Provides a fixed amount for each continuous and completed period of 24 hours that the Insured Person is Hospitalized due to an accidental bodily injury or illness first occurring or manifesting during the policy period.
We will pay the amount as specified in the schedule as Hospital Daily Cash, for each continuous and completed period of 24 hours, up to the benefit period per year, that the Insured Person is Hospitalised during the policy period due to an illness or accidental bodily injury.
In case of each continuous and completed period of 24 hours of hospitalization within the Intensive Care Unit (ICU), We will pay twice the benefit amount as specified in the schedule as Hospital Daily Cash.
Other Benefits -
Day Care Surgeries – We will pay the One day Daily Cash benefit as mentioned in the schedule, for the Day care surgeries as listed in Annexure – “List of Day Care Procedures” of the policy document.
Modern Treatment Methods and Advancement in Technologies - We will pay the Daily cash benefit for each day of hospitalization or One day Daily Cash benefit (depending upon the nature of procedure), up to the benefit period specified in the policy schedule, during the policy period for the following procedures (wherever medically indicated):
Note: The benefit period as specified in the policy schedule is cumulative of all hospitalizations, whether single or multiple, occurring in each policy year.
We will not pay for any claim caused by, based on, arising out of or attributable to any of the following:
Refractive Error: Any claim if the hospitalization relates to treatment for correction of eyesight due to refractive error less than 7.5 dioptres.
Any claim of hospitalization for Dental treatment or other dental examination and/or tests not incidental to the treatment or diagnosis of an injury, sickness or disease.
Sterility and Infertility – Any claim for hospitalization relating to sterility and infertility. This includes:
Any type of contraception, sterilization
Assisted Reproduction services including artificial insemination and advanced reproductive technologies such as IVF, ZIFT, GIFT, ICSI
Gestational Surrogacy
Reversal of sterilization
Maternity -Any claim for hospitalisation relating to -
Sleep disorder, Parkinson and Alzheimer’s disease, general debility or exhaustion (“run-down condition”); or growth hormone therapy.
Venereal disease, sexually transmitted disease or illness except for HIV/AIDS.
Change of Gender – Any claim relating to hospitalization of treatment, including surgical management, to change characteristics of the body to those of the opposite sex.
Circumcisions unless required as a part of treatment of an illness or injury.
Intentional self-injury, suicide or attempted suicide.
War (whether declared or not) and war like occurrence or invasion, acts of foreign enemies, hostilities, civil war, rebellion, revolutions, insurrections, mutiny, military or usurped power, seizure, capture, arrest, restraints and detainment of all kinds.
Nuclear, chemical or biological attack or weapons, contributed to, caused by, resulting from or from any other cause or event contributing concurrently or in any other sequence to the loss, claim or expense.
Breach of Law – Any claim for hospitalisation if treatment arises from or is consequent upon You/ any insured person committing or attempting to commit a breach of law with criminal intent.
Treatment of alcoholism, drug or substance abuse or any addictive condition and consequences thereof.
Hazardous or Adventure Sports: Any claim if the hospitalisation is 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.
Participation in a naval, military, air force or law enforcement operation.
Any sporting risk in so far as they involve, the training or participation in competitions of professional or semi-professional sportsmen or women or riding or driving in any form of race or competition.
Unproven Treatments – Any claim for hospitalisation relating 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.
Investigation, Prevention & Evaluation - Any claim if admission in hospital is primarily for diagnostics, preventive and evaluation purposes which are not related or not incidental to the current diagnosis and treatment.
Narcotics used by the Insured Person unless taken as prescribed by a registered Medical Practitioner.
Any external congenital anomaly or external birth defects.
IFFCO-Tokio may cancel the policy on grounds of fraud, moral hazard or misrepresentation or non-cooperation by the Policy holder by sending 15 (fifteen) days’ notice under recorded delivery to the Policy holder at his/her last known address and in such event, IFFCO-Tokio will return to the Policy holder, except in case of fraud or illegality on Policy holder’s part, the premium paid less the pro rata portion thereof for the period the Policy has been in force.