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ManipalCigna Lifestyle Protection – Critical Care
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ManipalCigna Lifestyle Protection – Critical Care

 When it comes to health, uncertainty occupies the highest risk factor when one keeps his/her future in mind. This is where, health insurance policies come in handy, keeping financial crisis, and the mammoth costs of medical treatment today at bay.

ManipalCigna Lifestyle Protection Critical Care plan is one such health insurance policy under ManipalCigna Health Insurance that takes care of all unforeseen expenses during a medical emergency. It also offers various options for choosing the sum insured as per one’s insurance needs.

What is ManipalCigna Lifestyle Protection Critical Care plan?

ManipalCigna Critical Care plan provides the financial backdrop for the policy owner to bear unforeseen medical expenses for themselves or their family. The said plan provides a sum insured for any of the illnesses covered under the plan to the insured upon diagnosis anywhere in the world, within the policy period. All such benefits are paid in Indian currency, regardless of the treatment undertaken by the policyholder in any country.

There are two cover options available under the said plan:

  • Basic Cover- The basic coverage plan under ManipalCigna Critical Care policy covers 15 critical illnesses.
  • Enhanced Cover- This variant covers 30 critical illnesses.

The following are the key components of the ManipalCigna Critical Care plan:

  • Critical Illness Cover

As mentioned above, one can opt for a basic critical illness plan or an enhanced plan, which covers double the number of critical illnesses. These include:

  • Severe Cancer
  • CABG (Open Chest)
  • Severe First Heart Attack
  • Open Heart Replacement/Heart Valve Repair
  • Kidney Failure Requiring Dialysis
  • Severe Coma
  • Bone Marrow/Major Organ Transplant
  • Permanent Limb Paralysis
  • Stroke within Permanent Symptoms
  • Multiple Sclerosis with Persisting Symptoms
  • Motor Neurone Disease with Permanent Symptoms
  • Primary Pulmonary Hypertension
  • Loss of Sight
  • Aorta Graft Surgery
  • Loss of Hearing
  • Coronary Artery Disease
  • End-Stage Lung Disease
  • Aplastic Anaemia
  • End-Stage Liver Failure
  • Fulminant Hepatitis
  • Major Burns
  • Alzheimer’s Disease
  • Benign Brain Tumor
  • Bacterial Meningitis
  • Apallic Syndrome
  • Medullary Cystic Disease
  • Parkinson’s Disease
  • Muscular Dystrophy
  • Systemic Lupus Erythematous
  • Loss of Speech
  • Second Medical Opinion

The policyholder will have the additional benefit of securing a second opinion through any medical practitioner registered with the insurance company if they are diagnosed with any of the above listed critical illnesses. This benefit can only be exercised once by the policyholder during a policy term.

  • Access to Online Wellness program

ManipalCigna Critical Care has its own health and wellness program, tailor-made for each customer and covering their varied health needs. This program is available on the insurer's official website and consists of many customised programs such as lifestyle management programs, nutrition programs, health risk assessments, and a whole section of related articles for raising health awareness for the customer's to read.

 Features of ManipalCigna Lifestyle Protection Critical Care Policy

Following are the key features of the plan:

  • Eligibility- The minimum age of entry is 18 years, while the maximum age of entry is 65 years.
  • Renewability - Policy owners have the advantage of lifelong renewability under ManipalCigna Critical Care plan.
  • Policy Coverage - The policy can be issued for self as an individual or on a family basis. However, the following are only included in coverage under the plan-

- Spouse

- Parents

- Parents-in Law

- Children

- Grandchildren

- Unmarried siblings up to 25 years

  • Policy Period Options- The plan is available for a period of 1,2, and 3 years, which is to be computed from the date of issuance of the policy.
  • Sum Insured- The sum insured under the plan ranges from 1 lakh to 25 crores, depending upon the income of the insured individual multiples by 10. The sum assured cannot exceed this amount.

Insured Member

Sum Insured

Earning member

Up to sum insured

non-earning spouse

 

60% of the sum insured

 

Dependent children

30% of the sum insured

 

Dependent parents/in-law parents/siblings

30% of the sum insured

 

 

  • Payment of Claims- The policy owner has the benefit of choosing between two options for receiving benefits. He/she must select one of the options at the time of buying the policy. These are:
  • Lump-sum Payout

Payment of the full amount of sum assured upon diagnosis with any of the covered critical illness.

  • Staggered Payout

Under this plan, the insured will get 25% of the lump-sum amount upon diagnosis with any critical illness covered under ManipalCigna Critical Care. The rest 75%+10% payment will be paid in 60 monthly instalments following the day of the claim.

  • Savings on Premiums under the Policy

Policyholders can save up to a considerable amount on premiums under the said policy:

  • Family Savings- 10% for covering more than 2 family members under the same policy
  • Long-term Savings- Avail 7.5% and 10%  for a 2 & 3 year policy period respectively
  • Direct Policy Savings- 10% savings upon buying the policy without any intermediary
  • Worksite marketing savings- A 10% savings to be availed if the policy is bought through a worksite marketing channel

 Benefits of ManipalCigna Lifestyle Protection Critical Care Plan

Following are the key benefits of ManipalCigna Critical Care:

  • Extensive Coverage - The policy covers 30 diseases of critical illness under its health insurance plan.
  • Wide Range for Sum Insured - The individual may opt for a sum insured amount up to Rs 3 crores, depending on the salary or income source.
  • Policy Payment- The plan provides a lump-sum payment during the claims, which is more than the medical expenses.
  • Second Medical Opinion - The plan confers the added benefit of second medical opinion for customers from their network of medical practitioners.
  • Access to Online Programs- ManipalCigna has various programs designed to inform and alleviate the health of customers. These include lifestyle management programs, nutrition programs, health risk assessments and many articles on healthcare.
  • Lifelong Renewability- The policy comes with the benefit of lifelong renewability.

 Exclusions under ManipalCigna Lifestyle Protection Critical Care Plan

The insurer has excluded certain conditions where the policyholder would not be able to get any payment if injury or illness arises due to the following conditions:

  • Any Illness, sickness or disease other than those specified as Critical Illnesses under this Policy
  • Any claim with respect to a critical illness diagnosed prior to the Policy Inception Date.
  • Any Pre-existing disease or complication arising therefrom
  • Any critical illness associated with AIDS
  • A condition caused by sexually transmitted diseases including Syphilis, Genital Warts, Gonorrhoea, Chlamydia, Genital Herpes, Trichomoniasis., and Pubic Lice
  • Any health issues arising out of usage of any substance, intoxicant, drug,

alcohol or hallucinogen

  • Narcotics, unless taken as prescribed by a registered Medical Practitioner
  • Intentional self-injury, suicide or attempted suicide; whether the person is medically sane or insane
  • Any critical illness occurring due to a foreign invasion, act of foreign

enemies, hostilities, warlike operations, civil war, etc.

  • Any critical illness caused by radioactivity
  • Working in mines, tunnelling or involving electrical

installations with high risk supply, or circus personnel/jockeys.

  • Congenital anomalies, inherited disorders, etc.
  • Insured persons engaging in adventure sports of any kind
  • Any loss arising out of childbirth or from pregnancy
  • Any critical illness treatment availed from persons not registered as Medical Practitioners, or who are practicing outside the discipline of medical science, or an unauthorized person
  • Any treatment/surgery for change of sex, cosmetic or plastic surgery or any cosmetic procedure
  • Any critical illness resulting from the insured person committing any breach of law
  • In case of the death of the policyholder within the stated survival period as set out above
  • Failure to seek or follow Medical Advice
  • Birth control procedures and hormone replacement therapy
  • Any mental illness, psychiatric, or psychological disorders
  • Any treatment arising from pregnancy like voluntary termination, miscarriage (due to accident), maternity (including Caesarean), childbirth, abortion, etc. This exclusion will not apply to ectopic pregnancy.

How to Claim ManipalCigna Lifestyle Protection Critical Care Plan?

Upon the occurrence of any illness covered under the policy, the policy owner must submit an application in writing or call the Customer Care centre within 10 days of such occurrence. Additionally, the following details must be provided to the insurer:

  • Policy number
  • Name of policyholder
  • Name of the insured person in favour of whom the claim is to be made
  • The critical illness suffered by the insured.
  • Name and address of the medical practitioner
  • Date of admission in hospital
  • Any other details as required by ManipalCigna 

Documents Required for Filing a Claim

Once the insured is diagnosed with any of the covered critical illness, they must make a claim within 60 days of the first diagnosis or surgical treatment. The following documents are required to make a claim under ManipalCigna Critical Care policy:

  • Duly filled and signed claim form
  • Medical certificate confirming the diagnosis of covered critical illness
  • Certificate from a medical practitioner confirming that the disease or illness was not pre-existing or borne out of any injury/illness within 90 days of the policy coming into force
  • Discharge or death summary report, if applicable
  • Investigation test report confirming the diagnosis of any covered critical illness
  • Consultation letters and prescription reports
  • Indoor case papers
  • KYC documents
  • If critical illness arises due to accident, medico-legal certificate or FIR copy will be required
  • Any other additional documentation as required by ManipalCigna.

How to Buy ManipalCigna Lifestyle Protection Critical Care Plan ?

One can easily buy ManipalCigna Critical Care plan through online as well as offline channels. One just needs to follow the below steps:

  • Fill in the Proposal Form

The proposal form is available on insurer’s official website. Conversely, one can buy the policy through intermediary websites such as Paisawiki.com, which is the easiest way of buying. The applicant must fill in the form with accurate personal details and medical history.

  • Submission of Form

Subsequently, the applicant must submit the form along with necessary documents and premium.

  • Medical Check-up

The policy provides for a medical health check-up for applicants applying for a sum insured of more than 25 lakh and more than 18-45 years of age. The medical examination will be held in one of ManipalCigna's network of diagnostic centres.

  • Acceptance or Rejection of application

Based on the above information, the proposal would be processed, and the insurance policy request shall either be accepted or rejected by the insurer. In case of rejection, reasons for such along with the premium shall be paid back to the applicant.

Documents Required for Buying ManipalCigna Lifestyle Protection Critical Care Plan

The applicant will require the following documents for buying ManipalCigna health insurance:

  • Aadhar Card
  • Birth Certificate
  • Bank A/C statement
  • Electricity Bill
  • PAN Card
  • Passport
  • Passport size coloured photograph
  • Utility Bill
  • Voter Card

Renewal of ManipalCigna Lifestyle Protection Critical Care Plan

Once the base policy expires fulfilling its tenure, it terminates. The policy which comes into force subsequently will be considered a fresh policy if there is an intervening period of more than 30 days since the expiration of previous policy and the current policy start date.

Once the original policy expires, the policyholder must notify the insurer of any underlying health conditions at the time of renewal of the policy. The request for renewal will not be denied except for reasons of misrepresentation, fraud, non-disclosure, or non-cooperation by the policyholder.

Any change that the policyholder may wish to make in the sum assured or policy period should be communicated during such renewal. As such, the rate of premium shall be computed accordingly.

In case the plan has been discontinued, the nearest available substitute shall be assigned to the policyholder. All details of change and withdrawal will be effectively communicated to the policyholder before the lapse of his/her original policy.

One can approach paisawiki.com in order to renew the policy. He/she must visit the website, go to the renewal option, pay the premiums online and get the fresh policy.

FAQs

  • Q. How can one cancel the Lifestyle Protection plan?

    Ans. The policyholder may cancel the plan at any time during the tenure of the policy. However, he/she needs to give a 15-day notice for cancellation of the policy. The premium will be refunded as per the terms and conditions of the policy.

  • Q. Can an individual port their existing health insurance plan for ManipalCigna Critical Care plan?

    Ans. Portability is allowed under the plan. ManipalCigna mandates that only individuals with a continuous health insurance policy from a non-life insurance company registered under IRDAI can only avail this option of portability. Additionally, the policyholder should submit the application for portability with all necessary documents at least 45 days prior to the expiration of his/her original policy.

  • Q. What is the free-look period under the policy?

    Ans. The policy owner will have 15 days from the date of receipt of the policy document to review the terms and conditions of the ManipalCigna Critical Care plan. If the policyholder wants to go ahead with the cancellation, they need to state the reasons for such along with returning the policy documents. Thereafter, the full amount of premium shall be paid back to the policyholder.

  • Q. What is the waiting period under the policy?

    Ans. The waiting period under the policy is 90 days from the start date of the plan.

  • Q. Can the sum insured be more than Rs 3 crore?

    Ans. The sum insured ranges from Rs 1 lakh to Rs 5 crores, depending on the income of the individual. However, one may be eligible for a higher claim amount, subject to underwriting and decided on a case to case basis.

  • Q. What are the exclusions under the ManipalCigna Critical Care plan?

    Ans. Following conditions are not included under the policy:

    • Illness or injury arising due to Substance abuse or consumption of drugs, alcohol
    • Injuries/illness arising out of pregnancy or abortion
    • Injuries due to working in mines, tunnels or electrical installations
    • Mental illness, psychiatric or psychological disorders
    • Sexually transmitted diseases
    • Any other injury, illness or disease not covered under the policy
  • Q. What are the cover types that once can avail under the plan?

    Ans. The ManipalCigna Critical Care policy comes with the individual as well as family floater plans. Moreover, one may avail savings on premiums by adding more than 2 family members under the plan.

Written By: Paisawiki - Updated: 22 October 2020

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