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Individual Health Insurance Plans

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Reliance Hospi-Care Health Insurance Policy

Reliance Hospi Care Insurance is a hospital cash benefit product that provides a lump sum payout for 150+ listed surgeries and more than 140 daycare procedures occurring due to an illness or accident. In need of the hour, the company makes sure your medical emergency does not become a financial one. This policy offers up to 100% of the sum insured for the expenses of certain surgical procedures. Vector-borne diseases are also covered under this policy. To know more about this plan, have a look at the following mentions.

Eligibility Criteria

Age at entry

Minimum – 18 years

Maximum – 65 years

Policy typeIndividual cover (This policy will cover only one person on an individual sum-insured basis)
Policy period1, 2, and 3 years
Sum insured optionRs. 1 lakh, Rs. 2 lakhs, Rs. 3 lakhs, Rs. 4 lakhs, Rs. 5 lakhs, and Rs. 10 lakhs
Exit ageNo maximum exit age
Who can buy it?Only Indian resident

Coverage Details

Sum insured optionsRs. 1 lakhRs. 2 lakhsRs. 3 lakhsRs. 4 lakhsRs. 5 lakhsRs. 10 lakhs
Surgical Procedure Cash (up to 100%)Rs. 1 lakhRs. 2 lakhsRs. 3 lakhsRs. 4 lakhsRs. 5 lakhsRs. 10 lakhs
Hospital Daily Cash (up to 60 Days)Rs. 1000Rs. 2000Rs. 3000Rs. 4000Rs. 4000Rs. 4000
Hospital Daily Cash ICU (up to 15 days)Rs. 2000Rs. 4000Rs. 6000Rs. 8000Rs. 8000Rs. 8000
Day Care Treatment CashRs. 5000Rs. 10000Rs. 15000Rs. 20000Rs. 25000Rs. 50000
Other Surgeries CashRs. 2000Rs. 4000Rs. 6000Rs. 8000Rs. 10000Rs. 20000
Hospitalisation due to Dengue, Malaria, ChikungunyaRs. 20000Rs. 20000Rs. 20000Rs. 20000Rs. 20000Rs. 20000

Key highlights of Reliance Hospi-Care Health Insurance Policy

This policy has come up with a sack full of benefits and facilities. The important mentions are as follows.

Daily Cash Allowance:

A daily cash allowance of up to the specified amount is payable for each continuous and completed period of 24 hours for up to 60 days. If the insured is admitted into the ICU, the company pays double the amount of allowance for up to 15 days.

Daycare Procedures:

In the case of a specified Care Procedure in a Hospital/Care Centre, a specified amount as per the sum insured is payable, regardless of the actual costs incurred.

Other Surgeries Cash:

In case of a surgery that is not listed under the Surgical Procedure Cash benefit, a certain specified amount is payable as ‘Other Surgeries cash’ irrespective of the actual cost incurred on the surgery.

Vector-borne Diseases:

In the case of Dengue, Malaria, or Chikungunya, hospitalization exceeds a continuous period of 3 days, and an amount of Rs. 20,000 is payable.

Multiple Discounts:

This policy offers various discounts.

  • 10% exiting customer – A one-time discount of 10% on the Premium is offered if the Insured Person is an existing customer/policyholder of Reliance General Insurance.
  • 10% Online Discount – The Insured Person is eligible for a 10% discount on the premium in case of buying or Renewing the Policy.
  • 10% Policy Tenure Discount – If the Policy Period of 2/3 years is selected while buying the policy, the Insured Person will be entitled to receive a discount of 10% on the premium.

General Exclusions of Reliance Hospi-Care Health Insurance Policy

The company will not be liable to make any payment under this policy in respect of any expense whatsoever incurred by any Insured Person in connection with or in respect of:

  • Expenses related to any admission are primarily for diagnostics and evaluation purposes.
  • Any diagnostic expenses that are not related or not incidental to the current diagnosis and treatment.
  • Expenses related to any admission primarily for enforced bed rest and not for receiving treatment.
  • Expenses related to any treatment, including surgical management, to change characteristics of the body to those of the opposite sex.
  • Expenses for cosmetic or plastic surgery or any treatment to change appearance unless for reconstruction following an Accident, Burns, or Cancer or as part of the medically necessary treatment to remove a direct and immediate health risk to the insured. For this to be considered a medical necessity, it must be certified by the attending Medical Practitioner.
  • Expenses related to any treatment necessitated due to participation as a professional in hazardous or adventure sports.
  • Expenses for treatment directly arising from or consequent upon any Insured Person committing or attempting to commit a breach of law with criminal intent.
  • Treatment for, Alcoholism, drug or substance abuse, or any addictive condition and consequences thereof.
  • Treatments received in health hydros, nature cure clinics, spas, or similar establishments or private beds registered as a nursing home attached to such establishments or where admission is arranged wholly or partly for domestic reasons.
  • Dietary supplements and substances that can be purchased without a prescription, including but not limited to Vitamins, minerals, and organic substances, unless prescribed by a medical practitioner as part of a hospitalization claim or day care procedure.
  • Medical treatment expenses traceable to childbirth (including complicated deliveries and cesarean sections incurred during hospitalization) except ectopic pregnancy.
  • Expenses towards miscarriage (unless due to an accident) and lawful medical termination of pregnancy during the policy period.
  • Expenses related to any unproven treatment, services, and supplies for or in connection with any treatment. Unproven treatments are treatments, procedures, or supplies that lack significant medical documentation to support their effectiveness.

Buying Process of Reliance Hospi-Care Health Insurance Policy

One can easily buy this policy following the below easy steps.

  • Go to the official website of Reliance General Insurance.
  • On the right side of the homepage, there will be a form. Select the health tab.
  • Put the required details such as name, phone number, and pin code.
  • After that, click on the View Prices option.
  • Select the policy, and provide other relevant details such as sum insured option, policy year, etc.
  • On the basis of the given details, the premium amount will be displayed before you.
  • Check it carefully, and if satisfied, pay the premium amount online safely.
  • Now, download the policy document for future convenience.

Claim Process of Reliance Hospi-Care Health Insurance Policy

This policy offers both cashless and reimbursement claims. Bot the procedures are discussed below.

Cashless Claim Procedure:

  • Inform the health claims team of the company, RCARE, of hospital admission using the helpline number 022-4890 3009 (Paid) given on your health card.
  • Submit the required documents to RCARE
  • RCARE will arrange for Cashless facility
  • A surveyor might be appointed on behalf of the company to evaluate the claim.
  • If no discrepancy is found, the claim amount will be settled directly with the network hospital.

Reimbursement Claim Procedure:

  • Intimate the insurer as soon as the incident happens.
  • Provide all the required details such as details of the patient, type of hospitalization, etc.
  • Avail of the treatment. Collect all the documents.
  • Submit all the necessary documents to the insurer within 7 days of the discharge from the hospital to initiate the claim.
  • After evaluation, if no discrepancy is found, the claim will be approved and will be paid to the insured person.

Frequently Asked Questions

The following waiting periods are there:

General waiting periodA waiting period of 90 days from the start date of the policy shall apply to all claims under the insurance plan.
A specific waiting periodSpecific illnesses and treatments will be covered after a waiting period of 2 years from the start date of the policy.
Pre-existing diseases waiting periodPre-existing diseases (PED) have a waiting period of 4 years.

Usually, for certain age groups Pre-policy health check-up is not required. PPHC is applicable for ages above 45 for Sum Insured above Rs. 5,00,000 and for all Sum Insured options above the age of 50. 100% of PPHC costs will be absorbed by the company. Reports will be issued to the insured for Accepted cases only.

The Sum-Insured can be enhanced only during Renewal as per underwriting norms. At the time of enhancement, the case may be subject to a health check-up. The waiting periods will apply afresh to the enhanced Sum Insured. The quantum of the increase shall be subject to underwriting guidelines. Additional premium if any, shall be charged as per the terms and conditions of the Policy. The sum insured will be applicable per insured per policy year.

You may terminate this Policy at any time by giving the Company written notice, and the Policy will terminate when such written notice is received. If no claim has been made under the Policy, then the insurer will refund the premium in accordance with the table below:

Length of time policy in forceRefund of premium
Up to 90 days100% refund
Above 90 daysPro-rata

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