Health Insurance IFFCO Tokio Health Insurance Critical Illness Benefit Policy

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IFFCO Tokio Critical Illness Benefit Policy

A standard health insurance policy usually does not cover critical illnesses, and for that reason, if you have a medical history in the family of critical illnesses such as kidney or heart-related issues, you need to have special protection for that. In that case, the health insurance companies have come up with dedicated critical illness policies. IFFCO Tokio General Insurance Company is not an exception, it has come up with a dedicated policy, the Critical Illness Benefit Policy, for those who want to protect themselves or their families against different types of critical illnesses. This plan offers coverage against 25 critical illnesses and surgeries where all the family members can be covered in a single policy, including parents and parents-in-law. To know more about this policy, have a look at the following mentions.

Eligibility Criteria

Parameters	Descriptions
Minimum entry age	Child – 3 years, Adult – 18 years
Maximum entry age	Child – 23 years, Adult – 65 years
Exit Age for child	24 years (in case of a 1-year policy where the child entered at 23 years of age) 25 years (in case of a 2-year policy where the child entered at 23 years of age) 26 years (in case of a 3-year policy where the child entered at 23 years of age).
Who can get cover	Self, spouse, daughter, son, brother, sister, parents, and parents-in-law.
Maximum Renewable Age for adult	Lifelong
Sum insured options	Rs. 1 lakh, Rs. 2 lakhs, Rs. 3 lakhs, Rs. 4 lakhs, Rs. 5 lakhs, Rs. 7.5 lakhs, Rs. 10 lakhs, Rs. 15 lakhs, Rs. 20 lakhs, Rs. 25 lakhs, Rs. 30 lakhs, 50 lakhs, Rs. 75 lakhs, and Rs. 1 crore
Policy period	1, 2, and 3 years
Grace period	30 days
Free look period	15 days

IFFCO Tokio Critical Illness Benefit Policy Details

This policy has come up with a bunch of benefits to safeguard you and your family against the specified critical illnesses and to offer you financial relief. The following table gives you the details of those. Have a look.

Parameters	Details
Conditions for coverage	The coverage will start only if the insured person fulfils the following conditions: The critical illness, medical event, and surgical procedure first commenced at least 30 days after the commencement of the policy period (or first policy period in case of renewal without break). The insured person needs to survive for a minimum of 28 days from the date of diagnosis.
Covered illnesses	Cancer of specified severity Kidney failure requiring regular dialysis Multiple Sclerosis with persisting Symptoms Benign Brain Tumour Motor Neuron Disease with Permanent Symptoms End Stage Lung Failure End Stage Liver Failure Primary (Idiopathic) Pulmonary Hypertension Parkinson’s Disease Before the Age of 50 Years Alzheimer’s Disease Before the Age of 50 Years
Covered surgical procedures	Major Organ (Heart, Lung, Liver, Kidney, Pancreas) or Human Bone Marrow Transplant Open heart replacement or repair of heart valves Open chest CABG Surgery Of Aorta
Covered medical events	Stroke resulting in permanent symptoms Permanent Paralysis of Limbs Myocardial Infarction (First Heart Attack of specified severity) Third Degree Burns Loss of Speech Blindness Loss of Limbs Deafness Coma of Specified Severity Major Head Trauma Muscular Dystrophy

Key highlights of IFFCO Tokio Critical Illness Benefit Policy

Apart from the above benefits and facilities, the policy has come up with several advantages that gave made the policy unique and popular among consumers. The mentions are as follows.

Pre-policy medical check-up:

No medical check-up is required up to the age of 50 years, which is subject to the proposal form having no adverse medical declaration. Wherever required, the Insured person(s) has to undergo a pre-policy check-up. If such a proposal is accepted and policy has been issued, the company would reimburse 50% cost of the diagnostic test charges.

Cancellation of the policy:

In case of cancellation of the policy, the refund will be calculated on a pro-rata basis as per the following formula:

R= [(365*k) -n/(365*k)]*p

Provided,

R = Refund on the policy

k = 1/2/3 years (policy duration)

n = total number of days of policy in force

P = Premium paid by the insured

Tax Exemption Benefits:

The premium paid under this policy is available for tax exemption benefits under Section 80D of the Income Tax Act.

Specific Conditions of IFFCO Tokio Critical Illness Benefit Policy

This policy includes certain specific conditions that you need to remember to avoid any misinterpretations. The mentions are as below.

The policy will provide one-time benefits for critical illnesses in a single policy period.

The policy is available on an individual basis.

For policies where all the members of the family are covered in a single policy, separate Sum Insured will be applicable for each member.

In case of an admissible claim for any insured person, the policy will terminate for him/her for the remaining policy period. The policy will remain active for other members covered in the policy.

Any critical illness/medical event/surgical procedure attributable to an Act of Terrorism stands covered.

Exclusions of IFFCO Tokio Critical Illness Benefit Policy

Understanding a policy is not completed if you do not go through its exclusions of it thoroughly. Therefore, to offer you a comprehensive idea of the policy, and to avoid future complications, here are the general and major exclusions of the IFFCO Tokio Critical Illness Benefit Policy.

Any existing loss, injury, or accident which occurred before the commencement of the policy will not be covered.

Injury, disease or damage due to a wilful act, including attempting suicide or intentional self-injury is excluded from the policy.

Any kind of breach of law, ordinance, or non-compliance of any statuary provision with or without criminal or malicious intent will not be entertained.

If any illness or accident occurs due to intoxication or addiction or overdose of drugs (except as medically prescribed) or narcotics/alcohol by the insured, the company will not take any liability for that.

Any claim if the insured person is taking part in a naval, military, air force, or law enforcement operation will be excluded.

If any injury occurs due to taking part in any kind of adventurous sports or hazardous activities, such as paragliding, mountaineering, scuba diving, etc., that will also fall under the category of exclusions.

Damage because of war, invasion, the act of a foreign enemy, hostilities (whether war be declared or not), civil war, military or usurped power, confiscation, nationalization, civil commotion, etc. will not be covered.

Any loss or injury caused by or contributed to, by, or arising from ionizing radiation or contamination by radioactivity from any nuclear fuel or from any nuclear waste from the combustion of nuclear fuel, will not be covered.

Any consequential or indirect loss or expenses arising out of or related to any insured event will not be taken care of.

Any critical illness arising out of birth control procedures and/or hormone replacement therapy will be excluded from the policy.

If the insured person receives any unrecognized treatments, or if the treating doctor is not certified, the policy will not take any care of the medical expenses.

IFFCO Tokio Critical Illness Benefit Policy Premium

Once you get to know about the inclusions and exclusions of the policy, the next important thing is to know how much premium amount you have to pay to purchase this policy. Therefore, for your better understanding, here is an example.

Mr. Mishra, a 36-year-old businessman bought IFFCO Tokio Critical Illness Benefit Policy for himself. Let us find out how much premium amount he has to pay to avail of the benefits of this policy for the given details.

Parameters	Credentials
Age	36 years
Cover for	Self
Policy tenure	2 years
Policy inception date	28th September 2022
Policy expiration date	27th September 2024
Sum insured	Rs. 4 lakhs
Premium amount	Rs. 813, excluding GST

Now, the same Mr. Mishra wants to include his daughter under the policy. The following table calculates the premium amount that he has to pay now for the given credentials.

Parameters	Data
Age	Self – 36 years, Daughter – 4 years
Policy tenure	3 years
Cover for	Self and daughter
Policy inception date	28th September 2022
Policy expiration date	27th September 2025
Sum insured options	Self – Rs. 10 lakhs, Daughter – Rs. 15 lakhs
Premium amount	Rs. 16,524, excluding GST

Frequently Asked Questions

1. Can I change the sum insured under this policy in the middle of the policy year?

Midterm revision of the sum insured will not be available in the policy.

2. For a claim under this policy, is there any third-party administrator?

All the claims will be directly serviced by IFFCO Tokio without any third-party administrator.

3. Can I cancel this policy?

Yes. If you are not satisfied with the terms and conditions of the policy, you can cancel the policy by sending 15 days written notice to IFFCO Tokio. The company will then allow a refund as per the terms and conditions of the company and the policy.

4. What will be the refund amount if I cancel this policy?

If the policy is canceled, the company will then allow a refund after retaining the premium based on the short period table as defined below.

Refund percentage	Policy tenure
Cancellation date up to (x months) from the Policy start date	1 year	2 years	3 years
Post free look up period and up to 1 month	75%	87%	91%
Up to 3 months	50%	74%	82%
Up to 6 months	25%	61.5%	72.5%
Up to 12 months	0%	48.5%	64.5%
Up to 15 months	NA	24.5%	47%
Up to 18 months	NA	12%	38.5%
Up to 24 months	NA	0%	30%
Up to 30 months	NA	NA	8%
Beyond 30 months	NA	NA	0%

5. What is the waiting period for pre-existing diseases?

The initial waiting period for pre-existing diseases is 48 months.

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