Future Generali Health Total Mediclaim Policy

Future Generali Health Total Mediclaim Policy

Health Total is a Comprehensive insurance plan with long-term benefits and wider coverage options. The plan comes in 3 different variants: Vital, Superior and Premiere. All the variants come in individual and family floater options with lifetime renewability option.

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Future Generali Health Total Mediclaim Plan Variants

• Vital Plan - This plan variant can include self, spouse, and their dependent children (who are unmarried and are below 25 years of age) and dependent parents.  
• Superior and Premiere Plan Variant - This plan variant offers coverage to self, spouse, dependent children (who are unmarried and are below 25 years of age)/non - dependent children, dependent siblings, dependent or non-dependent parents, grandparents, son in law, daughter in law, parents in law, and grandchildren (maximum up to 15 members).

Sum Insured (in Rs.)

• Vital Plan - 3,5 & 10 lakh
• Superior Plan - 15, 20, & 25 lakh
• Premiere Plan - 50 lakh to 1 crore

Future Generali Health Total Mediclaim Policy Term

• Minimum -1 Year
• Maximum -3 Years

Future Generali Health Total Mediclaim Policy Pre-medical Screening

• Vital Plan: Medical tests required only for applicants who are above 50-years of age
• Superior Plan: Medical tests required for 18 years onwards
• Premiere Plan:  Medical tests required for 18 years onwards

Key Features of Future Generali Health Total Mediclaim Policy

10% of family discount is available in case there are more than one members covered in the same policy on the basis of individual sum insured.

• Floater Discount: The premium for the primary insured will be the standard applicable premium. Floater discount is applicable for the dependent members as per their age.
• Voluntary Deductible Discount: 10% to 25% discount on the premium on the basis of the plan and voluntary deductibles. 10% discount is applicable on the purchase of a long-term health insurance policy.
• Installment Facility: Long term health insurance plans can be purchased on installment i.e. monthly, quarterly, and half yearly. Up to a maximum of 5% loading will be applicable on basic premiums on the basis of the opted installment frequency.
• Copayment: If the age of the proposer/insured is above 60 years then co-payment is applicable on every single claim.
• Tax Benefit: You can avail tax-saving benefits u/s 80D of the Income Tax Act on the premium that is paid by any other mode than cash

Inclusions of Future Generali Health Total Mediclaim Policy

Future Generali Health Total plan takes off the financial stress by offering compensation for the following medical expenses:

• Hospitalization Expenses - In-patient charges, day care treatment expenses, organ donor expenses, pre-hospitalization charges, post-hospitalization expenses, and cost of the domiciliary treatment.
• Reinstatement of the Sum Insured - If the cumulative bonus and sum insured are exhausted due to claims payable, then 100% sum insured will be restored automatically.
• Maternity Expenses - Maternity expenses are covered after a waiting period of 2 years if both husband and wife are covered.
• Accidental Hospitalization - in The event of an accidental hospitalization the sum insured is increased by 25% of the remaining Sum Insured up to a maximum of 10 lakhs.
• Miscellaneous Expenses - It also covers expenses incurred on Patient Care, Ambulance, Accompanying Person Expenses, Alternative Treatments, E-opinion, and Wellness Care.
• Emergency Medical Evacuation (only in Superior and Premiere Plan) - It reimburses medical evacuation expenses from the place of accident to other hospitals in India.
• Reimburse Expenses - Compensation is provided for diagnostic tests, consultation charges, and prescribed medications as per the plan opted.
• Out Patient Medical Expenses - It is only applicable for Superior Plan and Premiere Plan.
• Child Vaccination Cover - The cost of vaccination for children below 12 years of age, only available in the premier plan.
• New Born Baby - Newborn baby expenses are covered only in Superior and Premiere Plan.
• Additional covers - You can opt for add-on covers such as Patient Care, Ambulance, Accompanying Person Expenses, Alternative Treatments, E-opinion, and Wellness Care.
• Overseas Medical Treatment (for specific ailments) - It is only available in the Premiere Plan.
• Cumulative Bonus - For every claim-free year there is a cumulative bonus ranging from 50 to 100%.

Waiting Period in Future Generali Health Total Mediclaim Policy

• For pre-existing illnesses such as hernia, cataract surgery, hemorrhoids, Fistulae, Hysterectomy, there is a waiting period of 24 months.
• Any health ailment that has been diagnosed in the initial 30 days of purchasing the policy is not covered under this plan. Only accidental injuries shall be covered.
• There is a waiting period of 48 months for Osteoporosis, age-related osteoarthritis, organ transplant, Gout, Rheumatoid Arthritis, Joint replacement, except for injury related cases.

Exclusions of Future Generali Health Total Mediclaim Policy

• External congenital anomalies and related illnesses
• Non-prescribed medicines
• Hormone replacement therapy
• Sex change treatment and related disorders
• Any health condition resulting due to overconsumption of alcohol and drugs
• Any illness or injury directly or indirectly related to the war, the act of a foreign enemy, invasion, and war-related conditions

Future Generali Medical Insurance Claim Procedure

Depending on your case you can go for cashless treatment or opt for reimbursement of your medical expenses. The procedure for cashless and reimbursement claims is listed below:

Future Generali Cashless Hospitalization Claim Procedure

• Cashless medical treatments are only available at network hospitals
• Before starting the treatment you need to showcase your health card at the hospital desk
• The hospital will give you a properly filled pre-authorization request form
• If you cashless treatment is approved Future Generali General Insurance will send an approval to you
• Future Generali will directly settle all the hospital bills on your behalf
• If your claim is rejected, then also you can continue with the treatment and pay the bills on your own.
• Once discharged you can claim for reimbursement of your medical expenses

Future Generali Medical Reimbursement Claim Procedure

• You start with the treatment in a non-network hospital
• You pay for all the hospitalization expenses
• To get reimbursement of the expense incurred you need to submit the claim reimbursement form within the stipulated time frame
• The claim will be approved once all the documents are submitted
• The rejection and approval will be as per the terms and conditions mentioned in the policy wordings

Documents Required for Future Generali Health Total Mediclaim Claims

As a part of the claim procedure you need to submit the following documents:

• Submit the duly filled and signed claim form along with Medical Certificate form to be stamped by the treating doctor
• Doctor's consultation reports
• The discharge summary from the concerned hospital (in original)
• Hospitalization bills and receipts (in original)
• Cash Memos with pharmaceutical bills along with a proper prescription
• For accidental cases, you need investigation reports and Medico Legal Certificate (MLC)