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IFFCO Tokio Swasthya Raksha Bima Policy

The IFFCO Tokio Swasthya Raksha Bima Plan protects you and your family against any injury- or disease-related contingencies, such as hospitalization, medical costs, surgical costs, organ transplantation, etc. The family, which consists of you, your spouse, and any financially dependent children under the age of 23, is covered by the policy on a floater basis. It is a very cost-effective health insurance option for residents of small towns and non-metropolitan areas that was created with the main goal of reducing hospital expenses without sacrificing the standard of coverage.

Read on to know more about the IFFCO Tokio Swasthiya Raksha Plan in detail!

Eligibility Criteria

Here are the eligibility criteria for the IFFCO Tokio Swasthiya Raksha Bima Plan.

ParametersDetails
Age

Age 18 years and 65 years

No first-time coverage shall be provided for persons above 65 years.

Sum Insured1 lakh/ 2 lakh/ 3 lakh/ 4 lakh/ 5 lakh
Ambulance ChargesActual subject to a max of Rs. 750/-

Domiciliary Hospitalization

Treatment

20% of the Basic Sum Insured
AYUSH HospitalizationCovered within the Sum insured

Features and Benefits of Swasthya Raksha Bima Plan

Listed below are the key features and benefits of considering the IFFCO Tokio Swasthya Raksha Bima Plan. 

  1. Pre-hospitalisation

These costs are referred to as pre-hospitalization expenses if they are incurred before the hospitalization itself. Health insurance policies also cover these costs, but only up to a certain amount.

  1. Post-Hospitalisation

The policyholder is responsible for paying a variety of fees for monitoring your health and recovery after being released from the hospital. These costs—which are referred to as post-hospitalization expenses—are covered.

  1. Room & Nursing Expenses

As offered in the hospital or nursing home, room, board, and nursing expenses are subject to the following restrictions.

  • 1% of the Sum Insured is the daily sub-limit for typical room expenses.
  • Intensive Care/Therapeutic Unit Sublimit: 2.0% of the Sum Insured per day.
  • Registration and Service
  1. Hospital/Nursing Home Fees

One of the major key features of choosing the IFFCO Tokio Swasthya Raksha Plan is that it covers hospital and nursing home fees incurred by the policyholder during the hospitalization period. 

  1. Consultation fees

Another major feature of the IFFCO Tokio Swasthya Raksha Bima Plan is that it covers the consultation fee of medical professionals and anesthesiologists.

  1. Miscellaneous Expenses

Expenses for anesthesia, blood, oxygen, the operating room, surgical devices, medications, and drugs; dialysis; chemotherapy; radiotherapy; the cost of a pacemaker; the price of artificial limbs; the cost of transplantation; and similar costs.

  1. Additional Expenses

Expenses for vitamins and tonics are only allowed if they are prescribed by the attending physician.

  1. In-Home Hospitalization

The pertinent costs incurred for in-home hospitalization at reasonable and customary rates, up to an aggregate sub-limit of no more than 20% of the insured amount.

  1. Daily Allowance

An additional daily allowance of 150 rupees per day for the duration of the hospitalization to cover other costs.

  1. Ambulance fees 

The fees are only allowed to be 750 or actual fees, whichever is less, in connection with any admissible claim.

  1. AYUSH Treatments

Ayurveda, Unani, Siddha, and Homoeopathy (AYUSH) are among the non-allopathic treatments covered by the IFFCO Tokio Swathya Raksha Bima Plan. However, these AYUSH treatments are only covered to a certain extent.

  1. Daycare treatments

Daycare treatments do not necessitate a 24-hour hospital stay- all credit goes to advanced medical procedures.

Exclusions Under the IFFCO Tokio Swasthya Raksha Plan

Listed below are the things not covered under the IFFCO Tokio Swasthya Raksha Plan.

  1. Any condition(s) that the policy lists as a pre-existing disease, up to 48 continuous months.
  1. Any hospitalization costs for any disease during the first 30 days after the start of this insurance coverage, excluding those resulting from accidents.
  1. Any costs incurred for the treatment of Specific Diseases during the first year that the insurance was in effect.
  1. Any costs incurred for the treatment of Specified Diseases during the insurance coverage’s first two consecutive years of operation.
  1. Injuries or illnesses directly linked to hostilities, invasions, foreign enemy acts, or operations that resemble hostilities.
  1. Plastic surgery, immunization, vaccination, and cosmetic or aesthetic procedures.
  1. The price of eyeglasses, contact lenses, or hearing aids.
  1. Dental care or any type of dental surgery, unless necessary due to an accident requiring hospitalization.
  1. Recuperation, general senility, fatigue, or rest cure.
  1. Congenital anomalies, sterility, venereal disease, wilful self-harm, and alcohol/drug abuse.
  1. Costs associated with diagnostic, X-ray, or laboratory tests, unless they are directly related to the active management of disease or injury.
  1. Treatment costs related to or resulting from infertility, subfertility, infertility, miscarriage, or abortion.
  1. Any costs associated with the insured person’s outpatient hospital care.
  1. Any cost associated with a procedure or treatment that is not allopathic or AYUSH.
  1. Reliable external medical and non-medical equipment.
  1. Surgery or stem cell implantation.
  1. Obesity management, hormone replacement therapy, and sex modification

How To Buy the IFFCO Tokio Swasthya Raksha Plan?

It’s crucial to purchase health insurance for you and your family because, especially in the private sector, medical care is expensive. A hospital stay can break the bank and ruin your finances. If the person who brings in the money is now lying in a hospital bed, things will get even harder. Paying a small annual premium would alleviate your stress in the event of medical emergencies and allow you to avoid all of this. A good health insurance plan, such as the IFFCO Tokio Swasthya Raksha Bima Plan, will typically pay for costs associated with doctor visits, medical tests, ambulance rides, hospital stays, and even some post-hospitalization recovery costs. 

Step 1: Go to the official website of IFFCO Tokio Insurance using your smartphone or laptop.

Step 2: After that, you will need to scroll down to the last and find “Health Insurance” under Products and Resources. Click on it.

Step 3: Then, again you will need to scroll down and under “Various Health Insurance Plans from IFFCO Tokio”, you will see “Swasthya Raksha Bima”. Click on it to open the plan page.

Step 4: The moment you open the plan page, you will see the table wherein you need to enter your name and mobile number. Then, you will need to click on the “Submit” button.

Step 5: Once you click on it, you will see a message “Thank you for showing your interest. Our team will get back to you”.

How To Claim For IFFCO Tokio Swasthiya Raksha Bima Plan?

If you receive treatment at one of the network hospitals connected to your health insurance provider, you can take advantage of the cashless insurance facility. You can easily find the list of network hospitals on the insurer’s website, where you can also find the closest cashless hospital. However, there are two circumstances, namely planned or unexpected hospitalization, in which you may submit a cashless claim:

Claim Process for Planned Hospitalisation:

Step 1: Let your insurance company know about the anticipated treatment well in advance—ideally, 4-5 days before the hospitalization.

Step 2: Locate the closest cashless hospital where you want to receive treatment in step two.

Step 3: While in the hospital, present your cashless card, insurance policy number, and other pertinent paperwork.

Step 4: Get the pre-authorization form, which can be obtained at the hospital insurance desk or downloaded from the website of your insurer. Send it to the insurer once it is fully completed. Depending on the insurance company, you might also need to send in the pre-authorization form ahead of time.

Step 5: The IFFCO Tokio insurance company must confirm the information and let the hospital know.

Step 6: The hospital will send the insurer the medical bills and receipts, and the costs will be paid out by the terms of the plan.

Claim Process for Emergency Hospitalisation:

Step 1: As soon as you can, inform the IFFCO Tokio company about the claim. Most insurance providers have a specific window of time in which you must get in touch with them.

Step 2: Present your cashless card, insurance policy number, and other documents to be admitted to the hospital.

Step 3: Pick up the pre-authorization form from the hospital insurance desk or get a copy online through your insurer. Fill it out correctly, and send it to the insurer within the allotted time frame.

Step 4: The IFFCO Tokio insurance company must examine and approve the claim information.

Step 5: The hospital will send the insurance company the medical bills, and the costs will be paid by the terms and conditions of your policy.

Reimbursement Claim Process:

You are free to receive medical care at the hospital of your choice and then submit a claim for reimbursement. The procedures for filing a reimbursement claim for your IFFCO Tokio Swasthya Raksha Bima Plan are listed below.

Step 1: As soon as possible, inform the IFFCO Tokio of the claim. You must notify the insurer of any planned treatment or urgent hospitalization within the specified time frame.

Step 2: Cover the costs of the medical care received and keep the original receipts on hand.

Step 3: Send the insurance company the original invoices, the insurance claim form, and any other supporting paperwork.

Step 4: The IFFCO Tokio company will examine the invoices and claim information. The insurer may ask for additional documents if more information is needed.

Step 5: The claim will be approved or denied by the terms of your insurance policy and the claim.

Step 6: If your IFFCO Tokio Swasthya Raksha Bima insurance claim has been approved, the claim amount will be reimbursed shortly.

Documents Required to File Claims:

If you are submitting a reimbursement claim or a cashless claim, you must include the following paperwork:

  1. Documents detailing the doctor’s consultation
  1. Health insurance Identity Card
  1. Duly filled out health insurance claim form
  1. Copy of insurance policy document
  1. Medical bills and reports, including hospital admission and discharge slips, in case of hospitalization
  1. Copy of your prescription and pharmacy bills
  1. Investigative and diagnostic reports, such as X-rays, MRIs, etc.
  1. Copy of the First Information Report (FIR) filed with the police or Medico-Legal Certificate (MLC), in case of an accident
  1. Discharge summary
  1. Cancelled cheque, in case of reimbursement claim
  1. Other relevant documents

How To Renew Your IFFCO Tokio Swasthya Raksha Bima Plan?

Every health insurance plan, including the Swasthya Raksha Bima Plan, has a set duration of one, two, or three years. The policy must be renewed after this period. To continue receiving the coverage benefits provided by your health insurance, you must renew it. if an insurance plan isn’t renewed before it expires. You will have to buy the policy all over again, which could be difficult, and you will lose any accrued benefits like the No Claim Bonus or waiting period benefits.

Step 1: Go to the official website of IFFCO Tokio General Insurance.

Step 2: The “Renew Policy” section will then appear on the home page under the “How Can We Help You” tab. To continue the renewal process, click on it.

Step 3: To start the renewal process, click “Health” after that. You must then enter your name and policy number before clicking the “Proceed” button.

Step 4: To keep receiving the benefits of your policy, you must make the payment in this step.

Step 5: You will receive a confirmation message to both your registered email address and mobile number once your policy has been successfully renewed.

Frequently Asked Questions

Yes, the maximum sub-limit for the domiciliary hospitalization was 20% of the insured amount.

Within 30 days of the hospital discharge date or the end of the course of treatment, the claim must be submitted.

Throughout the policy’s duration, any number of claims are permitted. The sum insured, however, represents the policy’s upper limit.

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