i'l

FormNo. : PD/BA/ProsPectus/90

AR
BHAVISHYA
INSUR
ilIEDICLAIM
PROVIDENT

PROSPEC
t
l---
I
I

of GeneralInsurance
(A subsldiary of lndia)
Corporation
Fegd.& HeadOffloe: tt'env nsiurance
InOia 87,
Buildlng, MahatmaGandhi Rd.Fort,Bombay- 400001.

Gontact : Any of our officesfor Insurance

 PROSPECTUS

BHAVISHYA AROGYA

1.. SALIENT FEATURES OF THE POLICY

1.1 The schemehas been designed so as to eft

during his old age out of saving during hi
policy-themedicil expensesto bejncurred
of retiremeut will be reimbursedupto tht
arrrountper' Any One Illness/Injury"
.j..2 ,Theschr.mewill be available to all Indian citizens provided his,/her age at the time gf taking
policy is within the age grouP of 25 yearsto 55 years'

1.3 The schcmeprovides for paymentof insur

ing from any selecteddate between25 ye
selecteclage'of retirement i'e' between5l
instalment premium shall signify the c<
annual instalmentpremium dePosituPto
date. It is necessaryto have minimum inl
retiremeut age. The schemealso provic
instalmc-ntand evenin that casethereshor
ofentryandPolicyRetirementAge.Premiumtablesareendosed.
'1,.4 Crace Period : A graceperiod of 30 day
instalment of premium deposit' If paym
premium will be chargedat the rate of 19
of six months, including Sraceperiod ol
withirr the maximum period of 6 monthq
for refund on demand at Prescribedscale'
'1.5
No pre-irrsurancemedical examinationis required'

1.6 Refund of Frerniurn :

paid in ftre event of
7"6.1 The scheme allows a suitable refund of premium already
withdrawals from
premature death of the insured,a,sper scale..Incaseof voluntary
to the extentof 75Voof refund payable on death'
the schemerefund is allowed

7.6.2 After commencementof risk at;

is also made for refund at aPPr
preferred. SimilarlY in caseof
illowed to extentof 75Voof refur
will be S0,@0fittupees
.tr
.7 The am.unt of maximum total benefit availableunder the basicpolicy
comrnencingfrom thePolicyRetiremont
fifty thousa.d only) duringttre tifetimeof thelnsured
- (Rupees twenty thousand only) per any pne ilinessor
Age a.rd.shall noiexceedlts. zo,}w/
injuryr'
to four yearsof comrnencement
i..8 The lnsured can increasethe amount of benefitanytime prior
 of PolicyRetirementAgebyadditional units of Rs.10,000each. Premium payablefor eachsuch
additional unit shall be at the rateof 20?oof thebasicpremium applicabl-efor the relevantage
at which such additional units are opted for.
'1,9
Advancement/postponementof retirementage is not permissible.

1.10 The schemeprovides for assignment.

1.11 In the event ojany claim becomingadmissibleunder the poliry, the Company will reimburse
to the insured person the amount of such expensesas areictuitty and necessirily incuned in
resPectthereof anywhere in India by or on behalf of such Iniured but not eiceeding the
amounts_A-ny_Orre lllness/Iniury and overall limit during the coveredperiod as providEd in
the'SCHEDULE'after comrhencementof the policy redlement age.

7'12 Proof of age-: Completed number of years will be considered for the purpose of age. Birth
certificate,schoolcertificateor any other certificategiving proof of age io be submittEdat the
time of entry which will be valid throughout pre-re-tiremlntand poit-retirement period.

1.L3 After commencementof risk, Cumulative Bonus at57o of maximum benefit availabie
at the
beginning of each-claimfreeyear will be added to the sum insured for the subsequentyears
subjectto maximum accumulationfor 10 (ten)such claim freeyearsin all during entire policy
period.

2. DEFINITIONS

2.1 HOSPITALS/NURSING HOMES

Shallbedeemedtomeananyinstitutioninlndiaestablished forindoorcareandtreatmentofsickness
and injuries and which has been registeredeither as a Hospital or Nursing'Home with the local
authorities and is under the supervisionof a registeredandqualified doctor.

2.1.7, The term 'Hospital' shall not include an establishmentwhich is a place of rest, a place for
the aged, a place for drug addicts,a place of alcoholics,a hotel or a similar place.In case
Hospital/Nursing Home is not registeredwith the local authority, the minimum require-
ments to be complied with will be as under :
1) it should have atleast10 in-patientbeds.
2) fully equipped nursing staff in its employment round the clock.
3) fully equipped operation theatreof its own.
$ fully qualified Doctor should be in chargeround the clock.

2.2 DOMICILIARYHOSPITALISATION BENEFIT

Meansmedical treatmentfor a period exceedingthreedays for such illness/disease/injury which
in the normal courseshould require careand treatmentat a Hospital/Nursing Home but acrually
taken vThilstconfined at home in India under any of the following circumstancesviz.

2.2.1 Thecondition of thepatientissuch that he/shecannotbe removed to theHospital/Nursing

Home or

2.2.2 ThepatientcannotberemovedtoHospital/NursingHomefor lackof accomodationtherein

or

2.?.3 The patient prefers to be confined at home for the trearment with the approval of the
attending Medical Practitioner.
 ;,--
Subjecthowever thatdomiciliaryhospitalisationbenefitsshall notcoverexPensesirrdned
for treatment for any of the following diseases:

1. Asthama
2. Bronchitis
''n. 3filHif; ifi,l,'J incr tis
udingGastroenteri
i"J'"""
*X"i"o,|oo'f
5. Epilepsy
6. Hypertension
7. Influenza,CoughandCold
B. All Psychiatricor PsychosomaticDisorders
9. Pyrexiaof Unknown Origin for lessthan 10 days
10. Tonsilitisand Upper RespiratoryTract infectionincluding Larymgitisand Pharingitis
11. Arthritis, Cout and Rheumatism
Note : When treatmentsuchasDialysis,Chemotherapy,Radiotherapyetc.is taken.inthe
Hospital/Nursing Home and the Insuredis dischargedon the sameday, the treatment
will be consideredto be takenunder HospitalisationBenefitSection.

3.0 A ONE ILLNESS

Any OrreIllnesswill be deemedto meancontinuousperiod of illnessand it includesrelapsewithin
45 days from the date of last consultationwith the Doctor/Hospital/Nursing Home Occurrenceof
. some illness after a lapseof 45 days as statedabove will be consideredas new illness.

3.1. MEDICALPRACTITIONER
Means a person who holds a degree/diploma of a recongnisedinstitution and is registeredby
Medical Council the of respectivestateof India.

3.2 QUALIFIED NURSE

Means a person who holds a certificate/diploma of a recognisedNursing Council and who is
employed on recommendationof the attending Medical Practitioner.

4.0 POLI RETIREMENT AGE

Mealrs the age selectedby the Insured at the time of signing the proposal and specified in the
Schedulefor the purpose of commencementof benefitsin the policy. The policy retirement age
cannot be advanceddue to any causeduring the pre-retirementperiod.

5.0 I'RE.RETItrTEMENTPEITIOD
Means the period commencingfrom the date of acceptanceof the proposal and ending with the
policy retirementagespecifiedin theScheduled uring whic\ the Insuredshallbepaying instalment/
single premium deposit as applicable.

5.1 The risk is to commencefrom the dateon which the last instalmentpremium is paid. In casethe last
instalrnent of premium is not paid on the due date maximum graceperiod allowable will be six
months without charging additional premium but the risk will commenceonly from the date of
paymentof the last instalment.After expiry of six months from the due date of the last instalment,
the policy wiil be treatedaslapsedand necessaryrefund of premium deposit will be allowed to the
insured as per the table of refund.

6.0 EXCLUSIOF]S
The company shall not be liable to make any pavment under the policy in respectof any exPenses
whatsoeverincurred by the Insured in connectionor in respect<lf:
 or attributable to War'
6.t Injury or disease directly or indire_ctlycaused by or arising from
r1.*y, wir tite ope.utiottt (whether war be declared or not)'
Invaiion, ACT ; F;;i6

6.TRoutineeyeexaminationandcostofglassesandcontactlenses.

6.3 Dental treatment or surgery of any kind unless requiring hospitalisation'

rest cure' contenital external
6.4 COnvalescenge,general debility, "Run-down" condition or
use of intoxicating
defects or anomalies, sterility, venereal disease,intentional self-iniury,
drugs.
x-flr laboratory
6.5 charges incurred at Hospital orNursing Home primarily for diagnosfc 9r
to the diagnosis
examinations oi other diagnostic studiEs not consistent with orlncidental for
sickn:11-olinj1r1.
and treatment of the posif,ve existenceor Presence9f-u.y ailment,
or at home under Domiciliary
which cor,finemeni is'reqrriied at Hospital, Nursing Home Ir'1l
i{ospitalisation as defined.
for injury or diseaseas
6.5 Expenseson vitamins and tonics unless forming Part of treafment
cerlified by the attending physician'
nuclear weapons'
6.7 Injury or Diseasedirectly or indirectly caused.byor contributed to by

6,8 NaturoPathY Treatment.

7.6 NOTICE OF CLAIM

prescribed time' 1;t

8.0 PAYMENT OF CLAIM for the

in Indian currency' All medical treatments
All claims under this policy shall be payable
only'
p".p"t".f this insuran." *itt have to be taken in India

9.0 INCOME TAX BENEFIT the

will be eligible for exemption under 80-D of
Premium instalment uPto Rs. 3,00oper year
lncome Tax Act.
 PREMIUM TABTE
SINGLE PREMIUM (in Rs. for Rs.
50,000Sum Insured) ANNUALPREMruM(in Rs. for Rs.50,000
sum insured)
Ageof

rl*"j'''.i*^"' ^ff' Ageof Retirement Age Selected (Running

Entry
(Completed
Years)
PREMIUMPAYBLEIN Rs.
,l
jL4 "l ,,1 Enlry(Completed
Years)

PREMILiMPAYBLEIN Rs.
446 416 388 352 337 314 25 44 47 38 35
26 491 458 427 33
,),
398 371, u5 26 52 49 45 42 39 %
540 503 470 438 408 380 27 58 54 50 46 43
28 594 554 515 40
482 449 479 28
?o 64 & 55 51 47 44
653 510 568 530 494 4& 29 71 66 67 52
30 626 583 543 507
5/ 49
30 79 73 68 63 58
,11
588 642 54
598 tr/ 88
32
ol 81 / 5 69 & 59
706 558 6't3 32 98 90 83 77 / l 66
JJ
834 777 724 675 33
4,1 109 101 93 86 79 73
917 8s5 796 742
"1761 1 0 8 :
34 r22 1,12 103 95 88
J5 009 941 81
877 8't7 ,tf rx. 725 1 1 5 106 98
36 7 2 7 7 1 1 9 1 1t l1 l1 035 90
965 899 % 153 740 728 1 1 8 7 W
-),/ 7406 1 3 11 222 t J > 100
062 989 3/ 171, 157 744 732 't21
15 4 8 1 443 345 254 111
169 1088 38 193 176 757 747 135
't704 r24
JA 15 8 9 4 8 1 380 286 11 9 8 39 278 198 181 165 151
40 1 8 77 17491 1 5 3 1 135
0 5 1 1141s
9 40
41 2 0 6 7 1926
I 11318 247 224 203 155
117e5 1672Irsss 1,451 41
42 281 253 229 173
))77' 21211 9 7 7r 8 4 1 1 7 1 51597
42 321 2 f f i 260
A '
*J /.Jtl 2 3 3 72 1 7 6 2028 188E7759 195
43 369 329 295
A
2765 z J / / 2398 22332o7sl 219
1935 44 426 378 338
45 3050 2837 26142459 2290 2132 247
.to
45 496 437 388 346 3 1 1 280
3 3 6 8 3 1 3 01 O 1 1 271.22522 2348
46 s85 509 448 398 JC3 319
47 3 7 1 . 8 345532,112986 2787 2585
47 697 500 523 46 408 364
48 4 1 1 1 3 8 15 3546,294 3062 2852
48 &15 / t 5 616 5% 471, 479
49 +J55 4279 , 9 1 5 )637 ,378 3140
49 t046 867 734 632 550 483
50 l s o
I
1073I sse 753| 648 I 56,4
[": I
,)l l s r 1 1 1 0 1972 772 It 6 r . 4
I

52 52 1406t1,29 935 792

53 53 = t n * 11 5 8 959
54
CJ
54
J5 -l-l-t
-l t: i 188
7517
 1
FACTORS FOR REFUND OF PREMIUM
On deathbeforecommencement flu
of Risk
ANNUAL PREMILIM (AP) SINGLEPREMIUM (SP)
Numberof Annu- Refund factor Year of death Refund factor
al Premiums(AP) to be applied from payment to be applied
paid before death to total premium of Single to Single
Paid Premium Premium
n i . e .( n X A P ) n i.e.(SP)
1 0.7271 1 0.7999
2 0.9034 2 1.0411
3 0.9981 J 7.2041
4 1.0757 4 "r.3567
5 't.7475
5 1.5135
6 1.2197 6 1.6803
7 r.2938 a
1.8603
I 7.371,2 8 2.0561
9 1,.4525 9 2.2700
10 7.5387 10 2.504r
11 7.6302 11 2.7670
t2 1.7277 1,2 3.0428
73 1. 8 3 1 8 13 3.3524
L4 r.9429. 14 3.6925
15 2.O6t9 15 4.0661
75 2.7892 16 ,1 An2a
1.7 2.3258 77 4.9290
18 2.4721 18 5.4256
79 2.6292 1.9 q o710
20 2.7979 20 6.5727
27 2.9790 27 7.2334
u 3.7738 22 7.9602
23 3.3831 29 fl,lt{.P4
24 F,e$cs
24 3.6083 t (),6t1t.5
3.8507 a5 r t ,6691
E 26 i 2.8390
26 4.1176 27
4.3924 74.1258
27 28
4.6957 15.5413
z8 29
5.O2r2 17.0983
29 30
5.3728 18.8110
30 31
5.7519 20.5949
31 32
6.7509 22.7674
32 JC
6.602r 34 25.0467
33 -
7.0784
"-'-
34
34 | r 'r^ -^r"nr{ 'rwable in case of death'

NoTE:RefundincaseorvoluntarywithdrawalwillbeTSTooftherefundPayable
OF RISK
REFUND AFTER COMMENCEMENT
NO CLAIM ' l * Rerunds"
claim ttofrrnrls"
or"No will
Wil
orrisk,theamounts
rntheevent o"ln""lffi;:;;.emenr
",
be as follows : Amount of refund
Age at retirement Rs.
(i;' Entry age Plus term)
6397
5) 6552
JO 6709
5l 6867
58 7026
59 7't',6
payable on death'
60 the ,l.ro craim refr:nd'
withdrawar v.tr^be757oof
in the event of voluntary
Nole;No claim refund