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Iffco-Tokio General Insurance Pvt Ltd

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Iffco-Tokio General Insurance (ITGI)

Tokio General Insurance (ITGI) was established on 4th December 2000 with headquarters at New Delhi, with a vision of developing customer satisfaction through fairness, transparency and quick response. It is a joint venture between the Indian Farmers Fertilizer Co-operative (IFFCO) and its associate and Tokio Marine and Nichido Fire Group is the largest listed insurance group in Japan.

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It is also the only insurance company in the country to have a 100%- owned distribution channel to service its retail customers called IFFCO-TOKIO Insurance Services Ltd (ITIS). During 2014-15, it achieved an impressive Rs 3398.68 crores, thereby becoming one of India’s leading private players.

Iffco-Tokio General Insurance (ITGI)

Individual Medishield & Mediclaim Policy

What does the Policy Cover?

In the unfortunate event of you or your family members meeting with an illness or accident resulting in hospitalization Iffco health insurance gives you a cash free hospitalization in more than 3000 hospitals across India. This also reimburses the expenses during pre-hospitalization and post-hospitalization stages of the treatment.

Pre-Hospitalization:

Medical expenses incurred 60 days prior to the hospitalization are reimbursed.

Hospitalization:

All expenses including the following reimbursed:

Room and board, doctors' fee, intensive care unit charges, nursing expenses, surgical fees, operating theatre expenses, anesthesia and oxygen administration expenses, room, boarding & nursing expenses for normal room/ICU limited to 1% or 2.5% of basic sum insured per day respectively.

Post-Hospitalization:

Once discharged from the hospital, the policy shall pay for medical expenses related to the hospitalization, for a period of 60 days after discharge.

Hospital Daily Allowance:

In addition to hospital expenses, a daily hospital allowance will be paid for the period of hospitalization.

Individual Medishield Policy of Iffco-Tokio General Insurance offers Daily Hospital Allowances

Emergency Assistance Service:

In the event of an emergency, assistance services like medical consultation, evaluation and referral, emergency medical evacuation, and care for minor children, among others. are provided.

Local Ambulance Service:

In the event of an emergency, the cover is provided for expenses incurred on ambulance services to the nearest hospital where emergency health facilities are available.

General Health Checkup:

Reimbursement will be given for the expenses incurred for general health examination (once in a block of 4 claims free years)

Cumulative Bonus:

You will be provided with a 5% extra sum insured for every claim free year subject to a maximum of 50% of capital sum insured.

Benefits under Section - 80D:

Premium up to Rs. 35,000 is eligible for deductions under Section 80D of Income Tax Act, 1961. However, there are sub-limits within this overall limit. Premium up to Rs 15,000 is eligible for tax deduction for self, spouse and dependant children. Additionally, premium up to Rs 20,000 is eligible for tax relief or parents’ health cover if they are senior citizens (otherwise Rs 15,000 is eligible)

ITGI's Medishield policy ensures comprehensive coverage by offering value-added features, at a nominal increase in premium, like:

Critical Illness Extension:

You will be covered for 10 named critical illness for double the basic cover sum insured at 40% of the basic cover premium

What does the Policy Not Cover?

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  • Diseases, which have been in existence at the inception of the policy.
  • Illness that commenced during the first 30 days of inception of the first policy.
  • Cataracts, benign prostate hypertrophy, hysterectomy for menorrhagia or fibromyoma, hernia, hydrocele, fistula in the anus, piles, sinusitis and related disorders, in the first year of insurance. However, on renewal, these exclusions shall not apply. For a complete list of exclusions, refer to the policy.
Medishield (Individual Plan) Covers
  • Hospitalization
  • Pre-hospitalization
  • Post-hospitalization
  • Emergency assistance service
  • Local ambulance service
Indicative Premium Chart*
Sum InsuredType ofCover*Up to 25Years26-35 Years36-45 Years46-55 Years56-60 Years
1 LakhsBasic1,098/-1,255/-1,513/-2,275/-3,200/-
Basic + Critical Illness1,537/-1,757/-2,119/-3,185/-4,480/-
1.5 LakhsBasic1,609/-1,838/-2,217/-3,351/-4,720/-
Basic + Critical Illness2,252/-2,574/-3,104/-4,691/-6,608/-
2 LakhsBasic2,069/-2,364/-2,851/-4,350/-6,145/-
Basic + Critical Illness2,896/-3,309/-3,991/-6,090/-8,603/-
2.5 LakhsBasic2,477/-2,830/-3,414/-5,273/-7,474/-
Basic + Critical Illness3,468/-3,963/-4,779/-7,382/-10,464/-
3 LakhsBasic2,886/-3,297/-3,977/-6,195/-8,804/-
Basic + Critical Illness4,040/-4,616/-5,567/-8,673/-12,326/-
3.5 LakhsBasic3,243/-3,706/-4,469/-7,041/-10,038/-
Basic + Critical Illness4,541/-5,188/-6,257/-9,857/-14,053/-
4 LakhsBasic3,601/-4,114/-4,962/-7,886/-11,273/-
Basic + Critical Illness5,054/-5,760/-6,947/-11,040/-15,782/-
4.5 LakhsBasic3,958/-4,523/-5,455/-8,732/-12,508/-
Basic + Critical Illness5,542/-6,332/-7,637/-12,225/-17,511/-
5 LakhsBasic4,316/-4,931/-5,947/-9,577/-13,742/-
Basic + Critical Illness6,042/-6,904/-8,326/-13,408/-19,239/-
  • Family discount is available (5% for 2 people, 10% for 3 or more people)
  • Benefits / rates given in the leaflet are indicative Maximum
  • Entry Age: 5- 55 years (medical reports required above 45 years of age)
*Rates are not Inclusive of Service Taxes.

Medishield (Individual Plan) Covers

Premium up to Rs. 35,000 is eligible for deductions under Section 80D of Income Tax Act, 1961. However, there are sub-limits within this overall limit. Premium up to Rs 15,000 is eligible for tax deduction for self, spouse and dependent children. Additionally, premium up to Rs 20,000 is eligible for tax relief or parents’ health cover if they are senior citizens (otherwise Rs. 15,000 is eligible).

Group Mediclaim Policy

This policy will be available for any group of more than 50 members.

Benefits
  • Lower premium costs
  • Coverage for all members
  • Cashless facility across network hospitals
  • Covers from the first day of inception of policy
  • Provides incentives
Coverage
  • Domiciliary Hospitalization
  • Day Care Treatment
  • Pre and Post-Hospitalization
Exclusions:
  • Vaccination
  • Naturopathy, acupuncture, magnetic treatment, alternative medicines, etc. ‘
  • Any claims arising from pregnancy, dangerous sports activities, HIV/AIDS, war, terrorism,
  • Obesity treatment, hormone replacement therapy, genetic disorders,
  • Nursing and medical expenses, pre and post hospitalization charges, outpatient diagnostic procedures
  • All non-medical expenses including personal comfort and convenience items or services such as telephone, television, diet charges, baby food, cosmetics, napkins, toiletry items and guest services

Individual Personal Accident Policy

It is a fact that life today is uncertain. Everybody is always at risk - on the roads, at work, while traveling, or even inside their own home. Some unfortunate accidental occurrence might bring a huge financial burden to you and your family. Although you cannot guard against all uncertainties of life, you can always take steps to help you tide over such accidental events. ITGI's personal accident insurance policy provides just the right kind of cover for these uncertain times.

A complete protector personal accident insurance policy gives complete protection against all accidental occurrences that might lead to death or bodily injury of the insured person. If the accident leads to the untimely death of the Insured, this policy will provide complete financial security to the insured's family members. The policy also covers eventualities where though the insured person survives an accident, he is crippled for the rest or part of his life. In such cases, the policy will pay a fixed percentage of sum insured depending upon the type of disablement.

Individual Personal Accident Policy for Permanent Disability

Benefits Available
 
The complete benefit plan under the policy is given below:
Death, loss of both hands or both feet or one hand, loss of one hand/foot and sight of one eye, loss of speech or hearing in both ears, permanent total disability100% of Sum Insured
100% of Sum Insured
50% of Sum Insured
50% of Sum Insured
100% of Sum Insured
Note: Other benefits for accidents resulting into loss of fingers/toes or any other permanent partial disablement range from 5% to 40% depending on the type of disability. For temporary total disability, 1% of sum insured per week is payable subject to a maximum of Rs.6,000/- per week. For that extra protection and relief in those hard times, ITGI's personal accident insurance policy also gives the following additional benefits:

Educational Benefit 

The education cost of the dependent children is provided in case of death, loss of limbs/ eyes or permanent total disability of the insured.

Employment Benefit

In the event of loss of employment of the insured due to unexpected accident resulting in total permanent disabililty, this policy provides financial compensation

Ambulance Benefit

This policy will pay ambulance expenses incurred during an accident.

Cumulative Benefit

The sum insured amount under individual and family covers is automatically increased on renewal up to specified limits without payment of any extra premium.

Other benefits include compensation for damaged clothing and expenses for carrying the dead body, etc.

When will Policy Not Pay?

Some of the important exclusions under the policy are self-injury, suicide, venereal disease, insanity, influence of intoxicating liquor or drugs, pregnancy or childbirth, HIV or AIDS, war and nuclear risks etc.

Who Can Apply for Personal Accident Insurance?

If you are not involved in any activity that is hazardous like aviation, ballooning, etc. and you are not a member of the armed forces and you fall within the specified age limits (5 to70 years), you can apply for this policy and get complete protection for yourself and your family members.

What are the Types of Policies?

The policy is available both as individual and family package covers and on group cover basis. Groups can comprise of employees of an organization and their dependents, members of clubs, societies and associations, holders of deposits/accounts with banks/financial institutions/companies, students/teachers of educational institutions, etc.

Group policies are eligible for attractive premium discounts depending on the size of the group.

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Group Personal Accident Policy

Iffco Tokio’s group personal accident policy is available to provide for payment of compensation in the event of members of your group:

Sustaining injury, disablement (permanent total, permanent partial and temporary total) or death arising out of accident

Coverage:

  • Death
  • Loss of limbs/eye
  • Permanent total disability
  • Permanent partial disability
  • Temporary total disability
  • Other coverages include expenses during carriage of the dead body, education benefit for two dependent children, etc.
Exclusions:
  • Self-injury, suicide, venereal disease or insanity
  • Influence of intoxicating liquor or drugs
  • Death due to pregnancy or childbirth
  • Breach of law with criminal intent
  • War and nuclear group of perils
  • On duty with armed forces
You Must Note
  • Group policies can be given to firm, company, association and clubs on named as well as unnamed basis where all members must be included
  • Group discount is allowed on size of group at inception of the policy
  • Additions and deletions can be done during currency of policy for people joining and leaving
  • The cover is normally available on 24-hour coverage basis
  • The company offers discount if you restrict the cover to your employees for on-duty cover only or for off- duty cover only
  • Other benefits like expenses for ambulance charges, damage to clothes, loss of employment, expenses for carriage of dead body are admissible- following an accident subject to a limit
  • Education fund for dependent child is admissible in case death or permanent total disablement
Documents required for settlement of claims
  • Claim form
  • Doctors report, bills in case of temporary/permanent disablement
  • Police report/post mortem report in case of accidental death
  • Leave certificate from employer in case of temporary disablement

Swasthya Kavach (Family Health) Policy

What does the Policy Cover

Swasthya Kavach (Family Health) policy gives protection cover for you and your family for any injury or disease-related contingencies like hospitalization, medical expenses, surgical expenses, organ transplantation, etc. The policy also offers unique critical illness coverage (optional) for the family and is available in two variants - base plan and wider plan and covers the following:

Swasthya Kavach Family Health Policy Gives Protection Cover for Your Family

Pre-Hospitalization:

Medical expenses incurred 30 days prior to the hospitalization are reimbursed.

Hospitalization:

All expenses including the following reimbursed:

Room and board, doctors' fee, intensive care unit charges, nursing expenses, surgical fees, operating theatre expenses, anesthesia and oxygen administration expenses.Room expenses for normal room/ICU limited to 1% /2% of sum insured per day for base plan and 1.5%/2.5% of basic sum insured for wider plan respectively. There are also restrictions on other hospital expenses in accordance with the room rent under the base plan.

Post-Hospitalization:

Once discharged from the hospital, the policy shall pay for medical expenses related to the hospitalization, for a period of 30 days after discharge subject to specified limits under base plan and 60 days after discharge under the wider plan.

Day Care Surgeries:

The policy covers 121 defined day care surgeries that require less than 24 hours hospitalization and ordinarily fall outside the scope of most health insurance policies.

Hospital Daily Allowance:

In addition to hospital expenses, a daily allowance will be paid for the period of hospitalization.

Emergency Assistance Service:

In the event of an emergency, assistance services like medical consultation, evaluation and referral, emergency medical evacuation, care for minor children, etc, are provided.

Local Ambulance Service:

In the event of an emergency, cover is provided for expenses incurred on ambulance services to the nearest hospital where emergency health facilities are available.

General Health Checkup:

Reimbursement for the expenses incurred for general health examination is given (once in a block of 4 claims free years). Applicable only under wider plan

Cumulative Bonus:

Provision with a 5% extra sum insured for every claim-free year subject to a maximum of 50% of capital sum insured. Applicable only under wider plan

Benefits under Section - 80D:

Premium up to Rs. 15,000 is eligible for self, spouse and dependant children with deductions under Section 80D of Income Tax Act, 1961.

ITGI’s Swasthya Kavach policy ensures comprehensive coverage by offering value-added features, at a nominal increase in premium, like:

Critical Illness Extension for Family:

Coverage will be given for 10 named critical illness for double the basic cover sum insured. 10 critical illness includes: paralytic stroke, cancer, renal failure, coronary artery disease, major injuries, end stage liver disease, major burns, coma, major organ transplant and multiple sclerosis. Applicable only under wider plan

What does the Policy Not Cover?
  • Diseases, which have been in existence at the inception of the policy.
  • Illness that commenced during the first 30 days of inception of the first policy.
  • During the first year of the policy, the expenses on treatment of diseases such as tonsillitis / adenoids, gastric or duodenal ulcer, any type of cyst/ nodules/ polyps, any type of breast lumps.
  • During the first two continuous years of the insurance with us, the expenses on treatment of diseases such as cataract, benign prostate hypertrophy, hysterectomy for menorrhagia or fibromyoma, hernia, hydrocele, fistula in anus, piles, sinusitis, cholelithiasis and cholecystectomy, inter- vertebral disc prolapse (other than caused by an accident), osteoarthritis, varicose veins / varicose ulcers etc.
  • Naturopathy, acupuncture, magnetic treatment, alternative medicines, etc.
  • Under the base plan, during the first two continuous years of the policy, the expenses on treatment of diseases such as renal failure, heart diseases, any type of carcinoma/sarcoma/blood cancer.
  • Any claims arising from pregnancy, dangerous sports activities, HIV/AIDS, war, terrorism, Obesity treatment, hormone replacement therapy, genetic disorders.
Swasthya Kavach (Family Health) Covers:
  • Hospitalization
  • Pre-hospitalization
  • Post-Hospitalization
  • Emergency assistance service
  • Local ambulance service
  • Critical illness extension (optional)
Indicative PremiumSum Insured options under this policy are Rs 2 lakhs, 3 lakhs, 4 lakhs and 5 lakhs only

(Base Plan) 2 Adults + 2 children *
YearsUpto 25 Years26-35 Years36-45 Years46-55 Years56-60 Years61-65 Years
S.I
2 Lakhs3,150/-3,443/-4,310/-6,525/-9,218/-11,523/-
3 Lakhs3,663/-3,976/-5,200/-9,293/-13,206/-16,508/-
4 Lakhs4,570/-4,961/-6,229/-11,829/-16,910/-21,138/-
5 Lakhs5,478/-6,259/-7,777/-13,791/-19,788/-24,735/-
(Wider Plan) 2 Adults + 2 children *
YearsUpto 25 Years26-35 Years36-45 Years46-55 Years56-60 Years61-65 Years
S.I
2 Lakhs3,652/-3,974/-5,297/-8,458/-11,949/-14,936/-
3 Lakhs4,852/-5,544/-7,038/-12,046/-17,119/-21,399/-
4 Lakhs6,054/-6,918/-8,782/-15,334/-21,920/-27,400/-
5 Lakhs7,257/-8,292/-10,526/-18,622/-26,721/-33,401/-
(Wider Plan with Critical Illness) 2 Adults + 2 children *
YearsUpto 25 Years26-35 Years36-45 Years46-55 Years56-60 Years61-65 Years
S.I
2 Lakhs4,565/-4,968/-6,622/-10,573/-14,936/-18,670/-
3 Lakhs6,065/-6,065/-8,798/-15,058/-21,399/-26,749/-
4 Lakhs7,568/-7,568/-10,978/-19,168/-27,400/-34,250/-
5 Lakhs9,071/-10,365/-13,158/-23,278/-33,401/-41,751/-
  • Benefits / rates given are indicative Maximum
  • Entry Age: Proposer: 18 years to 60 Years and dependent children: 91 days to 23 years (medical reports required for age of 45 years and above
  • Photographs of all insured members compulsory
*Rates are not inclusive of service taxes.

Section 80D Income Tax Benefits:

Premium up to Rs. 15,000 is eligible for tax deductions for self, spouse and dependent children under Section 80D of Income Tax Act, 1961.

Critical Illness Policy

At a time of increasing cost of living, the expenses for medical treatment have gone up substantially. Particularly if any person contracts a major disease (critical illness), then he/she has to spend a huge sum of money for treatment, which most people can ill afford.

Although you cannot prevent the occurrence of serious ailments and accidents, you can take steps to ensure that the same does not result in financial ruin for you and your family. ITGI's critical illness insurance policy provides just the right kind of cover for such situations at a very affordable price.

A Complete Protector

The standard medical cover available in the market is perceived to be rather expensive for the common man. Normal hospitalization while also involving a financial strain, can even then be sustained by an average person. But treatment for critical illness, while saving the person's life could cripple him financially. By paying a fraction of the normal premium required to be paid for a full-fledged medical cover, complete protection can be taken through this policy when it is needed the most. The ailments which are covered under this policy are cancer, renal failure, coronary artery diseases requiring bypass surgery, major organ transplant, paralysis, cerebral stroke as well as accidental injuries resulting in loss of limbs.

Benefits Available

The policy covers the following heads of expenses, which are normally incurred in the event of a critical illness treatment:
  • Room rent and boarding expenses.
  • Nursing expenses.
  • Surgeon, anesthetist and medical practitioner/consultant's fees.
  • Cost of anesthesia, blood, oxygen, operation theater, surgical appliances, medicines & drugs, diagnostic materials and X-ray, dialysis, chemotherapy, radiotherapy, pacemaker, artificial limbs etc. and similar expenses.
When will the Policy Not Pay?

Some of the important exclusions under the policy are as follows:
  • Treatment pertaining to pre-existing diseases. 
  • Any medical treatment due to a disease during the first 120 days of commencement of insurance cover. 
  • Any expense for treatment related to human T-cell lymphotropic viruses type II (HTLV-III) or lymphadenopathy associated viruses (LAV) or their mutant derivatives or variations, any syndrome or condition of a similar kind referred to as AIDS.
  • Treatment for ailments arising out of drug addiction or alcoholism.
  • War, nuclear and terrorism risks.
  • Any attempted self-injury or suicide.
Critical Illness Policy Does Not Cover Suicide

What Extra Benefits can be Covered?

At an extra premium, you can cover the following items under your critical illness insurance policy:
  • Education cover
  • Ambulance charges
  • Cost of travel
  • Cost of supporting items
  • Boarding and lodging expenses
Who can Apply for this Policy?

This policy can be issued to various categories of groups as under:
  • Employers covering their employees including dependants of the employees
  • Pre-identified segment/group where the premium is paid by the State/Central Government.
  • Members of registered service clubs.
  • Holders of credit cards or other financial cards.
  • Holders of deposit or certificate of banks/NBFCs.
  • Shareholders of public limited companies, cooperative societies, etc.
  • Students/teachers of educational institutions.
  • Members of any other group having common identification or interest.

Health Protector Policy

This policy offers a health protection cover for you and your family for any illness, disease or injury related contingencies like hospitalization, medical expenses, surgical expenses, organ transplantation, etc.  

Coverage
  • Hospitalization expenses
  • Room rent and boarding expenses. 
  • Nursing expenses. 
  • Surgeon, anesthetist and medical practitioner/consultant's fees. 
  • Cost of anesthesia, blood, oxygen, operation theater, surgical appliances, medicines & drugs, diagnostic materials and X-ray, dialysis, chemotherapy, radiotherapy, pacemaker, artificial limbs, etc. and similar expenses
  • Ayurdevic and other alternative treatment cost
Benefits

Pre-Hospitalization:

Medical expenses incurred 45 days prior to the hospitalization are reimbursed.

Post-Hospitalization:

Once discharged from the hospital, the policy shall pay for medical expenses related to the hospitalization, for a period of 60 days after discharge.

Day Care Surgeries:

This covers 121 defined day care surgeries that require less than 24 hours hospitalization and ordinarily fall outside the scope of most health insurance policies.

Hospital Daily Allowance:

In addition to hospital expenses, a daily allowance will be paid for the period of hospitalization.

Emergency Assistance Service:

In the case of an emergency, assistance services like medical consultation, evaluation and referral, emergency medical evacuation, care for minor children etc are provided.

Ambulance Service:

In the event of an emergency, cover is provided for expenses incurred on ambulance services to the nearest hospital where emergency health facilities are available.

General Health Checkup:

Reimbursement for the expenses incurred for general health examination is given (once in a block of 4 claim-free years) - Applicable only under Wider Plan

Cumulative Bonus:

Provision with a 5% extra sum insured for every claim-free year subject to a maximum of 50% of capital sum insured

Vaccination Expenses

Reimbursement of vaccination costs at the end of every block of two policy period of 365 days.

Senior Citizen Coverage

Grievance management for senior citizens based on IRDA regulations 

What Extra Benefits can be Covered?

This policy provides higher sum to cover expenses (as listed in Basic Cover) related to following critical illnesses:
  • Cancer
  • First heart attack
  • Open chestcoronary artery bypass surgery (CABG)
  • Open heart replacement
  • Coma
  • Kidney failure requiring regular dialysis
  • Stroke resulting In permanent symptoms
  • Permanent paralysis of limbs
  • Motor neurone disease with permanent symptoms
  • Multiple sclerosis with persisting symptoms
  • Major organ / bone marrow transplant
Health Protector Policy Offers Coverage for Organ Transplantion

Health Protector Policy (Family) covers
  • Hospitalization
  • Pre-hospitalization
  • Post-hospitalization
  • Emergency assistance service
  • Local ambulance service
  • Critical illness extension (optional)
  • Vaccination expenses
Health Protector Plus Policy

This policy offers protection for you and your family against any injuries or disease-related contingencies like hospitalization, medical expenses, surgical expenses, organ transplantation, etc.

Coverage
  • Hospitalization expenses
  • Room rent and boarding expenses
  • Nursing expenses
  • Surgeon, anesthetist and medical practitioner/consultant's fees. 
  • Cost of anesthesia, blood, oxygen, operation theater, surgical appliances, medicines & drugs, diagnostic materials and X-ray, dialysis, chemotherapy, radiotherapy, pacemaker, artificial limbs, etc. and similar expenses
  • Ayurdevic and other alternative treatment cost
  • Ambulance charges
Benefits:
  • Cashless hospitalization benefits in over 4000 hospitals across India
  • Can opt for one year or as a top-up plan
  • Lifelong renewal
  • Can be purchased without any other basic health plan
  • Income Tax benefits under Section 80D
  • Waiver of deductible in case of loss or change of job for a period of 30/60/90 days
Exclusions

Applicable only for insurers in service below 55 yrs of age and not for self-employed

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Good article and also informative
spatil579 Friday, March 12, 2010

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