Health Insurance Claims FAQ's | ManipalCigna Health Insurance

Frequently Asked Questions

Content with PRODUCTS Lifestyle Protection - Critical care .

Critical Illness insurance is a policy that pays an amount equal to the sum insured upon first diagnosis of a critical illness covered under the policy.

A basic health insurance policy generally pays hospitalization bills. But will a health insurance be enough if you are diagnosed of a critical illness. To help you tide over such medical exigencies, there are critical illness insurance plans that you should consider. Known as defined benefit plans, these pay you lump sum so that you can pay for the incidents. In that sense these work as income supplements.

Some health insurance plans come bundled with critical illness (as rider or add-on), but a standalone critical illness plan is more comprehensive both in terms of illnesses covered and the amount of cover it offers.

ManipalCigna  Lifestyle Protection Critical Care plan not only assures you financial support in critical times but also gives you access to a worldwide network of hospitals. Moreover, it brings you the best-in class medical care and services.

This plan is brought to you by ManipalCigna Health insurance, ManipalCigna Health insurance is a joint venture between Manipal Group, an eminent player in the field of healthcare delivery and higher education in India and Cigna Corporation, a global health services company with over 200 years of experience.

The Key Benefits under this policy includes:

A.  Critical Illness Cover for 15 or 30 illnesses as per plan
B.  Medical Second Opinion
C.  Access to Online Wellness Program

The Policy is available for a Sum Insured from Rs 1 Lac to 3 Crores. Higher cover is available subject to underwriting on case to case basis. You can choose to opt for a Basic Plan covering 15 Critical Illnesses or Enhanced Plan covering 30 Critical Illnesses.

The following Critical Illnesses are covered under the Policy.

1. Cancer of Specified Severity

2. Myocardial Infarction (First Heart Attack – of Specific Severity)

3. Open Chest CABG

4. Open Heart Replacement or Repair of Heart Valves

5. Coma of Specified Severity

6. Kidney Failure Requiring Regular Dialysis

7. Stroke Resulting in Permanent Symptoms

8. Major Organ / Bone Marrow Transplant

9. Permanent Paralysis of Limbs

10. Motor Neuron Disease with Permanent Symptoms

11. Multiple Sclerosis with Persisting Symptoms

12. Primary (Idiopathic) Pulmonary Hypertension

13. Aorta Graft Surgery

14. Deafness

15. Loss of Sight

16. Coronary Artery Disease

17. Aplastic Anaemia

18. End Stage Lung Disease

19. End Stage Liver Failure

20. Third Degree Burns

21. Fulminant Hepatitis

22. Alzheimer’s Disease

23. Bacterial Meningitis

24. Benign Brain Tumor

25. Apallic Syndrome

26. Parkinsons Disease

27. Medullary Cystic Disease

28. Muscular Dystrophy

29. Loss of Speech

30. Systemic Lupus Erythematous

Policy can be issued or renewed for one, two or three continuous years at the option of the Insured person.

The minimum age at entry under this policy is 18 years and maximum age at entry is 65 years. Renewals will be available for lifetime.

If the insured person is diagnosed for the first time with a covered critical illness, we will make payment upto the sum insured under the policy, provided the waiting periods are met.

The received amount can be used to pay hospitalization expenses.  There is no hospitalization cover or cashless benefit under this policy.

An Insured Person can choose to secure an expert opinion from Our Network of Medical Practitioners, if he/she is diagnosed with a covered Critical Illness during the Policy Period. This benefit can be availed once, by each Insured person during the lifetime of a policy for a particular Critical Illness.

This is ManipalCigna’s customized wellness program. It is a service benefit available to cater to the varied health needs of our customers through specialized programs like Health Risk Assessment, Lifestyle Management and Nutrition. It takes forward our proposition of being your partner in “illness and wellness” and ensures that you maintain your health at all times.

The premium will depend on the plan, sum insured, policy tenure, age on last birthday and gender of the insured person. Also the health status of the individual will be considered.

Premiums modes available in the policy are Monthly, Quarterly, Half Yearly, Yearly and Single

The coverage is available on individual and family basis.

Eligibility of Sum Insured will be maximum 10 times of annual income.

   For family policy, the eligibility will be as per below table.

Family Policy: Family Member

Sum Insured

Earning member  

As per the Sum Insured opted

Non-earning Spouse

60% of Sum Insured of Earning member (Max SI capped at Rs 50 Lacs)

Dependent Children

30% of the Sum Insured of Earning member  (Max SI capped at Rs 30 Lacs)

Dependent parents/parent in laws or dependent Siblings

30% of the Sum Insured of Earning member  (Max SI capped at Rs 30 Lacs)

The policy covers following relationships – Self, Lawfully Wedded Spouse, Dependent Parents and Dependent Parents-in Law. Dependent Children, Dependent Grandchildren and Dependent Siblings up to the age of 25 years and are unmarried.

On first diagnosis of the covered critical illness, we will make payment upto the sum insured under the policy provided the waiting periods are met. There is no specific benefit as “Death Benefit” under the policy.

You can avail the following discounts on your policy.

  1. Family Discount of 10% for covering more than 2 family members under the same individual policy.
  2. Long Term Discount of 7.5% and 10% on selecting a 2 and 3 years single premium policy respectively.
  3. Direct Policy Discount of 10%.

You can port your existing health insurance (Critical Illness) policy to ManipalCigna  Lifestyle Protection Critical Care policy provided you are covered under an Indian Health Retail policy from a Non-life insurance company.

You can claim tax deduction u/s 80D as per IT Act’1961 for premium paid towards this policy. For premiums paid in cash, tax benefit u/s 80D shall not be applicable. Please consult your tax advisor for more details.

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