ManipalCigna ProHealth Cash
ManipalCigna health insurance is well-known for providing a set of comprehensive health insurance policies to help protect any individual or their family members by providing insurance coverage in times of need. One such plan is the ManipalCigna Prohealth Cash plan.
What is ManipalCigna Prohealth Cash policy?
ManipalCigna Prohealth Cash policy is a hospital cash benefit policy. The policy provides a fixed Daily Cash benefit in which coverage is offered to the person insured for the expenses incurred as a result of hospitalization due to illness/disease/injury. The benefit is provided for each continuous period of 24 hours of being hospitalized during the policy period. The advantage of the Prohealth Cash plan is that it helps cover the expenses such as co-pays, and non-admissible items, and transportation expenses, which are a part of the out-of-pocket expenses that are not covered by a normal insurance policy. The plan is beneficial to expand the coverage of normal health insurance.
ManipalCigna Prohealth Cash Plan at a Glance
Daily Cash Plan
Minimum Age of Eligibility
5 years in case of optional coverage for accidental death and permanent total disability
Maximum Age of Eligibility
Rs 500 to Rs 5000
A policy year is considered as a period of 12 months from the date the policy is issued
60 days/90 days/180 days
Premiums charged will depend on Plan, Policy Tenure, Daily Cash Benefit, Age, the maximum coverage limit opted, and Optional covers
15 days from the due date of next instalment
Key Features of ManipalCigna Prohealth Cash Plan
A hospital cash policy, like ManipalCigna Prohealth Cash, offers many benefits and features along with the amount of coverage offered. The key features of the plan are-
- ManipalCigna Prohealth Cash plan is a cash benefit plan securing financial assistance in any part of the world.
- Individuals may select a suitable sum insured from the Daily Cash Benefit ranging from Rs 500(1unit) to Rs 5000(10 units). The sum insured available under the optional cover of personal accident or permanent total disability is between Rs 50,000 and Rs 25 Lakh. The eligibility for the optional cover will be determined based on income with a maximum of 10 times the annual income.
- A multi-faceted benefit of the plan includes the facility to select the maximum coverage limit period. The individual can choose any options from the 60 days or 90 days or 180 days for a single policy year. This gives the insured person an ability to customize the plan according to their choice.
- The policy can be claimed on an individual basis. The policy covers relationships such as Self, spouse, child, parents, siblings, in-laws, grandparents, and grandchildren.
- In the case of child coverage plans- children/grandchildren within the age bracket of 91 days to 17 years will be covered provided their parent is covered under the policy. The child has an option to move to an individual cover upon attaining the age of 18 years.
- The policy period offers options of 1,2 or 3 continuous policy years. A policy year means a period of 12 consecutive months from the date of commencement.
- Under the accidental hospital cash benefit, the policy provides two times the daily cash benefit sum of the policy schedule in case the person insured is hospitalized owing to accidental injury during the policy period.
- The ICU cash benefit provides insurance coverage for the expenses incurred upon admission in the ICU for treatment of any illness/injury to up to 3 times the daily cash benefit amount in the policy schedule. The coverage is for a maximum of 15 days per person in a single policy year.
- If an insured person is hospitalized for medically necessary treatment of an illness/injury for over 10 consecutive days during the policy period, the policy provides an additional amount of five times the daily cash benefit sum specified under the policy for every 24 hours completed as an inpatient.
- The Prohealth Cash plan covers the person accompanying the insured during his/her hospitalization period by giving an additional 50% of the daily cash benefit amount for each continuous completed 24 hours period.
- For individuals below the age of 45 years, the process of claiming the policy does not require undergoing a medical examination.
- During the event of the death of the insured person hospitalized owing to accidental injury, the policy pays the nominee with an amount 10 times that of the daily cash benefit for each day of hospitalization.
- Income tax benefits are available under Section 80D.
Benefits under ManipalCigna Prohealth Cash Policy
The ManipalCigna Prohealth Cash Plan comes in the form of two plans with optional covers. The plans under the policy are-
The plan I: Base Plan - The benefits included under this plan are
- Sickness Hospital Cash Benefit: It provides a daily cash benefit for each day an insured person is hospitalization for treatment of any illness/injury that has occurred during the policy period.
- Accidental Hospital Cash Benefit: For any injury occurring as a result of an accident, the insured person will be served with the coverage about double the daily cash benefit during each continuous and completed 24 hours period of hospitalization during the policy period.
- ICU Cash Benefit: This benefit covers the hospitalization period in the ICU by providing the insured person with a sum three times that of the daily cash benefit for completion of a period of 24 hours of hospitalization during the policy period.
- Worldwide Coverage: If the hospitalization of the insured person takes place outside of India, he/she will be provided with a coverage that is three times that of daily cash benefit.
Plan II: Enhanced Plan- The benefits included under this plan are:
- Sickness Hospital Cash Benefit
- Accidental Hospital Cash Benefit
- ICU Cash Benefit
- Worldwide Coverage
- Convalescence Benefit: In a scenario where the insured person is hospitalized for medically necessary treatment wing to illness/injury, the policy pays a lump sum amount of about 5 times the daily cash benefit amount mentioned in the policy document.
- Companion Benefit: An additional sum equal to 50% of the daily cash benefit will be given for the expenses in respect of an accompanying person to take care of the person insured.
- Compassionate Benefit: In the event of the sudden death of the policyholder due to accidental injury, the nominee is provided with a sum equivalent to 10 times that of the amount of daily cash benefit for every 24 hours completed under hospitalization.
Optional Covers under the Policy:
- Daycare Treatment Benefit- The benefit under this section provides cover for a medically necessary Day Care Treatment by paying an amount about 5 times slower than the daily cash benefit.
- Accidental Death and Permanent Total Disability Benefit: This cover provides the Accident Sum Insured as in the Policy to the Insured in case of Permanent Total Disablement or the Nominee in case of death of the person insured.
Exclusions of the ManipalCigna Prohealth Cash Policy
The noteworthy exclusions under this ManipalCigna health insurance policy are:
- The policy does not cover any pre-existing illnesses for a period of 48 months before the issuance of the policy.
- The insured individuals are not allowed to claim the policy within the initial 30 days of the policy period.
- In the case of certain specific illnesses, a two-year waiting period has to be obeyed.
- The policy does not cover any surgical or medical treatment regarding dental issues.
- The policy excludes coverage for illnesses such as AIDS or HIV infection.
- The treatment received outside India unless covered under Worldwide Cover Benefit will be excluded from the policy.
- Any expenses resulting from pregnancy or childbirth-related disorders, except in the case of ectopic pregnancy will be excluded from the policy.
- The policy does not allow coverage for medical emergencies arising as a result of drug abuse or suicide attempt.
Eligibility Criteria to Buy the ManipalCigna Prohealth Cash Policy
The minimum entry age under this policy is 91 days, and the maximum age at entry is 65 years. For availing coverage under the Accidental Death and Permanent Total Disability variant, the age of entry is 5 years.
Claim Process of ManipalCigna Prohealth Cash Policy
To claim the policy in the event of hospitalization, the proposer/insured person is required to provide details as mentioned below-
- Policy Number
- Name of the person insured that wants to make a claim.
- Proposer's name
- The Hospital’s and Medical Practitioner’s name and address.
- Nature of Injury/Illness
- Admission Date
- The procedure of policy claiming at ManipalCigna Insurance is different for cashless claims and reimbursement claims.
- Any other requested information.
The following documents are required to claim this ManipalCigna Health Insurance policy:
- Duly completed and signed claim form prescribed
- Hospital discharge summary
- Operation theatre notes, if applicable
- Hospital main bill/receipt
- MLC/ FIR report/Post Mortem Report, if applicable
- Death Summary, Death Certificate, if applicable.
- The documents have to be submitted within a period of 15 days after discharge from the hospital.
How to Buy the ManipalCigna Prohealth Cash Policy?
The policy can be bought easily at Paisawiki.com. The individual has to fill the proposal form available online and provide all the required details correctly. The filled proposal form along with the premium and any other documents (if necessary, is then submitted.
The proposer may be required to undergo medicals as per the age band and sum that was chosen, as per the norms of the insurer. Based on the submitted details, the proposal form undergoes processing and will be approved.
In the case of rejected proposals or where the customer does not accept a counteroffer, the company will bear 50% of the cost for such tests and the balance premium will be refunded.
Renewal of ManipalCigna Prohealth Cash Policy
The plan provides lifelong renewal and can be conveniently renewed online on platforms like paisawiki.com. Just go to the official website of Paisawiki, go to the renewal option, provide the necessary details regarding the policy. Pay the premiums online and get the renewed policy mailed.
The revival period of the policy is 15 days from the due date of the next instalment, and the policy will be terminated automatically at the end of the policy period.
Ans: For claim settlement, one should either contact the health advisor or contact the company directly.
Ans: Documents required at the time of intimation of the claim include:
- Name and complete address of the medical practitioner or the hospital.
- Any other documents requested by the company.
Ans: Documents required are:
- Duly signed claim form
- Hospital Break Up Bill
- Hospital Discharge Summary
- Copy of Photo ID of the patient
- Main Hospital Bill
- Operation Theater Notes
- Investigation reports
- Pharmacy Bills
- Post Mortem Report
- Doctor’s reference slip
Ans: There is no limit on the number of claims that can be made in a year. However, the sum insured is limited.
Ans: The period is generally 5 working days. This is followed by claim settlement which occurs within 30 days.
Written By: Paisawiki - Updated: 22 October 2020