Proposed Zee Learn Group Parental Mediclaim Policy vs.

Retail Policy - A comparative

Sr. No Parameter

Zee Learn Group Parental Mediclaim Policy

Coverage

Hospitalization and Critical illness

Additional Premium

Not applicable for Critical illness

Age Group

Upto 80 years

Family Floater Option

Available

Pre-Medical Check up

Not required

9
10
11
12

Hospitalisation Benefits:
a) Room Rent (General)
b) Room Rent (ICU)
c) Surgeon, Anaesthetist, Medical
Practitioner, Consultants, Specialists
Fees, Nursing Expenses
d)Ambulance Charges
Pre & Post Hospitalization Expenses
Limit
Ailment capping
a) Cataract
b) Benign Prostatic Hyperplasia
c) Fever, Viral, Typhoid, Jaundice,
Gastroentitls, Malaria, Hepatitis B,
etc
d) Piles
e) Appendicitis
f) Fistulas
Day Care
Co-Payment
Cashless benefits
Waiting Period

13

7
8

Retail Market Parental Mediclaim Policy

Hospitalization, Domiciliary Hospitalization and Critical
illness by paying additional premium
Applicable for Critical Illness
Upto 80 years, if enrolled earlier successfully else not
applicable
Not Available
Required if the insured was not covered under any
Insurance companies uninterruptedly for preceding three
years

Up to 1% of Sum Insured per day

Up to 2% of Sum Insured per day

Up to 1% of Sum Insured per day

Up to 2% of Sum Insured per day

No Capping

Up to 25% of Sum Insured per illness/ Injury

Rs.1,000/- per case

Rs.1,000/- per policy year
30 days pre hospitalization and 60 days post
30 days pre hospitalization and 60 days post hospitalization
hospitalization
Rs.18,000/- per eye
No Cappings

Rs.10,000/- per eye

Rs.20,000/-

Rs. 25,000/- maximum per case

No Capping

Rs.35,000/Rs.35,000/Rs.35,000/Covered
10% of claim amount
Available
Not Applicable

No Capping (Cannot claim for the first policy year)

No Capping (Cannot claim for the first policy year)
No Capping (Cannot claim for the first policy year)
Not covered
10% of claim amount
Available
30 to 90 days

1st, 2nd, 3rd & 4th Year Exclusions

Not Applicable

Applicable for certiain diseases

14

Any one illness

Not Applicable

15

Health Check up

Not required

16

Premium

Approx : Rs.18,000/- for Rs. 2 Lacs

Approx : Rs.27,000/- for Rs. 3 Lacs
Approx : Rs. 36,000/-for Rs. 4 Lacs

17

Portability of Policy

18

Pre Existing Ailment

45 days waiting period for recurring hospitalization of the

same illness.
Required
Approx Rs 10000/- per lac for a healthy person subject to
medical underwriting else not applicable

Applicable even after seperations from ZLL ( up to

Not Applicable
policy expiry I.e. 20th December 2015)
a) Covered after One Claimfree Year.
b) Dialysis, chemotherapy & radiotherapy will not be
covered even after one claimfree year.
c) Diabetes and/or Hypertension can be covered by paying
addition premium.
d) During the first one year of the policy Cataract, Benign
Prostatic Hypertrophy, Hysterectomy for Menorrhagia or
Covered from day one
Fibromyoma, Hernia, Hydrocele, Congenital Internal
Disease, Fistula in anus, Chronic fissure in anus, Piles,
Pilonidal Sinus, Sinusitis, Stone disease of any site, Benign
Lumps/growths in any part of the body, CSOM(Chronic
Suppurative Otitis Media), joints replacements of any kind
unless arising out of accident, surgical treatment of Tonsils,
Adenoids and deviated nasal septums and related disorders
are not payable