Reliance Arogya Sanjeevani Policy

Reliance Arogya Sanjeevani policy is a simple and affordable health plan that helps people in meeting their medical insurance needs at a nominal premium.  This is a standard health insurance policy that has been designed as per the IRDAI guidelines. The eligibility criteria and coverage benefits of the plan are given below.

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Reliance Arogya Sanjeevani Policy

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    Reliance Arogya Sanjeevani Policy Eligibility Criteria

    Reliance Arogya Sanjeevani policy is an easy to buy a plan that helps you pay for inpatient hospitalization expenses, modern treatments, Ayush treatments with a wide range of sum-insured options from Rs 1 lakh to Rs 10 lakh.

    Eligibility Criteria

    Parameters

    Specifications

    Entry Age for Adults

    18-60 years

    Entry Age for Children

    91 days- 25 years

    Sum Insured

    Rs 1 lakh- Rs 10 lakh

    Policy Type

    Individual/Family Floater

    Policy Term

    1-years

    Features of Reliance Arogya Sanjeevani Health Insurance Policy

    Arogya Sanjeevani policy, Reliance General Insurance provides the following features and benefits:

    • The policy sum insured ranges from Rs 1 lakh to Rs 10 lakh
    • Reliance Arogya Sanjeevani policy covers all the Day Care Procedures where 24 hours of hospitalization is not mandatory
    • 5% cumulative bonus is added for not filing a claim during the policy term
    • Pre-existing diseases can be claimed after a waiting period of 48-months is completed
    • The insured has an option to pay the premium in installments
    • Policy cancellation can be done within 15 days of the issuance

    Inclusions of Reliance Arogya Sanjeevani Health Insurance Policy

    The inclusions under the Arogya Sanjeevani health insurance plan are as listed under:

    • Hospitalization expenses including operation theatre, medicines, doctor fees, blood, oxygen, diagnostic tests are payable equal to Rs 5000 or 2% of the sum insured are claimable
    • The policy limit for Cataract Treatment is Rs 40,000 or 25% of Sum insured during the policy year
    • Ayush treatment expenses are covered such as in-patient treatment for Ayurveda, Unani,   homeopathy up to the policy amount
    • Pre- Hospitalization expenses coverage limit is 30 days and post-hospitalization expense coverage is 60 days
    • Emergency Road Ambulance services up to Rs 2000 for each hospitalization are provided in the Arogya Sanjeevani health insurance policy
    • Dental Treatment and Plastic Surgery as required during the treatment or accident or injury
    • ICU and ICCU expenses are claimable equal to Rs 10,000 on daily basis or 5% of the coverage amount
    • Ayush treatment cover is provided up to the sum insured limit

    Special/Modern Treatments

    Reliance Arogya Sanjeevani policy also covers the following modern treatments that are a part of today’s healthcare services:

    • Oral chemotherapy
    • Uterine Artery Embolization/High intensity focused ultrasound tests
    • Deep Brain stimulation
    • Intra vitreal injections
    • Immunotherapy
    • Robotic surgeries
    • Green laser treatment/ Prostate Vaporization
    • Intra Operative Neuro Monitoring
    • Bronchial Thermoplasty
    • Stem cell therapy ( as required in bone marrow transplant procedure)
    • Stereotactic radio surgeries
    • Balloon Sinuplasty

    Exclusions of Reliance Arogya Sanjeevani Health Insurance Policy

    Health insurance claims for Reliance Arogya Sanjeevani policy will not be payable for the following treatments:

    • Any claim filed in the initial 30-days of the policy purchase
    • Pre-existing illnesses until completion of 48-months of the continuous policy term
    • Domiciliary Hospitalization​​ expenses
    • Rest Cure, rehabilitation, and respite care​​ charges
    • Overseas treatments and Unproven Treatments are excluded
    • Maternity expenses are also not covered
    • Outpatient treatment (OPD) consultations

    How to File a Claim for Reliance Arogya Sanjeevani Health Insurance Policy?

    When filing a claim make sure that you inform the insurer within 24-hours of an emergency hospitalization or before getting discharged whichever is earlier.

    The process to file Reliance Arogya Sanjeevani health claims for both cashless and reimbursement processes is given below:

    Procedure for Reimbursement Claims

    The claim procedure for reimbursement of hospitalization expenses under the Reliance Arogya Sanjeevani policy is given below:

    • If it is a daycare and pre-hospitalization expense reimbursement claim then it needs to be intimated to the insurer within 30-days of the hospital discharge date
    • For post-hospitalization, you can inform within 15 days from completion of the treatment

    Procedure for Cashless Claims

    The treatment should be taken in a network hospital, which is subjected to authorization by the TPA or the Reliance Health Insurance Company:

    • For authorization send the complete claim form that is available with the TPA and network provider
    • Once the TPA/Company gets the cashless request claim form by you then a pre-authorization letter will be sent to the hospital post verification
    • While getting discharged from the hospital you need to pay the inadmissible expenses and sign the hospital discharge form
    • If all the documents and details provided as per the process your cashless claim will be processed else you can also file  for reimbursement

    Documents Required

    Here is the list of documents that you will need at the time of claim settlement:

    • Completed claim form
    • Patient’s ID proof/original bills/ doctor’s prescription for hospital admission
    • Payment receipts
    • Diagnostic reports/discharge summary/OT notes/ Invoice of the implants
    • Medico legal report, if required
    • NEFT Details
    • Customer KYC
    • Any other documents as required

    To know more about policy or claim assistance you can write to us at care@policybazaar.com or speak to us at 1800-708-8787.

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