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Health Insurance 420 views July 15, 2021
Navi COCOCure Plan provides financial protection to the insured person against medical expenses. This policy covers persons aged 91 days to 70 years. However, there is no maximum entry age limit for sums insured of INR 2 Lakh. You can cover a dependent child under this policy, while the maximum entry age limit for your child is 30 years. Read this page and know more about the Navi COCOCure Plan benefits.
Table of Contents
Under this policy, the insurer will cover the following medical expenses for the illness/injury that occurs during the policy period.
In-patient Hospitalization: The insurer will cover the expenses incurred for medically necessary treatment, provided the insured is admitted as an in-patient to a hospital for more than 24 consecutive hours. Under this policy, the insurer will cover the following:
Modern Treatments & Methods: The following procedures will be covered under this policy, provided the insured is admitted as an in-patient or if it is part of a daycare treatment:
Mental Illness: You will get coverage for the following mental illnesses:
The company’s maximum liability under this cover is restricted to the sum insured or INR 3 Lakhs, whichever is lower.
HIV & AIDS: The insurer will cover the in-patient hospitalization and daycare treatment for HIV or any condition caused by or associated with Acquired Immunodeficiency Syndrome (AIDS).
Daycare Treatment: You’ll get coverage for the list of daycare treatments as mentioned in the policy schedule.
Pre-hospitalization: Any medical expenses incurred before the hospitalization shall be covered for the number of days as specified in the policy schedule.
Post-hospitalization: Medical expenses incurred after discharge from the hospital shall be covered for the number of days as specified in the policy schedule. If the insured person has undergone more than one hospitalization within 45 days, the cover for post-hospitalization expenses shall not exceed 60 days.
Domiciliary Hospitalization: If the medical treatment is continuously required for at least three days at home, the insurer will cover the medical expenses incurred during such a period.
Critical Illness Benefit: The insurer will pay the sum insured as stated in the policy schedule if the insured person of 18 years or above is diagnosed to be suffering from any of the covered 10 critical illnesses during the policy period
In case of hospitalization due to any of the following illnesses, the sum insured will not be reduced if the claim amount is up to INR 20,000.
If the admissible claim amount exceeds INR 20,000, the amount over INR 20,000 will be reduced from the sum insured. The insurer will not pay for any hospitalization or treatment arising out of the above-mentioned illnesses during the first 15 days from the inception of the policy.
If the base sum insured and accrued cumulative bonus are exhausted due to claims, the insurer will automatically reinstate the sum insured up to 100% for that particular policy year. The reinstated base sum insured will only apply to in-patient hospitalization.
You can enhance your policy coverage by adding any of the following optional covers to it:
Emergency Road Ambulance, Repatriation of Mortal Remains & Funeral Expenses
The insurer shall cover the transportation expenses of the insured person from the place of the incident to the hospital or from one hospital to another hospital or diagnostic center for advanced diagnostic treatment. In case of death of the insured, the insurer shall cover the transportation of mortal remains from hospital to home or the cremation ground for funeral purposes.
Organ Donor Expenses: The insurer will reimburse the surgical expenses incurred for the donor in case of a major organ transplant. Under this policy, the insurer also covers the expenses incurred for transportation including preservation during transportation of the organ, subject to a maximum of INR 20,000 per event.
Medical expenses incurred on in-patient hospitalization for Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homeopathy treatment shall be covered under this policy
Hospital Daily Cash
The insurer will pay a fixed amount, as stated in the policy schedule, for each day of hospitalization up to 30 consecutive days in a policy year. In case you are admitted to ICU and partly to Non-ICU, the daily cash amount will double.
Maternity and Newborn Baby
The insurer will cover the following maternity expenses under this policy
Other than the maternity expenses, the insurer will also cover the medical expenses towards the treatment of a newborn baby post-birth up to 90 days from the date of delivery. The insurer shall also cover the expenses incurred for the vaccination of the newborn baby.
Worldwide Emergency Hospitalization
You’ll get coverage for in-patient hospitalization outside India, subject to the limit as stated in the policy schedule
Cumulative Bonus: You will receive 10% of the Base Sum Insured on a cumulative basis after each claim-free year on renewal. The accumulated cumulative bonus shall not exceed 50% of the Base Sum Insured in any policy year.
Medical Second Opinion
If you are diagnosed with any covered critical illness during the policy period, you can obtain a medical second opinion regarding the diagnosis of the same or before planning for any surgical procedure or course of treatment. A total of five sessions for each insured member is allowed in a year. The insurer’s maximum liability is limited to INR 1,500 per session under this cover.
Emergency Air Ambulance
You’ll get coverage for Air Ambulance in India for the treatment of a disease/illness/injury in case of an emergency.
The insurer will enhance the renewal policy sum insured by 10% of the base sum insured on a cumulative basis for each policy year, irrespective of a claim made in the expiring policy year.
Outpatient Treatment: Outpatient consultations, diagnostic examinations and pharmacy expenses shall be covered under this section.
Infertility Treatment: The insurer will cover medical expenses for two In-Vitro Fertilisation (IVF) cycles in the lifetime of the female insured person. The coverage is available for a female insured aged between 25 and 40 years.
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