SBI Life Arogya Shield Plan

As you already know this plan offers dual benefits, therefore this policy has come up with a sack full of benefits and facilities that have promised to keep you and your family protected till its expiry.

Hospitalization Expenses:

The insurer will reimburse the following medical expenses while the insured was under inpatient care:

1. Room rent, boarding expenses.

2. Medical practitioners’ fees (Including Teleconsultation)

3. Intensive care unit

4. Nursing expenses

5. Anaesthesia, blood, oxygen, operation theatre expenses, surgical appliances, medicines & consumables, diagnostic expenses, and x-ray, dialysis, chemotherapy, radiotherapy, cost of a pacemaker, prosthesis/internal implants, and any medical expenses incurred which is an integral part of the operation

6. Physiotherapy is covered as inpatient care when it is part of the treatment.

7. Drugs, medicines, and consumables consumed during the hospitalization period.

8. Diagnostic procedures

9. Dressing, ordinary splints, and plaster casts.

OPD Treatment:

Expenses for OPD consultation/Teleconsultation and treatment up to the limit specified in the policy schedule on the advice of a medical practitioner because of illness/disease and/or injury sustained or contracted during the Policy Period.

Pre and post hospitalization expenses:

Covered up to 60 and 90 days.

Day Care Expenses:

The insurer will pay for day care expenses incurred on technological surgeries and procedures requiring less than 24 hours of hospitalization up to the sum insured. A total of 141 day care procedures are covered.

Emergency Ambulance Expenses:

The insurer will reimburse actual ambulance expenses or INR 1500, whichever is lower per valid hospitalization claim, for transferring the insured to or between Hospitals in the Hospital’s ambulance or in an ambulance provided by any ambulance service provider.

Alternative Treatment:

The insurer will reimburse expenses for alternative treatment taken in a government hospital or in any institute recognized by the government and/or accredited by the quality council of India/national accreditation board on health.

Domiciliary Hospitalization:

The insurer will cover reasonable and customary charges towards domiciliary hospitalization. including pre and post-hospitalization expenses.

Maternity Expenses:

It is covered only under the OPD section and up to the OPD Limit specified in the policy schedule.

HIV/AIDS Cover:

The company will cover expenses incurred for Inpatient treatment due to any condition caused by or associated with human immune deficiency virus or variant/mutant viruses and/or any syndrome or condition similar kind commonly referred to as AIDS up to the Sum Insured as specified in the Policy Schedule.

Genetic Disorders or Diseases:

The pre-specified disorders/conditions will be covered only up to Rs. 50,000 on a cumulative basis. Pre-hospitalization and Post-hospitalization Medical Expenses are also covered.

Internal Congenital Diseases:

It is covered up to the limit of 10% of the Sum Insured.

Modern Treatment Cover:

The pre-specified modern treatments or procedures will be covered either as an in-patient or as part of day care treatment in a hospital up to 50% of the Sum Insured.

Death Benefits:

On the death of the life assured during the policy term after the expiry of the waiting period or due to an accident during the waiting period, the nominee/beneficiary will receive the Sum assured on death, in a lump sum which is:

• For Regular payment policies, it is the highest of

1. 1. 10 times the Annualized Premium
   2. 105% of all premiums paid as of the date of death
   3. Absolute amount assured+ to be paid on death

• On the death of the life assured due to other than an accident, during the waiting period, the nominee/beneficiary will receive the Death Benefit, which is equal to 100% of all the premiums paid, excluding taxes, if any.

Maturity Benefits:

Not available

Survival Benefits:

Not available

Policy Loan:

Not available

Rider Benefits:

No rider benefits are available under this product.

Free Look Period:

15 days. 30 days in case of electronic policies and policies obtained through distance mode.

Grace Period:

For Yearly and half-yearly premium payment mode 30 days, and for Monthly premium payment mode 15 days.