SANCHAY ADDA

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SANCHAY ADDA

HealthGuard Calculator

Principal Insured

Other insured family members

Add one or two eligible parents, and add children individually. Parent entry age: 18–65; child entry age: 90 days–20 years (age last birthday 0–20). Family eligibility and IDB limits apply.

Premium estimate

₹0
Annual premium
Insured memberAge / GenderIDBAnnual premium

Benefit Details

Waiting Period

General Waiting90 Days
Specified Disease Waiting24 Months
Pre-existing Disease36-month look-back period
Hospitalisation due to Accident0 Days
Major Surgery Benefit Details

#ProcedureCategoryBenefit Amount
Day Care Treatment Benefit Details

#ProcedureBenefit Amount
Explore Combined Benefits

Type of TreatmentCombine Benefit
1Major Surgery1Major Surgery + Hospital StayAs per surgery category + —/day
2Day Care2Day Care Treatment—
3Dialysis or Radiotherapy3Day Care Treatment—
4Other Surgery4Other Surgical Benefit + Hospital Stay—
5Specified Disease
  • Dengue
  • Malaria
  • Pneumonia
  • Pulmonary Tuberculosis
  • Viral Hepatitis A
5Medical Management Benefit + Hospital Stay—
6Over 30 Days Hospitalisation6Extended Care Benefit + Other Eligible BenefitExtended Care Benefit: — + Other Benefits
Specified Waiting Period — 24 Month

Conditions listed under Specified Waiting Period. Please refer to the complete policy wording for applicable terms and exceptions.

  1. Treatment for adenoid or tonsillar disorders
  2. Treatment for anal fistula or anal fissure
  3. Treatment for benign enlargement of prostate gland
  4. Treatment for benign uterine disorders like fibroids, uterine prolapse, dysfunctional uterine bleeding etc
  5. Treatment for Cataract
  6. Treatment for Gall stones
  7. Treatment for slip disc
  8. Treatment for Piles
  9. Treatment for Benign Thyroid Disorders
  10. Treatment for Hernia
  11. Treatment for Hydrocele
  12. Treatment for Degenerative Joint Conditions
  13. Treatment for Sinus Disorders
  14. Treatment for Kidney or Urinary Tract Stones
  15. Treatment for Varicose Veins
  16. Treatment for Carpal Tunnel Syndrome
  17. Treatment for Benign Breast Disorders e.g. Fibroadenoma, Fibrocystic disease etc
  18. Treatment for Benign Ovarian disorders
  19. Treatment for Gastric/Duodenal Ulcer
  20. Treatment for Retinal disorders
  21. Treatment for Knee/Joint Replacement Surgery (other than caused by an accident)
  22. Treatment for Osteoporosis or Osteoarthritis
  23. Treatment for Chronic renal failure or end stage renal failure
Exclusions

Brief summary only. Please refer to the complete policy wording and applicable exceptions.

  1. Pre-existing diseases or conditions not disclosed and accepted by LIC.
  2. Treatment or surgery by unqualified practitioners.
  3. Experimental or unproven treatments, medicines, or devices.
  4. Treatment outside India and routine or preventive check-ups.
  5. Surgery solely for diagnosis, screening, or investigation.
  6. Cosmetic, plastic, or aesthetic surgery, subject to policy exceptions.
  7. Organ donation-related hospitalisation or surgery for the donor.
  8. Dental treatment, except when required due to an accident.
  9. AYUSH treatment not meeting the policy conditions.
  10. Acupressure, acupuncture, magnetic, and similar therapies.
  11. Rest cures, general debility, infertility, and specified long-term care.
  12. Custodial care or admission primarily for bed rest.
  13. Attempted suicide or intentional self-inflicted injury.
  14. Influence of alcohol or drugs not prescribed by a registered practitioner.
  15. Removal or replacement of devices implanted before cover or revival.
  16. Pregnancy, childbirth, and related treatment, subject to exceptions.
  17. War, riots, terrorism, rebellion, and related events.
  18. Claims arising from specified military or security operations.
  19. Professional/competitive sports and hazardous activities.
  20. Exposure to radioactive or hazardous nuclear materials.
  21. Treatment arising from criminal or unlawful acts.
  22. Specified flying activities other than qualifying passenger travel.
  23. Eyeglasses, hearing aids, LASIK/PRK, and specified refractive procedures.
  24. Infertility, assisted conception, specified birth control, or sexually transmitted disease treatment.
  25. Sex change operation.
  26. Stem cell therapies except specified bone marrow transplantation.
  27. Hormone replacement therapy.
  28. Sleep disorders, sleep apnoea, obesity, and weight-control programmes.
  29. Pre- and post-hospitalisation treatment.
  30. Hospitalisation under 24 hours, subject to stated exceptions.
  31. Applicable general waiting period of 90/45 days, subject to policy exceptions.
  32. Applicable 24-month specific waiting period for specified conditions and procedures.
Policy Rules, Claims & Revival Guidelines

☑ 1. Claim Rules and Required Documents

1.1 How to Claim

  1. Inform LIC: If a claim arises due to an accident or illness, LIC must be informed as soon as possible.
  2. Complete the Claim Form: Fill in the prescribed LIC Claim Form correctly and submit it.
  3. Provide Bank Details: Submit the NEFT Mandate to receive the claim amount directly into your bank account.
  4. Submit Documents: Submit the necessary medical documents and bills.
  5. Additional Documents: If LIC requires any other documents during claim verification, those must also be submitted.

1.2 Required Documents

  1. Claim Form – The application form for making a claim.
  2. NEFT Mandate – Required to receive the claim amount in your bank account.
  3. Hospital Discharge Card – Details of the illness, treatment, and hospital admission and discharge dates.
  4. Operation Notes – Details of the operation, if surgery was performed.
  5. Hospital Bills – Proof of expenses incurred for hospitalisation, surgery, and emergency ambulance services.
  6. Doctor’s Certificate – For a Hospital Cash Claim involving ICU treatment, the prescribed certificate must be submitted.
  7. Death Summary – Required if the patient dies during treatment.
  8. Age Proof – Required if proof of age has not been accepted earlier.
  9. Other Documents – Any additional documents required by LIC for claim verification.

1.3 Important Notes

  • Original documents or duly attested copies, as required under the applicable rules, must be submitted.
  • Payment of the claim amount depends on the Policy Terms and Conditions.
  • For Rider Claims, the applicable terms and conditions of the respective Rider will apply.

☑ 2. Grace Period, Revival and Free-Look Period

2.1 Grace Period (Additional Time to Pay Premium)

  • For yearly and half-yearly premium payment modes, a Grace Period of 30 days is available.
  • During this period, the policy remains in force, and there is no interruption in Risk Cover.
  • If a claim arises during the Grace Period while the premium remains unpaid, the outstanding premium will be deducted from the claim amount.
  • If the premium is not paid before the end of the Grace Period, the policy will lapse, and no benefits will be available thereafter.

2.2 Waiting Period After Revival

  1. Revival Application Within 90 Days: If the revival application is submitted within 90 days from the due date of the first unpaid premium, the General Waiting Period will be 45 days from the Revival Date.
  2. Revival Application After 90 Days: If the revival application is submitted after 90 days from the due date of the first unpaid premium, the General Waiting Period will be 90 days from the Revival Date.
  3. Specific Waiting Period: If the revival application is submitted within 90 days, the applicable Specific Waiting Period will continue until completion of two years from the previous Effective Date. If the application is submitted after 90 days, a fresh two-year period will be calculated from the Revival Date.
  4. Applicability After Revival: The applicable Waiting Periods and Exclusions under the policy will apply after revival.

Important Notice

The premium shown is an estimate for reference purposes only. Actual benefits and premiums may vary depending on eligibility and applicable terms and conditions. Please verify the final details before making any decision.

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