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Health Insurance Policy: Quote Purpose Only
Health Insurance Policy: Quote Purpose Only
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Policy Details
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First Policy Inception Date Policy Number D128463884
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Family Composition 2 Adult and 2 Child Policy Nature New Business
*Based on your city of residence, Zones have been classified into two as mentioned belo
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Zone 1: Delhi/NCR, Mumbai including (Navi Mumbai, Thane, and Kalyan) and Greater Hyderabad Area. Zone 2: Rest of India apart from Zone 1.
As the treatment cost is different in different cities, there are certain conditions if you change your city of treatment:
1. At the time of claim, Insured needs to provide address proof as per the declaration in proposal form.
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2. In the absence of Address proof provided which validates the pricing zone opted, and if the place of hospitalization belongs to
Higher Zone Category - then Co-pay of 10% would be applicable on admissible claim amount.
3. Zone based Co-Pay, as mentioned above, will not be applicable in case of Accidental Injury.
4. If address proof as per declaration in Proposal form and Address proof provided at the time of claim is same, Zone based Co-pay
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will not be applicable.
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5. In case of family floater policies, a single zone shall be applied to all the members covered under the policy.
Sum Insured(SI)
Additional Sum
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AMAN S SINHJ
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AMAN SPOUSE S
AMAN
10,00,000 ` Ď 10,00,000
AMAN CHILD 1 S
AMAN
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AMAN CHILD 2 S
AMAN
*Cumulative Bonus will be applicable as per your opted plan. In case of an individual policy, cumulative bonus will not be
accumulated at the end of the year for all the new members added during the policy.
• In case of portability all the waiting period applicable under this policy shall be counted from First Policy Inception date
for each member for Sum Insured existing with the previous insurer.
• Fresh waiting periods will be applied on Enhanced Sum Insured opted with Go Digit at the time of porting the policy.
No room rent
1.1 In-Patient Hospitalization Cover ₹ 10,00,000*
restrictions
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1% of base Sum
1.5 Road Ambulance ₹ 10,000* Insured max upto
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INR 10,000
NA
1.6 Bariatric Surgery ₹ 10,00,000* NA
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1.7 Psychiatric Illness ₹ 10,00,000* NA
0.25% of base
Sum Insured,
1.8 Health Check-up ₹ 1,000** max upto INR
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1,000 after every
two year
Optional Covers
Section No. of Policy Sum Insured (`) Deductible/ Special Terms &
Coverages
Wordings Limits * Co-payments Conditions
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*These Sum Insureds will be part of Section 1 - Hospitalization Cover Sum Insured
**These Sum Insured will be over and above Section 1 - Hospitalization Cover Sum Insured
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Cumulative Bonus 10% of base Sum Insured for every claim free year, max up to 100%
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Initial
Waiting Pre-existing Worldwide Specific
Maternity Critical Illness
Member Period Disease Cover Disease
Waiting Waiting
Name and ID (excluding Waiting Waiting Waiting
Period Period
critical Period Period Period
illness)
AMAN CHILD 1 S
30 Days Initial
AMAN - 30 Days 3 Years NA NA 2 Years
waiting period
N0345521650
AMAN CHILD 2 S
30 Days Initial
AMAN - 30 Days 3 Years NA NA 2 Years
waiting period
N5057173351
Premium Details
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Description Amount (INR)
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Underwriting Loading NA
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IGST @ 18% = (2815.00) 2815.00
This quote is generated on the basis of basic information provided by you. Final premium under the policy will depend on the medical
and health related disclosures submitted by you in this proposal.
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Disclaimer:
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1. Year on year renewal premium indicated in this table is as per information given by you for this policy.
2. Premium may vary based on changes in medical or health related disclosures/ family composition/ sum insured and any changes in
premium rates as approved by IRDAI.
3. If a child has attained age of 25 years on date of policy renewal, a new and separate policy shall be issued for the child.
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You don’t have to fill these details again, just continue from where you left off.
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