Canara Bank Health Insurance

Introduction of Canara Bank Health Insurance

Canara Bank is offering new health insurance policies after Syndicate Bank has discontinued the Synd Arogya healthcare policy and offering another similar policy with Bajaj Allianz and Apollo Munich insurance company. Though the features of the new healthcare policies are similar to earlier Synd Arogya Policy which was offered in association with M/S United India Insurance Company Limited (UIICO) but comparatively at a higher premium.

General Features of Canara Bank Health Insurance

1. Option to cover yourself against heart problems, Cancer,, or major critical illness.

2. High coverages at affordable premiums.

3. Increased cover option for increasing medical needs.

4. Lump sum payout on the first diagnosis of illness irrespective of the actual amount spent on treatment.

5. Waiver of all future premiums on first diagnose of minor conditions covered under Cancer cover and Heart cover.

6. Option of additional monthly income in case of a major claim(Heart and Cancer cover) & major critical illness cover.

7. Age eligibility is 18 – 65 years(entry age) & 23 – 80 years(maturity age).

Benefits of Canara Bank Health Insurance

Lump sum payout on diagnosis

This plan provides a lump-sum payout on the first diagnosis of a covered illness, irrespective of the actual amount spent on treatment to help you recover without any financial stress.

Major illness coverage by Canara Bank Health Insurance

This option offers cover against 26 Major Critical Illnesses. Major or Critical illness causes a huge burden on you and your family due to not only the medical expenses but also the leave you may take from work. To protect against the financial burden, Canara Bank Health insurance schemes will pay you the applicable sum assured as a lump sum to meet your financial needs.

The benefit is payable irrespective of the actual expenses incurred by you. This product provides a lump-sum equal to the applicable sum assured on the first diagnosis of a major critical illness or undergoes the first performance of any of the listed surgeries about a major critical illness. On the payment of the applicable sum assured, coverage will terminate immediately.

Heart and Cancer cover

The scheme offers comprehensive cover for Heart and Cancer-related issues. You can choose the cover depending on the need at inception. The benefits payable under Heart or Cancer cover(as applicable) will be paid as a lump sum upon the first diagnosis of any of the covered illnesses/first performance of any of the covered surgeries(as listed below).

The payout depends on the severity of the diagnosed condition(Major/Minor) and claims previously admitted under this policy. The maximum claim payable in this policy shall not exceed 100% of the applicable sum assured.

  • Minor issue – 25% of applicable sum assured for Cancer and heart cover.
  • Major issue after minor condition claim – 75% of applicable sum assured of Cancer and heart cover.
  • Major issue without occurrence of minor condition claim – 100% of applicable sum assured of Cancer and heart cover.

Premium waiver

In Heart and Cancer cover the plan continues even after the first pay-out for a Minor condition claim is made, without having to pay any future premiums for the applicable coverage under which the claim is made.

Increase cover

You have the option to take increasing cover under all the three plan options(Major critical illness cover, Heart cover, Cancer cover) at the proposal stage. Increasing the Cover option helps to take care of growing medical expenses.

Under this option, the initial sum assured increases by 10%(simple rate) every year starting from the first policy anniversary, until the first claim is made. The sum assured can go up to a maximum of 150% of the initial sum assured.

Monthly income benefit

The plan gives you an additional benefit of 1% of the initial sum assured every month for 5 years(60 months) following the date of diagnosis of a Major Heart/Cancer condition/Major critical illness(as applicable), it helps you to deal with the loss of income. This monthly income payment is over and above the lump-sum payment made on the diagnosis of the illness/condition, and continues to be paid to your Nominee for the total defined period of 5 years, even in case of your unfortunate death.

The Nominee can also request for commuting the remaining monthly installments into lump sum within six months of the death of the Life Assured.

Maturity

The Policy does not provide any maturity benefit under the Heart or Cancer cover. In the case of Major critical illness cover, there is an option to take the Return of premium option(available with policy term 10-20 years), which provides maturity benefit.

Return of premium

This benefit ensures that your premiums come back to you at the end of the policy term(if no claim is made) to take care of ongoing health/medical expenses. Upon survival of the life assured till the end of the policy term without any claim, while the policy is in force, the Company will pay back total premiums paid(excluding underwriting extra premiums if any) during the policy term as a maturity benefit.

Features offered by Bajaj Allianz Health Insurance

  • Sum Insured options – Rs. 50,000/1/1.5/2/2.5/3/3.5/4/4.5/5 Lakhs.
  • Plan type – Floater.
  • Family definition – Self/Spouse/Dependent Children/Dependent Parents or Parents-in-law.
  • Entry Age eligibility – 18-65 years(adult) and 91-25 years(child).
  • Renewal Age eligibility – Lifetime.
  • Day care procedures – 182 Daycare procedures covered.
  • Pre hospitalization – 60 Days.
  • Post hospitalization – 90 Days.
  • Ambulance expenses – Up to Rs. 1000 per policy period.
  • Health CHECK-UP – 1% of Sum Insured after 3 Claim-free years.
  • Daily cash allowance – Only for single parent/Guardian accompanying an insured child below the age of 12 years.
  • Maternity expenses – Up to 5% of Base Sum Insured.
  • New born baby cover – Covered as part of Maternity Expense.
  • Funeral expense – Up to Rs. 1000 per policy period.
  • PED waiting period – 36 months.
  • Specific diseases waiting period – 24 months.
  • Maternity waiting period – 9 months – 30 days.

Eligibility

  • Customers of Bank(Self), lawfully wedded spouse, up to four dependent children, and either set of dependent parents or parents-in-law.
  • Entry age for Self Insured Person, Spouse and Dependent Parents/Parents in law are 18 years – 65 years.
  • Entry age for a dependent child is 91 days – 25 years.

Coverages

Inpatient hospitalization treatment

If you are hospitalized on the advice of a medical practitioner as defined under the policy because of illness or accidental bodily injury sustained or contracted during the policy period. Reasonable and customary medical expenses incurred as per the below list.

1. Room rent, ICU, and Boarding expenses as provided by the hospital up to the policy limit.

2. Nursing expenses as provided by the hospital.

3. Fees of Surgeon, Anesthetist, Medical Practitioner, Consultants, and Specialist doctors.

4. Operation Theatre charges, Anesthesia, Blood, Oxygen, surgical appliances, medicines & drugs, Dialysis, Chemotherapy, Radiotherapy, Cost of artificial limbs, cost of prosthetic devices implanted during surgical procedure like Pacemaker, orthopedic implants, infra cardiac valve replacements, vascular stents, relevant laboratory diagnostic tests, X-ray and such similar expenses that are medically necessary.

Pre hospitalization

Medical expenses for consultations, investigations, and medicines incurred up to 60 days before the date of admission to the Hospital. This is applicable for both In-patient and daycare treatment.

Other optional coverages

  • Cancer of specified severity.
  • First heart attack with specific severity.
  • Stroke resulting permanent symptoms.
  • Major organ transplant.
  • Kidney failure and require dialysis.
  • Coma with specified severity.
  • Permanent paralysis.
  • Major head trauma.

Exclusions

1. Any dental treatment that comprises of cosmetic surgery, dentures, dental prosthesis, dental implants, orthodontics, surgery of any kind unless as a result of Accidental Bodily Injury to natural teeth and also requiring hospitalization.

2. Medical expenses where Inpatient care is not warranted and does not require supervision of qualified nursing staff and qualified medical practitioners round the clock.

3. 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 nationalization or requisition of or damage by or under the order of any government or public local authority.
Any medical expenses incurred due to the Act of Terrorism will be covered under the Policy.

4. Expenses related to any admission primarily for diagnostics and evaluation purposes only are excluded even if the same requires confinement at a hospital.

5 Expenses related to any admission primarily for enforced bed rest and not for receiving treatment like custodial care either at home or in a nursing facility for personal care such as help with activities of daily living such as bathing, dressing, moving around, etc.

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6. Any diagnostic expenses which are not related or not incidental to the current diagnosis and treatment are excluded.

7. Expenses related to any treatment, including surgical management, to change characteristics of the body to those of the opposite sex.

8. Expenses for cosmetic or plastic surgery or any treatment to change appearance unless for reconstruction following an Accident, Burn(s), or Cancer or as part of the medically necessary treatment to remove a direct and immediate health risk to the insured. For this to be considered a medical necessity, it must be certified by the attending Medical Practitioner.

9. Expenses related to any treatment necessitated due to participation as a professional in hazardous or adventure sports, including but not limited to, para-jumping, rock climbing, mountaineering, rafting, motor racing, horse racing, or scuba diving, hand gliding, sky diving, deep-sea diving, etc.

10. Expenses related to the treatment for correction of eyesight due to refractive error less than 7.5 dioptres.

11. Intentional self-injury(including but not limited to the use or misuse of any intoxicating drugs or alcohol).

12. Expenses towards miscarriage(unless due to an accident) and lawful medical termination of pregnancy during the policy period.

13. Expenses related to any unproven treatment, services, and supplies for or in connection with any treatment. Unproven treatments are treatments, procedures, or supplies that lack significant medical documentation to support their effectiveness.

14. Any treatment received outside India is not covered under this Policy.

15. Treatment at a healthcare facility that is not a Hospital.

Premium Payment Rate Chart for Bajaj Allianz Health Insurance Policy

1+3(Self+spouse+2 dependent children) GST Included (Rs. per year)

Sum InsuredPremiums
50,000.003,859.00
1,00,000.007,458.00
1,50,000.0010,932.00
2,00,000.0014,075.00
2,50,000.0016,827.00
3,00,000.0019,675.00
3,50,000.0022,130.00
4,00,000.0024,594.00
4,50,000.0027,061.00
5,00,000.0029,522.00

1+5(Self+spouse+2 dependent children and parents/Parents-in-law) GST Included (Rs. per year)

Sum Insured Premiums
50,000.006,442.00
1,00,000.0012,451.00
1,50,000.0018,237.00
2,00,000.0023,465.00
2,50,000.0028,115.00
3,00,000.0032,767.00
3,50,000.0036,849.00
4,00,000.0040,933.00
4,50,000.0045,019.00
5,00,000.0049,103.00

Claim process

All claims will be settled by In house claims settlement team of the company and no third person or agent is engaged. If You meet with any accidental bodily injury or suffer an illness that may result in a claim, then as a condition precedent to policy liability, You must comply with the following.

Cashless claim

1. Before taking treatment and/or incurring medical expenses at a network hospital, You must call and request pre-authorization by way of the written form.

2. In case of planned hospitalization, You/the insured representative shall intimate such admission within 48 hours of such hospitalization.

3. In case of Emergency hospitalization, You/the insured representative shall intimate such admission within 24 hours of such hospitalization.

4. On receipt of your pre-authorization form duly filled and signed by you, the insurer representative will respond to the approval/rejection of any information within 2 hours.

5. After considering Your request and obtaining further information or documentation, the insurer will proceed(if satisfied) and send an authorization letter to you or the network hospital. You need to produce the authorization letter, the ID card issued to you along with the policy and other information or documentation(if any).

6. If the procedure is followed, You will not require to pay for the bill amount directly in the network hospital. The insurer will be liable under In-Patient hospitalization treatment. Pre-authorisation does not guarantee that all costs and expenses will be covered as the insurer reserve the right to review each claim for medical expenses and the coverage will be determined accordingly to the terms and conditions of this Policy.

Reimbursement claim

1. You or someone claiming on Your behalf must inform the insurer in writing immediately within 48 hours of hospitalization in case of emergency or planned hospitalization.

2. You must immediately consult a doctor and follow the advice and treatment that he recommends.

3. You must take reasonable steps or measures to minimize the quantum of any claim that may be made under this Policy.

4. You must have yourself examined by the insurer’s medical advisors if asked.

5. You/insured representative must inform within 30 days of discharge from a hospital.

6. In the event of the death of the insured person, someone claiming on his behalf must inform in writing immediately and send a copy of the post mortem report(if any) within 30 days to the insurer.

7. If the original documents are submitted with the co-insurer, the Xerox copies attested by the co-insurer should be submitted.

Required documents for the claim process

  • Duly completed Claim form with NEFT details & canceled cheque duly signed by Insured.
  • Original/Attested copies of Discharge Summary/Discharge Certificate/Death Summary with Surgical & anesthetics notes.
  • Attested copies of Indoor case papers(Optional).
  • Original/Attested copies of final hospital bill with the breakup of surgical charges, surgeon’s fees, OT charges, etc.
  • Original paid receipt against the final Hospital Bill.
  • Original bills towards Investigations done/Laboratory Bills.
  • Original/Attested copies of Investigation Reports against Investigations done.
  • Original bills and receipts paid for the transportation from the registered ambulance service provider. Treating doctor certificate to transfer the Injured person to a higher medical center for further treatment(if Applicable).
  • Cashless settlement letter or other company settlement letter.
  • First consultation letter for the current ailment.
  • In cases where fraud is suspected, the insurer may call for any additional document(s) in addition to the documents listed above.

Features offered by Apollo Munich Health Insurance

Coverages

  • In patient treatment.
  • Pre and post hospitalization.
  • Day care procedures.
  • Coverage for organ transplant.
  • Emergency ambulance upto Rs. 2,000 per hospitalization.
  • Domiciliary expenses upto the sum insured.
  • Daily cash of Rs. 500 for twin sharing accommodation/for accompanying insured child.
  • Annual health check-up upto Rs. 1,500(For Sum Insured of Rs. 1 lac), Rs. 2,000(For Sum Insured of Rs. 2 lacs), Rs. 2,500(For Sum Insured of Rs. 5 lacs), Rs. 3,000(For Sum Insured of Rs. 7.5 lacs) and Rs. 3,500(For Sum Insured of Rs. 10 lacs).

Offered value-added services

  • This scheme offers you a range of value added services to ensure your well being, prevent illness as well as make hospitalization hassle free.
  • Cashless hospitalization/Healthline access/access to a personalised wellness portal/exciting offers at pharmacies and diagnostic centers.

Special features of Apollo Munich Health Insurance

1. No pre-policy check-up.

2. Single premium rate across ages.

3. No Sub-limit on hospital room rent.

4. No Co-payment.

5. Group personal accident cover – Cover equivalent to base health sum insured for each insured member under the individual plan and a primary insured member under the family floater plan.

6. Optional critical illness cover – Additional indemnity cover of Rs. 50,000 for defined critical illnesses.

Sum Insured

You can choose from Sum Insured options of Rs. 100,000, Rs. 200,000, Rs. 500,000, Rs. 750,000 and Rs. 10,00,000.

Premium chart

premium chart

Duration

The proposed duration of the cover will be 12 months for every insured member in the group.

Eligibility

  • This plan will offer cover to person from the age of 5 years onwards. The maximum entry age is restricted upto 69 years with no maximum cover ceasing age.
  • Dependent children between 91 days and 25 years can be insured.
  • A dependent child between 91 days and 5 years can be covered if either parent is covered in this policy.

Tax benefits

With this plan,n you can avail of tax benefits for the premium amount under Section 80D of the Income Tax Act, 1961.

Exclusions

  • Any treatment within first 30 days of cover except any accidental injury.
  • Any Pre-existing diseases/conditions will be covered after a waiting period of 3 years if the risk is accepted.
  • 1 year exclusion for specific diseases like cataract, hernia, hysterectomy, joint replacement etc.
  • Expenses arising from HIV or AIDS and related diseases.
  • Abuse of intoxicant or hallucogenic substance like drugs and alcohol.
  • Pregnancy, dental treatment, external aids and appliances.
  • Hospitalization due to war or an act of war or due to nuclear, chemical or biological weapon and radiation of any kind.
  • Congenital diseases, mental disorder, cosmetic surgery or weight control treatments.

Contact of Canara Bank Health Insurance

Canara Bank

Address – Unit no. 208, 2nd floor, Orchid Business Park, Sector 48, Sohna Rd, Gurugram, Haryana – 122018.

Call (Toll-free) – 1800 425 0018 / 1800 103 0018

E-mail – [email protected] Or [email protected]

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