IOB Health Care

IOB Health Care
IOB Health Care
Health Care PLUS

The Scheme: The scheme provides for Mediclaim Insurance cover, which is available to all account holders maintaining a S.B. or C.D account in the age group of 18-65 years. The scheme is available to NRI customers also. However, the cover is available for treatment in hospitals in India. The Mediclaim Insurance cover is provided by Universal Sompo General Insurance Company Ltd(USGI).
The Scheme takes care of the hospitalization expenses, subject to maximum Sum Insured, in respect of the following eventualities:

  1. Sudden illness
  2. An accident
  3. Any surgery that is required in respect of any disease.

Salient Features:

  • The health insurance cover is available for a very low premium, which is far below the normal premium if the policy is taken individually by the account holder, directly from Insurance company.
  • Entire family of account holder, spouse and two dependent children are covered under Floater policy. Even parents of account holder are covered for additional premium.
  • Coverage option from Rs.50,000 to Rs.5.00 lakh is available.
  • Upper age limit for entry is up to 65 years. However, renewals are allowed up to 80 years. Age limit of dependant children - For male up to 21 years; For female up to 25 years or till their marriage whichever is earlier.
  • Preexisting diseases are not covered. However, the preexisting disease is covered in case of three continuous claim free years. 
  • Ambulance charges up to Rs.1,000 is reimbursable per policy period.
  • Cost of health check up allowed @ 1.00% of sum assured after completion of 3 continuous claim free years of policy.
  • In the case of Hospitalisation of children below 12 years a lump sum amount of Rs.1,000 as out of pocket expenses to any of the parent is payable per policy period.
  • Maternity benefit and baby care expenses are also reimbursed up to 5% of sum insured.
  • Treatment of NRIs in Indian Hospitals is allowed.
  • Treatment in hospitals in Nepal and Bhutan are also covered in Indian Currency.
  • Personal Accident death cover is available for additional premium.
  • Income tax benefit is available under section 80D for the premium paid.
  • Cash less access to networked hospitals is available through Third Party Administrator (TPA).
  • In case of death in hospital, funeral expenses are reimbursed up to Rs.1000 over and above the sum insured subject to original illness/accident claim admitted under the policy.

What are the exclusions in the policy :

  • The policy does not cover preexisting disease. However, the preexisting disease is covered in case of three continuous claim free years.
  • Hospitalisation expenses incurred in the first 30 days from the date of commencement of the cover except in the case of death due to accident.
  • Domiciliary hospitalisation is not covered under the policy.
  • Other standard exclusions applicable to mediclaim policy will also apply.

How can one become a member: The procedure to become a member of the scheme is very simple. There is no medical examination. All that the account holder requires to do is fill up and sign a proposal form which includes declaration of good health. 

How the premium is to be paid : The premium will be debited to the S.B. or C.D. account as per the authorisation given in the proposal form.

What is the period for which the insurance is available and how it is renewed : The insurance cover is available for a period of one year from the date of debit of the premium. Renewals are to be done on yearly basis on or before the due date.

What are the documents given in proof of insurance:  The account holder will be issued with a copy of the proposal form duly acknowledged by the branch for having debited the premium amount to the account. After receipt of the proposal form by the Insurance company and TPA, a policy will be issued by Insurance company and ID card will be issued by TPA.

How to make a claim in case of hospitalisation:  Cash less treatment can be availed at networked hospitals by showing the ID card issued by TPA along with the necessary ID proof as prescribed by the Insurance company and copies of valid insurance policiesand in case for any reason cashless service could not be availed, the insured can meet the hospital expenses and claim reimbursement from Universal Sompo General Insurance Company Limited(USGI).

Important Addresses:

Address of   Universal Sompo General Insurance Company Limited
1. Universal Sompo General Insurance Company Limited 
Head Office
A - 201, Crystal Plaza 
Opposite. Infinity Mall 
Link Road, Andheri (West) 
Mumbai - 400 058
Phone: 022-40287777 , Fax: 022- 40287781
 
For further details, please click at www.universalsompo.com

2. Universal Sompo General Insurance Company Limited
Southern Zonal Office
"Capitale Towers", 5 th Floor, "B" Wing
554-555, Anna Salai
Teynampet, Chennai - 600 018
Phone : 044-42975000

Address of TPA

 TTK HEALTHCARE SERVICES PRIVATE LIMITED

ANMOL PALANI, NO: 88, G.N. CHETTY ROAD

L 2, T. NAGAR, CHENNAI-600 017

PHONE NO:044-42894444, 42894530; FAX-42024343
Toll free number: 1800 425 7575 / 1800 424 8885
e-mail: iob@ttkhealthcareservices.com

 
Premium for New Policies / Renewal Policies w.e.f 01.04.2012 
 

Proposal Form for Fresh Applicants/ renewals

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