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Future Generali Health Suraksha Silver Plan

Product Description:

Health Suraksha Individual is the health insurance offering of Future Generali to Indian residents between the age of 18 yrs and 70 yrs. The Insurer allows online purchase of their health insurance without pre-medical acceptance tests for people upto the age of 45 yrs while those above 45 yrs need to consult the Insurer offline and undergo pre-acceptance medical tests (50% of the medical test expense will be reimbursed by the Carrier upon acceptance of risk). Along with the Primary Insured adult, one can also take cover for a child who is above 90 months old under this policy, provided both parents are concurrently insured under the plan. Future Generali divides India into 3 regions – Zone A, Zone B and Zone C (refer Future Generali’s website for a list of cities under various zones). The Silver plan has been underwritten for people residing in Zone B. Should the Insured need to undergo medical treatment in hospitals under Zone A, the claim settlement will be as per Insurer’s claim settlement procedures & guidelines (co-pay of 20% for treatment in Zone A)

Know more about your Insurance

Key features: Availability, Benefits and Exclusions

Minimum Age at Entry : 18 years
Maximum Age at Entry : 70 years
Maximum Age at Renewal : 70 years
Minimum Sum Assured : Rs 1 lacs
Maximum Sum Assured : Rs 5 lacs
No claim Bonus – Annual : 10%
No claim Bonus – cumulative : upto 50%
Maternity Benefits : N/A
Pre-Existing Disease cover : after 4 years
Waiting Period : 30 Days

Product pricing (Incl. S/Tax)   (Rs)
Age SA 0.5 lacs SA 1 lac SA 1.5 lacs SA 2 lacs SA 2.5 lacs SA 3 lacs SA 3.5 lacs SA 4 lacs SA 4.5 lacs SA 5 lacs
0 – 25 yrs 790 1394 1714 2290 2610 3155 3375 3833 3999 5271
26 – 35 yrs 887 1652 1944 2431 2723 3539 3745 4115 4352 5746
36 – 45 yrs 1032 1734 2177 3104 3312 4095 4389 4963 5248 6381
Above 45 yrs Consult offline Consult offline Consult offline Consult offline Consult offline Consult offline Consult offline Consult offline Consult offline Consult offline

Claim procedure

  1. Intimation & Assistance - In case of planned hospitalization, select and approach the service desk of the chosen network hospital, preferably at least 72 hrs in advance. Use your Future Generali Health card or share your policy no and passport no with the healthcare provider for identification purpose. One can also use PAN card and voter ID card for the same.

  2. Pre-authorization: Get the pre-authorization form (available at the hospital help desk and/or TPA website), filled and signed from the treating doctor and submit the same with the hospital. The network hospital checks the identity of the Insured for validation and submits the pre-authorization form to the TPA. After cross verifying the identity of the Insured and the policy coverage, the TPA will provide confirmation to the provider by e-mail/fax and also inform the Insured by way of a text message.

  3. Cashless settlement: Get admitted for treatment at the network hospital and sign all forms, invoices and documents on discharge. Future Generali will directly make the payment to the hospital for pre-approved treatment and as per policy terms & conditions. Any non-medical expense and/or expenses towards conditions not authorized under hospitalization need to be paid directly by the beneficiary of treatment. Also, remember signing the Future Generali claims form and hand it over to the hospital along with all the relevant supporting documents.

*Please note in case of an emergency pre-authorization needs to be done with in 24 hrs of admission.

Some key statistics for Future Generali

Claims Pending Ratio : To be Announced soon
Complaints Resolved Ratio : To be Announced soon
Provider Network (cashless) : To be Announced soon

General Health Insurance Tips

Understand the cost of healthcare in your city/area before deciding the total cover (Sum Assured)

If your family includes a young bride, it is important to ensure the coverage of maternity benefits

Ask about the coverage of pre-existing diseases

Look at the waiting period

Satisfy yourself about the specific disease’s coverage under the Critical Illness cover

Inquire about the availability of cashless facility at the Network hospitals

Always compare before buying

Disclaimer: This is only an illustrative document to serve as a quick guide for aide in decision making.

Information Source: Future Generali website www.online.futuregenerali.in as on 28th Sep’2011
IRDAI annual report’2010