IFFCO Tokio Family Health Protector Policy

Key Features of  Iffco Tokio Family Health Protector Plan

Reasons to buy Iffco Tokio Family Health Protector Plan are listed below:

• Ensure lifelong health with lifelong renewability option
• Avail cashless treatment in more than 3000 empanelled hospitals
• One of the best family health insurance provider
• Vaccination and health check-up expenses are also covered
• Financial assistance for critical illness and emergency services
• Up to Rs.1000 of daily hospital cash allowance on a daily basis
• Pre and post hospitalization expenses are also covered (up to a specified limit)
• Non-allopathic treatment like Ayurveda, Unani, Siddha, and homeopathy are recompensed as well
• Additional critical illnesses cover in your existing plan
• The company ensures hassle-free and timely settlement of claims in an effective manner
• Room rent charges including doctor fees, hospital registration, and medical expenses, etc.
• Tax saving under sec 80/D

Sum Insured

Minimum Rs. 1, 50,000 and Maximum Rs. 30, 00,000

Entry Age Criteria

Besides the policyholder and his spouse, the dependent members can be between 3 months and 23 years at the time of policy purchase, provided you have not purchased any policy from the insurer before. Dependent children can be insured in a family plan starting from the first day of the policy inception date provided both the parents are also insured in the same plan.

Inclusions of Iffco Tokio Family Health Protector Plan

The plan covers the following medical expenses:

• The compensation limit for room charges, nursing and boarding charges is up to 20% of the sum insured. If the SI amount is above 7 lakh rupees then the compensation provided is as per the actual invoice. And for sum insured higher than 7 lakh rupees the sum insured amount for a normal room is kept at 1.5% of the SUM and for other cities, it is 1.25% of the actual invoice
• For ICU/therapeutic expenses: the limit is 2.5% of the SI in Class A cities (check in the policy wordings). The limit is 2.0% of the SI in other cities
• Medical fees charged by a doctor, specialist, anesthetist, medical practitioner, surgeon, consultant, etc.
• Cost of surgical appliances, operation theatre, organ transplant, pacemaker, medicines, drugs, dialysis, chemotherapy, radiotherapy, etc.
• 45 days of pre-hospitalization charges
• 60 days of post-hospitalization charges
• Domiciliary hospitalization up to a 20% limit of the sum insured
• The plan covers 121 daycare procedures
• 11 critical illnesses are also covered - Cancer, Coma, Stroke, Kidney failure, Open Chest CABG, Permanent limb paralysis, major organ transplant, bone marrow transplant, motor neuron disease, multiple sclerosis with persisting symptoms.
• Reinstatement of the sum insured except for domiciliary hospitalization, critical illnesses, Ayurveda, homeopathy, and Unani treatment
• Up to Rs. 1000 of a daily cash allowance is provided
• It covers Unani, Ayurveda, Siddha and Homeopathy treatments
• Emergency medical evacuation
• Emergency message transmission between the insured and his family members
• Emergency cash assistance is also provided
• Emergency medical repatriation via air ambulance in a common carrier
• Documents and other formalities pertaining to the return of the mortal remains of the insured person
• Ambulance expenses while traveling to and from the hospital and the limit is 0.75% of the SI or Rs. 2,500 /individual per hospitalization.
• Cumulative bonus for the family for every claim-free year. It ranges from 5% to 5-% for subsequent renewals.

Exclusions of Iffco Tokio Family Health Protector Plan

• Treatment required for AIDS/HIV infection and other sexually transmitted diseases.
• Self-inflicted injuries and mental disorders like depression and anxiety are not covered
• Any medical concern arising due to drug intoxication and overdose of alcohol consumption
• If the treatment was sought outside India
• If the injury resulted due to a suicidal or deliberate attempt
• If the insured person was involved in an illegitimate act
• If the injuries resulted due to warlike operations, rebellion, or even participation in a war
• If the person had been consuming drugs or other intoxicating substances
• If any of the insured members was found to be traveling away from the registered address for more than 90 days us
• Students who stay away from their home in hostels

Documents Required for Iffco Tokio Family Health Protector Plan

For issuing Iffco Tokio Family Health Protector Plan you need to submit the following documents and their self-attested copies. Those who are purchasing the policy online can fill an online form and submit the self-attested and scanned copies of all the documents online.

And if you are purchasing the Iffco Tokio Family Health Protector policy online, you need to submit the hard copy of the form along with all the documents that are signed and printed.

Here is the list of documents that are required when applying for Iffco Tokio Family Health Protector Policy:

• Passport size photographs for each insured person
• Proposer’s KYC documents
• PAN Card of all the applicants
• Duly filled and signed proposal form (for offline purchase)
• Copy of the Existing or Expiring Insurance Policy (if you are porting out)
• Cheque Payment (for offline purchase)

IFFCO Tokio Health Insurance Claim Process

The procedure to file cashless and reimbursement claims are described below:

The Process to File a Cashless Claim in a Network Claim is Listed Below:

• For a planned hospitalization you need to inform the insurance company 3 days in advance
• For unplanned hospitalization, intimate the insurance company on the same day of hospitalization on email on their toll-free customer care number
• You need to show your health card and identification proof at the hospital desk. Once your verification is complete, a duly-filled claim form will be submitted to the insurance company by the hospital. The hospital will also submit a signed pre-authorization request form to the Iffco Tokio’s TPA desk.
• Once the verification is completed, the hospital process with cashless treatment on receiving approval from the Third-Party Administrator (TPA), which looks after Iffco Tokio insurance claims
• Once all the documents are submitted, you will receive the confirmation from the insurer to go ahead with cashless hospitalization
• Please note that cashless hospitalization is only valid in empanelled hospitals

The Process to Claim Reimbursement of Medical Expenses

• In case your cashless treatment request is disapproved, then you can get reimbursement of your medical expenses.
• To claim compensation, you need to furnish all the hospital/medical bills and reimbursement request should be filed within a week of getting discharged from the hospital.
• You also need to file the reimbursement claim form that is duly singed and filled. Also, you need to furnish all the essential documents at the nearest Iffco Tokio branch.
• Once the verification process is completed, the insured claim amount will be reimbursed through cheque to the policyholder. Your claim request shall be completed within 20 days of claim approval.