Key Features of Care Health Care Insurance (Formerly known as Religare Care Health Insurance)
With Care Health Care Insurance (Formerly known as Religare Care Health Insurance), you can avail the following unique medical benefits:
- 92% Claim settlement ratio(as per the insurer’s website)
- Cashless treatment in more than 16500network hospitals
- Annual medical check-up facility for all the insured members
- In-house claim settlement team with cashless claim approval in 2 hours
- Up to 150% increase in sum insured withNo Claim Bonus discount and NCB Super
- Automatic recharge of the sum insured
- 12 critical illnesses are covered under the Care Anywhere cover
- Various riders, such as Covid Care, Global Coverage, etc. to meet various health concerns
Inclusions of Care Health Care Insurance (Formerly Known as Religare Care Health Insurance) Plan
The following coverage is included under the Care Health Care Insurance policy:
- 30-day pre-hospitalization charges are covered
- Ambulance expenses are also covered under this plan
- In-patient hospitalization for a minimum of 24 hours including room rent charges, intensive care unit charges, nursing expenses, doctor and surgeon's fees, blood, anaesthesia, operation theatre, and oxygen charges.
- 540+day care treatments requiring hospitalization for less than 24 hours.
- 60-day post-hospitalization expenses are covered
- An Annual medical check-up is available.
- Reassurance of second medical opinion available
- Domiciliary hospitalization is also covered
- Organ donor expenses are also covered
- Alternate medical treatments are also covered
- Advance treatment methods are covered
- Daily allowance up to 5 days per hospitalization is available(under Rs 3 & 4 lakh SI)
- Global coverage for hospitalization expenses, excluding the USA, is available
- Vaccination cover for children available
- Care Anywhere cover with global coverage for 12 critical diseases available(under Rs 50 to Rs 75 lakh SI)
- Maternity cover available (under 50 to Rs 75 lakh SI)
Exclusions of Care Health Care Insurance (Formerly Known as Religare Care Health Insurance) Plan
The Care Insurance plan does not cover the following medical expenses:
- Expenses incurred on the treatment of congenital diseases are not paid by the insurer
- Hospitalization required due to self-inflicted injuries and suicidal attempts are not covered
- Medical treatment/hospitalization required due to an overdose of drugs and alcohol or intoxications are not recompensed
- Any disease/illness/surgery that has been diagnosed or has given symptoms within 30 days of the policy commencement date
- Medical tests and hospitalization pertaining to infertility and in vitro fertilization
- War, strike, nuclear weapons, and riots induced hospitalization
Refer to the policy wordings to get the complete list of exclusions.
Care Health Care Insurance (Formerly Known as Religare Care Health Insurance) Eligibility Criteria
Take a look at the eligibility criteria of the Care Health Care Insurance plan below:
- The minimum entry age is 5 years for individual coverage and 91 days for floater cover (with at least one insured above 18 years).
- There is no limit on maximum entry age.
- The plan offers a lifetime renewability benefit.
- There are 30 days of the waiting period for illness except for injuries
The waiting period of pre-existing illnesses is 4 years. Care Health Care Insurance (Formerly Known as Religare Care Health Insurance) Claim Process
Before filing a claim, it is always better to know the claim process that follows for different kinds of claims, including hospitalization, OPD, and everyday care. Take a look at the claim process below: Hospitalization Claim Process:
Emergency hospitalization treatment requires the policyholder to inform the insurance company within 24 hours of getting hospitalized. If it is a planned hospitalization, the insured should inform the insurer at least 48 hours before the hospitalization. The claim process for hospitalization is listed below:
- For Cashless Claims: Get admitted to a network hospital of Care Health Insurance Limited
- Submit the pre-authorization form at the hospital’s TPA desk who will fax it to Care Health Insurance Limited (Formerly known as Religare Health Insurance Company Limited)
- The claim management team will send the approval letter
- Receive the treatment and the insurance company will settle the claim after discharge from the hospital
- In case a query is raised by the claim management team, either the insured or the hospital can respond to them
- In case the cashless claim is rejected, the insured may start with the treatment, pay the bills and file a fresh claim for reimbursement after getting discharged from the hospital
For Reimbursement Claims:
- Avail treatment at a hospital and pay all the bills at the time of discharge
- Submit the claim form and all the required documents to the insurance company as per the terms and conditions
- The Care Health InsuranceLimited (Formerly known as Religare Health Insurance Company Limited)’s claim management team will verify the documents and coverage details
- The insurance company will inform the policyholder about claim approval and pay the claim amount.
- In case of rejection, the insurance company will inform the policyholder along with the reason for rejection.