.5k also the medical coverage is for 2L for self. The policy coverage is satisfactory.
I have taken the health insurance policy with the NATIONAL INSURANCE where i ma holding it since from many years but i have no claim experience. The premium is satisfactory and the medical coverage is for 5L for complete family. It includes the illness, disease coverage.
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1
MUKESH SHUKLA A
, faridabad
Reviewed on Jan 22, 2019
I am holding the corporate health insurance policy with the NATIONAL INSURANCE where i am using it since fro last 12 years and i had claim for 3-4 times it includes the cashless also the reimbursement. The medical coverage is for 10L for family.