Features & Benefits of Edelweiss Group Health Insurance
Here are some of the features and benefits provided by the Edelweiss group health insurance policy:
- The entry age to get covered under the policy is 18 years without any upper limit.
- Benefits are available to the insured person’s dependents such as spouse and children will be covered until they are 25 years old.
- The minimum sum insured offered is Rs 10,000 and the maximum is Rs 5,00,00,000.
- The policy can be renewed except if there was a fraud, misinterpretation, moral hazard or non-co-operation from the insured person’s end.
- The tenure of the policy is 1 year.
- The coverage is provided to the spouse, dependent children, parents, parents-in-law and siblings or any other person mentioned in the policy.
Edelweiss Group Health Insurance: Inclusions
Edelweiss group health insurance policy provides coverage to the policyholder for the following:
- Hospitalization: Hospitalization expenses are covered up to the sum insured specified in the policy documents.
- Pre & Post-hospitalization: The insurance plan provides coverage for 30 days of pre-hospitalization expenses and 60 days of post-hospitalization expenses.
- Day-Care Treatment: The insurance plan provides coverage for daycare treatment up to the amount of the sum insured.
- Domiciliary Hospitalization: The insurance plan provides coverage for up to 30% of the SI amount.
- AYUSH: The insurance plan provides coverage for AYUSH for up to 50% of the SI amount.
Optional Coverage
Here are some of the optional coverage provided under the Edelweiss group health insurance plan.
- Domiciliary Hospitalization & AYUSH: Insured can opt for the domiciliary and AYUSH coverage up to the amount of sum insured without any limitation.
- Pre & post-hospitalization Time Extention: Insured can opt for 60 days pre-hospitalization and 90 days post-hospitalization as well as 9- days pre-hospitalization and 180 days post-hospitalization also.
- Pre-existing Disease Exclusion Waiver: Insured can opt for pre-existing disease exclusion waiver which is applicable on the opted sum insured amount.
- Delete 30 Days & 2 Years Waiting Period: The insured can delete the 30 days waiting period that is applicable on the opted sum insured amount.
- OPD Treatment: Insured can select the limit up to the maximum sum insured amount.
- Maternity Treatment Expense: Insured can opt for maternity cover with or without 9 month waiting period up to Rs 1,50,000 or base sum insured or whichever is lower.
- Baby Day One Cover: Insured can opt for baby day one care cover up to Rs 1,50,000 or whichever is lower.
- Pre & Post-Natal Expenses: Insured can opt for Pre and Post-Natal expenses up to Rs 1,50,000 or the base sum insured, whichever is lower.
- Emergency Ambulance: Insured can opt for ambulance expenses up to Rs 10,000
- Extra Sum Insured for Hospitalization due to Critical Illness: Insured can opt for an additional sum insured amount up to 50% or 100% of SI due to critical illness.
*For more, refer to the policy wording of the Edelweiss Group Health Insurance Policy. T&C Apply
Edelweiss Group Health Insurance: Exclusions
Edelweiss group health insurance does not provide coverage for the following:
- 30 Days Waiting Period: The insurance plan does not provide coverage for any illness within the 30 days of policy purchase.
- Specified Disease Waiting Period: Diseases with the specified wiaiting period will not be covered until the waiting period is over.
- 90 Days Waiting Period: The insurance policy will not provide coverage for any treatment related to diabetes for up to 90 days.
- Pre-existing Disease: The insurance plan will not provide coverage for pre-existing diseases specified in the policy documents.
- Sterility & Infertility: There is no coverage for sterility or infertility.
- STD: There is no coverage provided for Sexually transmitted diseases.
- Medical Condition Below 91 days infant: No coverage is provided to the infant below the age of 91 days.
- Contraception or Sterilization: There is no coverage for contraception or sterilization.
- Sleep Apnoea: There is no coverage for any treatment related to Sleep Apnoea.
- Spas & Nature Cure Clinics: There is no coverage for any treatment received in the nature cure clinics, spas or similar establishments.
- Acupressure: No coverage is provided for any treatment related to acupuncture, acupressure or magnetic therapy.
- Plastic Surgery: No coverage is provided for cosmetic and plastic surgery.
- Unproven Treatment: There is no coverage for any unproven treatment of any disease.
- Cost of Lens & Hearing Aid: No coverage is provided to the policyholder for purchasing contact lenses, spectacles, hearing aid or routine eye and ear examination.
- Gender Change: No coverage is provided for the treatment of gender change.
- Donor Treatment: No coverage is provided for donor treatment including surgery, organ removal, etc.
- Alcoholism & Drug Abuse: No coverage is provided for the treatment of alcoholism or drug abuse.
- Nuclear, Chemical or Biological Attack: Any injury caused due to a nuclear, chemical or biological attack is not covered.
How To Raise Claim Under Edelweiss Group Health Insurance Policy?
Follow the steps given below to raise claim under Edelweiss group health insurance policy:
- Inform the insurer: Make sure to inform the insurer about the treatment of the ailment after consulting with the doctor.
- Ask for Claim Form: Ask the insurer about the claim form so that you can fill it up to begin the claiming process.
- Keep Documents Ready: Make sure to keep the required documents ready so that you can attach them to the claim form and submit it.
- Network Hospital: Look for the network hospital nearby to get the cashless claim.
- Reimbursement: In case the insured gets admitted in a non-network hospital, he/she can raise the claim after the treatment and the insurance company will reimburse the amount paid in to the hospital for treatment.
How To Renew Edelweiss Group Health Insurance Policy?
In order to raise a claim under the Edelweiss group health insurance policy, follow the steps given below:
- Step 1: Go to the Policybazaar Insurance Brokers Private Limited's official website.
- Step 2: Fill in your policy number and press enter.
- Step 3: Once you get into your account, make sure to check the insurance policy.
- Step 4: You can add or remove any add-on as per your requirement.
- Step 5: Addition or removal of any add-on will reflect in the final premium amount.
- Step 6: Make the payment using your debit/credit card, UPI or net banking.
- Step 7: Once the payment is done, the insurer will send an updated insurance policy to your registered email and a hard copy to your registered home address.
*Make sure to renew your insurance policy on time to get the benefit of coverage continuously.
