Genera| Insurance

Ceneral lnsurance developed ln lndla wlLh lndusLrlal revoluLlon ln Lhe WesL and consequenL growLh of
seafarlng Lrade and commerce ln Lhe 17
Lh
cenLury lL came Lo lndla from uk 1he 1
sL
general lnsurance
company 1rlLon lnsurance Company LLd was esLabllshed ln CalcuLLa ln 1830 whose shares were malnly
headed by 8rlLlsh 1he 1
sL
general lnsurance company esLabllshed by an lndlan was lndlan MercanLlle
lnsurance Company LLd ln 8ombay ln 1907
ln 1937Lhe Ceneral lnsurance Councll a wlng of Lhe lnsurance AssoclaLlon of lndla framed a code of
conducL for ensurlng falr conducL and sound buslness pracLlces ln Lhe general lnsurance lndusLry An
admlnlsLraLlve seLup headed by Lhe ConLroller of lnsurance was seL up aL uelhl ln 1937 wlLh a branch
offlce aL 8ombay CalcuLLa and Madras for admlnlsLraLlng code of conducL lurLher ln order Lo reLaln
Lhe buslness of general lnsurance ln lndla Lhe lnsurers sLarLed a relnsurance company vlz lndla
8elnsurance CorporaLlon LLd ln 1936 Lo whlch Lhey volunLarlly ceded 10 of Lhelr gross dlrecL buslness
ln 1961 by arrangemenL Lo lnsurance AcL Lhls volunLary arrangemenL was formallzed by noLlfylng Lhe
lndlan CuaranLy and Ceneral lnsurance Company LLd a governmenL company along wlLh Lhe lndlan
8elnsurance CorporaLlon as 'lndlan 8elnsures' ln 1968 Lhe lnsurance AcL was amended Lo provlde for
exLenslon of soclal conLrol over lnsurers LransacLlng general lnsurance 1he amendmenLs provlded lnLer
alla for regulaLlon of asseLs seLLlng up of Lhe 1arlff Advlsory CommlLLee (1AC) under Lhe chalrmanshlp of
ConLroller of lnsurance 8efore Lhe amendmenLs of Lhe acL could be lmplemenLed managemenL of non
llfe lnsurers was Laken over by Lhe CenLral CovernmenL ln 1971 as a prelude Lo naLlonallzaLlon 1he
Ceneral lnsurance 8uslness AcL 1972 naLlonallzed general lnsurance buslness wlLh effecL from 1173
1he purpose of esLabllshmenL of ClC as a holdlng company of Lhe four operaLlng companles as sLaLed ln
Ceneral lnsurance 8uslness AcL ls superlnLendlng conLrolllng and carrylng on Lhe buslness of general
lnsurance

nLAL1n INSUkANCL IN INDIA CUkkLN1 SCLNAkIC

Introduct|on
1he healLh care sysLem ln lndla ls characLerlsed by mulLlple sysLems of medlclne mlxed ownershlp
paLLerns and dlfferenL klnds of dellvery sLrucLures ubllc secLor ownershlp ls dlvlded beLween cenLral
and sLaLe governmenLs munlclpal and loocboyot local governmenLs ubllc healLh faclllLles lnclude
Leachlng hosplLals secondary level hosplLals flrsLlevel referral hosplLals (CPCs or rural hosplLals)
dlspensarles prlmary healLh cenLres (PCs) subcenLres and healLh posLs Also lncluded are publlc
faclllLles for selecLed occupaLlonal groups llke organlzed work force (LSl) defence governmenL
employees (CCPS) rallways posL and Lelegraph and mlnes among oLhers 1he prlvaLe
secLor (for proflL and noL for proflL) ls Lhe domlnanL secLor wlLh 30 per cenL of people seeklng lndoor
care and around 60 Lo 70 per cenL of Lhose seeklng ambulaLory care (or ouLpaLlenL care) from prlvaLe
healLh faclllLles Whlle lndla has made slgnlflcanL galns ln Lerms of healLh lndlcaLors demographlc
lnfrasLrucLural and epldemlologlcal (See 1ables 1 and 2) lL conLlnues Lo grapple wlLh newer challenges
noL only have communlcable dlseases perslsLed over Llme buL some of Lhem llke malarla have also
developed lnsecLlcldereslsLanL vecLors whlle oLhers llke Luberculosls are becomlng lncreaslngly drug
reslsLanL Plv / AluS has of laLe assumed exLremely vlrulenL proporLlons 1he 1990s have also seen an
lncrease ln morLallLy on accounL of noncommunlcable dlseases arlslng as a resulL of llfesLyle changes
1he counLry ls now ln Lhe mldsL of a dual dlsease burden of communlcable and noncommunlcable
dlseases 1hls ls coupled wlLh splralllng healLh cosLs hlgh flnanclal burden on Lhe poor and eroslon ln
Lhelr lncomes Around 24 of all people hosplLallzed ln lndla ln a slngle year fall below Lhe poverLy llne
due Lo
hosplLallzaLlon (wotlJ 8ook 2002) An analysls of flnanclng of hosplLallzaLlon shows LhaL large
proporLlon of people especlally Lhose ln Lhe boLLom fourlncome qulnLlles borrow money or sell asseLs
Lo pay for hosplLallzaLlon (wotlJ 8ook 2002)
1hls slLuaLlon exlsLs ln a scenarlo where healLh care ls flnanced Lhrough general Lax revenue communlLy
flnanclng ouL of pockeL paymenL and soclal and prlvaLe healLh lnsurance schemes lndla spends abouL
49 of Cu on healLh (wnk 2002) 1he per caplLa LoLal expendlLure on healLh ln lndla ls uS$ 23 of
whlch Lhe per caplLa CovernmenL expendlLure on healLh ls uS$ 4 Pence lL ls seen LhaL Lhe LoLal healLh
expendlLure ls around 3 of Cu wlLh breakdown of publlc expendlLure (09) prlvaLe expendlLure
(40) 1he prlvaLe expendlLure can be furLher classlfled as ouLofpockeL (CC) expendlLure (36) and
employees/communlLy flnanclng (04) lL ls Lhus
evldenL LhaL publlc healLh lnvesLmenL has been comparaLlvely low ln facL as a percenLage of Cu lL has
decllned from 13 ln 1990 Lo 09 as aL presenL lurLhermore Lhe cenLral budgeLary allocaLlon for
healLh (as a percenLage of Lhe LoLal CenLral budgeL) has been sLagnanL aL 13 whlle ln Lhe sLaLes lL has
decllned from 70 Lo 33











8ASIC IUNC1ICNS CI INSUkANCL

1 1rlmary luncLlons
2 2Secondary luncLlons
3 3CLher luncLlons
Primary functions of insurance
O 9rov|d|ng protect|on 1he elemenLary purpose of lnsurance ls Lo allow securlLy agalnsL fuLure
rlsk accldenLs and uncerLalnLy lnsurance cannoL arresL Lhe rlsk from Laklng place buL can for
sure allow for Lhe losses arlslng wlLh Lhe rlsk lnsurance ls ln reallLy a proLecLlve cover agalnsL
economlc loss by apporLlonlng Lhe rlsk wlLh oLhers
O Co||ect|ve r|sk bear|ng lnsurance ls an lnsLrumenL Lo share Lhe flnanclal loss lL ls a medlum
Lhrough whlch few losses are dlvlded among larger number of people All Lhe lnsured add Lhe
premlums Lowards a fund and ouL of whlch Lhe persons faclng a speclflc rlsk ls pald
O Lva|uat|ng r|sk lnsurance flxes Lhe llkely volume of rlsk by assesslng dlverse facLors LhaL glve
rlse Lo rlsk 8lsk ls Lhe basls for ascerLalnlng Lhe premlum raLe as well
O 9rov|de Certa|nty lnsurance ls a devlce whlch asslsLs ln changlng uncerLalnLy Lo cerLalnLy
$econdary functions of insurance
O 9revent|ng |osses lnsurance warns lndlvlduals and buslnessmen Lo embrace approprlaLe
devlce Lo prevenL unforLunaLe afLermaLhs of rlsk by observlng safeLy lnsLrucLlons lnsLallaLlon of
auLomaLlc sparkler or alarm sysLems eLc
O Cover|ng |arger r|sks w|th sma|| cap|ta| lnsurance assuages Lhe buslnessmen from securlLy
lnvesLmenLs 1hls ls done by paylng small amounL of premlum agalnsL larger rlsks and dubleLy
O ne|ps |n the deve|opment of |arger |ndustr|es lnsurance provldes an opporLunlLy Lo develop
Lo Lhose larger lndusLrles whlch have more rlsks ln Lhelr seLLlng up
ther functions of insurance
O Is a sav|ngs and |nvestment too| lnsurance ls Lhe besL savlngs and lnvesLmenL opLlon
resLrlcLlng unnecessary expenses by Lhe lnsured Also Lo Lake Lhe beneflL of lncome Lax
exempLlons people Lake up lnsurance as a good lnvesLmenL opLlon
O ,ed|um of earn|ng fore|gn exchange 8elng an lnLernaLlonal buslness any counLry can earn
forelgn exchange by way of lssue of marlne lnsurance pollcles and a dlfferenL oLher ways
O k|sk Iree trade lnsurance boosLs exporLs lnsurance maklng forelgn Lrade rlsk free wlLh Lhe
help of dlfferenL Lypes of pollcles under marlne lnsurance cover
lnsurance provldes lndemnlLy or relmbursemenL ln Lhe evenL of an unanLlclpaLed loss or dlsasLer
1here are dlfferenL Lypes of lnsurance pollcles under Lhe sun cover almosL anyLhlng LhaL one mlghL Lhlnk
of 1here are loads of companles who are provldlng such cusLomlzed lnsurance pollcles














MA!C8 LA?L8S ln PLAL1P lnSu8AnCL
lllCC 1CklC CLnL8AL lnSu8AnCL
About Us ProfIle
IFFCD-TokIo CeneraI Insurance (ITCI) was Incorporated on 4th 0ecember 2000 wIth a vIsIon of beIng
Industry leader by buIldIng customer satIsfactIon through faIrness, transparency, and quIck response. t
Is a joInt venture between the ndIan Farmers FertIlIzer CooperatIve (FFCD) and Its assocIates and
TokIo |arIne and NIchIdo FIre Croup, the largest lIsted Insurance group In Japan.
FFCD TokIo Ceneral nsurance has Pan ndIa presence wIth 57 'StrategIc 8usIness UnIts' and a wIde
network of over 100 Lateral Spread Centres and 280 8Ima Kendras. t offers a wIde range of unIquely
customIzed polIcIes coverIng a wIde range of customers, from farmers to some of ndIa's largest
automobIle manufacturers. From a modest Fs 21J Crores of CWP (Cross WrItten PremIum) In 200102 It
has achIeved an ImpressIve Fs 16J9.5 Crores In 200910, thereby becomIng one of ndIa's leadIng
prIvate players.
FFCD TokIo Ceneral nsurance has got the TechnIcal Support for underwrItIng and reInsurance from
TokIo |arIne and on FIsk |anagement from TokIo FIsk ConsultIng (TFC). t Is the fIrst company In ndIa
to underwrIte mega polIcIes for a fertIlIzer and an automobIle company. ThIs comprehensIve polIcy Is
based on InternatIonal rates and optImIzes the premIum outflow for clIents even as It offers a one
stop, allrIsk cover. Dther than the conventIonal products, It has been able to come out wIth nIche
products lIke CredIt nsurance, FIne Arts nsurance, P E nsurance, Errors E DmIssIons PolIcy for the T
Sector etc. At the same tIme It has steadfastly carrIed out Its rural centrIc InItIatIves by launchIng
products lIke Sankat Haran 8Ima Yojana, |ausam 8Ima Yojana, |ahIla Suraksha 8Ima Yojana and
Janata 8Ima Yojana for the masses. t's pIoneerIng work usIng technology lIke FF0(FadIo Frequency
dentIfIcatIon 0evIce) and N07 (NormalIsed 0Ifference 7egetatIon ndex) have made It possIble to offer
Cattle and Weather Insurance to the rural populatIon at large.
t Is also the only Insurance company In the country to have a 100owned dIstrIbutIon channel to
servIce Its retaIl customers called FFCDTDKD nsurance ServIces Ltd (TS). t fInds specIal mentIon In
the 'CapgemInI World nsurance Feport 2009' as an InnovatIve dIstrIbutIon channel. Today, TS has a
hIghly motIvated workforce of 1400 employees In over J50 towns.
As a customer focused company, It conducts bIannual customer satIsfactIon surveys through
Independent agencIes to gauge Its operatIonal effIcIencIes. ThIs Is backed by a robust T Infrastructure,
whIch has enabled, among other thIngs, speedy settlement of claIms.






MAx 8uA PLAL1P lnSu8AnCL
,ax 8upa A co||aborat|on of hea|thcare and exce||ence |n serv|ce
Max 8upa PealLh lnsurance Company LLd (Max 8upa) ls a [olnL venLure beLween Max lndla
LlmlLed and Lhe uk based healLhcare servlces experL 8upa

Cur vlslon ls real 1o become lndla's mosL admlred PealLh lnsurance Company And Lo make
Lhls vlslon a reallLy we have broughL LogeLher our vasL and varled experlence as Lhe experLs ln
healLhcare

Whlle 8upa has slx decades of experlence ln Lhe healLhcare lndusLry and a 10 mllllon cusLomer
base ln over 190 counLrles Lhe Max lndla Croup brlngs experLlse ln boLh healLh and lnsurance
relaLed servlces lncludlng hosplLals cllnlcal research and llfe lnsurance 1he perfecL blend of
global experLlse and local knowledge ln boLh healLhcare and lnsurance makes Max 8upa Lhe
perfecL cholce when lL comes Lo your famlly's healLh and wellness

AL Max 8upa our mlsslon ls Lo help our cusLomers llve healLhler and more successful llves by
provldlng experLlse as healLhcare parLners And Lhls we reallze ls only posslble by consLanLly
ralslng Lhe bar ln Lhe sLandard of healLh lnsurances and by keeplng our promlses Lo you our
cusLomer and carlng for you for llfe

lor us healLh lnsurance ls noL [usL an annual LransacLlon 8aLher lL ls abouL bulldlng a long
Lerm relaLlonshlp wlLh you





8PA81l AxA CLnL8AL lnSu8AnCL
WPC A8L WL
8harLl AxA Ceneral lnsurance ls a [olnL venLure beLween 8harLl one of lndla's leadlng buslness
groups wlLh lnLeresLs ln 1elecom AgrlculLure 8uslness and 8eLalland AxA world leader ln
llnanclal roLecLlon and wealLh ManagemenL8harLl Croup holds 74 of equlLy and AxA holds
26 of Lhe equlLy
WlLh a vlslon Lo become Lhe leader and preferred company for flnanclal proLecLlon ln
lndla8harLl AxA Ceneral lnsurance offers lLs cusLomers lndlvlduals and buslnesses a wlde
range of producLs and servlces LhaL meeL Lhelr lnsurance need1he values upon whlch lLs
buslness racLlces are based on avallablllLy alLernaLlves and rellablllLy1he company leverage
Lhe 8harLl Croup's large cosLomer pool and has developed a sLrong mulLlchannel dlsLrlbuLlon
neLwork ln boLh urban and rural markeLs
1he company was lncorporaLed on 13
Lh
!uly 2007PeadquarLered ln 8anglore Lhe company
currenLly has 40 branches across lndla1he ManagemenL Leam aL 8harLl AxA Ceneral lnsurance
conslsLs of experlenced leaders who are passlonaLe abouL Lhelr company's vlslon and goals and
are commlLLed Lo Lhe developmenL of 8harLl AxA Ceneral lnsurance as Lhe preferred company
for llnanclal roLecLlon ln lndla
8harLl AxA presenLs an array of proLecLlve plans Lo sulL your personal and buslness
requlremenLs 1hese embody our commlLmenL Lo our sysLem of values
a) 8ellable rompL seLLlemenLs cusLomer servlce and professlonallsm
b) ALLenLlve Lo cusLomer needs as Lhey change wlLh Llme and acLlvely llsLenlng Lo our
cusLomers
c) Avallable easy cusLomer access Lo money and Lo our company and plans LhaL have
bullL ln flexlblllLy and convenlence


ACLLC MunlCP PLAL1P lnSu8AnCL
-4:9&8

;uallLy healLhcare and Apollo have become synonymous ln Lhe lndlan subconLlnenL a facL
relLeraLed by global healLhcare experLs and lnLernaLlonal accredlLaLlon bodles CommlLLed Lo
brlng world class healLh care wlLhln Lhe reach of every lndlvldual Apollo PosplLals Croup has
[olned hands wlLh Munlch PealLh a world leader ln Lhe fleld of healLh lnsurance 1he [olnL
venLure ls polsed Lo make good Lhe convlcLlon of boLh Lhe parLners LhaL lndlan healLh lnsurance
markeL ls on Lhe brlnk of exploslve growLh
MlSSlCn
O ConsLanLly lnLroduce lnnovaLlve PealLh lnsurance and Wellness soluLlons LhaL meeL cusLomer
needs
O 8ulld an organlsaLlon on Lhe prlnclples of Lransparency LrusL and lnLegrlLy
O CreaLe opporLunlLles for our employees Lo learn and grow ln an en[oyable work culLure
O ConsLanLly dellver on our commlLmenLs Lo all Lhe sLakeholders









S1A8 PLAL1P lnSu8AnCL
SLar PealLh lnsurance ls a successful [olnL venLure beLween Cman lnsurance Company and L1A
Ascon Croup malnly AparL from Lhls Lhere are also some lnsurance veLerans from lndla ln Lhls
[olnL venLure 1hey are group dedlcaLed Lo provlde quallLy healLh lnsurance producLs Lo lndlan
consumers Llfe ls Lhe mosL lmporLanL aspecL and one needs Lo proLecL lL wlLh a healLh
lnsurance SLar healLh lnsurance sLrongly belleves ln offerlng quallLy producLs ln cosL effecLlve
packages
1he besL parL of sLar healLh lnsurance ls Lhe ulLlmaLe cusLomer saLlsfacLlon LhaL you can en[oy
deallng wlLh Lhem healLh lnsurance ls Lhe maln focus area of sLar healLh lnsurance company ln
healLh lnsurance Lhey provlde 1rue value lnsurance Medl Classlc lnsurance Medl remler sLar
healLh lnsurance n8l All Care sLar healLh lnsurance plan ulabeLes lnsurance plan lamlly
PealLh CpLlma and Senlor ClLlzen 8ed CarpeL lnsurance AparL from Lhls Lhey also offer
lnsurance servlces ln 1ravel plans accldenL plans sLudenL plans rural plans and corporaLe
plans 1hese lnsurance plans are flexlble and budgeL frlendly 1hey offer producLs ln all rages
boLh cosL effecLlve and premlum
SLar healLh lnsurance has a vlslon and Lhe requlslLe sklll experLlse and flnanclal sLrengLh lL ls
here Lo sLay and rule lndlan lnsurance markeL for many years Lo come
Cu8 vlSlCn roLecLlng healLhpromoLlng healLh
Cu8 MlSSlCnulLlmaLe cusLomer SaLlsfacLlon

8LLlAnCL CLnL8AL lnSu8AnCL

8ellance Ceneral lnsurance ls one of lndla's leadlng prlvaLe general lnsurance companles
wlLh over 94 cusLomlzed lnsurance producLs caLerlng Lo Lhe corporaLe SML and
lndlvldual cusLomers 1he Company has launched lnnovaLlve producLs llke lndla's flrsL
Cver1heCounLer healLh home lnsurance pollcles 8ellance Ceneral lnsurance has an
exLended neLwork of over 200 offlces spread across 173 clLles ln 22 sLaLes a wlde
dlsLrlbuLlon channel neLwork 24x7 cusLomer servlce asslsLance and a full fledged
webslLe lL ls also lndla's flrsL lnsurance company Lo be awarded Lhe lSC 90012000
cerLlflcaLlon across all funcLlons processes producLs and locaLlons panlndla

I|s|on

1o be an lnsurer of World SLandards and Lhe mosL preferred cholce for cllenLele aL Lhe
domesLlc and global level

,|ss|on

Cur Mlsslon ls Lo keep Lhe cusLomer saLlsfacLlon as focal polnL of all our operaLlons
adopL Lhe besL lnLernaLlonal pracLlces ln underwrlLlng clalms and cusLomer servlce be
Lhe mosL lnnovaLlve ln producL developmenL esLabllsh presence all over lndla ensure
susLalned value addlLlon Lo all sLake holders and Lo uphold CorporaLe value CorporaLe
Covernance

lllCC 1CklC SWAS1P?A kAvACP
n the unfortunate event of you or your famIly members meetIng wIth an Illness or accIdent resultIng In
hospItalIsatIon, our Swasthya Kavach (FamIly Health) PolIcy gIves protectIon cover for you and your famIly for any
Injury or dIsease related contIngencIes lIke hospItalIzatIon, medIcal expenses, surgIcal expenses, organ
transplantatIon, etc. The PolIcy also offers unIque CrItIcal llness Coverage (DptIonal) for the famIly and Is
avaIlable under two varIants 8ase plan and WIder Plan and covers the followIng:
O !re-HospItaIIsatIon:
O |edIcal expenses Incurred J0 days prIor to the hospItalIzatIon are reImbursed.
O HospItaIIsatIon:
O All expenses IncludIng the followIng reImbursed:
Foom and board, doctors' fee, IntensIve care unIt charges, nursIng expenses, surgIcal fees,
operatIng theatre expenses, anesthesIa and oxygen admInIstratIon expenses. Foom expenses for
normal room/CU lImIted to 1 /2 of sum Insured per day for 8ase Plan and 1.5/2.5 of basIc
sum Insured for WIder Plan respectIvely. There are also restrIctIons on other hospItal expenses In
accordance wIth the room rent under the 8ase Plan.
O !ost-HospItaIIsatIon:
O Dnce dIscharged from hospItal, the polIcy shall pay for medIcal expenses related to the
hospItalIsatIon, for a perIod of J0 days after dIscharge subject to specIfIed lImIts under 8ase Plan
and 60 days after dIscharge under wIder plan.
O ay care surgerIes:
O The polIcy covers 121 defIned day care surgerIes that requIres less than 24 hours hospItalIsatIon
and ordInarIly fall outsIde the scope of most health Insurance polIcIes.
O HospItaI aIIy AIIowance:
O n addItIon to hospItal expenses, a daIly allowance wIll be paId for the perIod of hospItalIsatIon.
O 2ergency AssIstance ServIce:
O n the event of an emergency, assIstance servIces lIke medIcal consultatIon, evaluatIon and
referral, emergency medIcal evacuatIon, care for mInor chIldren etc are provIded.
O ocaI A2-uIance ServIce:
O n the event of an emergency, cover Is provIded for expenses Incurred on ambulance servIces to
the nearest hospItal where Emergency Health facIlItIes are avaIlable.
O CeneraI HeaIth Check-up:
O You wIll be reImbursed the expenses Incurred for general health examInatIon (once In a block of
4 claIms free years) - AppIIca-Ie onIy under WIder !Ian
O Cu2uIatIve -onus :
O You wIll be provIded wIth a 5 extra sum Insured for every claIms free year subject to a
maxImum of 50 of capItal sum Insured ApplIcable only under WIder Plan
O enefIts under SectIon - 80:
O PremIum upto Fs. 15,000 Is elIgIble for self, spouse and dependant chIldren wIth deductIons
under SectIon 800 of ncome Tax Act, 1961.
TC's Swasthya Kavach PolIcy ensures comprehensIve coverage by offerIng value added features, at a nomInal
Increase In premIum, lIke:
O CrItIcaI IIIness extensIon for fa2IIy:
4 You wIll be covered for 10 named crItIcal Illness for double the basIc cover sum Insured. 10
CrItIcal llness Include: ParalytIc Stroke, Cancer, Fenal FaIlure, Coronary Artery 0Isease, |ajor
njurIes, End Stage LIver 0Isease, |ajor 8urns, Coma, |ajor Drgan Transplant and |ultIple
SclerosIs
hat does the policy not cover?
O 0Iseases, whIch have been In exIstence at the InceptIon of the polIcy
O llness that commenced durIng the fIrst J0 days of InceptIon of the fIrst polIcy.
O 0urIng the fIrst year of the PolIcy, the expenses on treatment of dIseases such as TonsIllItIs/ AdenoIds,
CastrIc or 0uodenal Ulcer, any type of Cyst/ Nodules/ Polyps, any type of 8reast lumps.
O 0urIng the fIrst two contInuous years of the Insurance wIth us, the expenses on treatment of dIseases such
as Cataract, 8enIgn ProstatIc Hypertrophy, Hysterectomy for |enorrhagIa or FIbromyoma, HernIa,
Hydrocele, FIstula In anus, PIles, SInusItIs, CholetIthIasIs and Cholecystectomy, nter vertebral 0Isc
Prolapse (other than caused by an accIdent), DsteoarthrItIs, 7arIcose 7eIns / 7arIcose Ulcers etc.
O Naturopathy, acupuncture, magnetIc treatment, alternatIve medIcInes, etc
O Under the 8ase Plan, durIng the fIrst two contInuous years of the PolIcy, the expenses on treatment of
dIseases such as Fenal FaIlure, Heart 0Iseases, any type of CarcInoma/Sarcoma/8lood Cancer.
For a co2pIete IIst of excIusIons, refer to the poIIcy.
$asthya Kavach (Family Health) covers
O HospItalIsatIon
O PrehospItalIsatIon
O Post HospItalIsatIon.
O Emergency AssIstance ServIce
O Local Ambulance ServIce.
O CrItIcal llness extensIon (DptIonal)
O 8enefIts / rates gIven are IndIcatIve |axImum
O Entry Age: Proposer: 18 years to 60 Years and dependent chIldren: 91 days to 2J years (medIcal reports
requIred for age of 45 years and above
O Photographs of all Insured members compulsory
O Fates not nclusIve of ServIce Taxes.
O
SCTIDN 80 INCDh TAX NFITS:
PremIum upto Fs. 15,000 Is elIgIble for tax deductIons for self, spouse and dependant chIldren under SectIon 800
of ncome Tax Act, 1961.




















nLAL1n INSUkANCL
kA1ING CkI1LkIA
A Iam||y S|ze(Adu|t + ch||d)
1 SLar 1+1
2 1+2
3 2+1
4 2+2
3 2+3

8 ,ax|mum Age (Adu|t)
1 SLar Less Lhan 43 years
2 46 30 years
3 31 60 years
4 61 73 years
3 More Lhan 73 years

C ,ax|mum age ( ch||d)
1 SLar Less Lhan 18 years
2 18 20 years
3 20 23
4 23 23
3 More Lhan 23 years

D ,|n|mum Sum Assured
1 SLar 1000001 8s or more
2 300001 1000000 8s
3 200001 300000 8s
4 100001 200000 8s
3 20000 100000 8s

L ,ax|mum Sum Assured
1 SLar 10000 30000 8s
2 30001 100000 8s
3 100001 200000 8s
4 200001 300000 8s
3 300001 8s or more

I koom Charges(per day)
1 SLar none
2 1 20 of SA
3 21 30 of SA
4 31 80 of SA
3 80 100 of SA

G ICU Charges
1 SLar none
2 1 20 of SA
3 21 30 of SA
4 31 80 of SA
3 80 100 of SA

n 9re hosp|ta||zat|on
1 SLar noL covered/none
2 up Lo 10 days/upLo 10 of SA
3 upLo 30 days/11 31 of SA
4 upLo 60 days/31 80 of SA
3 More Lhan 60 days/ 81 100 of
SA

I 9ost hosp|ta||zat|on
1 SLar noL covered/none
2 up Lo 10 days/upLo 10 of SA
3 upLo 30 days/11 31 of SA
4 upLo 60 days/31 80 of SA
3 More Lhan 60 days/ 81 100 of
SA

I Cumu|at|ve bonus
1 SLar none
2 01 2
3 21 3
4 31 10
3 More Lhan 10

k Cpt|on for 4 c|a|m free years
1 SLar none
2 ulscounL ln nexL premlum
3 lree lamlly healLh check up upLo
1 of SA
4
3

L 9rem|um
1 SLar More Lhan 10000 8s
2 8301 10000 8s
3 3001 8300 8s
4 3301 3000 8s
3 1000 3300 8s

, Cr|t|ca| |||ness benef|t
1 SLar noL covered
2 Covered ln new pollcy
3 Covered wlLh 100 of premlum
4 Covered wlLh [usL paylng
premlum upLo 30 of exLra
premlum
3 Covered wlLh [usL paylng 10 49
of exLra premlum

CvL8 ALL
8A1lnC
1C1AL S1A8S
1 SLar 120
2 2130
3 3140
4 4130
3 3160 C8 MC8L


Analysls
Sno 8ASlS lllCC1CklC S1A8 PLAL1P 8LLlAnCL
1 lAMlL? SlZL
2 MAxlMuM ACL(AuuL1)
3 MAxlMuM ACL(CPlLu)
4 MlnlMuM SuM ASSu8Lu
3 MAxlMuM SuM ASSu8Lu
6 8CCM CPA8CLS
7 lCu CPA8CLS
8 8LPCSl1ALlSA1lCn
9 CS1PCSl1ALlSA1lCn
10 CuMuLA1lvL 8CnuS
11 C1lCn lC8 4CLAlM l8LL ?LA8
12 8LMluM
13 C8l1lCAL lLLnLSS
1C1AL 8A1lnC 4 Z SLar 3 Z SLar 4 Z sLar

Sno 8ASlS ACLC MunlCP 8PA81l AxA MAx 8uA
1 lAMlL? SlZL
2 MAxlMuM ACL(AuuL1)
3 MAxlMuM ACL(CPlLu)
4 MlnlMuM SuM ASSu8Lu
3 MAxlMuM SuM ASSu8Lu
6 8CCM CPA8CLS
7 lCu CPA8CLS
8 8LPCSl1ALlSA1lCn
9 CS1PCSl1ALlSA1lCn
10 CuMuLA1lvL 8CnuS
11 C1lCn lC8 4CLAlM l8LL ?LA8
12 8LMluM #
13 C8l1lCAL lLLnLSS
1C1AL 8A1lnC 4 sLar 4 sLar 3 sLar


llnulnCS
lL can be observed from Lhe above Lable LhaL ouL of 6 ma[or players ln healLh lnsurance secLor
IIICC1CkIC Swasthya kavach W|der 9|an W|th Cr|t|ca| |||ness and ke||ance nea|thW|se
9o||cy Go|d p|an goL 4 x star raLlng whlle healLh lnsurance pollcy of 8hart| AkA Smart
hea|th Cr|t|ca| |||ness Insurance 9o||cy and Apo||o ,un|ch Lasy nea|th 9rem|um plan goL 4
Starwhlle healLh lnsurance pollcy of Star hea|th's Star Iam||y nea|th Cpt|ma goL 3 x StarAnd
whlle healLh lnsurance pollcy of ,ax 8upa neart8eat Iam||y I|oater (s||ver)plan goL 3 star
Poweverlamlly Slze means how many person of a famlly are lncludlng ln Lhe healLh pollcy llke
how many adulLs and how many chlldren's are lncludlng ln famlly floaLer plan 8ellance
PealLhWlse ollcy Cold plan 8harLl AxA SmarL healLh CrlLlcal lllness lnsurance ollcy and Max
8upa PearL8eaL lamlly lloaLer (sllver) goL 4 sLar ln famlly slze lL means Lhese pollcy offer 2
adulLs and 2 chlldren ln pollcyWhlle oLher pollcy llke lllCC1CklC SwasLhya kavach Wlder lan
WlLh CrlLlcal lllness Apollo Munlch Lasy PealLh remlum SLar healLh's SLar lamlly PealLh
CpLlma goL 3 SLar whlch means Lhese pollcy offer 2adulLs and 3 chlldren ln healLh pollcy
PoweverMaxlmum age (AdulL) lL means LhaL aL maxlmum whaL age Lhe person ls able Lo Lake
Lhe healLh lnsurance pollcy from Lhe healLh lnsurance company llke some companles offer
maxlmum age llmlL Lo enLer healLh lnsurance pollcy ls 33 years whlle some oLher aL same Llme
offer 63 years and some offer no age llmlL Lo enLer healLh lnsurance pollcy 8ellance PealLhWlse
ollcy Cold plan 8harLl AxA SmarL healLh CrlLlcal lllness lnsurance ollcy lllCC1CklC
SwasLhya kavach Wlder lan WlLh CrlLlcal lllness Apollo Munlch Lasy PealLh remlum SLar
healLh's SLar lamlly PealLh CpLlma goL 3 sLar ln maxlmum age lL means Lhese pollcy offer 31
years 60 years Lo enLer lnLo Lhe healLh lnsurance pollcy of Lhese companleswhlle Max 8upa
PearL8eaL lamlly lloaLer (sllver) goL 3 SLar whlch means aperson of age even more Lhan 73
years can opL for healLh lnsurance
PoweverMaxlmum Age (Chlldren) lL means up Lo maxlmum of whaL age Lhe chlldren of a
famlly are lncluded ln Lhe healLh lnsurance pollcysome companles healLh lnsurance pollcy
cover up Lo 21 years or some pollcy cover up Lo 23 years 8ellance PealLh Wlse ollcy Cold plan
Apollo Munlch Lasy PealLh remlum goL 3 SLarlL means chlldren less Lhan 23 years are
lncluded ln Lhese pollcleswhlle lllCC1CklC SwasLhya kavach Wlder lan WlLh CrlLlcal lllness
SLar healLh's SLar lamlly PealLh CpLlma 8harLl AxA SmarL healLh CrlLlcal lllness lnsurance
ollcy goL 4 sLar whlch means LhaL chlldren of 23 years of age or more buL less Lhan 23 years of
age are lncludlng ln Lhese pollcyWhlle Max 8upa PearL8eaL lamlly lloaLer (sllver) goL 3 SLar
Whlch means Lhe chlldren greaLer Lhan or equal Lo 23 years of age are covered ln Lhls pollcy
Powever Mlnlmum Sum Assured means Lhls much amounL of sum assurance you have lf you
Lake healLh lnsurance under LhaL parLlcular pollcy lllCC1CklC SwasLhya kavach Wlder lan
WlLh CrlLlcal lllness Max 8upa PearL8eaL lamlly lloaLer (sllver) 8ellance PealLh Wlse ollcy
Cold plan goL 4 SLar whlch means mlnlmum amounL of sum assured ls ln beLween 8s 100001
8s 200000Whlle SLar healLh's SLar lamlly PealLh CpLlma 8harLl AxA SmarL healLh CrlLlcal
lllness lnsurance Apollo Munlch Lasy PealLh remlum goL 3 SLar whlch means mlnlmum
amounL of sum assurance ls ln beLween 8s 20000 8s 100000
Powever Maxlmum Sum assured means Lhls ls Lhe maxlmum llmlL up Lo whlch Lhe pollcy
holder can Lake Lhe beneflL of Lhe healLh lnsurance pollcy 8ellance PealLhWlse ollcy Cold
plan 8harLl AxA SmarL healLh CrlLlcal lllness lnsurance ollcy lllCC1CklC SwasLhya kavach
Wlder lan WlLh CrlLlcal lllness Apollo Munlch Lasy PealLh remlum SLar healLh's SLar lamlly
PealLh CpLlma goL 3 SLarWhlch means LhaL maxlmum llmlL of healLh lnsurance pollcy ls more
Lhan 8s 300000 Whlle Max 8upa PearL8eaL lamlly lloaLer (sllver) geL 3 SLar lL means LhaL
Lhe maxlmum llmlL of Lhls pollcy ls ln beLween 8s 100001 8s 200000
Powever 8oom Charges means up Lo whaL amounL or llmlL Lhe pollcy wlll cover Lhe room renL
charges lf Lhe person admlLs ln Lhe hosplLal lllCC1CklC SwasLhya kavach Wlder lan WlLh
CrlLlcal lllness 8harLl AxA SmarL healLh CrlLlcal lllness lnsurance ollcy Max 8upa PearL8eaL
lamlly lloaLer (sllver) goL 2 SLarwhlch means LhaL under Lhese pollcles Lhe room renL covered
ls up Lo 20 of sum assured Whlle Apollo Munlch Lasy PealLh remlum SLar healLh's SLar
lamlly PealLh CpLlma goL 3 SLarwhlch means LhaL under Lhese pollcles Lhe room renL covered
ls ln beLween 21 30 of sum assured Whlle 8ellance PealLhWlse ollcy Cold plan geL 3
SLar means LhaL under Lhese pollcles Lhe room renL covered ls ln beLween 80 100 of sum
assured
PoweverlCu Charges means up Lo whaL llmlL lCu Charges ln hosplLal are covered under healLh
lnsurance pollcy lf Lhe person admlLs ln hosplLal lllCC1CklC SwasLhya kavach Wlder lan
WlLh CrlLlcal lllness 8harLl AxA SmarL healLh CrlLlcal lllness lnsurance ollcy Apollo Munlch
Lasy PealLh remlum goL 2 SLar whlch means LhaL under Lhese pollcles Lhe lCu charges
covered ls up Lo 20 of sum assuredWhlle Max 8upa PearL8eaL lamlly lloaLer (sllver) SLar
healLh's SLar lamlly PealLh CpLlma Lhese pollcy cover lCu charges buL llmlL ls noL
avallableWhlle 8ellance PealLhWlse ollcy Cold plan geL 3 SLar means LhaL under Lhese
pollcles Lhe lCu charges covered ls ln beLween 80 100 of sum assured
Poweverre hosplLallzaLlon charges lL means how much amounL or days are covered under
pollcy before hosplLallzaLlon of person lllCC1CklC SwasLhya kavach Wlder lan WlLh CrlLlcal
lllness Max 8upa PearL8eaL lamlly lloaLer (sllver) SLar healLh's SLar lamlly PealLh CpLlma
Apollo Munlch Lasy PealLh remlum goL 3 SLar Whlch means LhaL per hosplLallzaLlon expenses
maxlmum upLo 30 days or 11 31 of Sum Assured ls covered under Lhese pollcyWhlle
8ellance PealLhWlse ollcy Cold 8harLl AxA SmarL healLh CrlLlcal lllness lnsurance ollcy goL 3
sLar Whlch means LhaL per hosplLallzaLlon expenses of more Lhan 60 days/ 81 100 of Sum
Assured ls covered under Lhese pollcy
PoweverosL hosplLallzaLlon means lL means how much amounL or days are covered under
pollcy afLer comlng from hosplLal SLar healLh's SLar lamlly PealLh CpLlma goL 2 SLar Whlch
means posL hosplLallzaLlon expenses maxlmum up Lo 10 days or up Lo 10 of Sum Assured ls
covered under Lhls pollcyWhlle lllCC1CklC SwasLhya kavach Wlder lan WlLh CrlLlcal lllness
Max 8upa PearL8eaL lamlly lloaLer (sllver) Apollo Munlch Lasy PealLh remlum goL 4 SLar
Whlch means posL hosplLallzaLlon expenses maxlmum up Lo 60 days/31 80 of Sum
Assured ls covered under Lhls pollcy Whlle 8ellance PealLhWlse ollcy Cold 8harLl AxA SmarL
healLh CrlLlcal lllness lnsurance ollcy goL 3 sLar Whlch means LhaL posL hosplLallzaLlon
expenses of more Lhan 60 days/ 81 100 of Sum Assured ls covered under Lhese pollcy
PoweverCumulaLlve bonus means pollcy holder wlll be provlded wlLh some exLra sum lnsured
for every clalms free year lllCC1CklC SwasLhya kavach Wlder lan WlLh CrlLlcal lllness
8ellance PealLhWlse ollcy Cold 8harLl AxA SmarL healLh CrlLlcal lllness lnsurance ollcy goL 3
SLar whlch maens pollcy holder wlll be provlded wlLh 21 3 exLra Sum Assured for every
clalm free yearWhlle Apollo Munlch Lasy PealLh remlum SLar healLh's SLar lamlly PealLh
CpLlma Max 8upa PearL8eaL lamlly lloaLer (sllver) goL 4 SLar whlch maens pollcy holder wlll
be provlded wlLh 31 10 exLra Sum Assured for every clalm free year
PoweverCpLlon lf Lhe pollcy ls clalm free for four or more years SLar healLh's SLar lamlly
PealLh CpLlma Max 8upa PearL8eaL lamlly lloaLer (sllver) Lhese pollcy wlll noL glve any
beneflL Lo lLs pollcy holder even lf Lhe pollcy ls clalm free for four or more yearswhlle lllCC
1CklC SwasLhya kavach Wlder lan WlLh CrlLlcal lllness 8ellance PealLhWlse ollcy Cold 8harLl
AxA SmarL healLh CrlLlcal lllness lnsurance ollcy Apollo Munlch Lasy PealLh remlum Lhese
pollcy goL 3 SLar lL means LhaL lf Lhe pollcy ls clalm free for four or more year Lhan Lhe company
wlll provlde free famlly healLh check up upLo 1 of Sum Assured
Poweverremlum amounL lL means Lhe amounL Lhe person need Lo pay ln sLarLlng Lo geL Lhe
pollcy and premlum ln only for one year and afLer one year new premlum ls need Lo payhere
we calculaLe Lhe remlum( 2 adulLs aL 34 years+ 2 chlldren ) 8s 2 lakh Sun lnsured 8harLl AxA
SmarL healLh CrlLlcal lllness lnsurance ollcy premlum charL of Lhls pollcy ls unavallable
8ellance PealLhWlse ollcy Cold goL 1 SLar lL means LhaL premlum amounL ls more Lhan 8s
10000Whlle Max 8upa PearL8eaL lamlly lloaLer (sllver) goL 2 SLar whlch means LhaL
premlum amounL ls ln beLween 8s 8301 8s 10000whlle Apollo Munlch Lasy PealLh remlum
goL 3 SLar whlch means LhaL premlum amounL ls ln beLween 8s 3001 8s 8300whlle lllCC
1CklC SwasLhya kavach Wlder lan WlLh CrlLlcal lllness SLar healLh's SLar lamlly PealLh
CpLlma goL 3 SLar whlch means LhaL premlum amounL ls ln beLween 8s 1000 8s 3300
Powever CrlLlcal lllness beneflL means