Mediprime Eligibility

• Min Child age: 3 months
• Max adult age: 50yrs
• Max child age: 21yrs
• Members covered: Individual and family plan. You can avail this policy for maximum combination of 2A2C
• Policy Period: Policy available for 1yr and 2 yrs
• Policy Available for: Sum Insured Rs.3L-10L

Mediprime Benefits

• Ayush Benefit: The policy covers you for medical expenses incurred for In-patient treatment taken under Ayurveda, Unani, Sidha or Homeopathy, upto Rs. 20,000 for sum insured from 2lacs to 4lacs and upto Rs. 25,000 for sum insured from 5 lacs to 10 lacs per policy year.
• Daily Cash for Accompanying an Insured Child: If the insured person hospitalized is a child aged between 12 years or less, we will pay a daily cash of Rs. 300 per day & maximum upto Rs. 9,000 per hospitalization for sum insured from 2 lacs to 4 lacs & Rs. 500 per day & maximum upto Rs. 15,000 per hospitalization for sum insured from 5 lacs to 10 lacs.

Mediprime Features

• No medicals on enrollment – Upto 50 years and/or for sum assured upto Rs 5 lacs
• Comprehensive hospitalization coverage without any sub-limits
• Room & ICU charges
• On day care procedures expenses
• On domiciliary treatment
• On organ donor expenses
• Tax Benefits-Get tax benefits for premium paid on policies as per section 80D of the Income Tax Act.Tax benefits are subject to changes in tax laws.
• No co-pay is applicable
• Cashless hospitalization at 3000+ hospitals
• No loading on renewal premium in case of a claim
• We offer lifelong renewal provided renewal premium is paid without any break prior to policy expiry or within grace period.
• Free Look Period –You have a period of 15 days from the date of receipt of the Policy document to review the terms and conditions of this Policy. If You have any objections to any of the terms and conditions, You have the option of cancelling the Policy stating the reasons for cancellation and You will be refunded the premium paid by You after adjusting the amounts spent on any medical check-up, stamp duty charges and proportionate risk premium. You can cancel Your Policy only if You have not made any claims under the Policy. All Your rights under this Policy will immediately stand extinguished on the free look cancellation of the Policy. Free look provision is not applicable and available at the time of renewal of the Policy.
• Grace Period of 30 days for renewing the Policy is provided under this Policy. However, coverage would not be available for the period for which no premium has been received.
• Sum Insured Enhancement – Sum Insured can be enhanced only at the time of renewal. However the quantum of increase shall be as per underwriting guidelines of the company.
• Changes will be notified to the policyholders 3 months in advance in case of revision /modification in approved product.
• Option to migrate to similar Indemnity health insurance policy

Mediprime Claim Process

• Take advantage of cashless hospitalization facility across the +3000 strong network of hospitals. In case you have availed of treatment at hospitals not listed on the network, you can settle the bills at the hospital and then submit your original claim documents with required medical records to the TPA for reimbursement.
• For any emergency Hospitalization, please carry your cashless card and identity proof. The TPA must be informed within 24 hours after hospitalization. For planned hospitalization, kindly seek cashless authorization from TPA at least 48 hours prior to the hospitalization. For any claim related query &/or assistance, contact our Third Party Administrator (TPA) Family Health Plan (TPA) Limited as per details given below.
• Claims Department, Family Health Plan (TPA) Ltd, Ground Floor, Srinilaya - Cyber Spazio, Road No: 2, Banjara Hills, Hyderabad 500034. Website: www.fhpl.net , Email: info@fhpl.net , Toll Free: 1800-425-4033 / 1800 22 9966 (Only for Senior Citizens), Fax: +91-40-23541400
• Please contact our designated TPA atleast 48 hours prior to an event which might give rise to a claim. For any emergency situations, kindly contact Our TPA within 24 hours of the event.

Mediprime Exclusions

• General Exclusions:

  • War, Invasion, Acts of foreign enemies, Hostilities (whether war be declared or not).
  • Civil war, Commotion, Unrest, Rebellion, Revolution, Insurrection.
  • Military or usurped power or confiscation or nationalisation or requisition of or damage by or under the order of any government or public local authority.
  • Circumcision unless required for the treatment of Illness or Accidental bodily injury.
  • Cosmetic or aesthetic treatments of any description.
  • Treatment or surgery for change of life/gender.
  • Any form of plastic surgery unless necessary for the treatment of cancer ,burns or accidental Bodily Injury.

• 2 Year waiting period:

  • Gastric or duodenal ulcers.
  • Cataracts.
  • Hernia of all types.
  • All types of sinuses.
  • Surgery on all internal or external tumours / cysts/nodules/polyps of any kind including breast lumps with exception of Malignant tumor or growth.