Smart Health Basic Eligibility

  • Max adult age: 55yrs
  • Max child age: 23yrs
  • Members covered:Individual and family plan. You can avail this policy for maximum combination of 2A2C
  • Policy Period:Policy available for 1yr
  • Policy Available for: Sum Insured Rs.2L-5L

Smart Health Basic Benefits

Day care treatment where 24 hours of hospitalization is not required for treatments like dialysis, chemotherapy, eye surgery, lithotripsy, etc., undertaken in a hospital.

Domiciliary hospitalization where care and treatment is taken at home exceeding 3 days for disease, illness or injury. Critical Illness covered:
  • Cancer
  • First Heart Attack
  • Coronary Artery Disease
  • Coronary Artery bypass surgery
  • Heart Valve Surgery
  • Surgery to Aorta
  • Stroke
  • Kidney Failure
  • Aplastic Anemia
  • End Stage Lung Disease
  • End Stage Liver Failure
  • Coma
  • Major Burns
  • Major Organ/Bone Marrow Transplantation
  • Multiple Sclerosis
  • Fulminant Hepatitis
  • Motor Neurone Disease
  • Primary Pulmonary Hypertension
  • Terminal Illness
  • Bacterial Meningitis

Smart Health Basic Features

  • Access to our vast pan India Cashless Network comprising 4300+ hospitals
  • Coverage of Day-care procedures costs
  • Reimbursement of Pre and post hospitalization related expenses
  • Twice the sum insured in case of diagnosis of any of the 20 main critical illnesses (on selected health plans)
  • Unlimited room rent (on selected health plans)
  • Benefit of life long renewal
  • Tax benefits of up to Rs 25,000 under section 80 (D)
  • Multichannel 24x7 claim intimation and assistance
  • Simple, hassle free claim settlement process
  • Renewal discount of 5% each claim free year up to a maximum of 5 years on a progressive scale
  • Dedicated Claims Handler for health insurance claims

Smart Health Basic Claim Process

In the event of an occurrence likely to give rise to a claim (cashless or reimbursement) under the policy, you or your representative need to:

  • Contact the Third-Party Administrator (TPA) named in the schedule to the policy immediately. Cashless hospitalization facility is available in around 4300 hospitals around the country.
  • Deliver to the TPA all information and documents concerning the claim or reimbursement.
  • Submit all documents (original bills & prescriptions etc.) concerning all pre/post hospitalization expenses  Submit yourself, if so required, to examination by a Medical Practitioner authorised by the Company.
  • Please contact the number given on your medi-card for clarifications.

Smart Health Basic Exclusions

Hospitalization expenses for treatment taken for disease or illness within 30 days of inception of the policy.

This clause is not applicable on subsequent renewals.

First 2 years exclusions include –

  • Cataract, laser surgery
  • Myomectomy, Hysterectomy unless because of malignancy
  • Dilation and curettage
  • Hernia, Hydrocele, fistula in anus, sinusitis, hemorrhoids/piles
  • Joint replacement, unless due to accident
  • All types of skin and all internal tumors / cysts / nodules / polyps of any kind, including breast lumps, unless malignant
  • Dialysis required for chronic renal failure
  • Gastric and duodenal erosions & ulcers