Future Generali - FG Dog Health Cover

About Plan

Whereas the Insured named in the Schedule has made to Future Generali India Insurance Company Limited (hereinafter called the Company), a proposal which together with any other statements made by the Insured in writing, is hereby agreed shall be the basis of this Policy and is incorporated herein, and the Company has received the premium specified in the Schedule in full, now the Company agrees, subject always to the terms, conditions, exclusions, and limitations contained herein, to pay the stated sums, or indemnify the Insured in excess of the amount of the Deductible or Co-Pay and subject always to the Sums Insured for different coverages, as incurred by the Insured in respect of the Insured Dog during the Policy Period, as is herein provided.

Claims made in respect of the Insured under this Policy shall be made in accordance with the procedures set out in this Policy, and remain subject to the terms, conditions, and exclusions of this Policy.

The Policy, the Schedule and any endorsements shall be read together, and any word or expression to which a specific meaning has been ascribed in any part of this Policy shall bear such meaning wherever it may appear.

Coverage

The benefits under the Policy shall be in accordance with the terms and conditions below, and Claim amounts under the Policy shall always be subject to Sum Insured specified against each benefit in the Schedule, unless otherwise specified herein below:

1) Funeral Cost Cover

2) Terminal Illness Cover

3) Surgery and Hospitalization

4) Death Cover

Sum Assured Details

Sum Insured: The Sum Insured under the Policy shall be decided by the Company, on the basis of the health evaluation cum valuation certificate duly issued by a Veterinary Doctor which forms a part of the Proposal, and shall be as specified in the Schedule.

Grace Period

Grace Period means the specified period of time immediately following the premium due date during which premium payment can be made to renew or continue a Policy in force without loss of continuity benefits such as Waiting Periods and coverage of Pre-existing Diseases. Coverage under the Policy is not available for the period for which no premium is received by the Company.

Revival charges

Renewal Notice: The Company shall not be bound to accept any renewal premium or to give notice that such is due. Unless renewed as herein provided, this Policy shall terminate at the expiration of the Policy Period specified in the Schedule for which the premium has been received in full.

General Exclusions

The Company shall not be liable to make any payment for any Claim under the Policy, directly or indirectly for, caused by, arising from or in any way attributable to any of the following:

1. Accidents occurring and/or disease/Illness contracted prior to commencement of risk under this Policy. This exclusion is not applicable for the Policies renewed in continuity.

2. Any Claims for diseases for which preventive medicines/vaccines has not been taken.

3. Any excess amount as shown on the Schedule against each benefit in force under the Policy.

4. Any Claims for costs or fees for Experimental Surgery/Procedures.

5. Any Claims for costs incurred on alternate treatments.

6. Any Claim for treatment of disease or Injury due to an Accident to Working Dogs and Volunteer Dogs.

7. Any loss or damage caused wilfully or knowingly by the Insured, or any loss or damage in which the Insured or any person acting on his/her behalf, is involved or implicated.

8. Any consequential loss, how so ever arising.

9. Any Claims for a dog not identified and identified in the Schedule.

10. Any Claims arising outside the territorial limits of India.

11. The confiscation or destruction of Insured Dog by Government or public authorities, or under applicable laws.

12. The Insured breaking any laws, or regulations, including those relating to animal health or importation.13. Any medication or treatment not recommended by a Vet.

14. Where fraud or mis-representation has been committed against the Company or where false information has been provided to the Company.

15. Any loss where the Insured is entitled to indemnity under insurance cover under any other insurance policy

16. If the Insured Dog is sold or where any financial interest whatsoever is parted with by the Insured, whether temporarily or permanently.

17. Any endemic disease as declared by the Indian local authorities or State or Central Government.

18. Any Illness that Insured Dog contracted while outside the territorial limits of India that it would not normally have contracted in India.

19. Legal Expenses, fines and penalties connected with, or resulting from, a criminal case or an act of Parliament made in India.

20. Any Claim for treatment of a third party as a result of the disease transmitted from animals to humans.

21. Malicious or wilful Injury or neglect, or gross negligence to Insured Dog caused by the Insured, his/her agent, employees or members of Insured
s Family and unskilful medical treatment.

22. Any Claim in respect of a dog, categorized as dangerous dogs by State or Central government authority.

23. Any charges or fees billed by the treating Vet to complete a Claim form or to provide information to support the Insured
s Claim.

24. 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, riot, strike, or Terrorism.

25. Ionising radiation or contamination by radioactivity from any nuclear fuel or from any nuclear waste or nuclear weapons material or from the combustion of nuclear fuel, or the radioactive toxic explosive or other hazardous properties of any explosive nuclear assembly or nuclear component thereof.

26. Any cost directly or indirectly arising or resulting from, or contributed to or by chemical, biological, biochemical or electromagnetic weapon, device, agent or material, whether controlled or uncontrolled, accidental or otherwise;

28. Treatment to the teeth and gums of the Insured Dog is excluded except which is as a direct result of an Injury caused by an Accident to the Insured Dog.

29. Costs resulting from an Accident, Injury or Illness that first showed clinical signs and symptoms before the date of commencement of the Policy.30. Costs resulting from an Illness that first showed clinical signs and symptoms during the Waiting Period.

31. Costs resulting from an Accident, Injury or Illness that:

i. is the same as or has the same diagnosis or clinical signs and symptoms as an Accident, Injury or Illness of the Insured Dog before the date of commencement of the Policy;

ii. is caused by, relates to or results from an Accident, Injury, Illness or clinical signs and symptoms existent before the date of commencement of the Policy.

Claim Service

"Claim
means a claim for Illness and or Bodily Injury/Injury, under an Operative Part of the Policy Schedule read with these Terms and Conditions. All Claims resulting from or relating to one and the same event or circumstance shall jointly constitute one Claim under this Policy and as having been made at the time when the first Claim was made in writing.

CLAIMS PROCESS:

1. Our aim is to provide fast and efficient claims service to ensure payment to You of any valid claim as quickly as possible. To help Us achieve this please read this section carefully, note the information We require for each type of claim and send Your Claim to Us promptly. To download a claim form, please visit our website or connect to our customer care.

2. You will send any notice, letter, intimation or communication in writing to Us at Our branch office where You purchased this Policy. You can also send it at the address mentioned in the Policy Schedule.

3. We do not pay the cost charged by a Vet to fill or provide a prescription.

4. Always quote the Policy number printed on your Schedule every time You contact Us.

5. The Company shall disclaim liability to the Insured for any Claim hereunder and if such Claim shall not within 12 calendar months from the date of such disclaimer have been made the subject
matter of a suit in a court of law then the Claim shall for all purposes be deemed to have been abandoned and shall not hereafter recoverable hereunder.

6. On receipt of all required information/ documents that are relevant and necessary for the Claim, the Company shall, within a period of 30 days offer a settlement of the Claim to the Insured. If the Company, for any reasons, decides to reject a Claim under the Policy, it shall do so within a period of 30 days from the receipt of last relevant and necessary document. In the event the Claim is not settled within 30 days as stipulated above, the Company shall be liable to pay interest at a rate, which is 2% above the bank rate from the date of receipt of last relevant and necessary document from the Insured/Claimant till the date of actual payment.

7. List of Documents required at the time of Policy issuance are:

o Duly filled Proposal Form

o Color Photos from all sides

o Self-declaration on vaccinations conducted on time & declaration for insurable interest

8. Unless otherwise communicated by Company, following basic documents will be necessary for processing of a Claim under this Policy -

o Duly completed claim form

o Vaccination Certificates

o Death Certificate along with colored photographs of the Insured Dog (in case of Claim under Death Cover)

o Vet Medical Papers and Bill (in case of Claims under Surgery & Hospitalisation, Death Cover), Copy of General Diary Entry lodged by Police (in case of Claim under Lost and Stolen Cover)

o FIR (in case of Claim under Third Party Liability Cover)

o Copy of advertisement (in case of Claim under Lost and Stolen Cover)

o Hospitalization bill (in case of Claim under Surgery & Hospitalization Cover)

o Court Orders (in case of Claim under Third Party Liability Cover)

o Diagnostics Report (in case of Claim under Terminal Illness Cover, and Veterinary Consultation and Doctor On Call Cover)

o Any other documents if required by the Company to process the Claim

o Hospital bills of the Policyholder for Emergency Pet Minding Cover and self-declaration on non-availability of Family members.

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Frequently Asked Questions About Insurance

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What is health insurance? +

Health insurance is a type of coverage that pays for medical and surgical expenses incurred by the insured. It may also provide coverage for other types of health-related costs, such as prescription drugs, mental health services, and preventive care.

Why do I need health insurance? +

Health insurance helps protect you from high medical costs. It provides access to medical care when you need it, helping to pay for doctor visits, hospital stays, surgeries, prescription medications, and other health-related services.

What is a premium? +

A premium is the amount you pay for your health insurance every month. Depending on your plan, the premium may vary based on factors like age, location, and level of coverage.

What is a deductible? +

A deductible is the amount of money you must pay out-of-pocket before your health insurance starts covering your medical expenses. For example, if you have a deductible of $1,000, you must pay $1,000 out-of-pocket before your insurance starts covering your medical bills.

What are copayments and coinsurance? +

Copayment (copay): A fixed amount you pay for a covered health care service, typically when you get the service. Coinsurance: The percentage of the cost you pay for covered health services after you've paid your deductible. For example, if your coinsurance is 20%, you pay 20% of the bill, and the insurance company pays the remaining 80%.

What is an out-of-pocket maximum? +

The out-of-pocket maximum is the maximum amount you can spend on your health insurance. If you exceed this amount, your insurance company will pay 100% of your medical expenses.

What is the difference between in-network and out-of-network providers? +

In-network providers: Health care providers that have a contract with your health insurance plan to provide services at negotiated rates. Out-of-network providers: Providers that don't have a contract with your insurance plan. Services from these providers may cost more or not be covered at all.

What is a Special Enrollment Period (SEP)? +

The Special Enrollment Period (SEP) is a special time during the year when you can sign up for or make changes to your health insurance plan. If you miss this period, you may have to wait until the next one unless you qualify for a Special Enrollment Period (e.g., due to a life event like marriage or having a baby).

Can I keep my doctor with health insurance? +

If you have a preferred doctor, it’s important to check if they are in-network with your insurance plan. If they are not in-network, you may need to pay more out-of-pocket, or you may have to switch to another doctor who is in-network.

What is a Health Savings Account (HSA)? +

A tax-advantaged account for people with high-deductible health plans (HDHPs). The funds roll over from year to year and can be used for qualifying medical expenses.

What is a Flexible Spending Account (FSA)? +

A tax-advantaged account for people with low-deductible health plans (LDHPs). The funds roll over from year to year and can be used for qualifying medical expenses.

What is a Health Maintenance Organization (HMO)? +

An HMO is a type of health insurance plan that requires you to choose a primary care physician (PCP) and get referrals from them to see specialists. HMOs often have lower premiums and out-of-pocket costs but offer less flexibility in choosing providers.

What is a Preferred Provider Organization (PPO)? +

A PPO is a health insurance plan that offers more flexibility in choosing healthcare providers and doesn’t require referrals to see specialists. You can see any doctor, but you’ll pay less if you use in-network providers.

What is the difference between a Health Savings Account (HSA) and a Flexible Spending Account (FSA)? +

HSA: A tax-advantaged account for people with high-deductible health plans (HDHPs) The funds roll over from year to year and can be used for qualifying medical expenses. FSA: A tax-advantaged account for people with low-deductible health plans (LDHPs) The funds roll over from year to year and can be used for qualifying medical expenses.

What does the term "pre-existing condition" mean? +

A pre-existing condition is a medical condition that you had before you got your health insurance. It could include things like diabetes, high blood pressure, or heart disease.

Can I cancel my health insurance at any time? +

Yes, you can cancel your health insurance plan at any time. However, if you cancel outside the open enrollment period, you may not be able to get another plan until the next enrollment period unless you qualify for a Special Enrollment Period.

Are prescription drugs covered by health insurance? +

Many health insurance plans cover prescription medications, but the coverage may vary. Plans typically have a formulary, or list of covered drugs, and different drugs may have different levels of coverage, depending on whether they are generic, brand-name, or specialty drugs.

What is preventive care? +

Preventive care includes health services that help prevent illnesses, such as vaccinations, screenings, and annual checkups. Under the Affordable Care Act, most preventive services are covered by health insurance plans at no additional cost to the policyholder.

What should I do if my health insurance claim is denied? +

If your claim is denied, you can appeal the decision. Review the denial letter for reasons, contact your insurer for assistance, and file a written request for a hearing. If you win the appeal, you may be able to get a refund or other compensation.

How can I choose the best health insurance plan for me? +

When selecting a plan, consider factors like: Your health care needs (e.g., frequent visits, prescriptions) The plan’s network of doctors and hospitals The cost of premiums, deductibles, copays, and out-of-pocket maximums Coverage for specialized care or treatments Compare the different plans and benefits to find one that meets your needs.

What happens if I don't have health insurance? +

If you don’t have health insurance, you can still access some health care services, such as emergency care, in-network doctors, and in-network hospitals. You may be eligible for Medicaid, which provides some health care services at no cost to you.

What is life insurance? +

Life insurance is a contract between you and an insurance company, where you pay regular premiums in exchange for a lump sum payment (death benefit) to your beneficiaries upon your death.

What are the different types of life insurance? +

Term Life Insurance: Provides coverage for a specific period (e.g., 10, 20, or 30 years). If you pass away during this term, your beneficiaries receive the death benefit. It does not build cash value. Whole Life Insurance: Offers lifetime coverage with a death benefit and also builds cash value over time, which you can borrow against or use. Universal Life Insurance: A flexible policy that allows you to adjust the premiums and death benefit while also building cash value.

How much life insurance coverage do I need? +

The amount of coverage you need depends on factors like your income, debts, family needs, and long-term financial goals. A common rule is to have coverage worth 10 to 15 times your annual income, but this can vary based on your individual situation.

What is the difference between beneficiaries and policyholders? +

The policyholder is the person who owns the life insurance policy and pays the premiums, while the beneficiary is the person or group that receives the death benefit when the policyholder passes away.

Can I change my beneficiaries? +

Yes, you can change your beneficiaries at any time during the life of the policy, as long as the policy is in force and you follow the correct procedure with the insurance company.

What is the contestability period? +

The contestability period is the time during which you have the right to contest the decision of the insurer to pay the death benefit. This period varies depending on the type of life insurance policy and the insurer.

Does life insurance cover accidental death? +

Some life insurance policies include accidental death coverage, while others may require a separate rider for this benefit. Be sure to review your policy to understand what’s covered.

Can I cancel my life insurance policy at any time? +

Yes, you can cancel your life insurance policy at any time, provided you follow the correct procedure with the insurance company.

What is cash value? +

Cash value is the accumulated value of the life insurance policy that can be used to pay for expenses, such as medical bills or funeral expenses.

How do I borrow against cash value? +

You can borrow against the cash value of your life insurance policy, but it will need to be repaid, and any unpaid loan will reduce the death benefit.

What is the difference between whole life and universal life insurance? +

Whole life insurance provides coverage for a specific period (e.g., 10, 20, or 30 years) and builds cash value over time. Universal life insurance offers lifetime coverage with a death benefit and also builds cash value over time.

How are life insurance premiums determined? +

Life insurance premiums are based on factors like age, health, lifestyle (e.g., smoking), coverage amount, and type of policy. Generally, younger, healthier individuals pay lower premiums.

Can I borrow money from my life insurance policy? +

If you have a whole life or universal life policy, it may build cash value over time. You can borrow against this cash value, but it will need to be repaid, and any unpaid loan will reduce the death benefit.

What happens if I stop paying my life insurance premiums? +

If you stop paying premiums, your policy may lapse. For permanent policies like whole or universal life, the cash value may cover the premiums for a time, but eventually, if premiums are not paid, the policy will end.

What is auto insurance? +

Auto insurance is a contract between you and an insurance company that provides financial protection against damage or injury caused by accidents, theft, or other incidents involving your vehicle. It covers both liability and your vehicle's repair costs depending on the type of policy.

What types of auto insurance coverage are available? +

There are several types of auto insurance coverage, including liability, collision, comprehensive, uninsured/underinsured motorist, and additional coverage like roadside assistance and collision damage waiver.

How much auto insurance do I need? +

The amount of coverage you need depends on factors such as the value of your car, your driving habits, your state's legal requirements, and whether you own or lease your vehicle. A good starting point is to meet your state's minimum required coverage, but you may want additional coverage for added protection.

Can I cancel my auto insurance policy at any time? +

Yes, you can cancel your auto insurance policy at any time, provided you follow the correct procedure with the insurance company.

What is the difference between liability and comprehensive coverage? +

Liability coverage covers the damages and injuries caused by accidents, while comprehensive coverage also covers non-accident damages, such as theft or vandalism.

How do I choose the right auto insurance policy? +

When selecting an auto insurance policy, consider factors such as the type of coverage you need, your driving habits, the value of your vehicle, and your state's legal requirements.

What factors affect my auto insurance premium? +

Several factors impact your insurance premium, including: Your driving history (accidents, tickets), The make, model, and age of your car, Your location (accident rates in your area), Your age, gender, and marital status, The level of coverage you choose, Your credit score (in some states).

What is a deductible? +

A deductible is the amount you must pay out of pocket before your insurance policy starts to cover the remaining cost of repairs or claims. For example, if you have a $500 deductible and incur $2,000 in damages, you will pay $500, and your insurer will pay the remaining $1,500.

What is the difference between comprehensive and collision coverage? +

Collision coverage pays for repairs to your vehicle after a collision with another vehicle or object, regardless of who is at fault. Comprehensive coverage covers non-collision incidents, such as theft, vandalism, or damage from natural disasters.

Can I get uninsured/underinsured motorist coverage? +

Yes, uninsured/underinsured motorist coverage is available in some states. This coverage provides financial protection for you if another driver is uninsured or underinsured.

Is auto insurance required by law? +

Yes, in most states, you are required to have a minimum level of liability insurance. Some states also require additional coverage like Personal Injury Protection (PIP) or uninsured motorist coverage. The requirements vary by state, so it’s important to check your local laws.

What happens if I don’t have auto insurance? +

If you drive without insurance, you risk facing legal penalties, fines, and the possibility of your driver's license being suspended. If you're involved in an accident, you could be held responsible for the damages.

Can I add other drivers to my auto insurance policy? +

Yes, you can add other drivers, such as family members or friends, to your policy. However, their driving record and age may affect your premium. It's important to inform your insurer about all the drivers in your household.

What should I do if I get into an accident? +

If you're in an accident, follow these steps: Ensure safety by moving to a safe location if possible. Call the police and file a report. Exchange contact and insurance information with the other driver(s). Take photos of the accident scene, vehicle damage, and injuries. Notify your insurance company about the accident as soon as possible.

What is home insurance? +

Home insurance is a contract between you and an insurance company that provides financial protection against damage or loss caused by natural disasters, theft, or other incidents.

What types of home insurance coverage are available? +

There are several types of home insurance coverage, including flood, fire, burglary, and liability. You may also have coverage for water damage, mold, and other property damage.

How much home insurance do I need? +

The amount of home insurance coverage you need depends on the value of your property, the type of coverage you want, and your insurance provider. You may also need additional coverage for water damage, mold, and other property damage.

Can I cancel my home insurance policy at any time? +

Yes, you can cancel your home insurance policy at any time, provided you follow the correct procedure with the insurance company.

What is the difference between flood and fire coverage? +

Flood coverage covers damage caused by floods, while fire coverage covers damage caused by fires.

How do I choose the right home insurance policy? +

When selecting home insurance, consider factors such as the type of coverage you need, the value of your property, and your insurance provider.

What factors affect my home insurance premium? +

Factors such as the type of coverage you need, the value of your property, and your insurance provider can significantly impact your premium.