Pramerica Life - Group Health Kavach Plan

This is a Traditional Non-Linked, Non-Participating, Fixed Benefit One Year Renewable and a Single Premium Credit Linked Group Health Insurance plan. The product is designed to provide health benefits to your quality employees and/or your loyal customers.

Fixed benefits, no ambiguity
Option of 2 Premium variants: Single Premium Credit Linked or One Year Yearly Renewable
Flexibility to choose from two plan options on the basis of Premium variants:
Option A
Fixed Sum Insured throughout the Policy Term
Option B
Reducing Sum Insured as per Benefit Schedule fixed at policy inception. (applicable for Single Premium variant only)

Flexibility to choose from five coverage options:
Option I
Accidental Death Cover
Option II
Critical Illness Cover
Option III
Accidental Death plus Accidental Permanent, Total or Partial Disability Cover
Option IV
Accidental Death plus Critical Illness Cover
Option V
Accidental Death plus Accidental Permanent, Total or Partial Disability plus Critical Illness Cover
Hassle free enrolment process.
Tax benefits available as per current tax laws.

You as a Master Policyholder can:
Use this as a tool to attract and retain your loyal customers and/or quality employees.
Possibly lend higher amounts (subject to customer
s eligibility) because of the assurance of having no repayment in case of an unfortunate contingency.
Your Customers:
Have Health and Accidental Insurance protection at a very economical cost.

Have a sense of security.
Tax benefits under section 80D of the Income Tax Act, 1961.

Member s Age at Entry (last birthday):

One Year Renewable and Single
Premium in case of Policy Term 2 to 5 Years

For 1 Year Policy Term: Annual, Semiannual, Quarterly and Monthly modes are applicable
For 2 to 5 years policy term: Single premium

Minimum: Rs.1000 per life
Maximum:
-Accidental Benefits: Rs.3 Crore per life
-Critical Illness Benefit: Rs.50 Lakhs per life
-For all benefits combined together, maximum sum insured shall be restricted to Rs.3 Crore
per life, subject to board approved underwriting policy.

On occurrence of death due to an accident, a lump sum benefit equal to Accidental Death Sum Insured will be payable subject to the following and the cover will cease thereafter.
a) The member has sustained any bodily injury directly and solely from the accident, which has been caused by external, violent and visible means and the injury is independent of all other causes.
b) The death must occur within 180 days of the date of accident due to such injury as stated above solely, directly and independently of all other causes of death.
c) The accident which eventually leads to death has occurred during the term of the policy, even if the death occurs after policy term but within 180 days of accident.

Tax benefits will be applicable as per prevailing tax laws. Tax laws are subject to change from time to time. Please refer to your tax consultant for details.

You will have a period of 15 days from the date of receipt of the policy document to review the terms and conditions of the policy and where you disagree to any of these terms and conditions, you have an option to return the policy stating the reasons for objection. On receipt of the letter along the policy documents, the company will refund the premiums paid, subject to the deduction of proportionate risk premium for the period on cover and any expenses incurred by the Company on medical examination of the members and stamp fee.
This policy will not be sold through Distance Marketing mode.

For One year renewable cover, a grace period of 30 days in semi-annual mode and 15 days in case of monthly and quarterly mode is applicable under this product. There is no grace period applicable in case of yearly mode. If the company does not receive the premium due within the grace period, the policy will lapse at the expiry of the grace period. In case of a member(s) claim during the grace period, the claim benefit will be entertained, if the premium due for the scheme has been paid by the Master Policyholder before the end of the grace period.
For policy term of 2 to 5 years, only single premium option is available and hence there is no grace period applicable.

It is the duration between dates of diagnosis of the condition to date of eligibility for the benefit payment.
There will be a Survival Period of 14 days in case of Critical Illness cover. This means that the insured has to survive for 14 days after full diagnosis. Failure to do so entitles the Insurance Company to refuse any claim under this cover.
The diagnosis of the Critical Illness must be made perimortem (i.e. while the Insured member is still alive), and for those conditions that has an inherent deferment period in the definition (such as 3 months in case of
Stroke
), the Insured member must survive this
deferment period
before the Critical Illness benefit can be paid.

For one year renewable cover, no surrender value is available under this product.
In case of policy term from 2 to 5 years, following surrender value shall be payable upon full pre-payment of loan:
60% of Single Premium paid (excluding taxes, if any) *(Unexpired coverage term in completed months / Total coverage term in months) * (Coverage In-force / Initial
Coverage Amount)
Where, Coverage In-force means the benefit amount as per the Benefit Schedule as on the monthly plan anniversary immediately before the date of surrender of the policy.
In case of surrender of the Master Policy at the request of the Master Policyholder at any time, the existing members will have an option to: a) Continue the risk cover as per the contract, or
b) Terminate the risk cover and take the applicable surrender value (as mentioned above).
The members who choose to continue the risk cover, in such case the company shall continue to be responsible to serve such members on the existing terms and conditions till their coverage is terminated.