Frequently Asked Questions

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Yes, there will be a 30 days waiting period except for accidental hospitalization.

Category: Hospicash

Hospital cash insurance is a benefit plan where you get a fixed lump sum amount for each day of hospitalization. The amount paid is irrespective of your actual hospital bill. You can use this amount for medicines, diagnostics tests any other expenses which customer may incur.

Category: Hospicash

All existing customers of PayNearby and the new ones (by registering themselves on our platform) are eligible to get the benefit of the plan.

Category: Hospicash

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Health insurance covers majority of medical expenses but there could be other non-payables expenses or incidental expenses such as ambulance expenses, attendant charges etc. that could burn a hole in your pocket. The lump sum paid out from this plan can be used for all such expenses.

Category: Hospicash
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    Mediclaim is an indemnity health insurance product which is a reimbursement of expenses while Hospicash is a defined benefit product paying for each day of hospitalization irrespective of the actual bills.

     

    Particulars Details
    Cover Type Individual
    Type of Plan GFB – Group Hospicash
    Frequency of payment Annual in advance
    Policy Period 1 Year
    Age Group 18 – 60  Years
    Daily cash benefit Rs.1500 per day or Rs.2000 per day
    Premium Rs.885 per year Or Rs.1180 per year respectively
    Limit per policy year 30 days
    Deductible 1 day per hospitalization
    Waiting Period 30 days
    1 Year waiting period (Specified illness) Not Applicable
    Pre-existing diseases waiting period Not Applicable
    Category: Hospicash

    There is a 1-day deductible per hospitalization.

    Mr. Anand opted for Rs.1500 per day & got hospitalised for Dengue fever for 5 days in the second month after taking the policy. Mr. Anand will receive Rs.1500 X 4 days

    (5 days – 1-day deductible) = Rs.6000/-

     

     

    Mr. Anand is again hospitalised for fever the next month for 5 more days.

    Mr. Anand will receive Rs.1500 X 4 days

    (5 days – 1-day deductible) = Rs.6000/-

    1 day deductible will be applicable for every hospitalization.

    Category: Hospicash

    This plan provides Daily cash benefit options which are payable on each day of hospitalization.

    Category: Hospicash

    Yes, 30 days. Which means you will be able to claim until the number of days opted as the policy year limit.  In a year maximum claim cannot be for more than 30 days.

    Category: Hospicash

    Multiple claims for medically necessary treatment of same illness or injury will be covered up to a maximum of 30-days per policy year.

    Category: Hospicash

    Critical pre-existing conditions are not covered as part of the policy. The insured will need to agree to the below mentioned declaration displayed on the app/portal at the time of policy registration.

    “I hereby declare that I perform all my routine activities independently and that I have never suffered from, am not currently suffering from any of the mentioned critical illnesses namely Cancer, Major Organ disease / transplant, Stroke /Paralysis, Nervous disorders, HIV, etc.”

    Category: Hospicash

    You can purchase the policy for yourself only.

    Category: Hospicash

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    The minimum entry age is 18 years and the maximum entry age is 60 years.

    Category: Hospicash

    No. You cannot cover all members of your family in one policy as each policy will cover only one person. Each family member can buy a separate policy if they are within the age group of 18 to 60 years.

    Category: Hospicash

    Your policy is valid for 1 year. You can renew your policy at the end of policy term.

     

    Category: Hospicash

    Life-Long renewability is available provided the policy is purchased within the age group of 18-60 years.

    Category: Hospicash

    Hospitalization at all allopathic hospitals and government approved non-allopathic hospitals are approved for coverage.

    Category: Hospicash

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    No. Policy will not cover suicide cases.

    Category: Hospicash

    No. Hospitalisation for pregnancy is not covered under the policy.

    Category: Hospicash

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    All diagnostic procedures are excluded from coverage. Angioplasty is covered if hospitalisation is for more than 24 hours.

    Category: Hospicash

    Organ transplant will be covered only if the procedure is compliant under Human Organs Act, 1994 (amended).

    Category: Hospicash

    Hospitalization for life support is not covered if such treatment will not result in recovery or restoration of the previous state of health.

    Category: Hospicash

    No. Hospitalization is not covered for AIDS/HIV or any Sexually Transmitted Diseases.

    Category: Hospicash

    No, you cannot request for enhancement of sum insured.

    Category: Hospicash

    Customer has to raise request with Aditya Birla Health Insurance Co. Ltd.  Customer can call on 1800 270 7000 or write at care.healthinsurance@adityabirlacaptial.com .

    Category: Hospicash

    The below documents needs to be submitted within 30 days from the date of hospitalization or within 30 days from the date of discharge

    • Duly filled claim form
    • Certificate of Insurance
    • Copy of Discharge Summary detailing the period and reason for admission plus the line of treatment
    • Copy of the final bill or payment receipt
    • KYC documents – Photo ID, Address and Age proof
    • In case of Accident Cases – Certificate from the doctor stating Details of Accident/trauma & Whether the patient was under the influence of alcohol or any intoxicating substance during incident / accident.
    • Any other documents which the Insurer will ask in case the submitted claim has to be further investigated
    Category: Hospicash

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    To do so, customer has to raise request with Aditya Birla Health Insurance Co. Ltd.  Customer can call on 1800 270 7000 or write at care.healthinsurance@adityabirlacaptial.com .

    Category: Hospicash

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