Shri Hospital Daily Cash Benefit Insurance (UIN: SGLHLIP22230V012122)

Shri Hospital Cash Insurance policy is the health insurance benefit product. It provides additional benefit to take care of your incidental expenses such as food, lodging, and travelling which are not covered in health insurance policy in an event of hospitalization.

Who Can Take This Policy?

The Policy can be taken by an individual for covering himself / herself and his/ her family i.e. spouse, dependent children up to 25 years of age and dependent parents.

Eligibility Criteria(Age of Entry)

  • Proposer Age - 18 Year – 65 years
  • Dependent Children Age – 91 Day to 25 Years
  • Coverage for child (91 days – 18 years) is not allowed without any family member (more than 18 years) being the proposer or covered in the policy.

Renewability Age – Life Long

Policy Available for period - 1 Year, 2 Year and 3 Year.

Pre- Medical Examination – Following test is required for person age above 45 years.

Fasting Sugar Blood (FBS), Complete Blood Count (CBC), Blood Pressure (BP)report and Electro Cardio Gram (ECG) may be required to be submitted to us on request.

Available Plans

Plan Type Basic Plan Advance Plan
Plan available in days 15/30/60/90/120/180 90/120/180
Per day benefit limit 500/1000/2000/3000 3000/4000/5000
Coverage
Sickness Daily Hospital Cash Benefit Yes Yes
Accident Hospital Cash Benefit Yes Yes
Intensive Care Unit (ICU) Benefit: Yes Yes
Convalescence Benefit Na Yes
Child Birth Hospital Cash Na Yes
Compassionate Benefit Na Yes
Optional Cover (subject to opt by insured)Day Care Treatment Benefit Yes Yes

Scope of Coverage

Main Coverage
I. Sickness Daily Hospital Cash Benefit
During the period stated in the Schedule, if the insured person shall contract any disease or suffer from any illness and if such disease / illness shall, upon the advice of a duly Qualified Medical Practitioner, require admission of the insured Person as an In-patient in any Hospital in India for the purpose of medical /surgical treatment, then the Company will pay to the Insured Person, Daily Hospital Cash amount mentioned in the schedule for each consecutive 24 hours of hospitalization subject to maximum number of days stated in the Schedule.
Deductible - 1- day deductible is applicable on every hospitalization.
II.Accident Hospital Cash Benefit
During the period stated in the Schedule, if the insured person shall sustain bodily injury due to accident and if such accident shall, upon the advice of a duly Qualified Medical Practitioner, require admission of the insured Person as an In-patient in any Hospital in India for the purpose of medical /surgical treatment, then the Company will pay to the Insured Person, 2 times of Daily Hospital Cash amount mentioned in the schedule for each consecutive 24 hours of hospitalization subject to maximum number of days stated in the Schedule. Deductible: Not Applicable
III. Intensive Care Unit (ICU) Benefit During the policy period stated in the schedule If the insured person shall, upon the advice of a duly Qualified Medical Practitioner, require admission in ICU for the purpose of treatment of Sickness/Accident /Injury, then We will pay 2.5 times of the Daily Hospital Cash amount for each consecutive 24 hours that the Insured Person is admitted in an Intensive Care Unit, subject to maximum of 15 days per Policy Year. Whenever Intensive Care Unit benefit is admissible under the Policy, We will not pay for Daily Hospital Cash benefit in I or II above for the period when the Insured Person is in Intensive Care Unit.
Deductible: 1- day deductible is applicable on every hospitalization except accidental hospitalization.
IV. Convalescence Benefit
If the Insured Person is Hospitalized in India during the Policy Period for Medically Necessary treatment of an Illness Or an Injury that occurred during the Policy Period and the continuation of such Hospitalization is Medically Necessary for at least 15 consecutive days, then will pay a lump sum amount equal to 5 times of the Daily Cash Benefit amount specified in the Policy Schedule.
This benefit is payable in addition to basic plan if there is an admissible claim under same.
For Individual Policy: This benefit is available only once during the Policy tenure for per Insured Person.
Deductible - Not Applicable
V. Child Birth Hospital Cash
During the period stated in the Schedule the insured person shall, upon the advice of a duly Qualified Medical Practitioner, require admission of the Insured Person as an In-patient in any Hospital in India for the purpose of Child Delivery, then the Company will pay to the insured person Daily Hospital Cash amount stated in the schedule subject to maximum number of days stated in the schedule.
Special Condition:
1. The benefit under this cover is payable after waiting period of 2 years from date of addition of spouse in the policy period subject to both self and spouse are covered.
2. This cover is available for maximum of 2 child for life time.
Deductible - Not Applicable
VI. Compassionate Benefit
If the Insured Person is Hospitalized during the Policy Period for Medically Necessary treatment of an Injury due to an Accident that occurred during the Policy Period and the Insured Person dies during the course of such Hospitalization, We will pay the Nominee a lump sum amount equal to 10 times of the Daily Hospital Cash Benefit amount specified in the Policy Schedule
This benefit is payable in addition to basic plan only if there is an admissible claim under same.
Deductible - Not Applicable
Optional Cover
Day Care Treatment Benefit
If the Insured Person requires and avails a Medically Necessary Day Care Treatment (as defined under Annexure II below) during the Policy Period, We will pay a lump sum benefit amount which is the lower of 5 times the Daily Cash Benefit specified in the Policy Schedule or Rs.25,000 to the Insured Person for such Day Care Treatment provided the Insured Person is admitted in the Hospital for less than 24 hours.
The benefit under this Section shall be available for a maximum of 1 Day Care Treatments per Policy Year.
In case of Cataract, coverage is limited to 1 surgery in a Policy year.

General Exclusions

i. Pre-existing Diseases
ii. Specified disease
iii. Investigation & Evaluation
iv. Rest Cure, rehabilitation and respite care
v. Obesity/ Weight Control
vi. Cosmetic or Plastic Surgery
vii. Hazardous or Adventure sports
viii. Breach of law

Additional Key Features

The Claim will be settled within 15 Days Subject to all documents submitted in on go and subject to Policy Terms & Conditions.

80 Tax Benefit
Free Look Period of 15 Days
30 Days Renewal Grace Period
Portability & Migration

Discount

1. Direct Discount 18%
2. Family Discount 10% if more than 2 members are covered
3. Long term discount if policy year 2 Year – 5% 3 Year - 10%
4. Higher Deductible - 2 Days
• Age - 91 Days to 49 Years 5%
• Age - 50 Years and Above 10%

Claim Procedure

i. You or someone claiming on Your behalf must inform Us in writing immediately within 48 hours of hospitalization in case of emergency hospitalization and 48 hours prior to hospitalization in case of planned hospitalization.


ii. You can intimate Us through E-mail, Fax, Telephone or at our website. You or someone claiming on Your behalf must promptly and in any event within 7 days of discharge from a Hospital give Us the necessary documents along with all original supporting documentation, including but not limited to the following, and other information We ask for, to investigate the claim for Our obligation to make payment for it.

Note: Conditions a is precedent to admission of liability under the policy. However, the Company will examine and relax the time limit mentioned in these conditions depending upon the merits of the case.

The Insured Person/s shall submit to the Company: -

a. Duly completed claim form, and
b. Discharge Summary from the hospital
c. Hospital Main bill with breakup details.
d. Aadhar card & PAN card Copies (Not mandatory if the same is linked with the policy while issuance or in previous claim)

The Company shall pay interest as per Insurance Regulatory and Development Authority of India (Protection of Policyholders' Interests) Regulations, 2017, in case of delay in payment of an admitted claim under the Policy.


iii. Any medical practitioner authorized by the Company shall be allowed to examine the Insured Person in case of any alleged injury or diseases requiring Hospitalization when and as often as the same may reasonably be required on behalf of the Company.

iv. You must take reasonable steps or measures to minimize the quantum of any claim that may be made under this Policy.


How to claim?

Inform our 24x7 Claim Help Desk about the loss on Toll Free Numbers & Mail id:-
Toll Free: 1800-103-3009, 1800-300-30000
Mail ID: chd@shriramgi.com

Please refer the policy wording for more details

Frequently Asked Questions

Q1. What is Hospital Daily Cash Benefit Insurance?

Hospital Daily Cash Benefit Insurance policy is the health insurance benefit product. It provides additional benefit to take care of your incidental expenses such as food, lodging, and travelling which are not covered in health insurance policy in an event of hospitalization

Hospital Daily Cash Benefit Insurance gives you a daily benefit for every 24 hours of hospitalization. The coverage commences after the first 24 hours of admission, if the reason for hospitalization is not falling under exclusion in the Policy. The cash benefit, depending on the plan, ranges from ₹ 500 per day to ₹ 5000 per day with an option to choose from 15 Days to 180 days.

Q2. How is Hospital Daily Cash Benefit Insurance different from Health Insurance?

Health Insurance policy reimburses inpatient hospital bills while Hospital Daily Cash Benefit Insurance offers you fixed daily benefits, per 24 hours spent in hospital. This is aimed in covering the incidental expenses during hospitalization which are normally not covered under health insurance. Hospital Daily Cash Benefit Insurance is NOT a substitute of Health Insurance. Rather it acts as a supplement.

Q3. What is the deductible under the policy?

An excess equivalent to the first 24 hours Hospitalization benefit will be applicable on each and every Hospitalization during the Policy Period except for accidental cases.

Q4. Who can buy this policy?

Anyone in the age group of 18- 65 years can buy this policy. Children can be covered from 91 days along with family members.

Q5. What is the waiting period under this policy?

There is a waiting period of 30 days before you can claim under this policy.

Q6. What plan options are available under this policy?

You can buy a maximum 15 days or 180 days of hospitalization plan and choose the daily cash benefit from ₹ 500 per day to ₹5000 per day under this policy.

Q7. Is Pre-Policy Acceptance Health Check Up mandatory under this policy?

Pre-Policy Aacceptance Health check is not mandatory for people who are less than 45 years

Q8. Is a Free- Look option available in this policy?

Yes, it is available. You can avail this option within 15 day from the date of inception of the policy. Same is not available on renewal.

Q9. What do you mean by Pre-Existing Disease? Are pre-existing diseases covered in this policy?

Any condition, aliment or injury or relation condition(s), for which the insured had signs or symptoms and/or diagnosed and/or received medical advice/treatment prior to the inception of the policy. Pre-existing diseases are covered after 48 Months if declared at the time of application and accepted by insurer.

Q10. Can I port any other policy into this policy?

Portability is applicable only within similar products. In this case you can port your existing Hospital Daily Cash Benefit policy into this policy.

Q11. What are the tax benefits that can be availed on this plan?

Yon avail tax benefit under section 80D of Income Tax Act.

Q12. Will Hospital Daily Cash Benefit Insurance cover maternity?

Yes, Our Hospital Daily Cash Benefit Insurance Covers Childbirth / hospitalization due to maternity
The benefit under this cover is payable after waiting period of 2 years from date of addition of spouse in the policy period subject to both self and spouse are covered.
This cover is available for maximum of 2 child for life time.

Q13. Is Day Care Treatment covered?

Yes, it is covered for following diseases.

1. Cataract
2. Lithotripsy/ Nephrolithotomy for renal calculus
3. Coronary angiography
4. Haemodialysis
5. Parenteral Chemotherapy
6. Manipulation of dislocation under GA
7. Radiotherapy
8. Cystoscopy under GA
9. Therapeutic curettage
10. Surgery for ligament tear

Q14 HOW DO I RENEW MY POLICY?

Call on Our Toll-Free No’s 1800-300-30000

Written By: Shriram General Insurance - Updated: september 2022
IRDAI Consumer Education:- Insurance is the subject matter of solicitation. IRDAI Registration Number - 137. CIN No. U66010RJ2006PLC029979. BEWARE OF SPURIOUS PHONE CALLS AND FICTITIOUS/FRAUDULENT OFFERS. IRDAI clarifies to public that IRDAI or its officials do not involve in activities like sale of any kind of insurance or financial products nor invest premiums. IRDAI does not announce any bonus. Public receiving such phone calls are requested to lodge a police complaint along with details of phone call, number.

Shriram General Insurance Co. Ltd. (In partnership with Sanlam, South Africa)
E-8, EPIP, RIICO Industrial Area, Sitapura, Jaipur - 302022 (Raj.)
Toll free: 1800-300-30000(Policy Holders), 1800-103-3009(Others) Fax: 0141-2770692, 2770693

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