Fund | Asset Mix | Min.% | Max.% | Potential risk- reward |
Health Protector: Accumulated steady income at a lower risk | Debt Instruments, Money Market & Cash | 100% | 100% | Low |
Coverage under the policy
A Hospitalisation Insurance Benefit:This benefit in your policy provides you cover against medical expenses that require a minimum of 24 hours hospitalisation. In addition, over 125 day-care procedures are also covered.
The following expenses incurred during hospitalisation are covered, subject to your annual limit:
1. Room, boarding and nursing expenses as charged by the hospital where the insured availed medical treatment. You are entitled to a single A/C room (room rent capped at 1% of annual limit per day). However for twin share A/C room there is no such cap applicable.
2. Intensive Care Unit (ICU) charges
3. Fees for doctor, surgeon, anaesthetist, medical practitioner, consultant and specialist
4. Anaesthesia, blood, oxygen, operation theatre charges, surgical appliances, medicines and drugs, diagnostic materials and x-ray, dialysis, chemotherapy, radiotherapy, cost of pacemaker, cost of artificial limbs3.
Feature | Description |
Family- Floater | With the family floater option, you can additionally cover your spouse and up to the first three dependant children under the same annual limit. |
Daycare Treatment Cover | In addition to hospitalisation, you are also covered for procedures which require less than 24 hours of hospitalisation. These include over 125 listed day care surgeries, parenteral chemotherapy, radiotherapy, intervention cardiology, intervention radiology, radio frequency ablation treatment, lithotripsy and dialysis. |
Pre & Post Hospitalisation Cover | Pre hospitalisation expenses up to 30 days prior to hospitalisation and post hospitalisation expenses up to 60 days from the date of discharge are also covered. The pre and post hospitalisation expenses would be covered only in case the expenses incurred are related to the main hospitalisation event. |
Medical check-ups | Reimbursement of medical tests subject to a limit of Rs. 5,000 or 1% of the annual limit, whichever is lower, once every two years after the first year. |
Ambulance charges | Up to Rs. 1,000 per policy year4. |
No Claim Bonus | A no claim bonus in the form of an increase in annual limit by 5% of the base annual limit is provided for every claim free year. The maximum increase over the base annual limit will be capped at 25%. In case of a claim, the accumulated no claim bonus will reduce by 10% of the base annual limit in the following year. In no circumstance will this reduction cause the annual limit to go below the base annual limit. |
Cashless Network Access | You can avail of cashless claims through our extensive network of hospitals across the country. |
Out of network claims | A co-pay5 of 20% on the eligible medical expenses6 will be applicable in case you either
In case of emergency hospitalisation related to cardiac and trauma cases, co-pays will not be levied even when hospital is outside your chosen network as long as benefit availed is in a twin sharing room. |
This benefit entitles you to claim reimbursement for health care expenses incurred by any of the insured members from your health fund. Some of the benefits covered under the health savings benefit are:
Medicines and drugs
Diagnostic expenses
Dental expenses
Co-pays or deductibles as part of the medical insurance cover
Other miscellaneous medical expenses not covered under medical insurance
The benefit can be claimed after 3 completed years of the policy and is subject to the existing fund value as given below:
4th Year & 5th Year | 6th Year to 10th Year | 11th year onwards |
20% of Health Fund | 50% of Health Fund | 100% of Health Fund |
Claims can be made once in a policy year on producing actual bills or proof of expenses. The minimum amount that can be claimed is Rs. 1,000. To create the health fund part of the premium paid by you is invested in unit linked funds.
Investment Details
Life-cycle based portfolio strategy
Your investments will be redistributed between two funds as you move from one age band to another as per below table.
Age Band (Yrs) | 18-25 | 26-35 | 36-45 | 46-55 | 56-65 | 66-75 | 76+ |
Health Flexi Growth | 85% | 75% | 65% | 55% | 45% | 35% | 0% |
Health Protector | 15% | 25% | 35% | 45% | 55% | 65% | 100% |
Quarterly Rebalancing - Your fund allocation might get altered because of market movements and claims from your health savings benefit. We will visit your allocations every quarter and reset it to prescribed limits. This vital feature will ensure that you take advantage of the market movements.
Fixed Portfolio Strategy
Under this strategy you can allocate your investment among the following 7 funds:
Fund | Asset Mix | Min.% | Max.% | Potential risk- reward |
Health Flexi Growth: Long term returns from an equity portfolio of large, mid and small cap companies | Equity & Related Securities Debt, Money Market & Cash | 80% 0% | 100% 20% | High |
Health Multiplier: Long term capital appreciation from an equity portfolio | Equity & Related Securities Debt, Money Market & Cash | 80% 0% | 100% 20% | High |
Health Flexi Balanced: Balance of capital appreciation and stable returns from an equity (large, mid & small cap companies) & debt portfolio | Equity & Related Securities Debt, Money Market & Cash | 0% 40% | 60% 100% | Moderate |
Health Balancer: Balance of growth and steady returns from an equity & debt portfolio | Equity & Related Securities Debt, Money Market & Cash | 0% 60% | 40% 100% | Moderate |
Health Protector: Accumulated steady income at a lower risk | Debt Instruments, Money Market & Cash | 100% | 100% | Low |
Health Preserver:Protection of capital through very low risk investment. | Debt Instruments Money Market & Cash | 0% 50% | 50% 100% | Low |
Health Return Guarantee Fund*: Provides guaranteed returns through investment in a diversified portfolio of high quality fixed income instruments | Debt Instruments Money Market & Cash | 100% | 100% | Low |
Fund Management Charge (FMC)
The annual fund management charges, which will be adjusted from the Net Asset Value (NAV), for the various Funds are as follows:
Fund Name | Health RGF | Health Flexi Growth | Health Multiplier | Health Flexi Balanced | Health Balancer | Health Protector | Health Preserver |
FMC (p.a.) | 1.50% | 1.50% | 1.50% | 1.00% | 1.00% | 0.75% | 0.75% |
| Period | Absolute (%) | Annualised (%) |
|---|---|---|
| 1 Week | -0.3 | 0 |
| 1 Month | 0.7 | 9.1 |
| 3 Months | 0.6 | 2.6 |
| 6 Months | 0.8 | 1.7 |
| 1 Year | 2.5 | 2.5 |
| 2 Years | 14.2 | 6.9 |
| 3 Years | 21.9 | 6.8 |
| 5 Years | 32.2 | 5.7 |
| Claim Ratio | Solvency Ratio |
|---|---|
| 99% (2023-24) | 2% (March 2024) |