Health Insurance Claims FAQ's | ManipalCigna Health Insurance

Frequently Asked Questions

Content with PRODUCTS Lifestyle Protection Group Policy .

A Corporate can purchase this policy for their Employees and Dependents, or groups/ associations with commonality of purpose can purchase this policy for their members and dependents. Affinity groups would include Co-operative Society, NGO, Bank/Mutual Fund customer group, holders of the same credit card and members of the same social or cultural association and so on.

The Policy is issued in the name of the Company / Employer / Affinity Group, so the Company/Affinity Group is therefore the owner of the Policy and is known as the Policy Holder. The Policy then states that all benefits are paid to the Employees/Group members, who are therefore the Insured Persons.

The policy is issued for a term of 1 year. Only for credit linked policy, term can be up to 5 years.

Yes, foreign national working in India and earning in Indian currency can be covered under this policy.

Yes, Non-resident Indian working in India and earning in Indian currency can be covered under this policy.

There is no cumulative bonus or no claim discount in Lifestyle Protection Group policy.

Minimum number of members required to issue a group policy is 7.

Nomination is a right conferred on the insurance holder to appoint a person to receive the policy monies in the event of his or her death. You can change your nomination any time before the date of policy termination. Nomination is required for valid discharge of claim.

The policy provides cover towards injuries due to personal accident and listed critical illnesses along with a range of options for groups.

Outpatient and physiotherapy expenses are not covered unless specifically selected as a part of optional covers and mentioned in the policy schedule/certificate of insurance.

Alternative treatment including chiropractic treatment is not covered.

Medical tests may be required subject to underwriting assessment depending on policy type, age and health status of the persons to be covered in a group.

 Yes, the policy allows Companies/Affinity group to tailor-make different benefit structures for Employees/Group members, which will result in different benefit categories being reflected on the policy schedule.

To purchase/renew the policy, please get in touch with us at the 1800-102-4462 or visit any of our branches. For more details log on to our website www.manipalcigna.com

Cover under the policy for any particular insured person shall automatically terminate on the earliest happening of the following events:

For Group Personal Accident:

  • On the death of such insured Person; or
  • The total aggregate sum payable of 100% sum insured has been paid; or
  • Upon such insured person ceasing to satisfy any of the eligibility requirements set out in the policy; or
  • Upon such insured person ceases to be employee/member of the group
  • Cover on the insured member automatically ceases once the master policy contract is terminated due to nonpayment of premiums or other causes specified in the policy contract.

For Group Critical Illness:

  • The total aggregate sum payable of 100% sum insured has been paid; or
  • Upon such insured person ceasing to satisfy any of the eligibility requirements set out in the policy; or
  • Upon such insured person ceases to be employee/member of the Group

Cover on the insured member automatically ceases once the master policy contract is terminated due to nonpayment of premiums or other causes specified in the policy contract.

 For any query or assistance, you can contact us with the details through:

Our Website: www.manipalcigna.com 

E-mail: servicesupport@manipalcigna.com 

Toll Free: 1800-102-4462

 If claims occurs during the grace period it will not be covered.

A medical practitioner is a person who holds a valid registration from the medical council of any state or Medical Council of India or Council for Indian Medicine or for Homeopathy set up by the Government of India or a State Government  and is thereby entitled to practice medicine within its jurisdiction, and is acting within the scope and jurisdiction of his license. It includes physician, specialist or surgeon etc.

Co-payment means a cost-sharing requirement under a health insurance policy that provides that the insured will bear a specified percentage of the admissible costs. A co-payment does not reduce the sum insured, however it reduces the premium payable by the insured to the insurer.

Common Carrier means transportation which is available as a public service and operated by an entity in the business of transporting goods or people for hire, as a public service. Example – bus, train, air plane, ship etc.

Tax benefit is applicable for Contributory policy (where insured member pays premium towards the policy) for Group Critical Illness plans only.

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