JIO SUPER TOP UP MEDICLAIM

Payment for policy premium is accepted only through Online Payment

CASH/ CHEQUE/ NEFT & RTGS WILL NOT BE ACCEPTED

 



 

SUPER TOP UP : UNIQUE TYPE OF MEDICLAIM

An ADDITIONAL COVERAGE of Mediclaim BEYOND a Chosen Specified Limit,
SO IT ACTS as a Cushion & Comes in to Action When Such Limit Is Exhausted
Salient Features Of Jio Super Top Up Mediclaim
  1. Available for All JAIN Shravak-Shravika Members of JIO .

  2. ENHANCE Your MEDICLAIM Sum Insured UPTO Rs.20 Lakh at very Nominal Premium.

  3. Available SUPER TOP-UP Sum Insured of Rs.2 Lakh, Rs.5 Lakh and Rs.10 Lakh

  4. Family Floater for Maximum 6 Members (1 + 5).

    Proposer + Spouse ( Husband/wife)

    + 2 Dependent Children Up to 25 years of age

    + 2 Dependent Parents OR Parents In-Laws Up to 85 years

    ( Any one set of parents to be covered, combination not allowed).

  5. Maximum entry age: - Up to 85 Years. Once enrolled LIFE TIME renewal possible.

  6. NO Medical Checkup required.

  7. PRE-EXISTING Diseases are covered from DAY ONE.

  8. NO Waiting Period. (Waiting period for 1st year, 2nd year and 4th year disease are Not Applicable.)

  9. NO Capping ( Sub-Limit) applicable on any disease & on any family member.

  10. NO Co-Payment applicable on any type of claims.

  11. Opportunity to Avoid Heavy Deduction due to ROOM RENT LIMITS.

  12. HIGHER of the ROOM RENT is applicable,

    1% and 2% of SUPER TOP-UP Sum Insured

    OR

    1% and 2% of BASE POLICY Sum Insured.

  13. Pre-Hospitalization Medical Expenses up to 30 DAYS are also COVERED.

  14. Post-Hospitalization Medical Expenses up to 60 DAY are also COVERED.

  15. 562 Types of DAY CARE Procedures are covered.

  16. Claims Payable on REIMBURSEMENT Basis only.

  17. AYUSH TREATMENT is also covered up to limits defined by IRDA.

  18. Proposer will be eligible for Deduction Under SEC. 80 D of Income Tax Act.

  19. ADDITIONAL POLICY : Accidental Relief Cover for PROPOSER is also attached of Rs.10 Lakh and Rs.5 Lakh Sum Insured with extra ordinary features.

  20. ## POINTS TO BE NOTED FOR "SUPER TOP UP"

    Some more important information about this policy

    (Please read it carefully)

  21. It ENHANCES your Existing Mediclaim Sum Insured.

  22. This plan is ALSO AVAILABLE for members WITHOUT any Existing Mediclaim policy.

  23. You can TOP UP ANY TYPE of your existing MEDICLAIM issued by any insurance company

    Like Retail Personal Mediclaim, Family Floater Mediclaim, Group Mediclaim, JIO Mediclaim etc.

  24. IRRESPECTIVE of your Existing MEDICLAIM Sum Insured, You Can Choose ANY AMOUNT as DEDUCTIBLE LIMIT (from the available option- Rs.2 lakh, Rs.3 lakh, Rs.5 lakh and Rs.10 lakh).

  25. DEDUCTIBLE LIMIT: The chosen amount up to which the AGGREGATE Medical CLAIMS of FAMILY, Incurred During The Policy Period WILL NOT Be Payable by this Super Top Up Mediclaim AND The SAME AMOUNT shall be PAYABLE BY Member’s BASE POLICY OR the EXPENSES will be BORNE BY THE FAMILY.

  26. Hospitalization CLAIMS incurred During the Super Top Up Policy Period for the WHOLE Family in ONE OR MORE Occasions will be Considered TO CALCULATE THE DEDUCTIBLE LIMIT.

  27. Super Top Up Mediclaim PREMIUM CHART :

  28.  

     

     

    The Member who DOES NOT HAVE BASE POLICY (Existing Mediclaim) their deductible limit starts from Rs 3 Lakh and more.

    They can also choose following option apart from the table above.

     

     

  29. Deductible Limit for Proposer WITHOUT ANY EXISTING MEDICLAIM has to be Minimum of Rs.3 Lakh.

  30. Deductible limit of Minimum Rs.3 Lakh is also Applicable for that Particular Member of family Who Does Not Have Any Base Policy AT THE TIME OF CLAIM.

  31. After The INCEPTION of Super Top Up Mediclaim, the Expenses incurred thereafter shall only be considered TO CALCULATE THE DEDUCTIBLE LIMIT.

  32. After CROSSING the Chosen Deductible LIMIT, Due To Aggregate Claims falling WITHIN POLICY PERIOD of super top up Mediclaim Shall Be Payable under this policy Upto the Sum Insured.

  33. IF Base Policy Sum Insured is exhausted or partially Exhausted Before Inception of Super Top Up Mediclaim then the same WILL NOT BE Considered IN CALCULATION OF DEDUCTIBLE LIMIT.

Portability Available for the policy After a Year AT THE TIME OF RENEWAL.

Salient Features

of

ACCIDENTAL RELIEF COVER

S.N.

Benefit

Sum Insured

Plan A

Plan B

1

Accidental In-patient Hospitalization (limited to India)

Upto 1,00,000

Upto 2,00,000

2

Recovery Benefit

10,000

20,000

3

Permanent Partial Disablement

Upto 5,00,000

Upto 10,00,000

4

Permanent Total Disablement

5,00,000

10,00,000

5

Accidental Death

5,00,000

10,00,000

6

Funeral Expenses

10,000

20,000

7

Education Fund for Children

1,00,000

2,00,000

8

Marriage Fund for Children

1,00,000

2,00,000

9

Orphan Benefit for Children

3,00,000

5,00,000

Per Life Premium - Including GST

Rs.472

Rs.944

 

Spouse and other Dependents can be covered on Individual Basis for all benefits except benefit Number 7,8 & 9 which is applicable only for Primary Insured Person.

Details of Coverage

1. Accidental In-patient Hospitalization (limited to India)

If an Insured Person suffers an Injury due to an Accident and such Injury requires the Insured Person to be Hospitalized as an In-patient in a Hospital room ( Shared/ Twin Sharing AC), then policy will cover the costs incurred on Medical Expenses up to the limit specified in the Policy Schedule or Certificate of Insurance provided that:

  1. The Insured Person is Hospitalized in India;

  2. The Hospitalization is for Medically Necessary Treatment and is on the written advice of a Medical Practitioner.

  3. The Insured Person is admitted to Hospital within 7 days of the occurrence of the Accident.

 

2.Recovery Benefit

If the Insured Person suffers an Injury due to an Accident and such Injury results in the Hospitalization of the Insured Person during the Policy Period for at least 10 consecutive days ( Minimum continuous 10 days), then policy will pay the lump sum amount as specified in the Policy Schedule or Certificate of Insurance.

 

3.Permanent Partial Disablement

If the Insured Person suffers an Injury due to an Accident that that results in the permanent partial disablement of the Insured Person of the nature as specified in the table below, then policy will pay the percentage of the Sum Insured as specified in the table below.

Table of Benefits

Percentage of the Sum Insured payable

Type of Permanent Partial Disablement

i)    Total and irrecoverable loss of sight of one eye

50%

ii)   Loss of one hand or one foot

50%

iii)  Loss of all toes - any one foot

10%

iv)  Loss of toe great - any one foot

5%

v)  Loss of toes other than great, if more than one toe lost, each

2%

vi) Total and irrecoverable loss of hearing in both ears

50%

vii)  Total and irrecoverable loss of hearing in one ear

15%

viii)  Total and irrecoverable loss of speech

50%

ix)   Loss of four fingers and thumb of one hand

40%

x)  Loss of four fingers

35%

xi) Loss of thumb –both phalanges

25%

xii)  Loss of thumb - one phalanx

10%

xiii) Loss of index finger-three phalanges

10%

  • two phalanges

8%

  • one phalanx

4%

xiv)Loss of middle/ring/little finger-three phalanges

6%

  • two phalanges

4%

  • one phalanx

2%

 

In case the Insured Person suffers a loss not mentioned in the table above, then an external medical advisor will determine the degree of disablement and the amount payable, if any.

 

4.Permanent Total Disablement

If the Insured Person suffers an Injury due to an Accident that results in the permanent total disablement of the Insured Person of the nature as specified in the table below, policy will pay 100% of the Sum Insured.

Table of Benefits

Type of Permanent Total Disablement

1. Total and irrecoverable loss of sight of both eyes

2. Loss by physical separation or total and permanent loss of use of both hands or both feet/Leg

3. Loss by physical separation or total and permanent loss of use of one hand and one foot

4. Total and irrecoverable loss of sight of one eye and loss of a Limb ( Any one from two hands or two legs)

5. Total and irrecoverable loss of hearing of both ears and loss of one Limb/loss of sight of one eye

6. Total and irrecoverable loss of hearing of both ears and loss of speech

7. Total and irrecoverable loss of speech and loss of one Limb/loss of sight of one eye

8. Permanent total and absolute disablement (not falling under the above) disabling the Insured Person from engaging in any employment or occupation or business for remuneration or profit, of any description whatsoever which results in Loss of Independent Living

For the purpose of this Benefit,

- Limb means a hand at or above the wrist or a foot above the ankle;

- Physical separation of one hand or foot means separation at or above wrist and/or at or above ankle, respectively.

Once a claim has been accepted and paid under this Benefit then cover under this Benefit shall immediately and automatically cease in respect of that Insured Person.

5. Accidental Death

If the Insured Person suffers an Injury due to an Accident that results in the death of the Insured Person, Policy will pay 100% of the Sum Insured provided that:

  1. Once a claim has been accepted and paid under this Benefit then cover under this Policy shall immediately and automatically cease in respect of that Insured Person.

6. Funeral Expenses

If We have accepted a claim under Accidental Death in accordance with Sections II.1 then in addition to the amount payable under that Section, POLICY WILL PAY A LUMPSUM AMOUNT as specified in the Policy Schedule or Certificate of Insurance towards funeral, cremation/ or burial and transportation of the body to the place of the funeral ceremony for the Insured Person.

7. Education Fund for Children

If We have accepted a CLAIM UNDER ACCIDENTAL DEATH OR PERMANENT TOTAL DISABLEMENT, then in addition to the amount payable under that Section, Policy will PAY A LUMP SUM AMOUNT as specified in the Policy Schedule or Certificate of Insurance in respect of each surviving Dependent Child, UP TO 2 DEPENDENT CHILDREN, if specified in the Policy Schedule or Certificate of Insurance irrespective of whether the child is an Insured Person under this Policy.

This Benefit shall be payable subject to the Dependent Child being up to 25 years of Age as on date of occurrence of the event irrespective of whether the child is an Insured Person under this Policy and PROVIDED THAT THE DEPENDENT CHILD DOES NOT HAVE ANY INDEPENDENT SOURCE OF INCOME.

8. Marriage Fund for Children

If We have accepted a CLAIM UNDER ACCIDENTAL DEATH OR PERMANENT TOTAL DISABLEMENT, then in addition to the amount payable under that Section, We will PAY A LUMP SUM AMOUNT as specified in the Policy Schedule or Certificate of Insurance in respect of the Dependent Child that is UNMARRIED, UP TO 2 DEPENDENT CHILDREN, if specified in the Policy Schedule or Certificate of Insurance, irrespective of whether the child is an Insured Person under this Policy.

9. Orphan Benefit for Children

If We have accepted a CLAIM UNDER ACCIDENTAL DEATH for the INSURED PERSON and that INSURED PERSON’S SPOUSE (who may or may not be an Insured Person) is also deceased in the SAME POLICY YEAR at the time of death of the Insured Person, and the CHILD BECOMES ORPHAN, then in addition to the amount payable under that Section, POLICY WILL PAY A LUMP SUM AMOUNT as specified in the Policy Schedule or Certificate of Insurance in respect of the DEPENDENT CHILD, up to 2 Dependent Children, if specified in the Policy Schedule or Certificate of Insurance, irrespective of the whether the child is an Insured Person under this Policy.

This Benefit shall be payable subject to the DEPENDENT CHILD BEING UP TO 25 YEARS OF AGE as on date of occurrence of the event and provided that the Dependent Child does not have any independent source of income.

Any claim towards Orphan Benefit where the Dependent Child is a minor, shall be payable to the legal guardian of the Dependent Child.