ManipalCigna Disclaimers
Standard Disclaimer
ManipalCigna Health Insurance Company Limited | CIN: U66000MH2012PLC227948 | IRDAI Reg. No.: 151 | Regd. Office: 401/ 402, 4th Floor, Raheja Titanium, Off Western Express Highway, Goregaon East, Mumbai – 400 063 | Toll Free: 1800-102-4462 | Website: www.manipalcigna.com | Category - General (Health) Insurance
For more details on risk factors, terms and conditions, please read the sales brochure/ sales document available on our website (Download section) before concluding a sale. Trade Name / Trade Logo belongs to MEMG International India Private Limited and Cigna Intellectual Property Inc and is being used by ManipalCigna Health Insurance Company Limited under license.
© @ 2019 ManipalCigna Health Insurance Company Limited. All rights reserved.
In order to avail any other Sum Insured , benefit OR Add-on cover which is not available at the time of buying on the website, please feel free to contact us on our Toll free number that is 1800-102-4462 or visit our branches. You may also contact us at our customer service email id: customercare@manipalcigna.com or write to us at ManipalCigna Health Insurance Company Limited ,401/402,Raheja Titanium, Western Express Highway, Goregaon (East)-Mumbai-400063 for any assistance
Product Disclaimer
1. ManipalCigna ProHealth Prime UIN: MCIHLIP26036V022526
2. ManipalCigna Super Top Up UIN: MCIHLIP23022V032223
3. ManipalCigna Lifetime Health UIN: MCIHLIP21559V012021
4. ManipalCigna Health 360 Rider UIN: MCIHLIA23023V012223
5. ManipalCigna Prime Senior UIN: MCIHLIP27039V022627
6. ManipalCigna Accident Shield UIN: MCIPAIP24083V012324
7. ManipalCigna Sarvah UIN:MCIHLIP26038V022526
8. Infinix UIN: MCIHLIP27044V012627
The solutions demonstrated in this video are optional and for illustration purpose depicting some of the possible combination of various plans and optional covers available under the product – ManipalCigna ProHealth Prime. These plans and optional covers are also available for sale individually without these combination/ solutions. There is no compulsion whatsoever that these plans and covers are to be taken together and presented above. You may choose to opt for any other combination or individual plan or optional covers as per your need.
~Available as an optional cover on payment of additional premium.
(5)Available under ProHealth Prime – Advantage Plan.
(11)Wellness Program Earn reward points of up to 20% of your base premium and use them as a discount on the renewal premium.
(12)Condition Management Program Earn reward points of up to 15% of your base premium and use them as a discount on the renewal premium.
(13)Room upgradation: Suite or any room above the suite room is only available with the Enhance Plus, Enhance, and Freedom Packages under ProHealth Prime Protect and Advantage plans.
Claims under this policy will be payable only if the aggregate of all covered medical expenses exceeds the deductible limit applicable per policy year.
*Guaranteed continuity benefit will be available as an optional cover with additional premium.
~Optional covers are available on payment of additional premium.
**Available on porting existing base sum insured (excluding bonus) of ₹ 10 lakhs & more.
~~ Under Premium Waiver Benefit, 1 year premium is waived off if the insured who is also the proposer suffers from any of the covered contingencies.
+Coverage outside India is available with Lifetime Health Global plan for opted major illness/es within opted area of cover.
##Available for coverage in India.
Within ManipalCigna, this is the first time, we offer riders that enhances the base covers of the policy. This in no way compares with any other Insurer offering such covers.
The solutions demonstrated below are for illustration purpose depicting some of the possible combination of various plans and excluding optional covers available under the product – ManipalCigna Sarvah.
*Wellness Program - Rewards can be earned by completing activities specified under Our Healthy Life Management Program up to maximum of 20% of expiring base Premium (excluding Premium for optional covers other than Deductible, Voluntary Co-Payment, Twin Sharing, Extension of Specific Disease Waiting Period, Pratiksha, Rider and taxes (as applicable)). These earned Reward Points can be used as premium discount from 1st Renewal of the Policy
Carry forward of earned Reward Points shall not be allowed.
(1a)- Major Illnesses : Major Illnesses are Heart Conditions, Cancer, Stroke, Major Organ and Bone Marrow Transplant
(1b)- Gullak Benefit: Gullak Benefit is available as optional cover with ManipalCigna Sarvah (Pratham and Uttam) at an additional cost and as base cover with ManipalCigna Sarvah Param Plan
(1c)- Sarathi Benefit: Any condition or illness, complication or ailment related to Cancer, Heart, Stroke & Major Organ/Bone Marrow Transplant (in ManipalCigna Sarvah Pratham Plan as an optional cover) or any condition or illness, complication or ailment (in Uttam plan as an optional cover) arising out of Asthma/ Diabetes/ Dyslipidaemia/ Obesity/ Hypertension declared and accepted as a part of Pre-existing disease will be covered from 31st day from policy inception at an additional cost.
(1d)Maternity Benefit: Get 20% coverage of the sum insured maximum up to 5Lacs over and above the sum insured. This benefit is available as an optional cover with ManipalCigna Sarvah Uttam Plan and ManipalCigna Sarvah Param Plan at an additional cost.
(1e) Restoration : Available as base cover in ManipalCigna Sarvah Param Plan , and as optional covers in ManipalCigna Sarvah Uttam Plan & ManipalCigna Sarvah Pratham plans at an additional cost.
(1f)Surplus Benefit: Get 100% refill of your base Sum Insured on your 1st claim. Available as optional covers in ManipalCigna Sarvah Pratham Plan, Sarvah Uttam Plan & Sarvah Param Plan at an additional cost.
(1g)Personal Accidental Cover: Get a fixed benefit coverage up to Rs 3cr, available as optional covers in ManipalCigna Sarvah Pratham Plan, Sarvah Uttam Plan & Sarvah Param Plan at an additional cost.
(1h)Anant: Get unlimited sum insured for major illnesses- Heart, Cancer, Stroke, Major organ/ bone marrow transplant and Accident for any number of times in a Policy Year. Available with ManipalCigna Sarvah Uttam Plan and ManipalCigna Sarvah Param Plan as an optional cover upon payment of additional premium.TnC applied.
(1i)Tatkal : Zero waiting period. Available only in ManipalCigna Sarvah Param Plan.
ManipalCigna Sarvah is the product and ‘Param’, ‘Uttam’ and ‘Pratham’ are the names of available plans under the said product. Benefits and features vary from plan to plan. For more details on product and its plan, kindly refer sales brochure or contact your insurance advisor.
(2a) Preferred Provider Network-
- Treatment taken at hospitals outside the opted PPN package shall attract a co-payment (25% if treatment is taken in Premier+ & 10% if treatment is taken in Premier). Such co-pay shall not apply in case of hospitalization for life threatening medical emergencies.
- Also, kindly note that we do not cover treatment taken at Unrecognised hospitals, unless it is for a life-threatening medical emergency.
- You can view the list of PPN hospitals in each package and also the details of unrecognised hospitals by clicking on the Link
(2b) No Claim Discount-
- Once the eldest member covered under the Policy reaches age of 56 years at the time of renewal, further movement to a higher discount level will stop for the entire policy.
- The discount level already earned at age 56 will continue until a claim is made. After a claim is made post age 56, the discount will reset to 0 and will not build up again in future policy years, irrespective of claim history.
(2c) One Time Aggregate Deductible-
- One Time Deductible discount applies every year for 10 policy years.
- Once selected, the Policyholder will not have the option to opt out of this benefit.
- This cover is optional in nature & can be selected voluntarily.
- One Time deductible, Annual Aggregate deductible and GMC discount are mutually exclusive.
(2d) New Beginnings-
- Coverage increases by 100% post completion of the 2nd policy year with New Beginnings. Maximum accumulation can be upto 1000% of originally chosen benefit amount for New Beginnings.
- This is an optional cover available on payment of an additional premium.
(2e) High- End Diagnostic Tests –
- Coverage is available up to ₹50,000 at policy level per policy year and this limit will reset at the start of every new policy year.
- Only available with Unlimited Base Sum Insured.
- This is an optional cover available on payment of an additional premium.
(2f) QuickAccess-
- Available as an optional cover only under ManipalCigna Infinix Core Plan upon payment of additional premium.
- QuickAccess will apply only for declared and accepted listed Pre-existing Diseases (Asthma, Diabetes, Dyslipidaemia, Obesity, Hypertension, Hypothyroidism, Migraine, and Leukoderma).
- Coverage starts from the 31st day only for the declared and accepted listed Pre-existing Diseases.
- Specified Disease Waiting Period will also reduce to 24 months.
- QuickAccess and Reduction of Waiting Period are mutually exclusive and cannot be opted together.
(2g) Wellness Program -
- Rewards can be earned by completing steps as specified under the benefit.
- A maximum discount of 20% of the expiring base Premium can be availed at subsequent renewal.
(2h) Home Treatment-
- This cover is available only with Unlimited Sum Insured option, coverage for admissible expenses is available up to a maximum limit of ₹50,000.
- Kindly note that you must pre-inform us before starting the home treatment. The request will be valid only after we approve it.
- Also, home treatment may not be accessible in every location. This benefit will therefore be available subject to service availability in your area.
- Home treatment will be covered for up to 60 days per policy year at the policy level. This may be extended only with our explicit prior approval.
(2i) Modern Treatment-
- It is mandatory to provide prior intimation and seek approval from Us for both cashless and reimbursement claims before commencement of the treatment.
(2j) Personal Accident Plus-
- If any Insured Person is 76 years or above at renewal, the maximum payout under PA+ specifically for that Insured Person in all future policy years will be limited to ₹10 lakh or the applicable Benefit Amount, whichever is lower. Premium will be charged in line with such applicable Benefit Amount.
- This is an optional cover available on payment of an additional premium.
(2k) Health Check-up-
- Under this benefit, every Insured Person who is 18 years or above at the start of a Policy Year can avail a Health Check-up once during every Policy Year, including the first Policy Year.
- This benefit can be opted at the policy level, on an all-or-none basis.
(2l) Air Ambulance-
- This benefit has an independent benefit limit of ₹10 lakh per policy year which can be used by all Insured members under this Policy combined.
- This limit will reset at the start of every new policy year.
- This is an optional cover available on payment of an additional premium.
(2m) GMC Discount- You can choose any one of these options: One Time Aggregate Deductible, Annual Aggregate Deductible, or GMC Discount. Only one option can be active at a time.
(2n) Coverage for Non-Medical Expenses (NME) and Durable Medical Equipment (DME)
- Durable Medical Equipment has a separate benefit limit of ₹1 lakh per policy year.
- This is the maximum amount that can be used by all Insured members under this Policy combined. This limit will reset at the start of every new policy year.
- This is an optional cover available on payment of an additional premium.
(2o) Reduction of Waiting Period-
- Available as an optional cover only under ManipalCigna Infinix Core Plan upon payment of additional premium.
- QuickAccess and Reduction of Waiting Period are mutually exclusive and cannot be opted together.
Standard Exclusions- Out-Patient Treatment expenses | Treatment costs arising from criminal conduct and illegal acts | Coverage for health conditions caused by war, armed conflict, or civil unrest | Medical expenses incurred and treatment received outside India | Appearance enhancing treatments and cosmetic procedures except for reconstruction due to accident, burns, cancer or medically necessary. Only a few exclusions have been highlighted above for reference. Please refer to the policy wordings for the complete list of exclusions.
ManipalCigna Infinix is the name of the product. ‘Now’ and ‘Core’ are the names of available plan variants under the said product. Benefits and features vary across plan variants. For more details on the product and its plan variants, kindly refer to the prospectus or contact your insurance advisor.
Tax Disclaimer
*Deduction under section 80D is applicable under the provisions of Income Tax Act, 1961. Please consult your Tax advisor for more details on Tax benefits. Tax treatment are subject to change in Tax laws.
#An individual or HUF can claim a deduction up to ₹ 25,000 for the insurance of self, spouse, and dependent children. An additional deduction for the insurance of parents is available to the extent of ₹ 25,000 if parents are less than 60 years of age, or ₹ 50,000 if parents are aged above 60 years. Deduction of ₹ 1 lac is available if the age of Self & parents is above 60 days or more. Please consult your tax advisor for more details on tax benefits.
Tax benefit is subject to changes in tax laws.
Other Disclaimers
*^Available as an optional cover on payment of additional premium. Non-Medical Expense benefit available under ProHealth - Protect & Advantage Plan (UIN MCIHLIP22224V012122), ManipalCigna Super Top Up (UIN MCIHLIP23022V032223) & Health 360 Rider (MCIHLIA23023V012223)