Family Health Optima Insurance Plan Eligibility

• Min Child age: 16 days
• Max adult age: 65yrs
• Max child age: 25yrs
• Members covered: Individual and family plan. You can avail this policy for maximum combination of 2A3C
• Policy Period: Policy available for 1yr
• Policy Available for: Sum Insured Rs.2L-15L

Family Health Optima Insurance Plan Benefits

• Single policy, wider coverage for whole family at an affordable premium.
• Get extra sum insured (auto recharge) at no extra cost, up to 30%  of sum insured.
• Health Checkup costs up to Rs.5,000/- for every block of 3 years of policy coverage.
• Automatic restoration of entire Sum insured by 100%.
• New-born baby cover from 16th day.
• Donor expenses for organ transplantation.
• Domiciliary Hospitalization Expenses for treatment exceeding 3 days.
• Cover for over 400 day care procedures.

Family Health Optima Insurance Plan Features

• Recharge Benefit.
• More than 400 Day Care procedures.
• Expenses incurred towards cost of Health Check up.
• Coverage for New born Baby.
• Coverage for Domiciliary hospitalization treatments.
• Donor expenses for organ transplantation.
• Automatic Restoration of Sum Insured.
• Bonus in respect of a claim-free year of insurance.

Family Health Optima Insurance Plan Claim Process

When the member of the covered family is aware of the hospitalisation in advance.In case of planned hospitalisation:

• Please contact the toll-free help line: 1800 425 2255
• Fax the Pre-Authorization form duly filled from the hospital at the below numbers
• Toll-free: 1800 425 5522
• Non Toll-free: 044 28302200
• Please carry your ID card and policy schedule.

Emergency:When the Insured meets with an accident or suffers from bout of illness that requires immediate admission to the hospital.

• After the patient is rushed to the hospital and avails treatment.
• Family to contact the toll free help line - 1800 425 2255 and Fax the Pre-Authorization form duly filled from the hospital at the below numbers within 24 hours of admission.
• Toll-free:1800 425 5522
• Non Toll-free: 044 28302200

When the Insured gives prior intimation about the treatment and the insured pays the expenses himself with the hospital and then claims for a reimbursement of those expenses.

Family Health Optima Insurance Plan Exclusions

• All treatments of illness / disease / sickness by the insured person within the first 30 days from the date of commencement of the policy
• Exclusion of certain diseases from the first two policy years namely - cataract, Replacement surgery for knee and/or joint, Hysterectomy for Menorrhagia or Fibromyoma, varicose veins and Prolapse of intervertebral disc, varicose ulcers. Some of them are covered in case caused due to accident.
• Exclusion of few diseases from the first policy year like Piles, Hernia, congenital internal disease/defects, Hydrocele, Fistula in anus, Sinusitis and related disorders, removal of gallstones and renal stone, Benign Prostate Hypertrophy
• If certain expenses are incurred but are only diagnostic in nature and there is no positive existence of any illness or disease
• Non-allopathic treatment expenses
• Treatment of any congenital disease, defects or anomalies that are external
• Naturopathy treatment
• Expenses that are cosmetic in nature.