Frequently Asked Questions

The Sum Insured and Deductible combination are:

Hospital daily cash insurance is a pre-defined benefit plan where a fixed amount per day of hospitalization is paid in lump-sum to the policyholder/insured person. The plan has no link with the actual medical expenses incurred.

If the Insured Person is Hospitalized 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 Hospitalisation is Medically Necessary for at least 10 consecutive days, then We will pay a lump sum amount equal to 5 times the Daily Cash Benefit amount specified in the Policy Schedule for each continuous and completed period of 24 hours of Hospitalisation.

A standalone personal accident policy covers you and your family for accidental death, permanent disability and loss of income. But many a times you remain unprotected for partial disability, ambulance cover, orphan benefit, funeral expenses cover and many more risks.

ManipalCigna Accident Shield plan comes with all the above benefits along with other benefits like Child Welfare benefit, temporary total disability (for both Earning as well as Non-earning members ), burns benefit, brokenbones and coma cover, Loan shield and EMI shield under one policy that assures financial support and provides cushion for a better tomorrow in any accidental eventualities.

With Prime Senior we restore 100% of Sum Insured after 1st claim in a policy year, if at any point in time you are short of the coverage. This is possible in case of both related and unrelated illnesses.

Yes, our ManipalCigna Sarvah – Param covers the pre-existing disease without any waiting period

Waiting period for pre-existing diseases shall be 36 months for Pratham and Uttam plan

Unless necessary endorsements or exemptions are made below diseases and expenses arising out of or attributable to any of the following will not be covered in the policy.
1. Investigation & Evaluation
2. Rest Cure, rehabilitation and respite care
4. Change of Gender Treatments except for sex reassignment surgeries of transgender person.
5. Cosmetic or Plastic Surgery
6. Hazardous or Adventure sports
7. Treatment for Alcoholism, drug or substance abuse or any addictive condition and consequences thereof
8. Expenses related to the treatment for correction of eye sight due to refractive error less than 7.5 diopters
Above List is only indicative and not exhaustive. Please refer the Policy Wordings for detailed list.

You cannot insure more than 2 adults and 3 children in a floater policy, however you can buy multi-individual policy and can enjoy additional discount of 10% on total premium.

ManipalCigna comes with 3 different plans that can provide you a coverage for the medical expense as per your requirements.
a.    ManipalCigna Sarvah – Pratham (Essential): Protect yourself with health insurance coverage securing against Cancer, Heart, Stroke, and major organ/bone marrow transplant hospitalization expenses
b.    ManipalCigna Sarvah – Uttam (Personalized): Experience peace of mind with our comprehensive hospitalization coverage which ensure you and your loved ones are protected against high medical expenses without any financial burden and provides the flexibility to add multiple optional covers to make your health coverage more personalized.
c.    ManipalCigna Sarvah – Param: Provides comprehensive hospitalization coverage which ensure you and your loved ones are protected against high medical expenses without any financial burden or any waiting period on your pre-existing medical conditions.

Covered up to Sum Insured

This benefit provides for reimbursement of expenses incurred for availing emergency medical assistance due to illness, injury sustained or contracted outside the territorial limits of India.

The benefit amount will be limited to the sum insured available under ProHealth Select Plan A.

Expenses will be limited to in-patient hospitalization only. All payments will be in Indian rupees on reimbursement basis and as per the Exchange rate published by RBI (Reserve Bank of India) on the date of payment to the hospital.

It allows an increase in the Sum Insured by a fixed percentage as per below option. Cumulative Bonus Booster if opted will be in place of Cumulative Bonus in the base policy.

Option A) 10% increase in Sum Insured, maximum up to 100%. This will not reduce in case of a claim under the Policy. or

Option B) 25% increase in Sum Insured, maximum up to 100%. This will not reduce in case of a claim under the Policy. or

Option C) 50% Increase in Sum Insured, maximum up to 100%, irrespective of a claim under the Policy.

Option D) 10% increase in Sum Insured, maximum up to 200% irrespective of a claim under the Policy.

ManipalCigna under this policy will cover In-patient Hospitalization Medical Expenses towards the donor for harvesting the organ up to the limits of the Sum Insured, provided that:

1. The organ donor is any person in accordance with the Transplantation of Human Organs Act

1994 (amended) and other applicable laws and rules.

2. The organ donated is for the use of the Insured Person who has been asked to undergo an organ transplant on Medical Advice.

3. We have admitted a claim under in-patient hospitalization.

We will not cover:

a. Any pre or post hospitalization expenses

b. Cost towards donor screening

c. Cost directly or indirectly associated to the acquisition of the organ

d. Any other medical treatment or complication in respect of the donor, consequent to harvesting.

In this scenario, the medical treatment and expenses will be covered under Day Care Procedure.

Sub-limits are applicable on room rent and other expenses as follows:

Room Rent: Covered up to 2% of Sum Insured for a Hospital Room, up to a maximum of Rs 3,000 per day

ICU Charges: Up to 4% of Sum Insured for ICU up to a max of Rs 7,000 per day

For in-patient hospitalization, we will pay for the below medical expenses:

• Room rent for accommodation in Hospital room up to a max. of Rs.3000/- per day

• Intensive Care Unit charges for accommodation in ICU up to a max. of Rs. 7000/- per day

• Operation theatre charges,

• Fees of Medical Practitioner,

• Anaesthetist,

• Qualified Nurses,

• Specialists,

• Cost of diagnostic tests,

• Medicines

You can choose from Sum Insured available under ProHealth Select Plan A and Plan B.

Plan A - 0.5, 1, 2, 3, 4, 5, 7, 10, 15, 20, 25 Lacs

Plan B - 2,3, 4, 5, 7, 10, 15, 20, 25 Lacs

ProHealth Select offers wide range of protection including Inpatient, Day care, Pre and Post hospitalization benefits, Donor and Domiciliary cover. It provides Restoration of Sum Insured (SI) and Smart non- reducing Cumulative bonus as an inbuilt benefit.

Its optional Cumulative Bonus Booster works on non-reducing/guaranteed basis (as selected) and adds more flexibility to the policy coverage.You get unique choice of Re-assurance cover, Worldwide Emergency and Health Maintenance Benefit for OPD expenses.

You also have option to select Removal of Room Rent limit and Disease Specific Sub-limits. ManipalCigna offer Healthy Rewards as value added benefit associated with ProActiv Living Program.

All benefits are even offered for policies where Deductible or Voluntary co-pay has been opted.

#Voluntary Co-pay and Deductible cannot be taken under a single plan.

*Available for Plan A

#The covers are available as per the plan chosen.

Policy holder will get 1% discount on the renewal premium if no claim has been made during the expiring policy tenure.

If you wish to insure more than 2 adults or 3 children in a floater plan, you need to buy an additional policy.
Under any plan of your choice, there is no family floater option. The family members can buy a multi-individual policy.