Health Insurance 534 views June 7, 2021

Reliance HealthGain Policy

Reliance HealthGain policy provides financial protection against medical expenses during the policy term. This policy is available to persons aged between 18-65 years. Under this policy, you can cover your spouse, daughter, son, mother, father, siblings, grandmother, grandfather, granddaughter, grandson and daughter-in-law/son-in-law. You can purchase this policy on an individual or family floater basis. Continue reading this page below and know more about the coverage of the Reliance HealthGain Insurance Plan.

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Reliance HealthGain Policy Options

You can purchase this plan by choosing any of the following plans –

Plan APlan B
Sum insured options of INR 3 Lakh, 6 Lakh and 9 Lakh

Road ambulance cover up to INR 1,500 per hospitalization

No entry age bar

Pre-Policy Issuance Medical Check-up is required for individuals aged >=45 years
Sum insured options of INR 15 Lakh, 15 Lakh and 18 Lakh

Road ambulance cover up to INR 3,000 per hospitalization

Personal accidental death cover of INR 1 Lakh

One time renewal premium waiver if the policyholder suffers from a critical illness as specified in the policy schedule

Reliance HealthGain Policy Base Cover

You’ll get coverage against the following medical expenses under this policy

  1. In-Patient Treatment
  2. Pre & Post-hospitalization Expenses up to 60 days
  3. Day Care Treatments
  4. Donor Expenses up to 50% of the sum insured, subject to a maximum of INR 5 Lakh
  5. Domiciliary Hospitalization Expenses up to 10% of the sum insured, subject to a maximum of INR 50,000
  6. AYUSH Treatment covered up to 100% of the sum insured
  7. Modern Treatments covered up to 50% of the sum insured

Reinstatement of Base Sum-Insured

If the policy sum insured exhausts due to a claim or two, the insurer will restore it to 100% for further usage. However, only 20% of the restored sum insured can be used for the illness for which you have already claimed during the policy year. Whereas 100% of the sum insured can be used for a new or unrelated illness.

Cumulative Bonus

If you haven’t filed any claim during a policy year, you’ll be entitled to a cumulative bonus of 33.33% on your base sum insured.

Note: Total Cumulative Bonus should not exceed 100% of sum-insured.

Reliance HealthGain Policy Call Option

At the end of 4 consecutive claim-free years, you will receive the Call-Option with which you can double your sum-insured using your cumulative bonus. You can increase your sum insured up to 4X the base sum insured (under the first policy period) or INR 50 Lakh.

Note: You can exercise this option up to the age of 60 years. Exercising the call option will attract an extra premium.

Waiting Period Applicable to Reliance HealthGain Policy

Under this policy, the following waiting period shall apply from the date of inception –

  1. Initial Waiting Period: 30 days, applies to the treatment of illness
  2. Pre-Existing Diseases: 3 years
  3.  Specific Diseases: 2 years

Exclusions from Reliance HealthGain Policy

The insurer shall not pay for the medical expenses arising out of the following –

  1. Investigation & Evaluation/ Wellness and Rejuvenation
  2. Dietary Supplements & Substances
  3. Cosmetic or Plastic Surgery unless due to Accident/Burns or Cancer
  4. Hazardous or Adventure sports
  5. Breach of law
  6. Substance Abuse and Alcohol
  7. Refractive Error less than 7.5 dioptre
  8. Sterility and Infertility
  9. Maternity Expenses
  10. Dental Treatment
  11. External Congenital Anomaly
  12. Non-Allopathy Treatment except AYUSH
  13. Self-injury or suicide
  14. Nuclear Attack/War

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