{"uin":"ACKHLIP27040V012627","name":"Acko Health III","url":"https://indiainsurances.com/policy/acko-general-insurance/acko-health-iii-ackhlip27040v012627","insurer":{"slug":"acko-general-insurance","name":"Acko General Insurance Limited","url":"https://indiainsurances.com/insurer/acko-general-insurance"},"line":"health","category":"health-indemnity","category_name":"Health insurance (hospitalisation)","irdai_type":null,"kind":"product","status":"active","approved_on":null,"withdrawn_on":null,"summary":"Acko Health III is an indemnity health product that can be issued on an individual or family floater basis for 1 year, 2 years or 3 years. The documents show sum insured options from 3 Lakhs to Unlimited, with plan and optional-cover variations for waiting periods, deductibles, co-pay, room category, restoration and worldwide inpatient hospitalisation.","analysis":{"state":"machine","analysed_at":"2026-10-19 17:53:41.276347+00","note":"First pass: one AI reading; every stated fact carries a verbatim quote found in the cited clause, but it has not been reviewed. Check the clause before relying on it."},"facts":[{"key":"plan_variants","label":"Plans and variants","section":"Overview","meaning":"The named plans inside this product (not cover types or payout options). Facts can differ between them.","status":"quote-verified","value":["ACKO Health III","ACKO Health III (Platinum)","ACKO Health III (Platinum Lite)","ACKO Health III (Platinum Super Top-up)","Plan 1","Plan 2","Plan 3","Plan 4","Plan 5","Plan 6"],"display":"ACKO Health III; Platinum; Platinum Lite; Platinum Super Top-up; Plan 1 to Plan 6","note":null,"quote":"ACKO Health III – Policy Wordings ... ACKO Health III (Platinum) – Policy Wordings ... ACKO Health III (Platinum Lite) – Policy Wordings ... ACKO Health III (Platinum Super Top-up) – Policy Wordings ... Particulars | Plan 1 | Plan 2 | Plan 3 | Plan 4 | Plan 5 | Plan 6","sources":[{"clause":null,"heading":"ACKO Health III – Policy Wordings","page":1,"url":"https://indiainsurances.com/policy/acko-general-insurance/acko-health-iii-ackhlip27040v012627/document/1440#c-acko-health-iii-policy-wordings"},{"clause":null,"heading":"ACKO Health III (Platinum) – Policy Wordings","page":1,"url":"https://indiainsurances.com/policy/acko-general-insurance/acko-health-iii-ackhlip27040v012627/document/1444#c-acko-health-iii-platinum-policy-wordings"},{"clause":null,"heading":"ACKO Health III (Platinum Lite) – Policy Wordings","page":1,"url":"https://indiainsurances.com/policy/acko-general-insurance/acko-health-iii-ackhlip27040v012627/document/1448#c-acko-health-iii-platinum-lite-policy-wordings"},{"clause":null,"heading":"ACKO Health III (Platinum Super Top-up) – Policy Wordings","page":1,"url":"https://indiainsurances.com/policy/acko-general-insurance/acko-health-iii-ackhlip27040v012627/document/1452#c-acko-health-iii-platinum-super-top-up-policy-wor"},{"clause":"Annexure 3","heading":"Plans Offered","page":21,"url":"https://indiainsurances.com/policy/acko-general-insurance/acko-health-iii-ackhlip27040v012627/document/1442#c-annexure-3"}],"law":[]},{"key":"policy_term","label":"Policy term","section":"Eligibility","meaning":"How long one policy runs before it ends or must be renewed.","status":"quote-verified","value":"This policy can be purchased for 1 year, 2 years or 3 years.","display":"1 year / 2 years / 3 years","note":null,"quote":"This policy can be purchased for a period of 1 year / 2 years / 3 years.","sources":[{"clause":"8","heading":null,"page":1,"url":"https://indiainsurances.com/policy/acko-general-insurance/acko-health-iii-ackhlip27040v012627/document/1442#c-8"}],"law":[]},{"key":"claim_intimation","label":"Claim intimation deadline","section":"Claims","meaning":"How soon you must tell the insurer about a claim or hospitalisation.","status":"quote-verified","value":"Claims may be notified via app, email, call center or through TPA at hospital. For cashless pre-authorisation, planned admission approval must be requested at least 2 days before admission and emergency admission within 48 hours of admission; reimbursement documents must be submitted within 15 days from discharge.","display":"Notify via app/email/call center/TPA; planned cashless at least 2 days before admission; emergency within 48 hours; reimbursement documents within 15 days from discharge","note":null,"quote":"• Notify via app/email/call center or through TPA at hospital. ... • Planned admission: Request approval at least 2 days before admission\n• Emergency admission: Within 48 hours of admission ... Submit documents within 15 days from discharge through Acko app.","sources":[{"clause":null,"heading":"6.1. Claim registration / intimation","page":14,"url":"https://indiainsurances.com/policy/acko-general-insurance/acko-health-iii-ackhlip27040v012627/document/1440#c-6-1-claim-registration-intimation"},{"clause":null,"heading":"Pre-authorization","page":15,"url":"https://indiainsurances.com/policy/acko-general-insurance/acko-health-iii-ackhlip27040v012627/document/1440#c-pre-authorization"},{"clause":null,"heading":"6.3. Reimbursement claims","page":15,"url":"https://indiainsurances.com/policy/acko-general-insurance/acko-health-iii-ackhlip27040v012627/document/1440#c-6-3-reimbursement-claims"}],"law":[{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, V.1","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, V.1","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part C, V.1","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Para 20, 21","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"}]},{"key":"claim_documents","label":"Claim documents","section":"Claims","meaning":"Documents the insurer asks for when you claim.","status":"quote-verified","value":["Claim form (filled & signed)- Digital submission through App doesn't necessitate this","Original discharge/day care/transfer summary","Original death summary (if death case)","Hospital registration certificate/number for non-network provider","Original hospital bill with detailed break-up","Original payment receipts (receipt nos., stamp/seal)","Original pharmacy/medicine receipts","Implant invoice/stickers/barcode copies","Lab/test reports with prescription + diagnostic invoices/receipts","First consultation paper related to past medical ailment (origin/duration/progress)","Previous consultation papers/history (for current illness)","FIR/MLC (in case of accident)","Medical prescriptions and advice for admission/procedure","Indoor case papers/nursing sheet (where required)","Ambulance invoices and details in prescribed format","Bank details for NEFT","Aadhaar/other Govt photo ID + PAN","Legal heir/succession certificate where applicable","Doctor certificate for domiciliary treatment circumstances (domiciliary claims)","Any other documents required to assess admissibility"],"display":"Claim form, discharge summary, bills, receipts, prescriptions, reports, accident papers where applicable, ID/KYC, bank details and benefit-specific documents","note":"Additional documents are listed for domestic emergency evacuation and second opinion.","quote":"Hospitalization reimbursement documents:\n• Claim form (filled & signed)- Digital submission through App doesn't necessitate this\n• Original discharge/day care/transfer summary\n• Original death summary (if death case)\n• Hospital registration certificate/number for non-network provider (or facility certificate, wherever required e.g. new hospital for which no past claim experience exist with Acko and we aren't able to independently verify)\n• Original hospital bill with detailed break-up\n• Original payment receipts (receipt nos., stamp/seal)\n• Original pharmacy/medicine receipts\n• Implant invoice/stickers/barcode copies\n• Lab/test reports with prescription + diagnostic invoices/receipts\n• First consultation paper related to past medical ailment (origin/duration/progress)\n• Previous consultation papers/history (for current illness)\n• FIR/MLC (in case of accident)\n• Alcohol/intoxication history at incident (certified by first treating doctor) for accident cases\n• Medical prescriptions and advice for admission/procedure\n• Indoor case papers/nursing sheet (where required)\n• Ambulance invoices and details in prescribed format\n• Vaccination invoice and payment receipt, if part of hospitalization\n• Bank details for NEFT (not mandatory if verified details available with Acko)\n• Aadhaar/other Govt photo ID + PAN (not mandatory if already linked)\n• KYC resubmission if changes as per AML guidelines\n• Legal heir/succession certificate where applicable\n• Doctor certificate for domiciliary treatment circumstances (domiciliary claims)\n• Any other documents required to assess admissibility","sources":[{"clause":null,"heading":"6.3. Reimbursement claims","page":15,"url":"https://indiainsurances.com/policy/acko-general-insurance/acko-health-iii-ackhlip27040v012627/document/1440#c-6-3-reimbursement-claims"}],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 17","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 22","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 23","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, V.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, V.3(iii)","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part C, V.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"}]},{"key":"claim_settlement_time","label":"Claim settlement time promised","section":"Claims","meaning":"How quickly the policy says a claim is decided or paid, and from when that is counted (intimation or last document).","status":"quote-verified","value":"Cashless preauthorization TAT is 1 hour and cashless final bill authorization TAT is 3 hours. For claim payment delay beyond 15 days from receipt of necessary documents, the policy says interest is payable from intimation to payment at 2% above RBI bank rate.","display":"Cashless preauthorization 1 hour; cashless final bill authorization 3 hours; interest if delayed beyond 15 days from receipt of necessary documents","note":null,"quote":"• Turn around time for preauthorization of cashless facility is1 hour ... • Turnaround time for cashless final bill authorization is 3 hours ... • In case of delay beyond 15 days from date of receipt of necessary documents, we pay interest from date of intimation to date of payment at rate 2% above RBI bank rate.","sources":[{"clause":null,"heading":"Pre-authorization","page":15,"url":"https://indiainsurances.com/policy/acko-general-insurance/acko-health-iii-ackhlip27040v012627/document/1440#c-pre-authorization"},{"clause":null,"heading":"Discharge","page":15,"url":"https://indiainsurances.com/policy/acko-general-insurance/acko-health-iii-ackhlip27040v012627/document/1440#c-discharge"},{"clause":null,"heading":"6.4. Scrutiny, assessment, investigation & timelines","page":16,"url":"https://indiainsurances.com/policy/acko-general-insurance/acko-health-iii-ackhlip27040v012627/document/1440#c-6-4-scrutiny-assessment-investigation-timelines"}],"law":[{"title":"The Insurance Act, 1938","section":"Section 64UM(4) to (6)","url":"https://indiainsurances.com/law/insurance-act-1938"},{"title":"Master Circular on General Insurance Business, 2024","section":"Ch I, Para 10","url":"https://indiainsurances.com/law/irdai-general-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 15","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 16","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 22","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, V.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, V.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, V.3(i), V.3(ii)","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, V.3(iii)","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part C, V.3","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part C, V.4","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Para 23","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"The Motor Vehicles Act, 1988: Chapter XI, insurance of motor vehicles against third party risks","section":"Section 149","url":"https://indiainsurances.com/law/motor-vehicles-act-1988"}]},{"key":"exclusions_main","label":"Main exclusions","section":"Exclusions","meaning":"What the policy does not pay for, in the policy's own words.","status":"quote-verified","value":["Expenses for PED and direct complications are excluded until the waiting period expires","Listed conditions/surgeries/treatments excluded until waiting period expires","Expenses for treatment of any illness within 30 days from first policy commencement excluded, except accidents.","Admissions primarily for diagnostics/evaluation are excluded.","Admissions primarily for enforced bed rest and not active treatment.","Change-of-gender treatments","Cosmetic/plastic surgery","Treatment at providers excluded by the insurer","Correction of eyesight due to refractive error < 7.5 diopters excluded.","Unproven treatments/services/supplies","Expenses related to sterility and infertility.","childbirth (incl. complicated delivery/C-section) and pre/post hospitalization","Treatment outside India","OPD consultations/diagnostics/pharmacy/procedure","war/war-like situations, rebellion, revolution, terrorism, nuclear/biological/chemical emissions"],"display":"PED, specified disease/procedure waiting period, 30-day waiting period, diagnostics-only admission, rest cure, gender change, cosmetic surgery, excluded providers, refractive error below 7.5 diopters, unproven treatment, infertility, maternity, outside India, OPD and war/terrorism/nuclear risks","note":null,"quote":"• Expenses for PED and direct complications are excluded until the waiting period expires (months) as specified in the Policy Schedule from inception of the first policy with us. ... • Listed conditions/surgeries/treatments excluded until waiting period expires (months) as per Schedule from inception. ... • Expenses for treatment of any illness within 30 days from first policy commencement excluded, except accidents. ... • Admissions primarily for diagnostics/evaluation are excluded. ... • Admissions primarily for enforced bed rest and not active treatment. ... Excluded. ... Excluded unless reconstruction after accident/burn/cancer or medically necessary to remove direct/immediate health risk, certified by attending Medical Practitioner. ... Treatment at providers excluded by the insurer (disclosed on website/notified) not admissible. ... Correction of eyesight due to refractive error < 7.5 diopters excluded. ... Unproven treatments/services/supplies lacking significant medical documentation or not approved for medical use as per prevailing protocols excluded. ... Expenses related to sterility and infertility. ... • childbirth (incl. complicated delivery/C-section) and pre/post hospitalization ... • Treatment outside India; if Worldwide In-Patient Hospitalization cover is available in your policy schedule, this exclusion shall be waived off.\n• OPD consultations/diagnostics/pharmacy/procedure, unless covered by OPD add-on cover opted or as part of Pre/Post hospitalization of admitted in-patient/day care claim. ... • war/war-like situations, rebellion, revolution, terrorism, nuclear/biological/chemical emissions","sources":[{"clause":null,"heading":"3.1. Standard Exclusions 3.1.1. Pre-Existing Diseases (PED)","page":8,"url":"https://indiainsurances.com/policy/acko-general-insurance/acko-health-iii-ackhlip27040v012627/document/1440#c-3-1-standard-exclusions-3-1-1-pre-existing-disea"},{"clause":null,"heading":"3.1.2. Specified disease/procedure waiting period","page":8,"url":"https://indiainsurances.com/policy/acko-general-insurance/acko-health-iii-ackhlip27040v012627/document/1440#c-3-1-2-specified-disease-procedure-waiting-period"},{"clause":null,"heading":"3.1.3. 30-day waiting period","page":9,"url":"https://indiainsurances.com/policy/acko-general-insurance/acko-health-iii-ackhlip27040v012627/document/1440#c-3-1-3-30-day-waiting-period"},{"clause":null,"heading":"3.1.4. Investigation & Evaluation","page":9,"url":"https://indiainsurances.com/policy/acko-general-insurance/acko-health-iii-ackhlip27040v012627/document/1440#c-3-1-4-investigation-evaluation"},{"clause":null,"heading":"3.1.5. Rest cure, rehabilitation, respite care","page":9,"url":"https://indiainsurances.com/policy/acko-general-insurance/acko-health-iii-ackhlip27040v012627/document/1440#c-3-1-5-rest-cure-rehabilitation-respite-care"},{"clause":null,"heading":"3.1.7. Change-of-gender treatments","page":9,"url":"https://indiainsurances.com/policy/acko-general-insurance/acko-health-iii-ackhlip27040v012627/document/1440#c-3-1-7-change-of-gender-treatments"},{"clause":null,"heading":"3.1.8. Cosmetic/plastic surgery","page":9,"url":"https://indiainsurances.com/policy/acko-general-insurance/acko-health-iii-ackhlip27040v012627/document/1440#c-3-1-8-cosmetic-plastic-surgery"},{"clause":null,"heading":"3.1.10. Excluded Providers","page":9,"url":"https://indiainsurances.com/policy/acko-general-insurance/acko-health-iii-ackhlip27040v012627/document/1440#c-3-1-10-excluded-providers"},{"clause":null,"heading":"3.1.13. Refractive error","page":10,"url":"https://indiainsurances.com/policy/acko-general-insurance/acko-health-iii-ackhlip27040v012627/document/1440#c-3-1-13-refractive-error"},{"clause":null,"heading":"3.1.14. Unproven treatments","page":10,"url":"https://indiainsurances.com/policy/acko-general-insurance/acko-health-iii-ackhlip27040v012627/document/1440#c-3-1-14-unproven-treatments"},{"clause":null,"heading":"3.1.15. Sterility & infertility","page":10,"url":"https://indiainsurances.com/policy/acko-general-insurance/acko-health-iii-ackhlip27040v012627/document/1440#c-3-1-15-sterility-infertility"},{"clause":null,"heading":"3.1.16. Maternity","page":10,"url":"https://indiainsurances.com/policy/acko-general-insurance/acko-health-iii-ackhlip27040v012627/document/1440#c-3-1-16-maternity"},{"clause":null,"heading":"3.2. Specific Exclusions 3.2.1. Permanent Exclusions","page":10,"url":"https://indiainsurances.com/policy/acko-general-insurance/acko-health-iii-ackhlip27040v012627/document/1440#c-3-2-specific-exclusions-3-2-1-permanent-exclusio"}],"law":[{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 11","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Para 16","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"}]},{"key":"grievance","label":"Grievance route","section":"Claims","meaning":"Who to complain to first, as stated in the policy, before going to the Insurance Ombudsman.","status":"quote-verified","value":"For grievances, contact ACKO at toll-free 1800 210 4990 or grievance@acko.com. Escalation is to the Chief Grievance Officer at gro@acko.com before approaching IRDAI or the Insurance Ombudsman.","display":"ACKO grievance toll-free 1800 210 4990 / grievance@acko.com; escalate to Chief Grievance Officer at gro@acko.com","note":null,"quote":"• Toll-free: 1800 210 4990 (10 AM – 7 PM, all days)\n• Email: grievance@acko.com. Acknowledgement within 24 hours; final resolution within 14 days. ... • Email: gro@acko.com\n• Address: ACKO General Insurance Limited, 36/5 Hustlehub One East, Somasandrapalya, 27th Main Road, Sector 2, HSR Layout, Bengaluru, Karnataka – 560102 CGO responds within 7 days.","sources":[{"clause":null,"heading":"7.2.2. Grievances","page":19,"url":"https://indiainsurances.com/policy/acko-general-insurance/acko-health-iii-ackhlip27040v012627/document/1440#c-7-2-2-grievances"},{"clause":null,"heading":"7.2.4. Escalation – Chief Grievance Officer","page":19,"url":"https://indiainsurances.com/policy/acko-general-insurance/acko-health-iii-ackhlip27040v012627/document/1440#c-7-2-4-escalation-chief-grievance-officer"}],"law":[{"title":"Consumer Protection (Jurisdiction of the District Commission, the State Commission and the National Commission) Rules, 2021","section":"Rule 3","url":"https://indiainsurances.com/law/consumer-jurisdiction-rules-2021"},{"title":"Consumer Protection (Jurisdiction of the District Commission, the State Commission and the National Commission) Rules, 2021","section":"Rule 4","url":"https://indiainsurances.com/law/consumer-jurisdiction-rules-2021"},{"title":"Consumer Protection (Jurisdiction of the District Commission, the State Commission and the National Commission) Rules, 2021","section":"Rule 5","url":"https://indiainsurances.com/law/consumer-jurisdiction-rules-2021"},{"title":"The Consumer Protection Act, 2019","section":"Section 2(11)","url":"https://indiainsurances.com/law/consumer-protection-act-2019"},{"title":"The Consumer Protection Act, 2019","section":"Section 2(42)","url":"https://indiainsurances.com/law/consumer-protection-act-2019"},{"title":"The Consumer Protection Act, 2019","section":"Section 34","url":"https://indiainsurances.com/law/consumer-protection-act-2019"},{"title":"The Consumer Protection Act, 2019","section":"Section 69","url":"https://indiainsurances.com/law/consumer-protection-act-2019"},{"title":"The Insurance Act, 1938","section":"Section 38","url":"https://indiainsurances.com/law/insurance-act-1938"},{"title":"Master Circular on General Insurance Business, 2024","section":"Ch I, Para 12","url":"https://indiainsurances.com/law/irdai-general-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 19","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 20","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Life Insurance Products, 2024","section":"Chapter 1, Para 13","url":"https://indiainsurances.com/law/irdai-life-products-2024"},{"title":"Master Circular on Life Insurance Products, 2024","section":"Chapter 1, Para 2","url":"https://indiainsurances.com/law/irdai-life-products-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 5(5), 5(6)","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 5(9)","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 25","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, VI.1","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, VI.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, VI.3","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Para 26","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 11","url":"https://indiainsurances.com/law/irdai-products-regs-2024"},{"title":"Review of revision in premium rates under health insurance policies for senior citizens, 2025","section":"Para 3","url":"https://indiainsurances.com/law/irdai-senior-premium-2025"},{"title":"Insurance Ombudsman Rules, 2017","section":"Rule 13","url":"https://indiainsurances.com/law/ombudsman-rules-2017"},{"title":"Insurance Ombudsman Rules, 2017","section":"Rule 14","url":"https://indiainsurances.com/law/ombudsman-rules-2017"}]},{"key":"sum_insured_options","label":"Sum insured options","section":"Cover","meaning":"The cover amounts you can choose from.","status":"quote-verified","value":"Sum Insured options are 3 Lakhs, 5 Lakhs, 10 Lakhs, 15 Lakhs, 25 Lakhs, 50 Lakhs, 1 Crore, 1.5 Crores, 2.5 Crores, 5 Crores, 10 Crores and Unlimited; the prospectus benefit table also lists 20Lakhs.","display":"3 Lakhs, 5 Lakhs, 10 Lakhs, 15 Lakhs, 25 Lakhs, 50 Lakhs, 1 Crore, 1.5 Crores, 2.5 Crores, 5 Crores, 10 Crores, Unlimited","note":"The prospectus table additionally shows 20Lakhs.","quote":"Sum Insured options 3 Lakhs, 5 Lakhs, 10 Lakhs, 15 Lakhs, 25 Lakhs, 50 Lakhs, 1 Crore,1.5 Crores, 2.5 Crores, 5 Crores, 10 Crores, Unlimited. ... Base Sum Insured | Base Sum Insured | 3Lakhs / 5Lakhs / 10Lakhs / 15Lakhs / 20Lakhs /\n25Lakhs / 50Lakhs / 1cr / 1.5cr / 2.5cr / 5cr / 10cr / Unlimited","sources":[{"clause":"8","heading":null,"page":1,"url":"https://indiainsurances.com/policy/acko-general-insurance/acko-health-iii-ackhlip27040v012627/document/1442#c-8"},{"clause":null,"heading":"8.4. Escalation – Chief Grievance Officer","page":16,"url":"https://indiainsurances.com/policy/acko-general-insurance/acko-health-iii-ackhlip27040v012627/document/1442#c-8-4-escalation-chief-grievance-officer"}],"law":[]},{"key":"initial_waiting","label":"Initial waiting period","section":"Waiting periods","meaning":"Days from the start of the first policy during which illness claims are not paid (accidents usually are).","status":"quote-verified","value":{"unit":"days","amount":30},"display":"30 days","note":"Platinum and Platinum Super Top-up wordings mark the 30-day waiting period as not applicable for that plan; an Initial 30 Days Waiting Period Waiver can also be opted.","quote":"3.1.3. 30-day waiting period ... • Expenses for treatment of any illness within 30 days from first policy commencement excluded, except accidents.","sources":[{"clause":null,"heading":"3.1.3. 30-day waiting period","page":9,"url":"https://indiainsurances.com/policy/acko-general-insurance/acko-health-iii-ackhlip27040v012627/document/1440#c-3-1-3-30-day-waiting-period"}],"law":[]},{"key":"ped_waiting","label":"Pre-existing disease waiting period","section":"Waiting periods","meaning":"How long you wait before conditions you already had when you bought the policy are covered. The law caps it at 36 months.","status":"not-stated","value":null,"display":null,"note":"The wording states the PED waiting period is the number of months specified in the Policy Schedule, but no product-level number is printed.","quote":null,"sources":[],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 8","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 12","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 1.6","url":"https://indiainsurances.com/law/irdai-products-regs-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 7","url":"https://indiainsurances.com/law/irdai-products-regs-2024"}]},{"key":"specific_waiting","label":"Specific illness waiting period","section":"Waiting periods","meaning":"Waiting period for a list of named illnesses and procedures (cataract, hernia, joint replacement...). With several tiers (24 and 36 months), the shortest in the answer, the others in the note.","status":"not-stated","value":null,"display":null,"note":"The wording states specified diseases/procedures are excluded until the waiting period in months as per Schedule. The prospectus lists reduction options of 1 Year/ 2 Year and the plan chart shows 2 years for some plans, but no single standard waiting period is printed.","quote":null,"sources":[],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 12","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 1.7","url":"https://indiainsurances.com/law/irdai-products-regs-2024"}]},{"key":"specific_waiting_list","label":"Illnesses with a specific waiting period","section":"Waiting periods","meaning":"The named illnesses and procedures that carry the specific waiting period.","status":"quote-verified","value":["Eyes: Cataract, Glaucoma, disorders of lens, disorders of retina","Stone: Pancreatitis and stones in biliary and urinary system","Genitourinary: Abnormal utero-vaginal bleeding, female genital prolapse, endometriosis/adenomyosis, fibroids, PCOD, dilation & curettage or hysterectomy conditions, any surgery of genitourinary system unless necessitated by malignancy","Cysts/Tumor: All benign or in situ neoplasms/tumors, cyst, sinus, polyp, nodules, swelling, mass or lump","Hyperplasia of prostate, hydrocele, varicocele, spermatocele","Rectal: Hemorrhoids, fissure/fistula/abscess of anal/rectal region, pilonidal sinus, rectal prolapse","Hernia: Hernia of all sites","Arthritis: Osteoarthritis, systemic connective tissue disorders, dorsopathies, spondylopathies, inflammatory polyarthritis, arthrosis incl. rheumatoid arthritis, gout, intervertebral disc disorders, joint replacement","Kidney: Chronic kidney disease and failure","Varicose veins of lower extremities","ENT: Middle ear & mastoid disease incl. otitis media, cholesteatoma, tympanic membrane perforation, tonsils & adenoids, nasal septum, nasal sinuses/polyp","Internal congenital anomaly","Gastrointestinal: Gastritis, GERD, ulcer, erosion, varices of upper GI tract","Ligament, tendon & meniscal tear","Neurodegenerative disorders: Parkinson’s, Alzheimer’s, dementia etc.","Any other conditions mentioned in Schedule under this head"],"display":"Cataract/glaucoma, stones, genitourinary conditions, benign tumours/cysts, prostate/hydrocele/varicocele, rectal conditions, hernia, arthritis/joint replacement, kidney disease, varicose veins, ENT conditions, internal congenital anomaly, GI conditions, ligament/tendon/meniscal tear, neurodegenerative disorders and schedule-listed conditions","note":null,"quote":"List of specified diseases/procedures (as per policy):\n• Eyes: Cataract, Glaucoma, disorders of lens, disorders of retina\n• Stone: Pancreatitis and stones in biliary and urinary system\n• Genitourinary: | Abnormal | utero-vaginal | bleeding, | female | genital | prolapse,\nendometriosis/adenomyosis, fibroids, PCOD, dilation & curettage or hysterectomy conditions, any surgery of genitourinary system unless necessitated by malignancy\n• Cysts/Tumor: All benign or in situ neoplasms/tumors, cyst, sinus, polyp, nodules, swelling, mass or lump\n• Hyperplasia of prostate, hydrocele, varicocele, spermatocele\n• Rectal: Hemorrhoids, fissure/fistula/abscess of anal/rectal region, pilonidal sinus, rectal prolapse\n• Hernia: Hernia of all sites\n• Arthritis: Osteoarthritis, systemic connective tissue disorders, dorsopathies, spondylopathies, inflammatory polyarthritis, arthrosis incl. rheumatoid arthritis, gout, intervertebral disc disorders, joint replacement\n• Kidney: Chronic kidney disease and failure\n• Varicose veins of lower extremities\n• ENT: Middle ear & mastoid disease incl. otitis media, cholesteatoma, tympanic membrane perforation, tonsils & adenoids, nasal septum, nasal sinuses/polyp\n• Internal congenital anomaly\n• Gastrointestinal: Gastritis, GERD, ulcer, erosion, varices of upper GI tract\n• Ligament, tendon & meniscal tear\n• Neurodegenerative disorders: Parkinson’s, Alzheimer’s, dementia etc.\n• Any other conditions mentioned in Schedule under this head","sources":[{"clause":null,"heading":"3.1.2. Specified disease/procedure waiting period","page":8,"url":"https://indiainsurances.com/policy/acko-general-insurance/acko-health-iii-ackhlip27040v012627/document/1440#c-3-1-2-specified-disease-procedure-waiting-period"}],"law":[]},{"key":"moratorium","label":"Moratorium period","section":"Renewal and rights","meaning":"After this many months of continuous cover, the insurer cannot reject a claim for non-disclosure, except for proven fraud or permanent exclusions. The law sets 60 months.","status":"quote-verified","value":{"unit":"months","amount":60},"display":"60 continuous months (5 continuous years)","note":"For enhanced SI, 60 months applies from enhancement date for enhanced portion; limits, sub-limits, co-pay and deductibles still apply.","quote":"After 60 continuous months (5 continuous years) of coverage (including portability and migration):\n• No policy/claim contestable on grounds of non-disclosure/misrepresentation, except established fraud.","sources":[{"clause":null,"heading":"4.18. Moratorium period","page":13,"url":"https://indiainsurances.com/policy/acko-general-insurance/acko-health-iii-ackhlip27040v012627/document/1440#c-4-18-moratorium-period"}],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 13","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, IV.8","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 8","url":"https://indiainsurances.com/law/irdai-products-regs-2024"}]},{"key":"portability","label":"Portability","section":"Renewal and rights","meaning":"Whether you can move this policy to another insurer and keep waiting-period credit.","status":"quote-verified","value":"You may port to other insurers as per IRDAI guidelines, with waiting periods for PED, specified disease and 30-day waiting reduced by the number of continuous preceding years of coverage.","display":"Portability allowed; waiting periods reduced by continuous preceding years of coverage","note":"Application must reach at least 30 days before, but not earlier than 60 days from renewal due date; the company can consider proposals within 15 days from renewal date if there is no break.","quote":"You may port to other insurers as per IRDAI guidelines:\n• Waiting periods (PED, specified disease, 30-day) reduced by number of continuous preceding years of coverage.","sources":[{"clause":null,"heading":"4.16. Portability","page":13,"url":"https://indiainsurances.com/policy/acko-general-insurance/acko-health-iii-ackhlip27040v012627/document/1440#c-4-16-portability"}],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 11","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 12","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, IV.6","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, VII.3","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Para 24","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 1.4 and 1.5","url":"https://indiainsurances.com/law/irdai-products-regs-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 10","url":"https://indiainsurances.com/law/irdai-products-regs-2024"}]},{"key":"lifelong_renewal","label":"Lifelong renewal","section":"Renewal and rights","meaning":"Whether the policy can be renewed for life without a maximum age.","status":"quote-verified","value":true,"display":"Yes, no maximum cover ceasing age","note":null,"quote":"There is no maximum cover ceasing age. ... Policy is ordinarily renewable except on grounds such as established fraud, non-disclosure,\nmisrepresentation | (and | subject | to | product | not | being | withdrawn).\nRenewal | cannot | be | denied | because | you | made | a | claim.","sources":[{"clause":"5","heading":null,"page":1,"url":"https://indiainsurances.com/policy/acko-general-insurance/acko-health-iii-ackhlip27040v012627/document/1442#c-5"},{"clause":null,"heading":"4.14. Renewal","page":13,"url":"https://indiainsurances.com/policy/acko-general-insurance/acko-health-iii-ackhlip27040v012627/document/1440#c-4-14-renewal"}],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 10","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch II D.II","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, IV.5","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 9","url":"https://indiainsurances.com/law/irdai-products-regs-2024"},{"title":"Review of revision in premium rates under health insurance policies for senior citizens, 2025","section":"Para 7","url":"https://indiainsurances.com/law/irdai-senior-premium-2025"}]},{"key":"claim_loading","label":"Premium loading after claims","section":"Renewal and rights","meaning":"Whether the premium can go up at renewal because you made a claim.","status":"quote-verified","value":"The policy says ACKO will not apply premium loadings based on individual claim experience.","display":"No loading based on individual claim experience","note":null,"quote":"Based on health status and declarations at enrollment stage, we may apply a risk loading on premium (excluding taxes/levies) or impose special conditions like waiting periods or exclusions. These can apply from the first policy start date and continue on renewals. We will not apply loadings based on individual claim experience.","sources":[{"clause":null,"heading":"4.12. Underwriting loadings & conditions","page":12,"url":"https://indiainsurances.com/policy/acko-general-insurance/acko-health-iii-ackhlip27040v012627/document/1440#c-4-12-underwriting-loadings-conditions"}],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 10","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, IV.5","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 9","url":"https://indiainsurances.com/law/irdai-products-regs-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 4","url":"https://indiainsurances.com/law/irdai-products-regs-2024"},{"title":"Review of revision in premium rates under health insurance policies for senior citizens, 2025","section":"Para 7","url":"https://indiainsurances.com/law/irdai-senior-premium-2025"}]},{"key":"permanent_exclusions","label":"Permanent exclusions","section":"Exclusions","meaning":"Conditions or treatments that are never covered: the standard IRDAI exclusion codes Excl04 to Excl18 and the product's own permanent exclusions. Excl01 to Excl03 are waiting periods, not permanent exclusions.","status":"quote-verified","value":["Treatment outside India","OPD consultations/diagnostics/pharmacy/procedure","self-harm/attempted suicide","dental treatment","circumcision","prosthetics/devices not implanted internally by surgery","war/war-like situations, rebellion, revolution, terrorism, nuclear/biological/chemical emissions","hormonal therapies","substance abuse/addictions, withdrawal and de-addiction, oral/oropharynx/respiratory cancer excluded in tobacco user","sleep disorders","Venereal/sexually transmitted diseases except HIV.","Hazardous/adventure sports as a professional","External congenital anomaly/defects","analysis/adjustment of spinal subluxation; manipulation of skeletal structure","muscle stimulation except for fractures (excluding hairline) and dislocations of mandible/extremities"],"display":"Treatment outside India, OPD, self-harm, dental treatment, circumcision, external prosthetics/devices, war/terrorism/nuclear risks, hormonal therapies, substance abuse, sleep disorders, venereal/STDs except HIV, professional hazardous sports, external congenital anomalies and listed spinal/muscle-stimulation treatments","note":null,"quote":"• Treatment outside India; if Worldwide In-Patient Hospitalization cover is available in your policy schedule, this exclusion shall be waived off.\n• OPD consultations/diagnostics/pharmacy/procedure, unless covered by OPD add-on cover opted or as part of Pre/Post hospitalization of admitted in-patient/day care claim.\n• self-harm/attempted suicide\n• dental treatment (unless due to accident and forming part of in-patient or pre/post)\n• circumcision unless necessitated by illness/injury\n• prosthetics/devices not implanted internally by surgery\n• war/war-like situations, rebellion, revolution, terrorism, nuclear/biological/chemical emissions\n• hormonal therapies (growth hormone, HRT, hormonal medication)\n• substance abuse/addictions, withdrawal and de-addiction, oral/oropharynx/respiratory cancer excluded in tobacco user\n• sleep disorders (sleep apnea, snoring etc.)\n• Venereal/sexually transmitted diseases except HIV.\n• Hazardous/adventure sports as a professional (para-jumping, rock climbing, mountaineering, rafting, motor/horse racing, scuba, hand gliding, sky diving, deep-sea diving etc.)\n• External congenital anomaly/defects\n• Specific treatments:\n• analysis/adjustment of spinal subluxation; manipulation of skeletal structure\n• muscle stimulation except for fractures (excluding hairline) and dislocations of mandible/extremities.","sources":[{"clause":null,"heading":"3.2. Specific Exclusions 3.2.1. Permanent Exclusions","page":10,"url":"https://indiainsurances.com/policy/acko-general-insurance/acko-health-iii-ackhlip27040v012627/document/1440#c-3-2-specific-exclusions-3-2-1-permanent-exclusio"}],"law":[{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Para 16","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"}]},{"key":"cancellation_refund","label":"Cancellation by you","section":"Renewal and rights","meaning":"What you get back if you cancel during the year.","status":"quote-verified","value":"You may cancel with 7 days’ written notice; refund is proportionate premium for the unexpired period. No refund is paid if any claim is admitted or lodged or any benefit has been availed.","display":"Proportionate premium for unexpired period after 7 days’ written notice; no refund if any claim admitted/lodged or benefit availed","note":null,"quote":"• You may request to cancel your policy with 7 days’ written notice → refund of proportionate premium for unexpired period be made. No refund if any claim admitted/lodged or any benefit availed.","sources":[{"clause":null,"heading":"4.19. Cancellation","page":13,"url":"https://indiainsurances.com/policy/acko-general-insurance/acko-health-iii-ackhlip27040v012627/document/1440#c-4-19-cancellation"}],"law":[{"title":"The Insurance Act, 1938","section":"Section 64VB","url":"https://indiainsurances.com/law/insurance-act-1938"},{"title":"Master Circular on General Insurance Business, 2024","section":"Ch I, Para 8","url":"https://indiainsurances.com/law/irdai-general-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 6","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Life Insurance Products, 2024","section":"Chapter 1, Para 5","url":"https://indiainsurances.com/law/irdai-life-products-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 17","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 20(3) to 20(5)","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, III.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, IV.4","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part C, IV.3","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"}]},{"key":"territory","label":"Where it covers","section":"Overview","meaning":"Geographic area of cover: India only, worldwide, or listed countries. 'As stated in the schedule' is not an answer.","status":"quote-verified","value":"Cover is India-only unless the Worldwide In-Patient Hospitalization cover is opted and shown in the schedule. Domestic emergency evacuation is within India only.","display":"India only, unless Worldwide In-Patient Hospitalization is opted","note":null,"quote":"• Treatment outside India; if Worldwide In-Patient Hospitalization cover is available in your policy schedule, this exclusion shall be waived off. ... If opted, this benefit extends your in-patient hospitalization cover outside India. ... • Territory: within India only.","sources":[{"clause":null,"heading":"3.2. Specific Exclusions 3.2.1. Permanent Exclusions","page":10,"url":"https://indiainsurances.com/policy/acko-general-insurance/acko-health-iii-ackhlip27040v012627/document/1440#c-3-2-specific-exclusions-3-2-1-permanent-exclusio"},{"clause":"2.12.7","heading":"Worldwide In-Patient Hospitalization- Part of base SI","page":5,"url":"https://indiainsurances.com/policy/acko-general-insurance/acko-health-iii-ackhlip27040v012627/document/1440#c-2-12-7"},{"clause":"2.6","heading":"Domestic Emergency Evacuation Limit (India)- Part of base SI","page":2,"url":"https://indiainsurances.com/policy/acko-general-insurance/acko-health-iii-ackhlip27040v012627/document/1440#c-2-6"}],"law":[]},{"key":"free_look","label":"Free-look period","section":"Renewal and rights","meaning":"Days after you receive the policy in which you can return it for a refund if you do not agree with its terms.","status":"quote-verified","value":{"unit":"days","amount":30},"display":"30 days","note":null,"quote":"• 30 days from date of receipt of policy to review the terms and conditions of the Policy, and to return the same if not acceptable (only at inception, not renewals/porting).","sources":[{"clause":null,"heading":"4.15. Free look period","page":13,"url":"https://indiainsurances.com/policy/acko-general-insurance/acko-health-iii-ackhlip27040v012627/document/1440#c-4-15-free-look-period"}],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 5","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Life Insurance Products, 2024","section":"Chapter 1, Para 5","url":"https://indiainsurances.com/law/irdai-life-products-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 20(1), 20(2)","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 20(3) to 20(5)","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 20(6)","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, II.8","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, III.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, III.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"}]},{"key":"grace_period","label":"Grace period","section":"Renewal and rights","meaning":"Days you get after the due date to pay without losing cover or continuity.","status":"quote-verified","value":{"unit":"days","amount":30},"display":"30 days for renewal; 15 days for monthly instalments and 30 days for quarterly/half-yearly/annual instalments","note":"Norm uses the renewal grace period.","quote":"• 15 days grace for monthly instalments\n• 30 days grace for quarterly/half-yearly/annual instalments ... • For renewal:\n• 30 days grace period to renew and maintain continuity.","sources":[{"clause":null,"heading":"4.6. Grace period (renewal + instalments)","page":11,"url":"https://indiainsurances.com/policy/acko-general-insurance/acko-health-iii-ackhlip27040v012627/document/1440#c-4-6-grace-period-renewal-instalments"}],"law":[{"title":"The Insurance Act, 1938","section":"Section 50","url":"https://indiainsurances.com/law/insurance-act-1938"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 8","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 9","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Life Insurance Products, 2024","section":"Chapter 1, Para 8","url":"https://indiainsurances.com/law/irdai-life-products-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, IV.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, IV.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Para 3","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule I, Para 1.2","url":"https://indiainsurances.com/law/irdai-products-regs-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 1.3","url":"https://indiainsurances.com/law/irdai-products-regs-2024"}]},{"key":"eligibility_entry_age","label":"Entry age","section":"Eligibility","meaning":"The youngest and oldest age at which you can buy this policy.","status":"quote-verified","value":"Entry age starts at 91 days onwards, and there is no maximum entry age restriction. The maximum entry age for a dependent child is 24 years.","display":"91 days onwards; no maximum entry age restriction","note":null,"quote":"This Policy covers persons in the age group of 91 days onwards ... There is no maximum entry age restriction ... The maximum entry age for a dependent child is 24 years.","sources":[{"clause":"1","heading":"This Policy covers persons in the age group of 91 days onwards","page":1,"url":"https://indiainsurances.com/policy/acko-general-insurance/acko-health-iii-ackhlip27040v012627/document/1442#c-1"},{"clause":"2","heading":"There is no maximum entry age restriction","page":1,"url":"https://indiainsurances.com/policy/acko-general-insurance/acko-health-iii-ackhlip27040v012627/document/1442#c-2"},{"clause":"4","heading":null,"page":1,"url":"https://indiainsurances.com/policy/acko-general-insurance/acko-health-iii-ackhlip27040v012627/document/1442#c-4"}],"law":[]},{"key":"premium_modes","label":"Premium payment options","section":"Premium","meaning":"How often you can pay: yearly, half-yearly, quarterly, monthly.","status":"quote-verified","value":["Monthly","Quarterly","Half Yearly","Single payment"],"display":"For 1 Year Policy: Monthly / Quarterly / Half Yearly / Single payment; for 2 Years or 3 Years Policy: Single payment","note":null,"quote":"Frequency of payment: For 1 Year Policy- Monthly / Quarterly / Half Yearly / Single payment; For 2 Years or 3 Years Policy- Single payment","sources":[{"clause":null,"heading":"2.3. Premium Payment Option","page":1,"url":"https://indiainsurances.com/policy/acko-general-insurance/acko-health-iii-ackhlip27040v012627/document/1442#c-2-3-premium-payment-option"}],"law":[]},{"key":"optional_covers","label":"Optional covers","section":"Cover","meaning":"Covers you can add for an extra premium. They change the answers above only if you buy them.","status":"not-stated","value":null,"display":null,"note":null,"quote":null,"sources":[],"law":[]},{"key":"grace_cover","label":"Cover during the grace period","section":"Renewal and rights","meaning":"Whether a claim during the grace period is paid.","status":"quote-verified","value":"Coverage continues during the grace period for instalment premium payments, but there is no liability for claims arising from insured events during the renewal grace period.","display":"Covered during instalment grace period; not covered for insured events during renewal grace period","note":null,"quote":"• Coverage continues during the grace period for installment payments. ... • No liability for claims arising out of any insured event that occurred during the grace period.","sources":[{"clause":null,"heading":"4.6. Grace period (renewal + instalments)","page":11,"url":"https://indiainsurances.com/policy/acko-general-insurance/acko-health-iii-ackhlip27040v012627/document/1440#c-4-6-grace-period-renewal-instalments"}],"law":[]},{"key":"room_rent","label":"Room rent limit","section":"Limits and co-pay","meaning":"The most the policy pays per day for the hospital room, or the room category allowed. If you take a costlier room, other bills can be cut in proportion.","status":"quote-verified","value":"Platinum, Platinum Lite and Platinum Super Top-up say actual room rent and ICU charges are covered without capping. The general wording says room rent and ICU charges are for the room category specified in the schedule, and the prospectus plan table shows Room Rent/ ICU up to SI.","display":"Up to SI / no capping, subject to plan and schedule","note":"Room limit varies by variant and schedule.","quote":"We cover room rent and ICU charges for the room category as specified in the schedule. ... We cover actual room rent and ICU charges without any capping. ... Room Rent/ ICU | Up to SI | Up to SI | Up to SI | Up to SI | Up to SI | Up to SI","sources":[{"clause":"2.2","heading":"Room Rent / ICU- Part of base SI","page":1,"url":"https://indiainsurances.com/policy/acko-general-insurance/acko-health-iii-ackhlip27040v012627/document/1440#c-2-2"},{"clause":"2.2","heading":"Room Rent / ICU- Part of base SI","page":1,"url":"https://indiainsurances.com/policy/acko-general-insurance/acko-health-iii-ackhlip27040v012627/document/1444#c-2-2"},{"clause":null,"heading":"Basic Benefits","page":21,"url":"https://indiainsurances.com/policy/acko-general-insurance/acko-health-iii-ackhlip27040v012627/document/1442#c-basic-benefits"}],"law":[]},{"key":"room_category","label":"Room category allowed","section":"Limits and co-pay","meaning":"Shared room, single private room or any room, by plan, when the limit is a room type rather than a rupee amount.","status":"quote-verified","value":"The prospectus benefit table lists room category options as General Ward, Shared Room, Single AC Room and Up to SI.","display":"General Ward / Shared Room / Single AC Room / Up to SI","note":"The general wording says the applicable room category is as specified in the schedule.","quote":"Room Rent/ ICU | Room Rent/ ICU | Room Category: General Ward / Shared Room /\nSingle AC Room / Up to SI","sources":[{"clause":null,"heading":"8.4. Escalation – Chief Grievance Officer","page":16,"url":"https://indiainsurances.com/policy/acko-general-insurance/acko-health-iii-ackhlip27040v012627/document/1442#c-8-4-escalation-chief-grievance-officer"}],"law":[]},{"key":"icu_limit","label":"ICU limit","section":"Limits and co-pay","meaning":"The most the policy pays per day for intensive care.","status":"quote-verified","value":"Platinum, Platinum Lite and Platinum Super Top-up say actual ICU charges are covered without capping. The general wording says ICU charges are for the room category specified in the schedule, and the prospectus plan table shows Room Rent/ ICU up to SI.","display":"Up to SI / no capping, subject to plan and schedule","note":"ICU limit varies by variant and schedule.","quote":"We cover room rent and ICU charges for the room category as specified in the schedule. ... We cover actual room rent and ICU charges without any capping. ... Room Rent/ ICU | Up to SI | Up to SI | Up to SI | Up to SI | Up to SI | Up to SI","sources":[{"clause":"2.2","heading":"Room Rent / ICU- Part of base SI","page":1,"url":"https://indiainsurances.com/policy/acko-general-insurance/acko-health-iii-ackhlip27040v012627/document/1440#c-2-2"},{"clause":"2.2","heading":"Room Rent / ICU- Part of base SI","page":1,"url":"https://indiainsurances.com/policy/acko-general-insurance/acko-health-iii-ackhlip27040v012627/document/1444#c-2-2"},{"clause":null,"heading":"Basic Benefits","page":21,"url":"https://indiainsurances.com/policy/acko-general-insurance/acko-health-iii-ackhlip27040v012627/document/1442#c-basic-benefits"}],"law":[]},{"key":"proportionate_deduction","label":"Proportionate deduction","section":"Limits and co-pay","meaning":"If you choose a room above your limit, whether the insurer reduces associated charges (doctor fees, tests, procedures) by the same proportion.","status":"not-stated","value":null,"display":null,"note":"No clause states that associated charges are reduced proportionately when a higher room category is chosen.","quote":null,"sources":[],"law":[]},{"key":"copay","label":"Co-payment","section":"Limits and co-pay","meaning":"The share of every admissible claim you pay yourself, and when it applies (age, zone, choice of hospital).","status":"quote-verified","value":"Co-pay is an optional premium-discount feature where the insured bears a fixed percentage of every admissible claim. The prospectus lists compulsory co-pay options of 5%, 10%, 15%, 20%, 25%, 30%, 40% and 50%, and FNOC/PPN co-pay options of 10%, 15% and 20% if those options are chosen and conditions are not met.","display":"None unless opted; optional compulsory co-pay 5% to 50%; FNOC/PPN 10%, 15% or 20% if opted and condition not met","note":"Co-pay applies only if selected in the schedule or triggered by optional FNOC/PPN conditions.","quote":"If opted, insured agrees to bear a fixed percentage of every admissible claim. Key Rules:\n• Percentage as per Schedule.\n• Applies on final admissible amount after assessment.\n• Does not reduce Sum Insured.\n• Premium discount applicable. ... Co-pay | Co-pay | Compulsory Co-pay: 5% / 10% / 15%/ 20% / 25% /\n30%/40%/50% ... First Notification of Claim (FNOC) | Compulsory Co-pay if no FNOC: 10% / 15% / 20%\nPreferred Providers Network | Compulsory Co-pay If no PPN: 10% / 15% /20%","sources":[{"clause":"2.12.14","heading":"Co-pay","page":6,"url":"https://indiainsurances.com/policy/acko-general-insurance/acko-health-iii-ackhlip27040v012627/document/1440#c-2-12-14"},{"clause":null,"heading":"8.4. Escalation – Chief Grievance Officer","page":16,"url":"https://indiainsurances.com/policy/acko-general-insurance/acko-health-iii-ackhlip27040v012627/document/1442#c-8-4-escalation-chief-grievance-officer"}],"law":[]},{"key":"deductible","label":"Deductible","section":"Limits and co-pay","meaning":"An amount of each claim or each year that you bear before the policy pays.","status":"quote-verified","value":"Deductible options include floater deductible and individual deductible. The prospectus lists Individual Deductible and Floater Deductible in the range of 0.5 Lakhs to 25Lakhs; each applies to cumulative admissible claims during a policy year and the insurer pays only the amount exceeding the deductible.","display":"Optional individual or floater deductible: 0.5 Lakhs to 25Lakhs","note":"Deductible availability depends on plan and schedule.","quote":"We indemnify medical expenses exceeding the Annual Aggregate Deductible during a Policy Year. Key Rules:\n• Deductible applies on cumulative admissible claims.\n• We pay only the amount exceeding deductible. ... We indemnify medical expenses from individual member in the policy exceeding the deductible during a Policy Year. Key Rules:\n• Deductible applies on cumulative admissible claims from individual member.\n• We pay only the amount exceeding deductible. ... Individual Deductible | In the range: 0.5 Lakhs to 25Lakhs\nFloater Deductible | In the range: 0.5 Lakhs to 25Lakhs","sources":[{"clause":"2.12.15","heading":"Floater Deductible","page":6,"url":"https://indiainsurances.com/policy/acko-general-insurance/acko-health-iii-ackhlip27040v012627/document/1440#c-2-12-15"},{"clause":"2.12.16","heading":"Individual Deductible","page":6,"url":"https://indiainsurances.com/policy/acko-general-insurance/acko-health-iii-ackhlip27040v012627/document/1440#c-2-12-16"},{"clause":null,"heading":"8.4. Escalation – Chief Grievance Officer","page":16,"url":"https://indiainsurances.com/policy/acko-general-insurance/acko-health-iii-ackhlip27040v012627/document/1442#c-8-4-escalation-chief-grievance-officer"}],"law":[]},{"key":"disease_sublimits","label":"Disease or procedure sub-limits","section":"Limits and co-pay","meaning":"Caps on what is paid for named treatments (cataract, knee replacement...), even if the sum insured is higher.","status":"not-stated","value":null,"display":null,"note":"The documents say sub-limits or medical-condition sublimits may be as specified in the schedule, but no product-level disease/procedure cap is printed.","quote":null,"sources":[],"law":[]},{"key":"pre_hospitalisation","label":"Pre-hospitalisation cover","section":"Cover","meaning":"Medical costs in the days before admission that are paid if related to the hospitalisation.","status":"quote-verified","value":{"unit":"days","amount":60},"display":"60 days","note":"The prospectus feature table also lists Pre: 30, 60, 90 Days as options.","quote":"Pre and Post | 60/180 days | 60/180 days | 60/180 days | 60/180 days | 60/180 days | 60/180 days\nHospitalization Medical | 60/180 days","sources":[{"clause":null,"heading":"Basic Benefits","page":21,"url":"https://indiainsurances.com/policy/acko-general-insurance/acko-health-iii-ackhlip27040v012627/document/1442#c-basic-benefits"}],"law":[]},{"key":"post_hospitalisation","label":"Post-hospitalisation cover","section":"Cover","meaning":"Medical costs in the days after discharge that are paid if related to the hospitalisation.","status":"quote-verified","value":{"unit":"days","amount":180},"display":"180 days","note":"The prospectus feature table also lists Post: 60, 90, 120, 180 Days as options.","quote":"Pre and Post | 60/180 days | 60/180 days | 60/180 days | 60/180 days | 60/180 days | 60/180 days\nHospitalization Medical | 60/180 days","sources":[{"clause":null,"heading":"Basic Benefits","page":21,"url":"https://indiainsurances.com/policy/acko-general-insurance/acko-health-iii-ackhlip27040v012627/document/1442#c-basic-benefits"}],"law":[]},{"key":"day_care","label":"Day-care treatments","section":"Cover","meaning":"Treatments needing less than 24 hours in hospital (chemotherapy, dialysis, cataract) and whether all or only listed ones are covered.","status":"quote-verified","value":"Day Care Treatment, including AYUSH treatment, is covered in a Hospital, Nursing Home or Day Care Centre. OPD treatments are outside the coverage, and the list of day-care procedures is hosted on ACKO’s website.","display":"Covered, including AYUSH day care; OPD excluded; list hosted on website","note":null,"quote":"If any insured under this policy undergoes Day Care Treatment (including AYUSH treatment) in a Hospital/Nursing Home/Day Care Centre, we cover the expenses. OPD treatments are out of scope of coverage.\n• List of day care procedures is hosted on our website at https://ackocms.ackoassets.com/Acko_Day_Care_List_2d5b412dbf.pdf","sources":[{"clause":"2.3","heading":"Day Care Treatment- Part of base SI","page":1,"url":"https://indiainsurances.com/policy/acko-general-insurance/acko-health-iii-ackhlip27040v012627/document/1440#c-2-3"}],"law":[]},{"key":"domiciliary","label":"Treatment at home","section":"Cover","meaning":"Whether treatment at home is covered when hospital admission is not possible or a doctor advises it.","status":"quote-verified","value":"Domiciliary hospitalisation is covered when treatment is taken at home due to inability to be moved or non-availability of hospital beds, if it continues for at least 3 consecutive days; if 3 days or more it is covered from day 1, and it is payable only on reimbursement basis.","display":"Covered if home treatment is due to inability to move or non-availability of beds and continues for at least 3 consecutive days","note":"Treating Medical Practitioner must confirm medical necessity in writing; payable on reimbursement basis only.","quote":"We cover costs of such domiciliary hospitalization if anyone insured takes treatment at home (instead of a hospital) due to:\n• Inability to be moved, OR\n• Non-availability of hospital beds.\nConditions:\n• Must continue for at least 3 consecutive days.\n• If 3 days or more→ covered from day 1\n• If less than 3 days → not payable","sources":[{"clause":"2.7","heading":"Domiciliary Treatment (Domiciliary Hospitalization)- Part of base SI","page":2,"url":"https://indiainsurances.com/policy/acko-general-insurance/acko-health-iii-ackhlip27040v012627/document/1440#c-2-7"}],"law":[]},{"key":"ayush","label":"AYUSH treatment","section":"Cover","meaning":"Ayurveda, Yoga, Unani, Siddha and Homeopathy treatment in a recognised hospital, and any limit.","status":"quote-verified","value":"In-patient AYUSH treatment is covered for Ayurveda, Yoga & Naturopathy, Unani, Siddha and Homeopathy at an AYUSH Hospital or healthcare facility.","display":"Covered for in-patient Ayurveda, Yoga & Naturopathy, Unani, Siddha and Homeopathy","note":null,"quote":"We indemnify in-patient medical expenses for AYUSH treatment if anyone insured undergoes medically necessary treatment at an AYUSH Hospital/healthcare facility for:\n• Ayurveda\n• Yoga & Naturopathy\n• Unani\n• Siddha\n• Homeopathy","sources":[{"clause":"2.10","heading":"AYUSH Treatment (In-patient only)- Part of base SI","page":3,"url":"https://indiainsurances.com/policy/acko-general-insurance/acko-health-iii-ackhlip27040v012627/document/1440#c-2-10"}],"law":[{"title":"Guidelines on providing AYUSH coverage in Health Insurance policies, 2024","section":"Para 1","url":"https://indiainsurances.com/law/irdai-ayush-2024"},{"title":"Guidelines on providing AYUSH coverage in Health Insurance policies, 2024","section":"Para 2","url":"https://indiainsurances.com/law/irdai-ayush-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 1","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch II A.I(1)","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 5","url":"https://indiainsurances.com/law/irdai-products-regs-2024"}]},{"key":"modern_treatments","label":"Modern treatments","section":"Cover","meaning":"Robotic surgery, immunotherapy, oral chemotherapy, stem cell therapy and the like, and any cap on them.","status":"quote-verified","value":"Modern treatments are covered for the listed in-patient or day-care procedures, including oral chemotherapy, immunotherapy by monoclonal antibody via IV injection, robotic surgeries, stereotactic radiosurgeries and hematopoietic stem cell therapy for bone marrow transplant for hematological conditions.","display":"Covered for listed procedures including oral chemotherapy, immunotherapy, robotic surgery and listed stem cell therapy","note":null,"quote":"If anyone insured undergoes in-patient or day care treatment for the following procedures, we indemnify medical expenses related to the procedures:\n• Uterine Artery Embolization and HIFU\n• Balloon Sinuplasty\n• Deep Brain Stimulation\n• Oral chemotherapy\n• Immunotherapy (Monoclonal Antibody via IV injection)\n• Intravitreal injections\n• Robotic surgeries\n• Stereotactic radiosurgeries\n• Bronchial Thermoplasty\n• Vaporisation of prostate (Green laser / Holmium laser)\n• IONM (Intra-Operative Neuro Monitoring) when used with surgery warranting it\n• Stem cell therapy: Hematopoietic stem cells for bone marrow transplant for hematological conditions","sources":[{"clause":"2.11","heading":"Modern Treatment- Part of base SI","page":3,"url":"https://indiainsurances.com/policy/acko-general-insurance/acko-health-iii-ackhlip27040v012627/document/1440#c-2-11"}],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 2","url":"https://indiainsurances.com/law/irdai-health-mc-2024"}]},{"key":"organ_donor","label":"Organ donor expenses","section":"Cover","meaning":"Whether the donor's hospital costs for an organ transplant are paid.","status":"quote-verified","value":"Organ donor in-patient hospitalisation expenses for harvesting the organ are covered within the inpatient sum insured of the insured, if the insured’s related in-patient claim is admitted and the transplant is legally compliant and advised in writing.","display":"Covered for donor’s in-patient harvesting expenses within insured’s inpatient sum insured","note":"Donor pre/post-hospitalisation, screening, organ acquisition, transport/preservation and experimental/investigational transplants are not covered.","quote":"If anyone insured requires organ transplant, we cover the organ donor’s in-patient hospitalization expenses for harvesting the organ within the inpatient Sum insured of the insured. Payable only if all the following conditions are met:\n• We admit the insured person’s claim under In-patient Hospitalization (2.1) related to the same illness/injury.","sources":[{"clause":"2.8","heading":"Organ Donor Expenses- Part of base SI","page":2,"url":"https://indiainsurances.com/policy/acko-general-insurance/acko-health-iii-ackhlip27040v012627/document/1440#c-2-8"}],"law":[]},{"key":"ambulance","label":"Ambulance cover","section":"Cover","meaning":"Road (and air) ambulance cover and its limit.","status":"quote-verified","value":"Road ambulance or public transport for emergency transport to a Hospital or Day Care Centre is covered up to the limit specified in the schedule; Platinum variants show up to the sum insured. Domestic emergency evacuation may include ambulance or air ambulance within India.","display":"Road ambulance up to schedule limit or up to sum insured by plan; domestic emergency evacuation may include air ambulance within India","note":null,"quote":"If an insured needs emergency transport to a Hospital/Day Care Centre by ambulance or public transport, we cover the reasonable cost of such transportation up to the limit specified in the schedule. ... If an insured needs emergency transport to a Hospital/Day Care Centre by ambulance or public transport, we cover the reasonable cost of such transportation up to the sum insured. ... Transport modes may include medically equipped specialty aircraft, commercial airline, train, ambulance, or air ambulance.\n• Territory: within India only.","sources":[{"clause":"2.5","heading":"Road Ambulance Limit- Part of base SI","page":1,"url":"https://indiainsurances.com/policy/acko-general-insurance/acko-health-iii-ackhlip27040v012627/document/1440#c-2-5"},{"clause":"2.5","heading":"Road Ambulance Limit- Part of base SI","page":1,"url":"https://indiainsurances.com/policy/acko-general-insurance/acko-health-iii-ackhlip27040v012627/document/1444#c-2-5"},{"clause":"2.6","heading":"Domestic Emergency Evacuation Limit (India)- Part of base SI","page":2,"url":"https://indiainsurances.com/policy/acko-general-insurance/acko-health-iii-ackhlip27040v012627/document/1444#c-2-6"}],"law":[]},{"key":"restoration","label":"Restoration of sum insured","section":"Cover","meaning":"Whether the sum insured is refilled after it is used up in a year, how much, how often, and whether it works for the same illness.","status":"quote-verified","value":"If opted and total sum insured is exhausted in a policy year, the policy automatically restores it. Restoration is not applicable for the first claim, may be for related or unrelated illnesses as specified in the schedule, can be multiple times if specified as unlimited, and is not carried forward if unused.","display":"Optional restore after total Sum Insured is exhausted; related/unrelated and once/unlimited as per schedule","note":"Prospectus options include once for unrelated, once for related and unrelated, unlimited times for unrelated, and unlimited times for related and unrelated.","quote":"If you exhaust your total Sum Insured in a Policy Year, we automatically refill (restore) it. How It Works:\nRestoration happens only:\n• Not applicable for the first claim in the Policy Year.\n• Available for related/unrelated illnesses as specified in Schedule.\n• In individual plans it works per person; in floater plans it works for the whole family. ... • Can restore multiple times if specified as unlimited.","sources":[{"clause":"2.12.11","heading":"Restore Sum Insured","page":6,"url":"https://indiainsurances.com/policy/acko-general-insurance/acko-health-iii-ackhlip27040v012627/document/1440#c-2-12-11"},{"clause":null,"heading":"Key Rules","page":6,"url":"https://indiainsurances.com/policy/acko-general-insurance/acko-health-iii-ackhlip27040v012627/document/1440#c-key-rules"}],"law":[]},{"key":"no_claim_bonus","label":"No-claim or cumulative bonus","section":"Cover","meaning":"How much the cover grows each year, the maximum, whether it depends on not claiming, and what happens after a claim.","status":"quote-verified","value":"Cumulative Bonus and No Claim Bonus Sum Insured are optional. Cumulative Bonus adds a fixed percentage of Base SI every renewal and making a claim does not reduce or stop it; No Claim Bonus Sum Insured adds a fixed percentage in renewal year if no in-patient hospitalisation or day care claim was made in the previous year and cannot exceed Base Sum Insured.","display":"Optional cumulative bonus and no-claim bonus; NCB options 5% to 50%; cumulative bonus options 1X to 10X","note":"Availability and percentages are as per schedule.","quote":"We provide an additional Sum Insured in renewal year as per Schedule. Key rules:\n• Only if policy is active/renewed next year.\n• Fixed percentage of Base SI added every renewal\n• Capped at maximum limit specified in Schedule. ... • Making a claim does not reduce or stop the bonus from accumulating. ... We will provide an additional Sum Insured in renewal year if no claim made in the previous year as per Schedule. Key rules:\n• Only if policy and this cover is active/renewed next year.\n• Fixed percentage of Base SI added every renewal.\n• No Inpatient hospitalization or day care claim in previous year.\n• Cannot exceed Base Sum Insured. ... Cumulative Bonus | 1X/2X/3x/4X/5X/10X\nNo Claim Bonus Sum Insured | 5% / 10% / 15% / 20% / 25% / 50%","sources":[{"clause":"2.12.8","heading":"Cumulative Bonus","page":5,"url":"https://indiainsurances.com/policy/acko-general-insurance/acko-health-iii-ackhlip27040v012627/document/1440#c-2-12-8"},{"clause":"2.12.9","heading":"No Claim bonus Sum Insured","page":5,"url":"https://indiainsurances.com/policy/acko-general-insurance/acko-health-iii-ackhlip27040v012627/document/1440#c-2-12-9"},{"clause":null,"heading":"8.4. Escalation – Chief Grievance Officer","page":16,"url":"https://indiainsurances.com/policy/acko-general-insurance/acko-health-iii-ackhlip27040v012627/document/1442#c-8-4-escalation-chief-grievance-officer"}],"law":[]},{"key":"consumables","label":"Consumables and non-medical items","section":"Cover","meaning":"Gloves, PPE, syringes and other items hospitals bill that standard policies exclude; whether this policy pays them.","status":"quote-verified","value":"The base in-patient cover includes associated medical expenditures such as IV fluids, blood transfusion, surgical appliances used, consumables and enteral feedings. A Waiver of Non-payable Medical Expenses option covers non-payable expenses only if selected and if the related claim is admitted.","display":"Consumables included in in-patient associated medical expenditures; non-payable medical expenses covered if waiver is selected","note":"Waiver of Non-payable Medical Expenses is an optional/basic benefit option depending on plan and schedule.","quote":"• Associated medical expenditures (IV fluids, blood transfusion, surgical appliances used, consumables, enteral feedings) ... We cover the non-payable expenses which are hosted on our website (https://ackocms.ackoassets.com/List_of_Non_Payable_Medical_Expenses_bf94e7b012.pdf ), only if:\n• Expenses are medically necessary, AND\n• We admit the claim for in-patient (2.1) or day care (2.3) or domiciliary treatment (2.7).","sources":[{"clause":"2.1","heading":"In-Patient Hospitalization - Part of base SI","page":1,"url":"https://indiainsurances.com/policy/acko-general-insurance/acko-health-iii-ackhlip27040v012627/document/1440#c-2-1"},{"clause":"2.12.1","heading":"Waiver of Non-payable Medical Expenses","page":3,"url":"https://indiainsurances.com/policy/acko-general-insurance/acko-health-iii-ackhlip27040v012627/document/1440#c-2-12-1"}],"law":[]},{"key":"maternity","label":"Maternity cover","section":"Cover","meaning":"Whether childbirth costs are covered, the limit and the waiting period.","status":"quote-verified","value":"Maternity is excluded, including childbirth, complicated delivery or C-section and pre/post hospitalisation; miscarriage is excluded unless due to accident, and ectopic pregnancy is an exception.","display":"Excluded, except ectopic pregnancy and miscarriage due to accident","note":null,"quote":"Excluded:\n• childbirth (incl. complicated delivery/C-section) and pre/post hospitalization\n• miscarriage (unless due to accident)\n• lawful medical termination of pregnancy Exception: ectopic pregnancy","sources":[{"clause":null,"heading":"3.1.16. Maternity","page":10,"url":"https://indiainsurances.com/policy/acko-general-insurance/acko-health-iii-ackhlip27040v012627/document/1440#c-3-1-16-maternity"}],"law":[]},{"key":"newborn","label":"Newborn baby cover","section":"Cover","meaning":"Whether a newborn is covered from birth and for what.","status":"quote-verified","value":"The policy covers persons from 91 days onwards, and a child above 91 days can be added as per underwriting assessment process. No cover from birth is stated.","display":"Children from 91 days onwards; no newborn-from-birth cover stated","note":null,"quote":"This Policy covers persons in the age group of 91 days onwards ... Child above 91 days will be added in the policy as per underwriting assessment process.","sources":[{"clause":"1","heading":"This Policy covers persons in the age group of 91 days onwards","page":1,"url":"https://indiainsurances.com/policy/acko-general-insurance/acko-health-iii-ackhlip27040v012627/document/1442#c-1"},{"clause":"3","heading":null,"page":1,"url":"https://indiainsurances.com/policy/acko-general-insurance/acko-health-iii-ackhlip27040v012627/document/1442#c-3"}],"law":[]},{"key":"mental_illness","label":"Mental illness","section":"Cover","meaning":"Cover for in-patient treatment of mental illness.","status":"not-stated","value":null,"display":null,"note":"The provided clauses do not specifically state cover for in-patient treatment of mental illness.","quote":null,"sources":[],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 3","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch III I","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"The Mental Healthcare Act, 2017","section":"Section 21(4)","url":"https://indiainsurances.com/law/mental-healthcare-act-2017"},{"title":"The Mental Healthcare Act, 2017","section":"Section 2(1)(s)","url":"https://indiainsurances.com/law/mental-healthcare-act-2017"},{"title":"The Mental Healthcare Act, 2017","section":"Section 21(1)","url":"https://indiainsurances.com/law/mental-healthcare-act-2017"}]},{"key":"health_checkup","label":"Health check-up","section":"Cover","meaning":"Free preventive check-ups and how often.","status":"quote-verified","value":"Preventive Health Check-up is provided for insured persons aged above 18 as per schedule, arranged and paid at network or empaneled service providers; if ACKO cannot provide a network provider, reimbursement may be up to ₹900. The prospectus lists frequency options once in a year, once in two years or once in three years.","display":"Preventive health check-up for insured above 18; once in a year / once in two years / once in three years; reimbursement up to ₹900 if no network provider is available","note":null,"quote":"For insured persons aged above 18, we facilitate and provide tests as per Schedule: ... • Arranged and paid at our Network Providers/Empaneled Service Providers only.\n• If we are not able to provide a network provider for the tests, then we may reimburse at our discretion up to ₹900 only on submission of report + invoice/payment proof. ... Preventive Health Check-up | Preventive Health Check-up | Once in a year/ Once in two years/ Once in three\nyears","sources":[{"clause":"2.12.4","heading":"Preventive Health Check-up - Additional benefit and not part of base SI","page":4,"url":"https://indiainsurances.com/policy/acko-general-insurance/acko-health-iii-ackhlip27040v012627/document/1440#c-2-12-4"},{"clause":null,"heading":"8.4. Escalation – Chief Grievance Officer","page":16,"url":"https://indiainsurances.com/policy/acko-general-insurance/acko-health-iii-ackhlip27040v012627/document/1442#c-8-4-escalation-chief-grievance-officer"}],"law":[]},{"key":"opd","label":"Out-patient (OPD) cover","section":"Cover","meaning":"Doctor consultations, tests and medicines without admission, and the limit.","status":"quote-verified","value":"OPD treatments are out of scope under day-care cover, and OPD consultations, diagnostics, pharmacy and procedures are permanent exclusions unless covered by an OPD add-on or as part of pre/post hospitalisation of an admitted in-patient or day-care claim.","display":"OPD excluded unless OPD add-on is opted or it is covered pre/post hospitalisation for an admitted claim","note":"Second opinion is payable only if consultation is on an OPD basis and the first opinion advises hospitalisation, surgery or day care treatment.","quote":"OPD treatments are out of scope of coverage. ... • OPD consultations/diagnostics/pharmacy/procedure, unless covered by OPD add-on cover opted or as part of Pre/Post hospitalization of admitted in-patient/day care claim.","sources":[{"clause":"2.3","heading":"Day Care Treatment- Part of base SI","page":1,"url":"https://indiainsurances.com/policy/acko-general-insurance/acko-health-iii-ackhlip27040v012627/document/1440#c-2-3"},{"clause":null,"heading":"3.2. Specific Exclusions 3.2.1. Permanent Exclusions","page":10,"url":"https://indiainsurances.com/policy/acko-general-insurance/acko-health-iii-ackhlip27040v012627/document/1440#c-3-2-specific-exclusions-3-2-1-permanent-exclusio"}],"law":[]},{"key":"zone_pricing","label":"Zone or city-based premium","section":"Premium","meaning":"Whether premium or co-pay depends on the city you are treated in.","status":"quote-verified","value":"Premium calculation uses two zones based on city of residence. Zone A includes Delhi/NCR, Mumbai including Navi Mumbai, Thane and Kalyan, Kolkata including Howrah, and certain non-preferred pin codes; Zone B is the rest of India.","display":"Premium is zone-wise: Zone A and Zone B","note":null,"quote":"Zone-wise classification (for premium) For premium calculation, we classify cities of residence into two zones. For family floater policies, one zone applies to all members under the policy.\n• Zone A: Delhi/NCR; Mumbai (including Navi Mumbai, Thane, Kalyan); Kolkata (including Howrah); and certain non-preferred pin codes based on company/industry experience as mentioned in https://acko-cms.ackoassets.com/Annexure_Zone_Classification_d9845ed62d.pdf.\n• Zone B: Rest of India.","sources":[{"clause":null,"heading":"4.11. Geography","page":12,"url":"https://indiainsurances.com/policy/acko-general-insurance/acko-health-iii-ackhlip27040v012627/document/1440#c-4-11-geography"}],"law":[]},{"key":"cashless","label":"Cashless treatment","section":"Claims","meaning":"Whether and where the insurer pays the hospital directly instead of you paying and claiming back.","status":"quote-verified","value":"Cashless claims are available at network providers, where ACKO pays the network hospital directly to the extent authorised. The current network hospital list is available on the website or app.","display":"Cashless at network hospitals; insurer pays hospital directly to the authorised extent","note":null,"quote":"You can submit claims as Cashless (network provider) or Reimbursement (you pay first, we reimburse if the claim is admissible). ... Cashless means we pay the network hospital directly to the extent authorized on your behalf. You would be able to access the as on date network hospital list at our website or App, which would help you decide the nearest facility to use for cashless utilization.","sources":[{"clause":null,"heading":"6. Claim Process","page":14,"url":"https://indiainsurances.com/policy/acko-general-insurance/acko-health-iii-ackhlip27040v012627/document/1440#c-6-claim-process"},{"clause":null,"heading":"6.2. Cashless claims (Network provider)","page":14,"url":"https://indiainsurances.com/policy/acko-general-insurance/acko-health-iii-ackhlip27040v012627/document/1440#c-6-2-cashless-claims-network-provider"}],"law":[]},{"key":"claims_handled_by","label":"Claims handled by","section":"Claims","meaning":"The insurer itself or a third-party administrator (TPA).","status":"quote-verified","value":"Claims are handled by ACKO, with intimation possible through app, email, call center or through TPA at hospital.","display":"ACKO; intimation can also be through TPA at hospital","note":null,"quote":"We check claim forms and documents; deficiencies of information/documents which cannot be procured by us directly from the provider (if any) are communicated. ... • Notify via app/email/call center or through TPA at hospital.","sources":[{"clause":null,"heading":"6.4. Scrutiny, assessment, investigation & timelines","page":16,"url":"https://indiainsurances.com/policy/acko-general-insurance/acko-health-iii-ackhlip27040v012627/document/1440#c-6-4-scrutiny-assessment-investigation-timelines"},{"clause":null,"heading":"6.1. Claim registration / intimation","page":14,"url":"https://indiainsurances.com/policy/acko-general-insurance/acko-health-iii-ackhlip27040v012627/document/1440#c-6-1-claim-registration-intimation"}],"law":[]},{"key":"family_floater","label":"Family floater available","section":"Cover","meaning":"Whether one sum insured can be shared by the whole family.","status":"quote-verified","value":true,"display":"Yes, family floater basis available","note":null,"quote":"This policy can be issued on an individual and/ or a family floater basis. ... Floater: One Sum Insured is shared by all insured persons in the floater unit.","sources":[{"clause":"7","heading":null,"page":1,"url":"https://indiainsurances.com/policy/acko-general-insurance/acko-health-iii-ackhlip27040v012627/document/1442#c-7"},{"clause":null,"heading":"4. What You Need to Know 4.1. Sum Insured basis (Individual vs Floater)","page":11,"url":"https://indiainsurances.com/policy/acko-general-insurance/acko-health-iii-ackhlip27040v012627/document/1440#c-4-what-you-need-to-know-4-1-sum-insured-basis-in"}],"law":[]}],"documents":[{"kind":"wording","label":"ACKO Health III - Policy Wordings","pages":22,"fetched_at":"2026-10-17 19:30:37+00","source_url":"https://acko-cms.ackoassets.com/Policy_Wordings_ACKO_Health_III_de395d1997.pdf","url":"https://indiainsurances.com/policy/acko-general-insurance/acko-health-iii-ackhlip27040v012627/document/1440"},{"kind":"wording","label":"ACKO Health III - (Platinum) - Policy Wordings","pages":18,"fetched_at":"2026-10-17 19:30:44+00","source_url":"https://acko-cms.ackoassets.com/Policy_Wordings_ACKO_Health_III_Platinum_43d3abfe1b.pdf","url":"https://indiainsurances.com/policy/acko-general-insurance/acko-health-iii-ackhlip27040v012627/document/1444"},{"kind":"wording","label":"ACKO Health III - (Platinum Lite) - Policy Wordings","pages":18,"fetched_at":"2026-10-17 19:30:52+00","source_url":"https://acko-cms.ackoassets.com/Policy_Wordings_ACKO_Health_III_Platinum_Lite_749c872319.pdf","url":"https://indiainsurances.com/policy/acko-general-insurance/acko-health-iii-ackhlip27040v012627/document/1448"},{"kind":"wording","label":"ACKO Health III - (Platinum Super Top-up) - Policy Wordings","pages":18,"fetched_at":"2026-10-17 19:31:00+00","source_url":"https://acko-cms.ackoassets.com/Policy_Wordings_ACKO_Health_III_Platinum_Super_Top_up_93a2e79848.pdf","url":"https://indiainsurances.com/policy/acko-general-insurance/acko-health-iii-ackhlip27040v012627/document/1452"},{"kind":"prospectus","label":"Acko Health III - Prospectus","pages":21,"fetched_at":"2026-10-17 19:30:40+00","source_url":"https://acko-cms.ackoassets.com/Prospectus_Acko_Health_III_8d36488120.pdf","url":"https://indiainsurances.com/policy/acko-general-insurance/acko-health-iii-ackhlip27040v012627/document/1442"},{"kind":"cis","label":"Acko Health III - CIS","pages":7,"fetched_at":"2026-10-17 19:30:36+00","source_url":"https://acko-cms.ackoassets.com/CIS_Acko_Health_III_dafdde7dc6.pdf","url":"https://indiainsurances.com/policy/acko-general-insurance/acko-health-iii-ackhlip27040v012627/document/1439"}],"versions":[],"where_to_buy":[{"purpose":"buy","kind":"insurer","name":"Acko General Insurance official website","url":"https://www.acko.com/gi","note":"Buy directly from the insurer."},{"purpose":"buy","kind":"ours","name":"Get free help from IndiaInsurances","url":"/help","note":"Free. We do not sell insurance and earn no commission; your request is not passed to anyone."}],"claims_and_complaints":[{"purpose":"claim","kind":"insurer","name":"Car insurance claims","url":"https://www.acko.com/car-insurance/claims/","note":null},{"purpose":"claim","kind":"insurer","name":"Travel insurance claim process","url":"https://www.acko.com/travel-insurance/claim-process/","note":null},{"purpose":"claim","kind":"insurer","name":"Two-wheeler insurance claims","url":"https://www.acko.com/two-wheeler-insurance/claims/","note":null},{"purpose":"claim","kind":"ours","name":"Get free help from IndiaInsurances","url":"/help","note":"Free. We do not sell insurance and earn no commission; your request is not passed to anyone."},{"purpose":"grievance","kind":"official","name":"Bima Bharosa (IRDAI grievance portal)","url":"https://bimabharosa.irdai.gov.in/","note":"Register and track a complaint against any insurer with IRDAI. Complain to the insurer first; escalate here if the reply is late or unsatisfactory."},{"purpose":"grievance","kind":"official","name":"e-Daakhil (consumer commission e-filing)","url":"https://edaakhil.nic.in/","note":"Not reachable from our crawler on 2026-10-19; use e-Jagriti if this link does not open."},{"purpose":"grievance","kind":"official","name":"e-Jagriti (consumer commission filing)","url":"https://e-jagriti.gov.in/","note":"Ministry of Consumer Affairs platform for consumer commission cases, a route for insurance disputes that the Ombudsman does not settle."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Ahmedabad","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Gujarat, Dadra & Nagar Haveli, Daman and Diu. Email: oio.ahmedabad@cioins.co.in. Phone: 079 - 25501201/02. Address: Office of the Insurance Ombudsman, Jeevan Prakash Building, 6th floor, Tilak Marg, Relief Road, AHMEDABAD – 380 001."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Bengaluru","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Karnataka. Email: oio.bengaluru@cioins.co.in. Phone: 080 - 26652048 / 26652049. Address: Office of the Insurance Ombudsman, Jeevan Soudha Building,PID No. 57-27-N-19 Ground Floor, 19/19, 24th Main Road, JP Nagar, Ist Phase, Bengaluru – 560 078."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Bhopal","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Madhya Pradesh, Chhattisgarh. Email: oio.bhopal@cioins.co.in. Phone: 0755 - 2769201 / 2769202 / 2769203. Address: Office of the Insurance Ombudsman, 1st floor,\"Jeevan Shikha\", 60-B,Hoshangabad Road, Opp. Gayatri Mandir,Arera Hills Bhopal – 462 011."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Bhubaneswar","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Odisha. Email: oio.bhubaneswar@cioins.co.in. Phone: 0674 - 2596461 /2596455/2596429/2596003. Address: Office of the Insurance Ombudsman, 62, Forest park, Bhubaneswar – 751 009."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Chandigarh","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Punjab, Haryana (excluding Gurugram, Faridabad, Sonepat and Bahadurgarh), Himachal Pradesh, Union Territories of Jammu & Kashmir,Ladakh & Chandigarh. Email: oio.chandigarh@cioins.co.in. Phone: 0172-2706468. Address: Office Of The Insurance Ombudsman, Jeevan Deep Building SCO 20-27, Ground Floor Sector- 17 A, Chandigarh – 160 017."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Chennai","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Tamil Nadu, PuducherryTown and Karaikal (which are part of Puducherry). Email: oio.chennai@cioins.co.in. Phone: 044 - 24333668 / 24333678. Address: Office of the Insurance Ombudsman, Fatima Akhtar Court, 4th Floor, 453, Anna Salai, Teynampet, CHENNAI – 600 018."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Delhi","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Delhi & following Districts of Haryana - Gurugram, Faridabad, Sonepat & Bahadurgarh. Email: oio.delhi@cioins.co.in. Phone: 011 - 46013992/23213504/23232481. Address: Office of the Insurance Ombudsman, 2/2 A, Universal Insurance Building, Asaf Ali Road, New Delhi – 110 002."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Guwahati","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Assam, Meghalaya, Manipur, Mizoram, Arunachal Pradesh, Nagaland and Tripura. Email: oio.guwahati@cioins.co.in. Phone: 0361 - 2632204 / 2602205 / 2631307. Address: Office of the Insurance Ombudsman, Jeevan Nivesh, 5th Floor, Near Pan Bazar , S.S. Road, Guwahati – 781001(ASSAM)."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Hyderabad","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Andhra Pradesh, Telangana, Yanam and part of Union Territory of Puducherry. Email: oio.hyderabad@cioins.co.in. Phone: 040 - 23312122 / 23376991 / 23376599 / 23328709 / 23325325. Address: Office of the Insurance Ombudsman, 6-2-46, 1st floor, \"Moin Court\", Lane Opp.Hyundai Showroom , A. C. Guards, Lakdi-Ka-Pool, Hyderabad - 500 004."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Jaipur","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Rajasthan. Email: oio.jaipur@cioins.co.in. Phone: 0141- 2740363. Address: Office of the Insurance Ombudsman, Jeevan Nidhi – II Bldg., Gr. Floor, Bhawani Singh Marg, Jaipur - 302 005."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Kochi","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Kerala, Lakshadweep, Mahe-a part of Union Territory of Puducherry. Email: oio.ernakulam@cioins.co.in. Phone: 0484 - 2358759. Address: Office of the Insurance Ombudsman, 10th Floor, Jeevan Prakash,LIC Building, Opp to Maharaja's College Ground,M.G.Road, Kochi - 682 011."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Kolkata","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: West Bengal, Sikkim, Andaman & Nicobar Islands. Email: oio.kolkata@cioins.co.in. Phone: 033 - 22124339 / 22124341. Address: Office of the Insurance Ombudsman, Hindustan Bldg. Annexe, 7th Floor, 4, C.R. Avenue, KOLKATA - 700 072."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Lucknow","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Districts of Uttar Pradesh : Lalitpur, Jhansi, Mahoba, Hamirpur, Banda, Chitrakoot, Allahabad, Mirzapur, Sonbhabdra, Fatehpur, Pratapgarh, Jaunpur,Varanasi, Gazipur, Jalaun, Kanpur, Lucknow, Unnao, Sitapur, Lakhimpur, Bahraich, Barabanki, Raebareli, Sravasti, Gonda, Faizabad, Amethi, Kaushambi, Balrampur, Basti, Ambedkarnagar, Sultanpur, Maharajgang, Santkabirnagar, Azamgarh, Kushinagar, Gorkhpur, Deoria, Mau, Ghazipur, Chandauli, Ballia, Sidharathnagar. Email: oio.lucknow@cioins.co.in. Phone: 0522 - 4002082 / 3500613. Address: Office of the Insurance Ombudsman, 6th Floor, Jeevan Bhawan, Phase-II, Nawal Kishore Road, Hazratganj, Lucknow - 226 001."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Mumbai","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: List of wards under Mumbai Metropolitan Region excluding wards in Mumbai – i.e M/E, M/W, N , S and T covered under Office of Insurance Ombudsman Thane and excluding areas of Navi Mumbai. Email: oio.mumbai@cioins.co.in. Phone: 022 - 69038800/27/29/31/32/33. Address: Office of the Insurance Ombudsman, 3rd Floor, Jeevan Seva Annexe, S. V. Road, Santacruz (W), Mumbai - 400 054."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Noida","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: State of Uttarakhand and the following Districts of Uttar Pradesh: Agra, Aligarh, Bagpat, Bareilly, Bijnor, Budaun, Bulandshehar, Etah, Kannauj, Mainpuri, Mathura, Meerut, Moradabad, Muzaffarnagar, Oraiyya, Pilibhit, Etawah, Farrukhabad, Firozbad, Gautam Buddh nagar, Ghaziabad, Hardoi, Shahjahanpur, Hapur, Shamli, Rampur, Kashganj, Sambhal, Amroha, Hathras, Kanshiramnagar, Saharanpur. Email: oio.noida@cioins.co.in. Phone: 0120-4027589. Address: Office of the Insurance Ombudsman, Bhagwan Sahai Palace 4th Floor, Main Road, Naya Bans, Sector 15, Distt: Gautam Buddh Nagar, U.P-201301."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman: offices and jurisdiction","url":"https://www.cioins.co.in/Ombudsman","note":"Addresses, phone numbers, e-mail and the states or districts each Ombudsman office covers."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Patna","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Bihar, Jharkhand. Email: oio.patna@cioins.co.in. Phone: 0612-2547068. Address: Office of the Insurance Ombudsman, 2nd Floor, Lalit Bhawan, Bailey Road, Patna 800 001."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Pune","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: State of Goa and State of Maharashtra excluding areas of Navi Mumbai, Thane district,Palghar District, Raigad district & Mumbai Metropolitan Region. Email: oio.pune@cioins.co.in. Phone: 020-24471175. Address: Office of the Insurance Ombudsman, Jeevan Darshan Bldg., 3rd Floor, C.T.S. No.s. 195 to 198, N.C. Kelkar Road, Narayan Peth, Pune – 411 030."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman: register a complaint online","url":"https://cioins.co.in/Complaint/Online","note":"Council for Insurance Ombudsmen. Free. For disputes with an insurer after its own grievance process; the office is chosen by where you live (see the offices list)."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Thane","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Area of Navi Mumbai, Thane District, Raigad District, Palghar District and wards of Mumbai , M/East, M/West, N, S and T. Email: oio.thane@cioins.co.in. Phone: 022-20812868/69. Address: Office of the Insurance Ombudsman, Jeevan Chintamani Building, 2nd Floor,Near New RTO Office, Louis Wadi,Vasantrao Naik Mahamarg, Thane (West)- 400604."},{"purpose":"grievance","kind":"official","name":"National Consumer Helpline","url":"https://consumerhelpline.gov.in/public/","note":"Government consumer helpline; can take up a complaint before you go to a consumer commission."},{"purpose":"port","kind":"ours","name":"Get free help from IndiaInsurances","url":"/help","note":"Free. We do not sell insurance and earn no commission; your request is not passed to anyone."},{"purpose":"renew","kind":"insurer","name":"Health insurance renewal","url":"https://www.acko.com/health-insurance/renewal/","note":null}],"notice":"Information, not advice. IndiaInsurances is not an insurer or an insurance intermediary, does not sell insurance and earns no commission. Policy terms change and your own policy schedule can differ: always confirm with the policy document and the insurer before you buy or claim.","cite_as":"Acko Health III (UIN ACKHLIP27040V012627), IndiaInsurances, https://indiainsurances.com/policy/acko-general-insurance/acko-health-iii-ackhlip27040v012627"}