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OneHealth Brochure

This document summarizes the key features of a health insurance plan offered by Magma HDI. The plan offers various types of coverage options including individual and floater plans. It provides features such as restoration of sum insured, hospital daily cash benefits, and cumulative bonus. The plan also offers optional covers including critical illness, voluntary co-payments, and top-up policies. It details the eligibility criteria, claim procedure, and exclusions under the policy.

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0% found this document useful (0 votes)
638 views2 pages

OneHealth Brochure

This document summarizes the key features of a health insurance plan offered by Magma HDI. The plan offers various types of coverage options including individual and floater plans. It provides features such as restoration of sum insured, hospital daily cash benefits, and cumulative bonus. The plan also offers optional covers including critical illness, voluntary co-payments, and top-up policies. It details the eligibility criteria, claim procedure, and exclusions under the policy.

Uploaded by

Seemanadig
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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Product Highlights 3.

Voluntary Co-payment: Tax Benefits:


Payment of Premium by any mode other than cash for this insurance
You can choose this 10% or 20% co-payment optional cover and avail is eligible for relief under Section 80D of the Income Tax Act 1961.
Types of Plans: discount on premium. By opting for this, a defined percentage of each
One stop solution for all your health insurance cover needs. We have claim has to be borne by you, rest will be paid by us.
5 variants viz. Support, Secure, Support Plus, Shield and Premium. Exclusion:
Indicative list of permanent exclusion regarding claims for conditions
Features: Key Additional Features arising out of or related to -

IN SICKNESS AND
• Recharge of Sum Insured: Restore your Sum Insured in case Sum Early Joining benefits: • Substance abuse • Hazardous sports
Insured and Cumulative Bonus is insufficient due to previous claim If you buy this policy with us before the age of 40 and renew it • External congenital anomaly • Cosmetic treatment
in policy year, valid upto 5 times per policy year. continuously, and there is no claim, we give additional benefit amount - • Treatment not supported by prescription

IN HEALTH
• Hospital Daily Cash benefit: Additional lump sum daily cash • ` 2,500 in 6th Policy year, (i.e. 5 claim-free policy years) This is an indicative list. Please refer to policy wordings for complete details.
benefit amount for each day of hospitalization.
• Additional ` 5,000 in 11th Policy year (i.e. 10 claim - free policy
• Cumulative Bonus: For each claim-free policy year, a percentage years)
Claim Procedure:
of Sum Insured will be awarded as Cumulative Bonus. This bonus You can avail cashless facility at our Network hospital or claim as
You can claim this amount as OPD expenses (including pharmacy). Our new and improved OneHealth insurance
is not reduced in case of claim except if utilized in the form reimbursement.
Unutilized amount will be carried forward to subsequent years. Claims made easy - Download our "Magma HDI" mobile app or visit
of payout. protects you, come what may.
our website "www.magmahdi.com" to avail the following:
• Free Health check-up: Annual free health check-up irrespective Second E-Opinion: 1. Intimate and track claims 2. Avail wellness services
of claims in a policy year. You can choose to avail second e-opinion in case of any specified 3. Download forms 4. Search hospital for cashless facility
Critical Illness. 5. Access your policy features and health card, and more.
New age Covers:
We understand the health insurance needs of new age customers.
Fitness rewards and Wellness services: Freelook:
Hence, we also offer gen-next covers like:
Undertake fitness activities and earn fitness reward points. Redeem We provide you 15 days period from the date of receipt of the Policy
i) Loss of Income Benefit ii) Psychiatric Inpatient iii) Bariatric Surgery these as discount on your renewal premium. document to review the terms and conditions of this Policy. If you are
iv) Lasik Surgery v) In-vitro Fertilisation (IVF) Wellness Services: Avail Wellness Services like Doctor-on-call, not satisfied, you can request cancellation within this period - we will
Nutritionist e-consultation, etc. refund your premium after adjusting for pre-policy medical test cost,
Eligibility if conducted.
Avail Top-Up Policy
Age: Disclaimer:
You can convert this into a top-up policy by opting aggregate
Proposer/policyholder has to be minimum 18 years of age. Liability of the Company does not commence until the Company has
deductible optional cover and by paying applicable discounted
Minimum entry age: For Individual Plan - 5 years, for Floater accepted the proposal and full premium has been paid.
premium. Claim in a Policy Year becomes payable by us only after
Plan - 91 days | Maximum entry age is 65 years | Renewal - Life long
deductible limit is crossed.
Policy Type: During the proposal stage, proposer may need to undergo pre-policy
Individual Plan: Covers single person Sum Insured (`) Deductible Options (`)
medical check-up (PPMC) at network diagnostic centres at cashless basis,
Floater Plan: Covers maximum up to 4 Adults and up to 3 children 2L, 3L 1L/2L/3L if applicable under Magma HDI health underwriting guidelines. In case of
4L 1L/2L/3L/4L non-acceptance of proposals, premium will be refunded after adjusting
Optional Covers the cost of PPMC.
5L 1L/2L/3L/4L/5L
1. Critical Illness: 7.5L 2L/3L/4L/5L Toll Free No. 1800 266 3202
Lump sum payment if insured suffers defined Critical Illness OneHealth - MAGHLIP20101V021920
10L, 15L, 20L 2L/3L/4L/5L/10L Registered Office: Development House, 24 Park Street, Kolkata - 700 016
Critical Illness Sum Insured
25L, 30L, 50L 3L/4L/5L/10L [email protected] | www.magmahdi.com
Support Secure Support Plus Shield Premium IRDAI REG NO.-149 DATED: 22ND MAY 2012 | CIN: U66000WB2009PLC136327
1Cr 5L/10L OneHealth.ver.07-01-20 BR ENG
Equal to Trade logos displayed above belong to Magma Fincorp Ltd. and HDI Global SE
Sum Insured or ` 10,00,000 respectively, and are being used by Magma HDI General Insurance Company
Equal to Sum Insured Your Premium Zone
` 10,00,000 Limited, under license. Benefits may vary according to the plan opted for. The
whichever is lower Pay premium as per zone opted: advertisement contains only an indication of covers offered. For more details on
Zone 1: Delhi including National Capital Region, Mumbai including Risk Factors and exclusions, please read the terms & conditions and sales
Thane, Navi Mumbai, Vasai-Virar, Bangalore and Gujarat brochure carefully before concluding a sale.
2. Personal Accident: Lump sum payment in case of: Zone 2: Coimbatore, Pune, Hyderabad, Chandigarh, Chennai, Kolkata
Health Insurance
• Accidental death • Permanent Total Disability and Kerala Statutory Warning: Prohibition of Rebates (Under Section 41 of Insurance Act,
Zone 3: Rest of India 1938): (1) No person shall allow or offer to allow, either directly or indirectly, as an
Personal Accident Sum Insured: inducement to any person to take or renew or continue an insurance in respect of
Support Secure Support Plus Shield Premium In case of treatment in higher zone, co-pay is applicable. Please read any kind of risk relating to lives or property in India, any rebate of the whole or part
the policy wordings for details. of the commission payable or any rebate of the premium shown on the policy, nor
Equal to shall any person taking out or renewing or continuing a policy accept any rebate,
Sum Insured or ` 10,00,000 Opt for multi-year policy and avail tenure discount: except such rebate as may be allowed in accordance with the published
Equal to Sum Insured prospectuses or tables of the insurer: (2) Any person making default in complying
` 10,00,000 2-year tenure policy: 10% discount
whichever is lower 3-year tenure policy: 12.5% discount with the provisions of this section shall be liable for a penalty which may extend to
ten lakh rupees.
Plan Support Secure Support Plus Shield Premium
Sum Insured (SI) Rs. 2L | 3L | 4L | 5L 2L | 3L | 4L | 5L | 7.5L | 10L 2L | 3L | 4L | 5L | 7.5L | 10L 5L | 7.5L | 10L | 15L | 20L | 25L | 30L | 50L 10L | 15L | 20L | 25L | 30L | 50L | 1Cr

In-patient care Covered up to SI; Covered up to SI; Covered up to SI; Covered up to SI; Covered up to SI;
1 Room Rent Capping Room rent capped at 1% for normal Single private room No room rent capping No room rent capping No room rent capping
room and 2% for ICU
2 Pre Hospitalisation Expenses 30 days 30 days 30 days 60 days 60 days
3 Post Hospitalisation Expenses 60 days 60 days 60 days 90 days 90 days
4 Day Care Treatment Covered up to SI
5 Ambulance Cover Up to Rs. 2,000 Up to 2,500 Up to Rs. 5,000 Up to Rs. 7,500 Up to Rs. 10,000
6 Organ Donor Expenses Covered up to SI
Base Covers
7 Domiciliary Hospitalisation Covered up to SI
8 AYUSH Treatment Covered up to 10% of SI Covered up to 10% of SI Covered up to 50% of SI Covered up to SI Covered up to SI
9 IVF Treatment Cover Up to Rs. 50,000
10 Bariatric Surgery Cover Up to Rs. 1,00,000
11 Psychiatric treatment Cover Covered up to SI (sub-limit of Rs. 50,000 applicable for few conditions)
12 Lasik Surgery Cover Up to Rs. 25,000
13 HIV/AIDS Cover Covered up to 50,000
14 Cumulative Bonus 10% of SI, subject to a maximum of 50% 10% of SI, subject to a maximum of 50% 10% of SI, subject to a maximum of 100% 20% of SI, subject to a maximum of 100% 33.33% of SI, subject to a maximum of 100%
15 E Opinion for Critical Illness Covered
16 Annual Health Check-up Annual
17 Fitness Rewards and Wellness Services Applicable (Fitness Rewards points maximum up to 10% of premium can be earned)
18 Early Joining Benefit One time benefit amount of Rs 2,500 for 5 claim-free years and Rs 5,000 for 10 claim-free years
19 Green Channel Benefit Rs.1,000 for claims up to 50,000 and Rs. 2,000 for claims above 50,000 if treatment taken at PPN

20 Recharge of Sum Insured Not Applicable Recharge up to 100% of SI, max 5 times a Recharge up to 100% of SI, max 5 times a policy year Recharge up to 100% of SI, max 5 times a policy year Recharge up to 100% of SI, max 5 times a policy year
policy year
21 Hospital Cash Not Applicable Not Applicable Rs. 500 per day Rs. 1,000 per day Rs. 1,500 per day
22 Compassionate visit in case of CI Not Applicable Not Applicable Rs. 5,000 Rs. 15,000 Rs. 30,000
23 Loss of Income benefit Not Applicable Not Applicable 1/12th of SI or 1/12th of annual salary, whichever is lower; payable in lump sumeach month for 6 months

Additional 24 Enhanced Daily cash Benefit Not Applicable Rs. 1,000 per day Rs. 1,000 per day Rs. 1,000 per day Rs. 1,500 per day
Covers Home Treatment Additional Daily Cash Home treatment covered up to SI; Home treatment covered up to SI; Home treatment covered up to SI; Home treatment covered up to SI; Daily cash - For Zone Home treatment covered up to SI; Daily cash - For Zone
25 Benefit Daily cash - Not Applicable Daily cash - Not Applicable Daily cash - Not Applicable 1& 2: Rs. 2,000 per day; For Zone 3: Rs. 1,500 per day 1 & 2: Rs. 3,000 per day; For Zone 3: Rs. 2,000 per day
26 Companion Benefit Not Applicable Not Applicable Not Applicable Rs. 1,000 per day Rs. 1,500 per day
27 Maternity Benefits
1) Maternity Cover Not Applicable Not Applicable Not Applicable Not Applicable Up to Rs. 1,00,000
2) New Born Baby Cover Not Applicable Not Applicable Not Applicable Not Applicable Up to Rs. 50,000
3) Vaccination for New Born Not Applicable Not Applicable Not Applicable Not Applicable Up to Rs.10,000 (included within limit defined for New Born Baby Cover)

28 Outpatient Cover Not Applicable Not Applicable Not Applicable Not Applicable Up to Rs. 20,000 (sublimit of 30% of this limit is available once in 2 policy years towards Dental treatment, spectacles,
contact lenses and hearing aids)
29 Convalescence Benefit Not Applicable Not Applicable Not Applicable Not Applicable Rs. 20,000

30 Worldwide Emergency Hospitalization Not Applicable Not Applicable Not Applicable Not Applicable Up to 50% of SI or Rs.20,00,000, whichever is lower Deductible of Rs. 2L
Cover
31 Air Ambulance Cover Not Applicable Not Applicable Not Applicable Not Applicable Up to Rs. 1,00,000
1 Critical Illness Cover Equal to SI Equal to SI Equal to SI Equal to SI or 10,00,000 whichever is lower Rs. 10,00,000
2 Personal Accident Cover Equal to SI Equal to SI Equal to SI Equal to SI or 10,00,000 whichever is lower Rs. 10,00,000
For SI 2,3L: 1L/ 2L/ 3L For SI 2,3L: 1L/ 2L/ 3L
For SI 2,3L: 1L/ 2L/ 3L For SI 4L: 1L/ 2L/ 3L/ 4L For SI 4L: 1L/ 2L/ 3L/ 4L For SI 5L: 1L/ 2L/ 3L/ 4L/ 5L For SI 10L,15L, 20L: 2L/ 3L/ 4L/ 5L/10L
Optional Covers For SI 7.5L: 2L/ 3L/ 4L/ 5L
3 Aggregate Deductible For SI 4L: 1L/ 2L/ 3L/ 4L For SI 5L: 1L/ 2L/ 3L/ 4L/ 5L For SI 5L: 1L/ 2L/ 3L/ 4L/ 5L For SI 25L,30L, 50L: 3L/ 4L/ 5L/10L
For SI 5L: 1L/ 2L/ 3L/ 4L/ 5L For SI 7.5L: 2L/ 3L/ 4L/ 5L For SI 7.5L: 2L/ 3L/ 4L/ 5L For SI 10L,15L, 20L: 2L/ 3L/ 4L/ 5L/10L For SI 1Cr: 5L/10L
For SI 10L: 2L/ 3L/ 4L/ 5L/10L For SI 10L: 2L/ 3L/ 4L/ 5L/10L For SI 25L,30L, 50 L: 3L/ 4L/ 5L/10L

4 Voluntary Co-Payment 10% or 20% 10% or 20% 10% or 20% 10% or 20% 10% or 20%
1 Initial waiting period 30 days 30 days 30 days 30 days 30 days
2 Specific Disease waiting Period 2 years 2 years 2 years 2 years 2 years

Waiting Period 3 Pre-Existing Disease Waiting Period 4 years 3 years 3 years 3 years 2 years

4 IVF, Psychiatric, Bariatric and Lasik 3 years 3 years 3 years 3 years 3 years
treatments
5 HIV Cover waiting period 4 years 4 years 4 years 4 years 4 years
Instalment
1 Premium in Instalments Quarterly / Semi Annual
Options

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