Aditya Birla Health - Group Protect

This Policy has been issued on the basis of the Disclosure to Information Norm, including the information provided by You in respect of the Insured Persons in the Proposal Form, any application for insurance cover in respect of any Insured Person and any other information or details submitted in relation to the proposal form / enrolment form. This Policy is a contract of insurance between You and Us which is subject to receipt of premium in full and accepted by Us in respect of the Insured Persons and the terms, conditions and exclusions as specified in the Policy Schedule / Certificate of Insurance / Product Benefit Table of this Policy. The terms listed in Section VII (Definitions) and which have been used elsewhere in the Policy shall have the meaning set out against them in Section VII (Definitions), wherever they appear in the Policy. The Policyholder prior to inception of the Policy can propose to cover any of the Policy Benefit or combination of Policy Benefits as specified in Product Benefit Table of this Policy, as per requirement of the group, subject to acceptance by Us. The Policy Schedule / Certificate of Insurance of this Policy shall specify which of the following covers are in force and available for the Insured Persons under the Policy during the Policy Period.

1. OPD Expenses
(a) Doctor Consultation
(b) Diagnostic Tests
(c) Pharmacy Expenses
2. Cancer Secure Cover
(a) Early Stage Cancer
(b) Major Stage Cancer
3. Income Protect
4. Preferred Provider Network
5. Heart Secure Cover

The Free Look Period shall be applicable on new individual health insurance policies and not on renewals or at the time of porting/migrating the policy. The insured person shall be allowed free look period of fifteen days (30 days in case of contracts with a term of 3 years, offered over distance marketing mode) from date of receipt of the policy document to review the terms and conditions of the policy, and to return the same if not acceptable.
lf the insured has not made any claim during the Free Look Period, the insured shall be entitled to
i. a refund of the premium paid less any expenses incurred by the Company on medical examination of the insured person and the stamp duty charges or
ii. where the risk has already commenced and the option of return of the policy is exercised by the insured person, a deduction towards the proportionate risk premium for period of cover or
iii. Where only a part of the insurance coverage has commenced, such proportionate premium commensurate with the insurance coverage during such period

i. ln the likelihood of this product being withdrawn in future, the Company will intimate the insured person about the same 90 days prior to expiry of the policy.
ii. lnsured Person will have the option to migrate to similar health insurance product available with the Company at the time of renewal with all the accrued continuity benefits such as cumulative bonus, waiver of waiting period. as per IRDAI guidelines, provided the policy has been maintained without a break.

You or anyone on behalf of the Insured Person(s) shall intimate a claim to Us within 7 days from the date of the Accident or diagnosis of the covered Illness or admission in the Hospital (as the case may be) by any of the following means
- Call centre
- Email
- Fax
- Writing to Our office address
The following minimum details are required to be provided at the time of intimation of claim:
1. The Policy number;
2. Name of the Policyholder;
3. Name and address of the Insured Person in respect of whom the request is being made
4. Details of Benefits to be claimed needs to be added (e.g. date of loss, nature of loss, etc.)