ITGI/HP/01

SALES LITERATURE
Iffco Tokio Health Protector
Scope of Cover
The Policy offers a health protection cover for you and your family for any illness, disease or injury related
contingencies like hospitalisation, medical expenses, surgical expenses, organ transplantation etc. The
policy covers the members of the family consisting of you, your spouse, dependent children, brother,
sister, brother-in-law, sister-in-law, nephew, niece or any other relation who is dependant or relatives
living together with you and dependant parents on individual Sum Insured basis.
Normal Policy Term is 1 Year. However, there is a provision of issuing policy on short term basis also.

Basic Cover
a) Room Rent Expenses as provided in the Hospital/Nursing Home including Hospital Registration/ Service
charges.
b) Nursing expenses during Hospitalisation periods on advice of Medical Practitioner for duration
specified.
c) Surgeon, Anesthetist, Medical Practitioner, Consultant, Specialist fees.
d) Anesthesia, Blood, Oxygen, Operation Theatre, Surgical Appliances, Medicines & Drugs, Diagnostic
Materials and X-ray, Dialysis, Chemotherapy, Radiotherapy, Cost of Pacemaker, Artificial Limbs, Cost of
Organs and similar expenses.
e) Ayurvedic and/ or Homeopathic and/or Unani and/or Sidha Hospitalisation Expenses (upto 10%(ten
percent) of Sum Insured).
f) Reasonable and customary charges incurred for Domiciliary Hospitalisation if Medically Necessary upto
a maximum aggregate sub-limit of 20% (twenty percent) of the Sum Insured.

Higher Sum Insured for Critical Illness

Higher sum insured for critical illness to cover expenses (as listed in Basic Cover) related to following
Critical Illnesses:
1. Cancer of Specified Severity
2. First Heart Attack - Of Specified Severity
3. Open Chest CABG
4. Open Heart Replacement or Repair of Heart Valves
5. Coma of Specified Severity
6. Kidney Failure Requiring Regular Dialysis
7. Stroke Resulting In Permanent Symptoms
8. Major Organ /Bone Marrow Transplant
9. Permanent Paralysis Of Limbs
10. Motor Neurone Disease with Permanent Symptoms
11. Multiple Sclerosis with Persisting Symptoms
As per this extension, the Basic Cover Sum Insured will be doubled for the aforesaid Critical Illness claims,
for which an additional 30% (thirty percent) of the Basic Cover premium is chargeable.

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LIMITS OF LIABILITY:
S No.

Nature of Expense

1.

Hospitalisation Stay

(a)

Room, Boarding & Nursing (Normal room)

(b)

Room, Boarding & Nursing (ICU/ITU)

(c)
2

Registration, Service Charges, Surcharge and

similar charges
Fees of Medical Practitioner, Anaesthetist,
Consultants and Surgeon
Anesthesia, Blood, Oxygen, Operation
Theatre, Surgical Appliances, Medicines and
Drugs, Diagnostic Materials and X-ray,
Dialysis, Chemotherapy, Radiotherapy, Cost
of Pacemaker, Artificial Limbs, Cost of
Organs and similar expenses.

Limits

1) In respect of class A cities, a limit of 1.75%

(one and three fourth of a percent) of the
sum insured on per day basis or actual
whichever is less.
2) In respect of cities other than class A cities,
a limit of 1.50% (one and half of a percent) of
the sum insured on per day basis or actual,
whichever is less.
Note: Class A cities are Hyderabad,
Secundrabad, National Capital Region of Delhi,
Ahmadabad, Bangalore, Greater Mumbai,
Nagpur, Pune, Jaipur, Chennai, Lucknow,
Kanpur and Kolkata.
1) In respect of class A cities a limit of 3% (three
percent) of the sum insured on per day basis
or actual whichever is less.
2) In respect of other than class A cities a limit
of 2.5% ( two and half percent) of the sum
insured on per day basis or actual whichever
is less.
Note: Class A cities are Hyderabad,
Secundrabad, National Capital Region of Delhi,
Ahmadabad, Bangalore, Greater Mumbai,
Nagpur, Pune, Jaipur, Chennai, Lucknow, Kanpur
and Kolkata.
Actual amount subject to maximum of 0.5% (half
percent) of Sum Insured.
Actual amount up to Sum Insured

Actual amount up to Sum Insured

4.

Vitamins and Tonics forming part of

treatment

Actual amount up to Sum Insured

5.

Reasonable and Customary Charges incurred

for Domiciliary Hospitalisation if Medically
Necessary

Upto a maximum aggregate sub-limit of 20%

(twenty percent) of the Sum Insured

6.

Ayurvedic and/ or Homeopathic and/or

Unani and/or Sidha Hospitalisation Expenses

Actual amount up to Sum Insured

7.

Terrorism Covered

Actual amount up to Sum Insured

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Unique Feature
a)

In respect of basic sum insured of Rs. 5 (five) lakhs and above (excluding the sum insured of critical
illness), the reimbursement of treatment expenses will be payable according to actual expenses
without any capping limits.

b) In respect of basic sum insured below Rs. 5 (five) lakhs (excluding the sum insured of critical illness),
the capping on Room rent expenses may be removed on additional payment of 6% on the basic
premium.

Additional Benefit
We will pay for the additional benefits as mentioned below in accordance with the main-coverage:
1. Daily allowance: An additional daily allowance amount equivalent to 0.20% (one fifth of a percent) of
the sum insured per day for the duration of hospitalisation.
2. Ambulance charges: Ambulance charges 1% (one percent) of the sum insured or Rs. 2500 (two
thousand & five hundred), whichever is less for each hospitalisation.
3. Pre and post hospitalisation expense: Nursing and Medical Expenses during pre & post hospitalisation
period on the advice of Medical Practitioners for duration specified subject to the maximum of 45 days
for pre hospitalisation and 60 days for post hospitalisation expenses.
4. Cumulative bonus:
a) The Cumulative Bonus shall be increased by 5% (five percent) of the basic sum insured at each
renewal in respect of each claim free year of insurance, subject to maximum of 50% (fifty
percent) of the insured persons basic sum insured of the expiring policy. For cumulative bonus
eligibility, the policy has to be renewed within the expiry date or within a maximum of 30 (thirty)
days from the expiry date, beyond which the entire cumulative bonus earned will lapse and be
forfeited.
b) In case of a claim under the policy in respect of any insured person who has earned cumulative
bonus, the existing cumulative bonus will be reduced by 5% (five percent) of basic sum insured at
the next renewal, subject to the stipulation that basic sum insured shall be maintained
5. Day care surgeries: 121 surgical procedures covered without 24 hours of hospitalisation stipulation.
6. Hospitalisation expenses if period of hospitalisation is less than 24 (twenty four) hours: We will pay
hospitalisation expenses if the duration of hospitalisation is more than 12 (twelve) hours but less than
24 (twenty four) hours except the day care surgeries, the room rent shall be limited to 50% (fifty
percent) of the entitled room rent per day.
7. Cost of health check up: Insured person(s) shall be entitled for reimbursement of cost of medical
checkup once at the end of a block of every four claim-free policies with us. The reimbursement shall
not exceed the amount equal to 1% (one percent) of the average sum insured during the block of four
claim free policies.
8. Reinstatement of Sum Insured: After occurrence of a claim under the policy, the basic sum insured
under the policy will be reinstated by the amount of the claim after charging appropriate premium as
per the following method for reinstatement of the basic sum insured so that full basic sum insured is
available for the policy period :

Reinstatement premium=

Sales Literature

Remaining number of days of the policy

(Annual premium x claim amount)
(calculated from the date of admission in hospital)
--------------------------------------------- x ------------------------------------------------------------------Total basic sum insured
365

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Reinstatement premium will be deducted from the claim amount. The reinstatement of sum insured
will not be available for Critical illness extension and cumulative bonus.
The reinstatement of sum insured will not be available for Domiciliary Hospitalisation and Ayurvedic
and/or Homeopathic and/or Unani and /or Sidha hospitalization.
9. Vaccination expenses: Insured person(s) shall be entitled for reimbursement of cost of vaccination at
the end of every block of two policy period of 365 (three hundred & sixty five) days with us or 366 days
in case of leap year, each subject to a maximum of 10% (ten percent) of the total premium paid
(excluding taxes, provided no claim are made and the policies were renewed without break).
10. Provision for Senior Citizens: Grievance Management for Senior citizen will be as per IRDA
regulations.
11. Emergency assistance services: This policy provides, at no additional cost, whatsoever, a host of
value added emergency medical assistance and emergency personal services. The services are
provided when insured person(s) is/are traveling within India 150(one hundred and fifty) kilometers
or more away from the residential address as mentioned in the policy schedule for less than
90(ninety) days. No claims for reimbursement of expenses incurred for services arranged by
insured/insured person(s) will be entertained unless agreed by us or our authorized representative.
Wherever, it is not reasonably possible to ascertain if the reported situation was an emergency or
not, the benefit of doubt shall be available to you in respect of the insured person.
IFFCO TOKIO General Insurance is the first Insurer to bring to you these services and that too without
any sub limits:
a) Medical Consultation, Evaluation and Referral
b) Emergency Medical Evacuation
c) Medical Repatriation
d) Transportation to Join Patient
e) Care and/or Transportation of Minor Children
f) Emergency Message Transmission
g) Return of Mortal Remains
h) Emergency Cash Coordination.
Specific Exclusions:
a) Trips exceeding 90(ninety) days from declared residence without prior notification to emergency
assistance service provider.
b) Students at home/school campus address (as they are not considered to be in travel status).

12. Hospitalization expenses (Items (a), (c) and (d) only of the Basic Cover listed above) of person donating
an organ during the course of organ transplant will also be payable subject to the limits applicable to
the Insured Person and within the overall Sum Insured of the Insured Person.

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Additional Advantages
1. Income Tax benefits under Section 80D only if paid by cheque.
2. Hassle free claims procedure.
3. Cashless claim facility available at over 4000 network hospitals across India.

Extension of policy period

In case the insured person(s) who is/are covered under Health Protector Policy has/have to go abroad
for a minimum of 30(thirty) days and accordingly he/she/they buy an Travel protector policy for those
30(thirty) days or more and submit(s) the proof thereof(copy of visa and photocopy of stamped passport
on return), in that event the period of insurance under the Health Protector policy in respect of the
insured person(s) will be extended by 30 (thirty) days or more i.e. the period of insurance under the policy
shall be extended for those number of days for which travel protector policy has/have run or actual
period abroad subject to a minimum of 30(thirty) days period abroad.

Payment of premium
The premium payable shall be paid in advance before commencement of risk. No receipt for premium shall
be valid except on our official form signed by our duly authorized official. In similar way, no waiver of any
terms, provision, conditions and endorsements of this policy shall be valid unless made in writing and
signed by our authorized official.

Sum Insured
1. The policy shall be available with the minimum Sum Insured of Rs.50,000 (fifty thousand) with
subsequent options available in multiple of Rs.50,000 (fifty thousand) upto Rs.5 (five) lakhs and then
in multiples of Rs.1 (one) lakhs upto maximum of Rs.20 (twenty) lakhs.
2. In case of increase in basic Sum Insured more than 10% (ten percent) of last year basic Sum Insured at
the time of renewal, subject to certain medical check-up required.

Important Exclusions
1. Co-payment: In case of second and subsequent claims under one policy period for the same insured
person, following scales of co-payment shall be applicable:
No. Of claims

Percentage of Co-payment

First claim

Nil

Second claim

7.5% (seven and half percent )of the admissible claim amount

Third claim

10% (ten percent) of the admissible claim amount

Fourth claim and above

20% (twenty percent) of the admissible claim amount

Note: The above co-payment will not be applicable on hospitalisation claim due to accidental
injury

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2.

a) Any condition(s) defined as pre-existing condition in the policy, until 36 (thirty six) months of
continuous coverage has elapsed, since inception of the first health insurance policy, whether group or
individual, without any break in the insurance coverage.
b) The following disease(s) arising out of or aggravated by diabetes, if existing at the time of taking the
first health insurance policy by insured person(s), will fall under the pre-existing condition as described
under 2(a) IMPROTANT EXCLUSION above and shall have a waiting period of 36 (thirty six))months:
i.
ii.
iii.
iv.
v.
vi.
vii.

Diabetic Nephropathy
Diabetic Retinopathy
Diabetic Neuropathy
Diabetic Angiopathy
Diabetic Ketoaciodosis or Hyper Hypoglycaemia
Hypoglycaemia
Diabetic Foot or Wound

c) The following disease(s) arising out of or aggravated by hypertension, if existing at the time of taking
the first health insurance policy by insured person (s), will fall under the pre-existing condition as
described under 2(a) above of IMPROTANT EXCLUSION and shall have a waiting period of 36 (thirty
six)months:
i.
ii.
iii.
iv.
v.
vi.

Cerebro Vascular Attack (CVA Hemorrhagic)

Hypertensive Encephalopathy;
Hypertensive Heart Disease {e.g. Left Ventricular Hypertrophy(LVH) Congestive
Heart Failure(CHF) etc. or Coronary Artery Disease (CAD)
Hypertensive Nephropathy;
Hypertensive Retinopathy;
Aneurysm.

3. Any expense on hospitalisation for any disease which incepts during first 30 (thirty) days of
commencement of the insurance cover. This exclusion shall not apply in case of the insured person(s)
having been covered under this policy or group or individual medical insurance policy with any of
Indian insurance companies for a continuous period of preceding 12(twelve) months without a break
exceeding 30(thirty) days. For hospitalisation owing to accidental injury, this 30(thirty) days waiting
period shall not apply.
4. a)Any expense incurred in the first year of operation of the insurance cover on treatment of the
following diseases:
i.
ii.
iii.
iv.

Cataract, Benign Prostatic Hypertrophy, Hysterectomy for Menorrhagia or

Fibromyoma
Hernia, Hydrocele, Congenital Internal Disease.
Fistula in Anus, Piles, Sinusitis
Choletithiasisand Cholecystectomy

However if these disease(s) is/are under pre-existing condition at the time of the first proposal, then
these will be falling under exclusion (2) and will be covered after 36 (thirty six)months of continuous
insurance with IFFCO TOKIO General Insurance.
This exclusion shall not apply in case of the insured person(s) having been covered under this policy
or group or individual medical insurance policy with any of Indian insurance companies for a
continuous period of preceding 12 (twelve) months without a break exceeding 30(thirty) days.

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b) Any expense on disease aggravated by Diabetes and/or Hypertension, incurred in the first two years
of operation of the insurance cover.
However if these diabetes and/or Hypertension is/are under pre-existing condition at the time of
first proposal, then these will be falling under exclusion 2 (b) and 2 (c) above and will be covered
after 36 (thirty six)months of continuous coverage with IFFCO TOKIO General Insurance.
This exclusion shall not apply in case of the insured person(s) having been covered under this policy
or group or individual medical insurance policy with any of Indian insurance companies for a
continuous period of preceding 24 (twenty four) months without a break exceeding 30 (thirty)
days.
5.

Cost of spectacles and contact lens or hearing aids.

6.

Expenses on diagnostic, x-ray, or laboratory examinations, investigations unless related to the active
treatment of disease or injury falling within ambit of hospitalisation claim under LIMIT OF LIABILITY.

7.

Procedures/treatments mainly done in outpatient department (OPD) even if these are converted to
day care surgery or as in patient in hospital to make it hospitalisation claim

8.

Dental treatment or surgery of any kind, unless requiring hospitalisation.

9.

Allopathic or Ayurvedic or Homeopathic or Unani or Sidha medicines shall not be allowed unless
prescribed by respective practitioner.

10. Maternity expenses (other than ectopic pregnancy requiring surgical intervention), childbirth,
miscarriage, abortion or complications of any of these, including caesarean section and any infertility,
sub fertility or assisted conception treatment.
11. Any expenses or treatment related to the disease if it is due to chronic alcohol consumption or any
self inflicted toxic or drug consumption.
12. Any expense on naturopathy, experimental or unproven treatments.
13. Any expense on procedure and treatment including acupressure, acupuncture, magnetic and such
other therapies etc.
14. Travel or transportation expenses, other than ambulance service charges.
15. Any expense related to disease/injury suffered whilst engaged in speed contest or racing of any kind
(other than on foot), bungee jumping, parasailing, skydiving, paragliding, hang gliding, deep sea
diving using hard helmet and breathing apparatus, snow and ice sports and activities of similar
hazard.
16. External medical equipment of any kind used at home as post hospitalisation care, like wheelchairs,
crutches, instruments used in treatment of sleep apnea syndrome (C.P.A.P) or continuous peritoneal
ambulatory dialysis (C.P.A.D) and oxygen concentrator for bronchial asthmatic condition, etc.
17. Genetic disorders and stem cell implantation/ surgery.
18. All non medical expenses including personal comfort and convenience items or services, such as
telephone, maid/ barber or beauty services, diet charges, baby food, cosmetics, napkins, toiletry
items etc, guest services and similar incidental expenses or services etc.
19. Treatment of obesity or condition arising there from (including morbid obesity) and any other weight
control programme, services or supplies etc, hormone replacement therapy, sex change or treatment
which results from or is in any way related to sex change.

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20. Any expenses for any mental disease (a mental or bodily condition marked by disorganization of
personality, mind, and emotions to impair the normal psychological, social or work performance of
the individual) regardless of its cause or origin.
21. Expenses related to physiotherapy in a hospital/ nursing home unless arising out of hospitalisation for
which the claim is admitted and it is advised by treating Medical Practitioner.
22. Rehabilitation expenses.
23. Ambulance charges, pre and post hospitalisation expenses and daily allowance for the donor in case
of major organ transplant.
24. Convalescence, general debility, run down condition or rest cure, congenital disease or defects or
anomalies, sterility, venereal disease, intentional self injury and use of intoxicating drugs/alcohols
25. Any expense on treatment related to HIV, AIDS and all related medical conditions.
26. Any expense due to War and Nuclear Risk
27. Injury or diseases directly or indirectly caused by or arising from or attributable to war, invasion, act
of foreign enemy, war like operation (whether war be declared or not).
28. Any expense under Domiciliary Hospitalisation for
a) Pre and Post Hospitalisation treatment
b) Treatment of following diseases:
i.
ii.
iii.
iv.
v.
vi.
vii.
viii.
ix.
x.
xi.
xii.
xiii.

xiv.

Asthma
Bronchitis
Chronic Nephritis and Nephritic Syndrome
Diarrhoea and all type of Dysenteries including Gastro-enteritis
Diabetes
Epilepsy
Hypertension
Influenza, Cough and Cold
All types of Psychiatric or Psychosomatic Disorders
Pyrexia of unknown origin for less than15(fifteen)days
Tonsillitis and Upper Respiratory Tract infection including Laryngitis and
Pharingitis
Arthritis, Gout and Rheumatism
Dental Treatment or Surgery
Critical Illness

29. Circumcision, unless necessary for the treatment of a Disease not otherwise excluded or required as a
result of accidental bodily Injury, vaccination unless forming part of post-bite treatment and as
covered in the Additional Benefit, inoculation, cosmetic or aesthetic treatment of any
description(including any complications arising thereof), plastic surgery except those relating to
treatment of Injury or Disease.
30. Expenses that are not covered as per Annexure 2 (Attached in Policy Document)

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Age Limits
st

The Insurance is available to persons from the age of 91 (ninety first) day onward. The maximum entry
age is 65 (sixty five) years. There is no age limit for renewal of the policy. The minimum age for the
proposer is 18 (eighteen) years. Dependents including children can be covered provided one or more
adults are covered concurrently. There is no upper age limit for coverage of dependents.
a) For an individual in age group of completed 45 (forty five) years to 55 (fifty five) years following Medical
checkup is required:
1. Blood Sugar (PP & Fasting)
2. ECG with Doctors report
3. Urine Test and Physical fitness certificate
b) For an individual in age group of 55 (fifty five) years to 65 (sixty five) years following Medical checkup is
required:
1. Lipid profile
2. Kidney Function Test
3. Reports as per tests defined under (a)
The above tests will also be mandatory in following cases:
a) Fresh proposals, as per a) and b) mentioned above in respect of persons between 45 to 55 years
and above 55 years, respectively.
b) If the basic sum insured is being sought to be enhanced by more than 10% (ten percent) at the
time of renewal.
c) When there is break in insurance for more than 30(thirty) days.
d) If there is a claim in the expiring policy because of any Critical Illness
In event of acceptance of proposal, 50% (fifty percent) cost of medical check-up will be reimbursed to
you. The validity of aforesaid tests would be 15 days.

Procedure for enhancement of Sum Insured

Sum Insured can be enhanced in case of renewal only. Mid-term enhancement of Sum Insured is not
allowed.
a) Intimation for enhancement of sum insured should be before the renewal of the policy.
b) If there is a break in insurance for more than 30 days, request for enhancement of sum insured
will be treated as a fresh proposal.
c) If insured is more than 45 years of age, fresh medical check-up would be required in case of
enhancement of Sum Insured beyond 10% on renewal. If the age is less than 45 years, an
increase in Sum Insured up to next two levels as per rate chart shall be permitted without
medical test, after which a medical test would be mandatory.

Renewal
Renewal shall not be refused unless justified on grounds of fraud, moral hazard or misrepresentation or
noncooperation by the insured, provided, however, that you apply for renewal and remit the requisite
premium before the expiry of this policy. The Policy has to be renewed within the expiry date or within a
maximum of 30 (thirty) days from the expiry date, beyond which the continuity benefits (relating to Preexisting Disease Exclusion, 30 (thirty) days Waiting Period, First Year Disease Exclusions and Cumulative
Bonus earning) will not be available and any insurance cover thereafter will be treated as fresh cover.
In any case, we shall not be liable to pay claim occurring during the period of break in insurance i.e. up to
30 (thirty) days from the due date of renewal.

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Portability :
The Portability of health insurance policies shall be governed by the Health Insurance Regulation, 2013 dated
16th February, 2013. For more information please refer to the page no.89 on the following URL of the IRDA
website:
http://www.policyholder.gov.in/uploads/CEDocuments/Health%20Insurance%20Regulations%202013.pdf
The salient features mentioning the rights and obligations of the insurer and insured are as follows:
a)

A policyholder desirous of porting his policy to another insurance company shall apply to such
insurance company, to port the entire policy along with all the members of the family, if any, at least
45 days before the premium renewal date of his/her existing policy.
b) Insurer may not be liable to offer portability if policyholder fails to approach the new insurer at least
45 days before the premium renewal date.
c) Portability shall be opted by the policyholder only as stated in (a) above and not during the currency
of the policy.
d) In case insurer is willing to consider the proposal for portability even if the policyholder fails to
approach insurer at least 45 days before the renewal date, it may be free to do so.
e) Where the outcome of acceptance of portability is still waiting from the new insurer on the date of
renewal :
a. The existing policy shall be allowed to extend, if requested by the policyholder, for the short
period by accepting a pro- rate premium for such short period, which shall be o f at least one
month and
b. Shall not cancel existing policy until such time a confirmed policy from new insurer is received or
at the specific written request o f the insured.
c. The new insurer, in all such cases, shall reckon the date o f the commencement o f risk to match
with date o f expiry o f the short period, wherever relevant.
d. If for any reason the insured intends to continue the policy further with the existing insurer, it
shall be allowed to continue by charging a regular premium and without imposing any new
condition.

Free Lookup Period

a)

b)

You will be allowed a period of at least 15 (fifteen) days from the date of receipt of the policy to
review the terms and conditions of the policy and to return the same if not acceptable stating the
reasons therein for doing so.
If you have not made any claim during the free look period, then you shall be entitled to :
i. A refund of the premium paid less any expenses incurred by us on medical examination of the
insured persons and the stamp duty charges or;
ii. Where the risk has already commenced and the option of return of the policy is exercised by
you, a deduction towards the proportionate risk premium for period on cover less any expenses
incurred by us on medical examination of the insured persons and the stamp duty charges or;
iii. Where only a part of the risk has commenced, such proportionate risk premium commensurate
with the risk covered during such period less any expenses incurred by us on medical
examination of the insured persons and the stamp duty charges

c)

Free Lookup Period is not applicable for renewal policies.

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Cancellation
i. We may cancel the policy on grounds of fraud, moral hazard or misrepresentation or noncooperation
by the insured, by sending a 30 (thirty) days notice by registered post to your last known address. You
will then be entitled, except in case of fraud or illegality on your part, to a pro-rata refund of premium
for unexpired period of this policy in respect of such insured person(s) in respect for whom no claim
has arisen.
ii. You may cancel the policy by sending written notice to us under registered post. We will then allow a
refund on following scale, except for those insured person(s) for whom claim has been preferred on us
under the current policy:

Period of cover up to

Refund of annual premium rate (%)

1 (one)month

75% (seventy five percent)

3 (three) months

50% (fifty percent)

6 (six) months

25% (twenty five percent)

Exceeding 6 (six) months

Nil

Limit of Indemnity
The liability under the subject policy by way of indemnity for all the covers shall in no way exceed the
overall Sum Insured opted by the Insured. However this condition is not applicable in case of Indemnity of
Critical Illness treatments.

Withdrawal & Alteration of Policy Conditions

The policy terms and conditions may undergo alteration as per the IRDA Health Regulation. However the
same shall be duly notified to you at least three months prior to the date when such alteration or revision
comes into effect by registered post at your last declared correspondence address. The timeliness for
revision in terms and rates shall be as per the IRDA Health Regulation.
A product may be withdrawn with the prior approval of the Authority and information of withdrawal shall
be given to you in advance as per the IRDA guidelines with details of options provided by us. If we do not
receive your response on the intimation of withdrawal, the existing product shall be withdrawn on the
renewal date and you shall have to take a new policy available with us, subject to portability conditions

Fraud
If a claim is fraudulent in any respect or supported by any fraudulent statement with or without your
knowledge or that of the insured person(s), all benefit(s) under this policy shall be forfeited

Premium
Basic cover
Depending upon the age of the insured person(s) and sum insured for that person.

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Loadings & Discounts

1) Family Discount: A Family Discount on total premium is permissible as per the following scale
depending upon the total number of insured persons covered under the policy at inception of the cover.
Increase/decrease in size of the family during the currency of the policy is permissible; however there will
not be any adjustment of discounts during the currency of policy.

2(two) Family Members --5%(five percent)discount on total premium (Main Cover

plus Higher Sum Insured for Critical Illness)

3(three)and more Family Members --10%(ten percent) discount on total premium

(Main Cover plus Higher Sum Insured for Critical Illness)

The above slabs for Family Discount on number of persons covered will be followed. However, depending
on specific requirement and merit of the case, it can be altered by CEO of IFFCO-TOKIO.

2) Discount for employees covered under the Group Mediclaim Policy: All the employees covered under
the Group Mediclaim Policy insured with IFFCO TOKIO will be eligible for a discount as per below
mentioned slabs.
Product Type

Sum Insured opted under Health Protector

Discount

Health Protector

Upto Rs 2(two)lacs

10%(ten
percent)

Health Protector

Above Rs 2(two)lacs

20%(twenty
percent)

3) 10% (ten percent) discount in policy premium for all customers holding any other insurance policy of
IFFCO TOKIO.
4) 20% (twenty percent) discount for all employees of IFFCO TOKIO.
Note: All the above mentioned discounts are on cumulative basis and cannot exceed a total of 25%
(twenty five) percent.

Documents required for settlement of claims:

Claim Form
Discharge Summary
Bills and Receipt of Hospital/Nursing Home
Attending Doctors Report and Bills as well as cash memos of medicines and pathological tests
duly supported by proper prescription.

This brochure provides only the salient features and for details kindly refers to the complete Policy
wordings. For enquires kindly contact our nearest Bima Kendra LSC, SBU or Dial Toll Free No. 1800-1035499 / 1800-345-3303 or visit our website www.iffcotokio.co.in

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Premium Sheets

Age (in Years)

/ Sum Insured
(in Rs)

50000

100000

150000

200000

250000

300000

350000

400000

450000

500000

600000

700000

800000

900000

1000000

1100000

1200000

1300000

1400000

1500000

1600000

1700000

1800000

1900000

2000000

Rate Sheet of Health Protector portfolio other than Gujarat

up to 25 yr

1191

1634

2124

2451

3040

3432

3947

4290

4804

5148

5582

6054

6565

7120

7721

7944

8372

8823

9298

9799

9987

10180

10376

10575

10779

26 to 35

1360

2043

2656

3064

3799

4290

4933

5362

6006

6435

6978

7568

8207

8900

9652

9930

10465

11028

11622

12249

12484

12725

12969

13219

13473

36 to 45

1641

2553

3319

3830

4749

5362

6166

6703

7507

8043

8723

9459

10258

11125

12065

12412

13081

13785

14528

15311

15605

15906

16212

16524

16842

46 to 55

3087

3702

4813

5554

6886

7775

8941

9719

10885

11663

12648

13716

14875

16131

17494

17997

18967

19989

21066

22201

22628

23063

23507

23960

24421

56 to 65

4337

5739

7460

8608

10674

12051

13859

15064

16872

18077

19604

21260

23056

25003

27116

27896

29399

30983

32652

34411

35073

35748

36436

37137

37852

66 to 70

7195

8895

11564

13343

16545

18680

21482

23349

26151

28019

30386

32953

35737

38755

42029

43239

45568

48023

50610

53337

54363

55410

56476

57563

58671

71 to 75

9211

10674

13876

16011

19854

22416

25778

28019

31382

33623

36463

39544

42884

46506

50435

51886

54682

57628

60732

64004

65236

66491

67771

69075

70405

76 to 80

12244

13343

17345

20014

24817

28019

32222

35024

39227

42029

45579

49430

53605

58133

63044

64858

68352

72035

75915

80005

81545

83114

84714

86344

88006

81 to 85

14693

16011

20814

24017

29781

33623

38667

42029

47073

50435

54695

59315

64326

69760

75652

77830

82023

86442

91099

96006

97854

99737

101657

103613

105607

86 to 90

16162

17612

22896

26418

32759

36986

42533

46232

51780

55478

60165

65247

70758

76736

83218

85613

90225

95086

100208

105607

107639

109711

111822

113974

116168

91 to 95

17778

19373

25185

29060

36035

40684

46787

50855

56958

61026

66181

71772

77834

84409

91539

94174

99248

104594

110229

116168

118403

120682

123005

125372

127785

96 to 100

19556

21311

27704

31966

39638

44753

51465

55941

62654

67129

72799

78949

85618

92850

100693

103591

109172

115054

121252

127785

130244

132750

135305

137909

140563

101 & Above

20534

22377

29089

33564

41620

46991

54038

58738

65787

70485

76439

82896

89899

97493

105728

108771

114631

120807

127315

134174

136756

139388

142070

144804

147591

Above rates (in Rs) are exclusive of Service Tax

Sales Literature

Page 13

Rate sheet of Health Protector with Critical Illness other than Gujarat

150000

200000

250000

300000

350000

400000

450000

500000

600000

700000

800000

900000

1000000

1100000

1200000

1300000

1400000

1500000

1600000

1700000

1800000

1900000

2000000

101 &
above

100000

upto 25
yr
26 to
35
36 to
45
46 to
55
56 to
65
66 to
70
71 to
75
76 to
80
81 to
85
86 to
90
91 to
95
96 to
100

50000

Age (in
Years) /
Sum
Insured
(in Rs)

1548

2124

2762

3187

3951

4461

5130

5577

6246

6692

7257

7870

8535

9256

10038

10327

10883

11469

12087

12739

12984

13234

13488

13748

14012

1768

2656

3452

3983

4939

5577

6413

6971

7807

8365

9071

9838

10669

11570

12547

12908

13604

14337

15109

15923

16230

16542

16860

17185

17515

2133

3319

4315

4979

6174

6971

8016

8713

9759

10456

11339

12297

13336

14463

15684

16136

17005

17921

18886

19904

20287

20677

21075

21481

21894

4013

4813

6257

7220

8952

10108

11624

12634

14151

15161

16442

17831

19337

20971

22742

23397

24657

25985

27385

28861

29416

29982

30559

31147

31747

5637

7460

9698

11191

13876

15667

18017

19583

21933

23500

25485

27638

29973

32504

35250

36265

38218

40277

42447

44734

45595

46473

47367

48278

49208

9353

11564

15033

17345

21508

24283

27926

30354

33997

36425

39502

42839

46458

50382

54638

56210

59239

62430

65793

69338

70672

72032

73419

74832

76272

11974

13876

18039

20814

25810

29140

33511

36425

40796

43710

47403

51407

55749

60458

65565

67452

71086

74916

78952

83206

84807

86439

88102

89798

91526

15917

17345

22549

26018

32262

36425

41889

45531

50995

54638

59253

64258

69686

75573

81957

84316

88858

93645

98690

104007

106009

108049

110128

112247

114408

19101

20814

27059

31222

38715

43710

50267

54638

61194

65565

71104

77110

83624

90687

98348

101179

106630

112374

118428

124808

127210

129658

132154

134697

137289

21011

22896

29765

34344

42586

48081

55293

60102

67314

72122

78214

84821

91986

99756

108183

111297

117293

123612

130271

137289

139931

142624

145369

148167

151018

23112

25185

32741

37778

46845

52889

60823

66112

74045

79334

86036

93303

101185

109732

119001

122426

129022

135973

143298

151018

153924

156887

159906

162983

166120

25423

27704

36015

41556

51529

58178

66905

72723

81450

87267

94639

102633

111303

120705

130901

134669

141924

149570

157628

166120

169317

172575

175897

179282

182732

26694

29089

37816

43634

54105

61087

70250

76359

85523

91630

99371

107765

116868

126740

137446

141402

149020

157049

165509

174426

177783

181204

184692

188246

191869

Above rates (in Rs) are exclusive of Service Tax

Sales Literature

Page 14

Rate Sheet of Health Protector for Gujarat

50000

100000

150000

200000

250000

300000

350000

400000

450000

500000

600000

700000

800000

900000

1000000

1100000

1200000

1300000

1400000

1500000

1600000

1700000

1800000

1900000

2000000

Age (in
Years) /
Sum
Insured
(in Rs)

upto 25
yr
26 to 35

1369

1879

2443

2819

3495

3947

4538

4933

5525

5920

6420

6962

7550

8188

8880

9135

9627

10146

10693

11269

11486

11707

11932

12162

12396

1564

2349

3054

3524

4369

4933

5673

6166

6906

7400

8025

8703

9438

10235

11100

11419

12034

12683

13366

14086

14357

14633

14915

15202

15494

36 to 45

1887

2936

3817

4405

5462

6166

7091

7708

8633

9250

10031

10878

11797

12794

13874

14274

15043

15853

16707

17607

17946

18292

18644

19002

19368

46 to 55

3550

4258

5535

6387

7919

8941

10283

11177

12518

13412

14545

15774

17106

18551

20118

20697

21812

22987

24226

25531

26022

26523

27033

27553

28084

56 to 65

4987

6600

8579

9899

12275

13859

15938

17324

19403

20789

22545

24449

26514

28754

31183

32080

33809

35630

37550

39573

40334

41110

41901

42708

43530

66 to 70

8274

10229

13298

15344

19026

21482

24704

26852

30074

32222

34944

37896

41097

44569

48333

49725

52403

55227

58202

61337

62518

63721

64947

66197

67471

71 to 75

10592

12275

15958

18413

22832

25778

29645

32222

36089

38667

41933

45475

49317

53482

58000

59669

62884

66272

69842

73605

75021

76465

77937

79437

80965

76 to 80

14081

15344

19947

23016

28540

32222

37056

40278

45111

48333

52416

56844

61646

66853

72500

74587

78605

82840

87303

92006

93777

95582

97421

99296

101207

81 to 85

16897

18413

23937

27619

34248

38667

44467

48333

54133

58000

62899

68213

73975

80224

87000

89504

94326

99408

104763

110407

112532

114698

116905

119155

121448

86 to 90

18586

20254

26330

30381

37672

42533

48913

53167

59547

63800

69189

75034

81372

88246

95700

98455

103759

109349

115240

121448

123785

126168

128596

131070

133593

91 to 95

20445

22279

28963

33419

41440

46787

53805

58483

65501

70180

76108

82537

89509

97071

105270

108300

114135

120284

126764

133593

136164

138784

141455

144178

146952

96 to
100

22490

24507

31860

36761

45584

51465

59185

64332

72052

77198

83719

90791

98460

106778

115797

119130

125548

132312

139440

146952

149780

152663

155601

158595

161647

23615

25732

33453

38599

47863

54038

62144

67549

75655

81058

87905

95331

103383

112117

121587

125087

131825

138928

146412

154300

157269

160296

163381

166525

169729

101 &
above

Above rates (in Rs) are exclusive of Service Tax

Sales Literature

Page 15

Rate Sheet of Health Protector with Critical Illness for Gujarat

150000

200000

250000

300000

350000

400000

450000

500000

600000

700000

800000

900000

1000000

1100000

1200000

1300000

1400000

1500000

1600000

1700000

1800000

1900000

2000000

101 &
above

100000

upto
25 yr
26 to
35
36 to
45
46 to
55
56 to
65
66 to
70
71 to
75
76 to
80
81 to
85
86 to
90
91 to
95
96 to
100

50000

Age (in
Years)
/ Sum
Insured
(in Rs)

1780

2443

3176

3665

4544

5130

5900

6413

7183

7696

8346

9051

9815

10644

11544

11876

12516

13190

13900

14649

14931

15219

15511

15810

16114

2034

3054

3970

4581

5680

6413

7375

8016

8978

9620

10432

11313

12269

13306

14429

14845

15644

16487

17376

18312

18664

19023

19389

19762

20143

2453

3817

4963

5726

7100

8016

9219

10020

11223

12025

13040

14142

15336

16632

18037

18556

19556

20609

21719

22890

23330

23779

24237

24703

25179

4615

5535

7196

8303

10295

11624

13367

14530

16273

17436

18908

20506

22238

24116

26153

26906

28356

29883

31493

33190

33829

34480

35143

35820

36509

6483

8579

11153

12869

15958

18017

20719

22521

25223

27025

29308

31784

34469

37380

40538

41704

43951

46319

48814

51444

52434

53443

54472

55520

56589

10756

13298

17288

19947

24734

27926

32115

34907

39096

41889

45427

49265

53426

57939

62833

64642

68124

71795

75662

79739

81273

82837

84432

86056

87713

13770

15958

20745

23937

29681

33511

38538

41889

46916

50267

54513

59118

64111

69527

75400

77570

81749

86153

90795

95686

97528

99405

101318

103268

105255

18305

19947

25931

29921

37102

41889

48172

52361

58645

62833

68141

73897

80139

86909

94250

96963

102187

107692

113494

119608

121910

124256

126647

129085

131569

21966

23937

31118

35905

44522

50267

57807

62833

70373

75400

81769

88677

96167

104291

113100

116355

122624

129230

136192

143530

146292

149107

151977

154901

157883

24162

26330

34229

39495

48974

55293

63587

69117

77411

82940

89946

97544

105784

114720

124410

127991

134886

142153

149812

157883

160921

164018

167174

170392

173671

26579

28963

37652

43445

53872

60823

69946

76028

85152

91234

98941

107299

116362

126192

136851

140790

148375

156369

164793

173671

177013

180420

183892

187431

191038

29237

31860

41417

47789

59259

66905

76941

83631

93667

100358

108835

118028

127999

138811

150536

154869

163213

172005

181272

191038

194714

198462

202281

206174

210142

30699

33453

43488

50178

62222

70250

80788

87813

98350

105376

114277

123929

134399

145752

158063

162612

171374

180605

190336

200590

204450

208385

212395

216483

220649

Above rates (in Rs) are exclusive of Service Tax

Note: The above stated premium & policy coverages, terms & conditions as per IRDA (Health Insurance Regulations are subject to revision from time to time but
chargeable/implementable only at the time of renewal.

Sales Literature

Page 16