Group Insurance June 4, 2021

Navi Group Critical Illness Insurance Policy

Navi Group Critical Illness Insurance Policy provides financial protection to the employees  against critical illness and personal accident  during the policy term. The plan comes with attractive features that you can see below.

  1. Critical Illness Cover
  2. Medical Second Opinion
  3. Free Health Check-up
  4. Child Tuition Benefit
  5. Additional Critical Illness Benefit
  6. Second Critical Illness Cover
  7. Personal Accident Cover
  8. Loss of Job

Keep reading this page below and learn about the coverage of Navi Group Critical Illness Insurance Policy in detail.

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Navi Group Critical Illness Insurance Policy Base Cover

The employees will get coverage against the following under this policy:

Critical Illness Cover: The insurer will pay the sum insured, as specified in the policy schedule, if the insured is diagnosed with any of the following critical illnesses for the first time during the policy period.

  1. Cancer of Specified Severity
  2. First Heart Attack of Specified Severity
  3. Myocardial Infarction
  4. Open Chest CABG
  5. Open Heart Replacement or Repair of Heart Valves
  6. Aorta Graft Surgery
  7. Cardiomyopathy
  8. Primary (Idiopathic) Pulmonary Hypertension
  9. Coronary Artery Disease
  10. Pulmonary Artery Graft Surgery
  11. Stroke Resulting In Permanent Symptoms
  12. Motor Neuron Disease with Permanent Symptoms
  13. Permanent Paralysis of Limbs
  14. Bacterial Meningitis
  15. Benign Brain Tumor
  16. Encephalitis
  17. Multiple Sclerosis With Persisting Symptoms
  18. Major Head Trauma
  19. Progressive Supranuclear Palsy
  20. Apallic Syndrome
  21. Spinal Stroke
  22. Kidney Failure Requiring Regular Dialysis
  23. End-Stage Liver Failure
  24. End-Stage Lung Failure
  25. Major Organ/Bone Marrow Transplant
  26. Coma of Specified Severity
  27. Pneumonectomy
  28. Aplastic Anemia
  29. Alzheimer’s Disease
  30. Blindness
  31. Deafness
  32. Loss of Speech
  33. Loss of Limbs
  34. Third-Degree Burns
  35. Primary Parkinson’s Disease
  36. Multiple System Atrophy
  37. Creutzfeldt-Jakob Disease (CJD)
  38. Systemic Lupus Erythematosus
  39. Goodpasture’s Syndrome
  40. Progressive Scleroderma
  41. Medullary Cystic Disease
  42. Muscular Dystrophy

Medical Second Opinion: If the insured is diagnosed with any of the above-mentioned critical illnesses during the policy period, they can obtain a medical second opinion before proceeding to any surgical procedure or course of treatment. The insurer will organize a medical second opinion for the insured through its service provider. Conditions applicable to this benefit are as follows:

  1. The second opinion will be based upon the information and documentation provided by the insured
  2. This benefit is available only once during the policy period
  3. The insured is free to choose whether or not to obtain the second opinion

Free Health Check-up: At the end of every two claim-free policy years, the insurer will arrange free health check-ups of the insured at the network hospital.

Child Tuition Benefit: The nominee will receive a sum insured against this benefit, as specified in the policy schedule, in case the insured suffers from critical illness or accidental death during the policy term. This benefit will be payable to the insured’s dependent child who is a full-time student in any recognized educational institute at the time of accidental death or critical illness.

Additional Critical Illness Benefit: You’ll get coverage against the following critical illnesses/surgery during the policy term in addition to the critical illness cover.

  1. Early Stage Cancer
  2. Carcinoma-in-situ
  3. Angioplasty

Second Critical Illness: The insurer will pay the applicable sum insured against this benefit as stated in the policy schedule if the insured is diagnosed with a second critical illness after the first incidence during the policy term. Such critical illness should not be the same for which the insured has already made a claim. The second critical illness claim is admissible if it is diagnosed one year after the diagnosis of the first critical illness.

Note: This benefit is payable to the insured only once during the policy period.

Personal Accident Cover: If the insured suffers an accidental injury during the policy period and it results in death within twelve months from the date of the accident, the insurer will pay a sum insured to the nominee as specified in the policy schedule. The benefit under this cover is also payable in case the insured person’s body cannot be located within twelve months from the date of the accident.

Loss of Job: The insurer will pay up to 3 EMIs of the insured’s loan in the event of loss of Job during the policy period. The covered loan EMIs are subject to the following conditions:

  1. Insured should be a confirmed permanent employee of the organization and receiving a a salary
  2. The insured is paying his/her EMI regularly
  3. The insured needs to submit a sanction letter and repayment track record or bank account statement or loan account statement reflecting EMIs
  4. The claim under this benefit is payable on termination, dismissal, temporary suspension or retrenchment from the employment for more than 30 days
  5. This benefit shall be paid once
  6. The due EMI must fall after the commencement of loss of job and before reinstatement of employment with the same or new employer

Navi Group Critical Illness Insurance Policy Waiting Period

The insurer will not cover any medical expenses arising out of pre-existing disease/illness/injury. However, the same would be covered under this policy after a 48-month waiting period, provided the policy is renewed without any break.

Exclusions from Navi Group Critical Illness Insurance Policy

The insurer will not provide coverage under this policy if the claim arises due to the following –

  1. Substance-related and Abusive Disorders
  2. Breach of Law
  3. Chemical and Nuclear Exposure
  4. War
  5. Self-Inflicted Injuries or Attempted Suicide
  6. External Congenital Anomaly, Disease or defects
  7. Participation or involvement in naval, military or air force operation, racing, diving, aviation, scuba diving, parachuting, hang-gliding, rock or mountain climbing, etc.
  8. Treatment by an unrecognized physician
  9. Maternity and Pregnancy-related expenses

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