Enrolment Closed: JIO 6 Saal Khushhal Parivar

Payment for policy premium is accepted only through Online Payment

CASH/ CHEQUE/ NEFT & RTGS WILL NOT BE ACCEPTED

 



 

A NEW INNOVATIVE MEDICLAIM

For all Shravak-Shravika members of JIO
( From all JAIN Sects, like Shwetamber, Digamber, Sthanakwasi, Terapanthi etc.)
JIO – Shravak Arogyam
Group Health Insurance Policy

6 Saal Khush-haal Pariwar

(6 Year Same Premium & Same Terms)

Salient Features of the policy:

  1. Policy Terms and Premium shall remain Same for 6 years **
  2. 8 Members Family Floater Policy including Father & Mother.
  3. Longest Entry age up to 90 years.
  4. NO MEDICALCHECK-UP required.
  5. Proposer will be eligible for INCOME TAX exemption under Sec 80-D.
  6. Excellent Benefits at appropriate Premium.
  7. Disease Contracted after taking policy shall be covered from day 1. (also refer point no. 8 of T & C along with point no. 36 of FAQ)
  8. Member can avail CASHLESS as well as REIMBURSEMENT facility across India.
  9. PRE-EXISTING DISEASE will cover after 1 year. (In 2nd year 75% of admissible claim amount & then after next 4 year 100% of admissible claim amount will be payable.) ***
  10. Maternity cover starts after 1 year.
  11. Those who join in 1st year, can only get benefits of next 5 years.
  12. 100% Claim settlement support by TPA, Broker & Insurance Company.
  13. The right claim would certainly pass, whereas a fraudulent one wouldn’t.
  14. ROOM RENT & ICU CHARGES limitation per day:
    1. 2 & 5 lac Sum Insured: 1% of Sum Insured for Normal Room and 2% of sum Insured for ICU room
    2. 10 lac Sum Insured: 7,500 for Normal Room and 13,000 for ICU
  15. No Capping in claims for any treatment, except in Maternity, New born baby & Internal congenital disease claims.
  16. New Born Baby covered from day 1, If you give intimation within 30 days from DOB.
    • New-born baby expenses related to Hospitalization shall be covered from Day One of the birth up to 90 days with a limit of Rs 35,000/-only.
    • New born baby of the insured person shall be covered from 91st day from date of birth under family floater Sum Insured
  17. Emergency Ambulance Charges: up to Rs. 2,500 or actuals whichever is less.
  18. DAY CARE PROCEDURES: covered
  19. CLAIM INTIMATION in case of CASHLESS claims or REIMBURSEMENT Claim, immediate intimation shall be given to our Call Centre or on Email (mentioned below) within 48 hours of Hospitalization.

Kindly read Terms & Condition properly, if required then only call to call centre.

Annual Premium as per Highest Member’s age in the family per Year ##

P
l
a
n
Policy
Type
Max. Person Max. Age Family Details Sum Insured Premium GST Final
Premium
with GST
A Family Floater 8 members 90 years Self + Spouse + 4
 children
+ 2
Parents / In Laws
10 lacs 22,034 3,966 26,000
B 5 lacs 17,034 3,066 20,100
C 60 years Self + Spouse + 4
children
+ 2
Parents / In Laws
10 lacs 18,517 3,333 21,850
D 5 lacs 13,051 2,349 15,400
E 4 Members 45 years Self + Spouse + 2
 children
  10 lacs 13,517 2,433 15,950
F 5 lacs 9,873 1,777 11,650
G Individual 1 member 65 years Self       2 lacs 6,525 1,175 7,700
H 45 years 3,153 567 3,720
Notes :
  • Children means Unmarried Dependent Children up to 25 Yrs.
  • Parents or Parents in law (Only one set of parents allowed)
  • Single person can also opt for Policy up to age of 65 years.
  • No Family Members will be covered above acceptable age of that particular plan. (Premium is calculated as per highest members current age in the family)
  • Individual Policy (Plan G & Plan H) is available only for members, who don’t have any other eligible family member to take policy. (self-affidavit OR certification from JIO Director required)
  • As premium will be transferred first to JIO by members individually and then JIO have to pay premium to insurance company as one consolidated payment, there is a time gap for reconciliation and procedure. So, we request you to pay the premium at the earliest to start coverage on time
  • Premium can be PAID only via Online Payment
  • Additional amount will be charged by payment gateway (Ease buzz) for providing safe & secure online money transfer facility.

* For detail terms and condition, rejections and sub-limits refer JIO website.
www.jiojac.com/6SAAL

** Policy terms and rates may be continued for next 6 years and shall be reviewed annually and necessary corrective action shall be taken (if required) to keep the portfolio viable

*** Pre- Existing Diseases against each insured / beneficiary, needs to be declare while filling up forms, If not disclose can be used as non- disclosure at time of claim & in court of law.

## However, The portfolio will be reviewed by Insurance company on periodic basis & to balance the claim ratio the Insurance company will offer Motor, Travel, Group Personal Accident, Home Insurance etc. policies to JIO members along with this policy.

    • PARTNERS for JIO MEDICLAIM POLICY
    • Insurance Company: UNIVERSAL SOMPO GENERAL INSURANCE Co. Ltd. (CIN- U66010MH2007PLC166770 UIN- UNIHLGP08001V020708)
    • Insurance Broker: EDELWEISS INSURANCE BROKERS LIMITED (CIN: U72200MH2000PLC124096)
    • TPA Name :- Ericson Insurance TPA Pvt. Ltd.

     

    1st year exclusion applicable as per standard policy terms (below given/mention list of disease are not covered for first 12 month of inception of policy or during First Year )
     

     

     
    First 1 Year Exclusions.
     
     
    Sl No.
    Body System
    Illness
    Treatment/ Surgery
    1
    Eye
    Cataract
    Cataract Surgery
    Glaucoma
    Glaucoma Surgery
    Other Eye Surgeries
    Other Eye Surgeries
    2
    Ear Nose Throat (ENT)
    Serous Otitis Media
     
    Sinusitis
    Sinus Surgery
    Rhinitis
    Surgery for the nose
    Tonsillitis
    Tonsillectomy
    Tympanitis
    Tympanoplasty
    Deviated Nasal Septum
    Surgery for Deviated Nasal Septum
    Otitis Media
    Surgery or Treatment for Otitis Media
    Adenoiditis
    Adenoidectomy
    Mastoiditis
    Mastoidectomy
    Cholesteatoma
    Resection of the Nasal Concha
    3
    Gynecology
    All Cysts & Polyps of the female genito urinary system
    Dilatation & Curettage
    Polycystic Ovarian Disease
    Myomectomy
    Uterine Prolapse
    Uterine prolapsed Surgery
    Fibroids (Fibromyoma)
    Hysterectomy unless necessitated by malignancy
    Breast lumps
    Any treatment for Menorrhagia
    Prolapse of the uterus
    Dysfunctional Uterine Bleeding (DUB)
    Endometriosis
    Menorrhagia
    Pelvic Inflammatory Disease
    4
    Orthopedic / Rheumatological
    Gout
    Joint replacement Surgery
    Rheumatism, Rheumatoid Arthritis
    Surgery for Prolapse of the intervertebral disc
    Non infective arthritis
     
    Osteoarthritis
     
    Osteoporosis
     
    Prolapse of the intervertebral disc
     
    Spondylopathies
     
     
     
     
     
    5
    Gastroenterology (Alimentary Canal and related Organs)
    Stone in Gall Bladder and Bile duct
    Cholestectomy / Surgery for Gall Bladder
    Cholecystitis
    Surgery for Ulcers (Gastric / Duodenal)
    Pancreatitis
    Fissure, Fistula in ano, hemorrhoids (piles), Pilonidal Sinus, Ano-rectal & Perianal Abscess
    Rectal Prolapse
    Gastric or Duodenal Erosions or Ulcers + Gastritis & Duodenitis
    Gastro Esophageal Reflux Disease (GERD)
    Cirrhosis
    Acute & Chronic Appendicitis, Appendicular lump, Appendicular abscess
    6
    Urogenital (Urinary and Reproductive system
    Stones in Urinary system (Stone in the Kidney, Ureter, Urinary Bladder)
    Prostate Surgery
    Benign Hypertrophy / Enlargement of Prostate (BHP / BEP)
    Hernia, Hydrocele,
    Surgery for Hydrocele, Rectocele and Hernia
    Varicocoele / Spermatocoele
    Surgery for Varicocoele / Spermatocoele
    7
    Skin
    Skin tumour (unless malignant)
    Removal of such tumour unless malignant
    All skin diseases
    8
    General Surgery
    Any swelling, tumour, cyst, nodule, ulcer, polyp anywhere in the body (unless malignant)
    Surgery for cyst, tumour, nodule, polyp unless malignant
    Varicose veins, Varicose ulcers
    Surgery for Varicose veins and Varicose ulcers
    Congenital Internal Diseases or Anomalies
    9
    Cardiac Surgeries
    CABG
    Thoraco Vascular / Cardiac Surgeries
    Angioplasty
    Other Heart Surgeries / Thoraco Vascular Surgeries
    10
    Other Treatments
    Chemotherapy/ Cancer Surgeries
    Cancer treatment
    Radiotherapy
    Cancer treatment
    Dialysis
    kidney / Liver Failure