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  • Hospitalisation Expenses (In Patient Treatment, Day Care & Accomodation Bonus) :- Covered up to the sum-insured Accommodation Bonus: Additional fixed daily amount of Rs. 1,000 on opting lower category room
  • Domestic Road Ambulance :- Covered up to Rs. 1500 per hospitalisation Intercity Ambulance cost (beyond 100km): Rs.20,000 per hospitalisation
  • Domiciliary Hospitalisation :- Within the Sum Insured
  • Modern Treatment :- Covered up to 50% of base sum insured
  • Pre & Post Hospitalisation :- Pre 60 days + Post 60 days within the sum insured
  • Organ Donor Expenses :- Covered up to 50% of base sum-insured, max Rs. 5 lakhs
  • Reinstatement of Base Sum Insured :- On subsequent claim, one reinstatement up to 100% of base sum insured for unrelated illness/injury, sub-limit of 20% of base sum insured for related illness/injury
  • Extra sum insured :- Additional, 20% of Base sum insured on same claim, in single Hospitalisation
  • Cumulative Bonus :- Increase in base sum-insured by 33.33% for every claim free policy year, subject to a maximum of 100% of base sum-insured and decrease by 33.33 % of base sum-insured for every claim year.
  • Call Option for Enhancement of Base Sum Insured :- After 4 continuous and consecutive claim free Policy Years, if policyholder avails this benefit then enhanced Sum Insured is sum of expiring Policy’s Base sum insured and accumulated Cumulative Bonus
  • Loyalty Cover :- At the end of each completed and continuous Policy Year, the Company shall provide Loyalty Cover to the policyholder (who is also an Insured Person) under the policy. (Refer Benefit-4.5.3 Loyalty Cover in Prospectus)
  • Wellness Services :- This is a service in which insured person can seek medical advice through telephonic or online mode
  • Claim Service Guarantee :- Cashless Claim - 1% of delayed claim amount (for delay beyond 6 hours to 12 hours), additional 1% for every additional delay of 6 business hoursReimbursement Claim -1% of delayed claim amount (for delay beyond 21 days to up to 42 days), additional 1% for every additional delay of 6 business hours Maximum limit - 6% of delayed claim amount
  • Policy Service Guarantee :- Rs. 10,000
  • Hospitalisation Expenses (In Patient Treatment, Day Care & Accomodation Bonus) :- Covered up to the sum-insured Accommodation Bonus: Additional fixed daily amount of Rs. 1,000 on opting lower category room
  • Domestic Road Ambulance :- Covered up to Rs. 3,000 per hospitalisation Intercity Ambulance cost (beyond 100km): Rs. 20,000 per hospitalisation
  • Domiciliary Hospitalisation :- Within the Sum Insured
  • Modern Treatment :- Covered up to 50% of base sum insured
  • Pre & Post Hospitalisation :- Pre 60 days + Post 60 days within the sum insured
  • Organ Donor Expenses :- Covered up to 50% of base sum-insured, max `5 lakhs
  • Reinstatement of Base Sum Insured :- On subsequent claim, one reinstatement up to 100% of base sum insured for unrelated illness/injury, sub-limit of 20% of base sum insured for related illness/injury
  • Extra sum insured :- Additional, 20% of Base sum insured on same claim, in single Hospitalisation
  • Cumulative Bonus :- Increase in base sum-insured by 33.33% for every claim free policy year, subject to a maximum of 100% of base sum-insured and decrease by 33.33 % of base sum-insured for every claim year.
  • Call Option for Enhancement of Base Sum Insured :- After 4 continuous and consecutive claim free Policy Years, if policyholder avails this benefit then enhanced Sum Insured is sum of expiring Policy’s Base sum insured and accumulated Cumulative Bonus
  • Loyalty Cover :- At the end of each completed and continuous Policy Year, the Company shall provide Loyalty Cover to the policyholder (who is also an Insured Person) under the policy. (Refer Benefit-4.5.3 Loyalty Cover in Prospectus)
  • Wellness Services :- This is a service in which insured person can seek medical advice through telephonic or online mode
  • Claim Service Guarantee :- Cashless Claim - 1% of delayed claim amount (for delay beyond 6 hours to 12 hours), additional 1% for every additional delay of 6 business hoursReimbursement Claim -1% of delayed claim amount (for delay beyond 21 days to up to 42 days), additional 1% for every additional delay of 6 business hours Maximum limit - 6% of delayed claim amount
  • Policy Service Guarantee :- Rs. 20,000
  • Accidental Death Cover (PA) :- 5% of base sum-insured subject to minimum of Rs. 1 lakh
  • Waiver of Premium :- This benefit waives off the renewal policy premium for one year, in case of first diagnosis of certain listed Critical Illness. For long term policies, the Company shall waive off one year proportionate renewal policy premium.
  • Hospitalisation Expenses (In Patient Treatment, Day Care & Accomodation Bonus) :- Covered up to the sum-insuredAccommodation Bonus: Additional fixed daily amount of Rs. 1,000 on opting lower category room
  • Domestic Road Ambulance :- Covered as per Actuals (including Intercity ambulance, beyond 100km)
  • Domiciliary Hospitalisation :- Within the Sum Insured
  • Modern Treatment :- Covered up to 100% of base sum insured
  • Pre & Post Hospitalisation :- Pre 60 days + Post 90 days within the sum insured
  • Organ Donor Expenses :- Covered up to 50% of base sum insured max Rs. 10 lakhs
  • Reinstatement of Base Sum Insured :- On subsequent claim, one reinstatement up to 100% of base sum insured for unrelated illness/injury, sub-limit of 20% of base sum insured for related illness/injury
  • Extra sum insured :- Additional, 20% of Base sum insured on same claim, in single Hospitalisation
  • Cumulative Bonus :- Increase in base sum-insured by 33.33% for every claim free policy year, subject to a maximum of 100% of base sum-insured and decrease by 33.33 % of base sum-insured for every claim year.
  • Call Option for Enhancement of Base Sum Insured :- After 4 continuous and consecutive claim free Policy Years, if policyholder avails this benefit then enhanced Sum Insured is sum of expiring Policy’s Base sum insured and accumulated Cumulative Bonus
  • Loyalty Cover :- At the end of each completed and continuous Policy Year, the Company shall provide Loyalty Cover to the policyholder (who is also an Insured Person) under the policy. (Refer Benefit-4.5.3 Loyalty Cover in Prospectus)
  • Wellness Services :- This is a service in which insured person can seek medical advice through telephonic or online mode
  • Claim Service Guarantee :- Cashless Claim - 1% of delayed claim amount (for delay beyond 6 hours to 12 hours), additional 1% for every additional delay of 6 business hoursReimbursement Claim -1% of delayed claim amount (for delay beyond 21 days to up to 42 days), additional 1% for every additional delay of 6 business hours Maximum limit - 6% of delayed claim amount
  • Policy Service Guarantee :- Rs. 20,000
  • Accidental Death Cover (PA) :- 5% of base sum-insured subject to minimum of Rs. 1 lakh
  • Waiver of Premium :- This benefit waives off the renewal policy premium for one year, in case of first diagnosis of certain listed Critical Illness. For long term policies, the Company shall waive off one year proportionate renewal policy premium.
  • Inpatient Care :- Covers medical expenses incurred during Hospitalization due to an illness or accident for period more than 24 hours.
  • Special Treatment :- Covers for the medical expenses incurred during the Policy Year on Inpatient Treatment or Daycare Treatment or Domiciliary Treatment of listed Special Treatments.
  • Day Care Procedures :- Medical expenses incurred for Day Care Treatment which is surgical procedure, chemotherapy or radiotherapy or hemodialysis taken by an Insured person during the Policy Period at a Hospital or Day Care Centre.
  • Domiciliary Hospitalisation :- Medical expenses for medical treatment at home for a period exceeding 3 consecutive days which would otherwise have necessitated hospitalisation.
  • Organ Donor :- Medical expenses on harvesting the organ from the donor for organ transplantation.
  • AYUSH Benefit :- The Medical Expenses for In-patient Treatment taken under Ayurveda, Unani, Sidha and Homeopathy.
  • Pre-Hospitalisation Medical Expenses :- Covers expenses incurred 90 days prior to the date of hospitalisation.
  • Post-Hospitalisation Medical Expenses :- Covers expenses incurred up to 180 days from the date of discharge
  • Emergency Ambulance :- Actual expenses incurred per Hospitalization for utilizing ambulance service for transporting the Insured Person to the nearest Hospital with adequate facilities in case of an emergency or from one hospital to another for medically necessary treatment.
  • Transportation Benefit :- Reasonable expenses incurred up to Rs 500 per Hospitalization for utilizing a registered radio cab operator’s services for transporting the Insured Person to and/or from the Hospital.
  • Restore Benefit :- On subsequent claim, one reinstatement up to 100% of Sum Insured for unrelated illness/injury.
  • Voluntary Co-payment :- On Opting for Voluntary Co-payment, the Insured person is eligible for a discount of 10% on premium. The Co-payment is applicable for each and every claim.
  • Renewal Benefit – Stay Healthy Discount :- The Insured Person will be get upto 10% discount at the time of Renewal for carrying out an annual health check-up and sharing the results of the same with the Company.
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Registered Address: Office No. 4022-25, 4th Floor, Currency Tower, VIP Chowk, Telibanda, Raipur, Chhattisgarh- 492001

Reg No. 958, Valid till : 02-04-2027, CIN - U66220CT2023PTC015076, Category - Composite, Principal Officer - RAHUL NIGAM, Contact No. 9713140004,
Email - rahul@epixinsurance.com