{"uin":"CHIHLIP27062V052627","name":"care advantage","url":"https://indiainsurances.com/policy/care-health-insurance/care-advantage-chihlip27062v052627","insurer":{"slug":"care-health-insurance","name":"Care Health Insurance Ltd","url":"https://indiainsurances.com/insurer/care-health-insurance"},"line":"health","category":"health-indemnity","category_name":"Health insurance (hospitalisation)","irdai_type":"New","kind":"product","status":"active","approved_on":"2020-04-30","withdrawn_on":null,"summary":"Care Advantage is an indemnity health insurance policy available on individual and family floater basis with sum insured options from Rs. 25 L to Rs. 600 L. It has 30 days initial waiting, 36 months PED waiting, 24 months specific disease waiting, no room or ICU sub-limit under the base cover, and automatic recharge once in a policy year.","analysis":{"state":"machine","analysed_at":"2026-10-20 03:30:48.682063+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":"not-stated","value":null,"display":null,"note":"The documents describe individual and family floater bases and optional covers, but do not state named plan variants inside the product.","quote":null,"sources":[],"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":"1/ 2/ 3 years","display":"1/ 2/ 3 years","note":null,"quote":"Policy Term | 1/ 2/ 3 years","sources":[{"clause":"1","heading":"ELIGIBILITY CRITERIA","page":1,"url":"https://indiainsurances.com/policy/care-health-insurance/care-advantage-chihlip27062v052627/document/19482#c-1"}],"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":"Notify the company with full particulars within 48 hours from the date of occurrence. Emergency hospitalisation must be notified immediately and within 48 hours of hospitalisation commencing or before discharge, and planned hospitalisation at least 48 hours before admission; the claim must be filed within 30 days from discharge.","display":"Within 48 hours; planned hospitalisation at least 48 hours prior; file claim within 30 days from discharge","note":null,"quote":"the Company shall be notified with full particulars within 48 hours from the date of occurrence of event either at the Company’s call center or in writing. ... Claim must be filed within 30 days from the date of discharge from the hospital in case of hospitalization ... In case of an Emergency Hospitalization, the Company shall be notified either at the Company’s call center or in writing immediately and in any event within 48 hours of Hospitalization commencing or before the Insured Person’s discharge from Hospital. ... In case of an Planned Hospitalization, the Company shall be notified either at the Company’s call center or in writing at least 48 hours prior to planned date of admission to Hospital","sources":[{"clause":"6.1.4(i)","heading":null,"page":48,"url":"https://indiainsurances.com/policy/care-health-insurance/care-advantage-chihlip27062v052627/document/19437#c-6-1-4-i"},{"clause":"6.1.4(ii)","heading":null,"page":48,"url":"https://indiainsurances.com/policy/care-health-insurance/care-advantage-chihlip27062v052627/document/19437#c-6-1-4-ii"},{"clause":"6.1.4(iv)","heading":null,"page":49,"url":"https://indiainsurances.com/policy/care-health-insurance/care-advantage-chihlip27062v052627/document/19437#c-6-1-4-iv"},{"clause":"6.1.4(v)","heading":null,"page":49,"url":"https://indiainsurances.com/policy/care-health-insurance/care-advantage-chihlip27062v052627/document/19437#c-6-1-4-v"}],"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":["Duly filled and signed Claim form by the Insured Person","Copy of Photo ID and address proof of Insured Person","Medical Practitioner’s first consultation paper and referral letter advising Hospitalization","Medical Practitioner’s prescription advising drugs or diagnostic tests or consultations","Original numbered bills/ receipts and discharge summary from the Hospital/ Medical Practitioner","Original numbered bills from licensed pharmacy/chemists","Original pathological/diagnostic test reports/radiology reports and payment receipts","Operation Theatre Notes(if applicable)","Emergency Notes, Initial Assessment Sheet and Indoor case papers(if applicable)","Original investigation test reports and payment receipts supported by Doctor’s reference slip","MLC/ FIR report, Post Mortem Report if applicable and conducted","Ambulance Receipt","Any other document as required by the Company to assess the Claim, in case fraud is suspected"],"display":"Claim form, ID/address proof, consultation/referral papers, prescriptions, original bills, discharge summary, pharmacy bills, test reports, OT/emergency/indoor papers, MLC/FIR/post-mortem if applicable, ambulance receipt and other documents if fraud is suspected","note":"The company may waive documents depending on the case and may seek other documents required to assess the claim.","quote":"1 Duly filled and signed Claim form by the Insured Person; 2 Copy of Photo ID and address proof of Insured Person; 3 Medical Practitioner’s first consultation paper and referral letter advising Hospitalization; 4 Medical Practitioner’s prescription advising drugs or diagnostic tests or consultations; 5 Original numbered bills/ receipts and discharge summary from the Hospital/ Medical Practitioner; 6 Original numbered bills from licensed pharmacy/chemists; 7 Original pathological/diagnostic test reports/radiology reports and payment receipts; Operation Theatre Notes(if applicable); Emergency Notes, Initial Assessment Sheet and Indoor case papers(if applicable); 10 Original investigation test reports and payment receipts supported by Doctor’s reference slip; 11 MLC/ FIR report, Post Mortem Report if applicable and conducted; 12 Ambulance Receipt; 13 Any other document as required by the Company to assess the Claim, in case fraud is suspected.","sources":[{"clause":"6.1.5","heading":"Documents to be submitted for registration of Claim","page":49,"url":"https://indiainsurances.com/policy/care-health-insurance/care-advantage-chihlip27062v052627/document/19437#c-6-1-5"}],"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":"The company shall settle or reject a claim within 15 days from the date of intimation on receipt of the last necessary document. If investigation is warranted, it must be completed not later than 15 days and the claim settled within 45 days from intimation on receipt of the last necessary document; delay attracts interest at 2% above bank rate.","display":"15 days from intimation on receipt of last necessary document; 45 days for investigated claims","note":null,"quote":"The Company shall settle or reject a claim, as the case may be, within 15 days from the date of intimation on receipt of last necessary document. ... where the circumstances of a claim warrant an investigation in the opinion of the Company, it shall initiate and complete such investigation at the earliest in any case not later than 15 days from the date of intimation on receipt of last necessary document. In such cases, the Company shall settle the claim within 45 days from the date of intimation on receipt of last necessary document. ... In case of delay beyond stipulated 45 days the company shall be liable to pay interest at a rate 2% above the bank rate","sources":[{"clause":"5.1.3","heading":"Claim Settlement (provision for Penal Interest)","page":36,"url":"https://indiainsurances.com/policy/care-health-insurance/care-advantage-chihlip27062v052627/document/19437#c-5-1-3"}],"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":["Pre-Existing Diseases: Code- Excl01","Specific Waiting Period: Code- Excl02","30-day waiting period- Code- Excl03","Investigation & Evaluation: (Code- Excl04)","Rest Cure, rehabilitation and respite care: (Code- Excl05)","Obesity/ Weight Control: (Code- Excl06)","Change-of-Gender treatments: (Code- Excl07)","Cosmetic or plastic Surgery: (Code- Excl08)","Hazardous or Adventure sports: (Code- Excl09)","Breach of law: (Code- Excl10)","Excluded Providers: (Code- Excl11)","Treatment for Alcoholism, drug or substance abuse or any addictive condition and consequences thereof. (Code- Excl12)","Maternity: (Code Excl18)","Non-Allopathic Treatment or treatment related to any unrecognized systems of medicine.","Any Illness or Injury attributable to consumption, use, misuse or abuse of tobacco, intoxicating drugs, alcohol, hallucinogens, smoking."],"display":"PED, specific waiting period, 30-day waiting period, investigation/evaluation, rest cure, obesity, change of gender, cosmetic surgery, hazardous sports, breach of law, excluded providers, alcohol/drug abuse, maternity, non-allopathic/unrecognised treatment and tobacco/intoxicant-related illness or injury","note":null,"quote":"Pre-Existing Diseases: Code- Excl01 ... Specific Waiting Period: Code- Excl02 ... 30-day waiting period- Code- Excl03 ... Investigation & Evaluation: (Code- Excl04) ... Rest Cure, rehabilitation and respite care: (Code- Excl05) ... Obesity/ Weight Control: (Code- Excl06) ... Change-of-Gender treatments: (Code- Excl07) ... Cosmetic or plastic Surgery: (Code- Excl08) ... Hazardous or Adventure sports: (Code- Excl09) ... Breach of law: (Code- Excl10) ... Excluded Providers: (Code- Excl11) ... Treatment for Alcoholism, drug or substance abuse or any addictive condition and consequences thereof. (Code- Excl12) ... Maternity: (Code Excl18) ... Non-Allopathic Treatment or treatment related to any unrecognized systems of medicine. ... Any Illness or Injury attributable to consumption, use, misuse or abuse of tobacco, intoxicating drugs, alcohol, hallucinogens, smoking.","sources":[{"clause":"4.1(a)(i)","heading":"Pre-Existing Diseases","page":28,"url":"https://indiainsurances.com/policy/care-health-insurance/care-advantage-chihlip27062v052627/document/19437#c-4-1-a-i"},{"clause":"4.1(a)(ii)","heading":"Specific Waiting Period","page":28,"url":"https://indiainsurances.com/policy/care-health-insurance/care-advantage-chihlip27062v052627/document/19437#c-4-1-a-ii"},{"clause":"4.1(a)(iii)","heading":null,"page":29,"url":"https://indiainsurances.com/policy/care-health-insurance/care-advantage-chihlip27062v052627/document/19437#c-4-1-a-iii"},{"clause":null,"heading":"1 Investigation & Evaluation: (Code- Excl04)","page":30,"url":"https://indiainsurances.com/policy/care-health-insurance/care-advantage-chihlip27062v052627/document/19437#c-1-investigation-evaluation-code-excl04"},{"clause":null,"heading":"2 Rest Cure, rehabilitation and respite care: (Code- Excl05)","page":30,"url":"https://indiainsurances.com/policy/care-health-insurance/care-advantage-chihlip27062v052627/document/19437#c-2-rest-cure-rehabilitation-and-respite-care-code"},{"clause":null,"heading":"3 Obesity/ Weight Control: (Code- Excl06)","page":30,"url":"https://indiainsurances.com/policy/care-health-insurance/care-advantage-chihlip27062v052627/document/19437#c-3-obesity-weight-control-code-excl06"},{"clause":null,"heading":"4 Change-of-Gender treatments: (Code- Excl07)","page":31,"url":"https://indiainsurances.com/policy/care-health-insurance/care-advantage-chihlip27062v052627/document/19437#c-4-change-of-gender-treatments-code-excl07"},{"clause":null,"heading":"5 Cosmetic or plastic Surgery: (Code- Excl08)","page":31,"url":"https://indiainsurances.com/policy/care-health-insurance/care-advantage-chihlip27062v052627/document/19437#c-5-cosmetic-or-plastic-surgery-code-excl08"},{"clause":null,"heading":"6 Hazardous or Adventure sports: (Code- Excl09)","page":31,"url":"https://indiainsurances.com/policy/care-health-insurance/care-advantage-chihlip27062v052627/document/19437#c-6-hazardous-or-adventure-sports-code-excl09"},{"clause":null,"heading":"7 Breach of law: (Code- Excl10)","page":31,"url":"https://indiainsurances.com/policy/care-health-insurance/care-advantage-chihlip27062v052627/document/19437#c-7-breach-of-law-code-excl10"},{"clause":null,"heading":"8 Excluded Providers: (Code- Excl11)","page":31,"url":"https://indiainsurances.com/policy/care-health-insurance/care-advantage-chihlip27062v052627/document/19437#c-8-excluded-providers-code-excl11"},{"clause":null,"heading":"15 Maternity: (Code Excl18)","page":32,"url":"https://indiainsurances.com/policy/care-health-insurance/care-advantage-chihlip27062v052627/document/19437#c-15-maternity-code-excl18"},{"clause":"4.2(a)","heading":null,"page":33,"url":"https://indiainsurances.com/policy/care-health-insurance/care-advantage-chihlip27062v052627/document/19437#c-4-2-a"}],"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":"First contact Care Health Insurance through its website/link, toll-free WhatsApp number, mobile app, courier to a branch or corporate office, or the grievance cell at a branch. If not satisfied, contact the grievance officer at the branch or corporate office before approaching the Insurance Ombudsman or IRDAI Bima Bharosa.","display":"Contact Care Health first via website, WhatsApp, app, branch/corporate office or grievance cell; then grievance officer; then Ombudsman/IRDAI","note":null,"quote":"In case of any grievance the insured person may contact the company through Website/link: https://www.careinsurance.com/contact-us.html Toll free (whatsapp no): xxxxxxxx Mobile App: Care Health – Customer App Courier: Any of Company’s Branch Office or corporate office Insured person may also approach the grievance cell at any of the company's branches with the details of grievance. If Insured person is not satisfied with the redressal of grievance through one of the above methods, insured person may contact the grievance officer at Branch Office or Corporate Office. ... the insured person may also approach the office of Insurance Ombudsman","sources":[{"clause":"5.1.16","heading":"Grievances","page":41,"url":"https://indiainsurances.com/policy/care-health-insurance/care-advantage-chihlip27062v052627/document/19437#c-5-1-16"}],"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":"25 L/ 50 L/ 75 L/ 100 L/ 200 L/ 300 L/ 600 L","display":"Rs. 25 L, 50 L, 75 L, 100 L, 200 L, 300 L or 600 L","note":"The policy wording says the sum insured is as specified in the Policy Schedule; the options are stated in the prospectus schedule of benefits.","quote":"Base Sum Insured (SI) – on annual basis (in Rs.) | 25 L/ 50 L/ 75 L/ 100 L/ 200 L/ 300 L/ 600 L","sources":[{"clause":null,"heading":"9. SCHEDULE OF BENEFITS","page":23,"url":"https://indiainsurances.com/policy/care-health-insurance/care-advantage-chihlip27062v052627/document/19482#c-9-schedule-of-benefits"}],"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":"Not applicable if the insured person has continuous coverage for more than twelve months.","quote":"Expenses related to the treatment of any illness within 30 days from the first policy commencement date shall be excluded except claims arising due to an accident, provided the same are covered.","sources":[{"clause":"4.1(a)(iii)","heading":null,"page":29,"url":"https://indiainsurances.com/policy/care-health-insurance/care-advantage-chihlip27062v052627/document/19437#c-4-1-a-iii"}],"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":"quote-verified","value":{"unit":"months","amount":36},"display":"36 months","note":"Optional Cover 5 reduces the PED wait period to 24 months.","quote":"Expenses related to the treatment of a pre-existing Disease (PED) and its direct complications shall be excluded until the expiry of 36 months of continuous coverage after the date of inception of the first policy with insurer.","sources":[{"clause":"4.1(a)(i)","heading":"Pre-Existing Diseases","page":28,"url":"https://indiainsurances.com/policy/care-health-insurance/care-advantage-chihlip27062v052627/document/19437#c-4-1-a-i"}],"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":"quote-verified","value":{"unit":"months","amount":24},"display":"24 months","note":"Not applicable for claims arising due to an accident; if the condition is also PED, the longer waiting period applies.","quote":"Expenses related to the treatment of the listed Conditions, surgeries/ treatments and its direct complications shall be excluded until the expiry of 24 months of continuous coverage, as may be the case after the date of inception of the first policy with the Company.","sources":[{"clause":"4.1(a)(ii)","heading":"Specific Waiting Period","page":28,"url":"https://indiainsurances.com/policy/care-health-insurance/care-advantage-chihlip27062v052627/document/19437#c-4-1-a-ii"}],"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":["Any treatment related to Degenerative Arthritis (if non-infective), Osteoarthritis and Osteoporosis, Gout, Spinal Disorders(unless caused by accident), Prolapse inter Vertebral Disc (unless caused by accident), Joint Replacement Surgery(unless caused by accident), Arthroscopic Knee Surgeries/ACL Reconstruction/Meniscal and Ligament Repair","Cataract and age related eye ailments","Fissure/ Fistula in anus, Hemorrhoids / Piles, Pilonidal Sinus, Gastric and Duodenal Ulcers","Surgery of Genito-urinary system unless necessitated by malignancy","All types of Hernia & Hydrocele","All External & Internal Benign tumours, cysts, skin tumours, nodules, polyps including breast lumps (each of any kind) unless malignant","Calculi in urinary system, Gall Bladder and Bile duct, excluding malignancy","Varicose veins and varicose ulcers","Genetic disorders","Treatment of fibroid of uterus/adenomyosis or Hysterectomy for menorrhagia or Fibromyoma or prolapse of uterus unless necessitated by malignancy.","Surgical treatments for Benign ear, nose and throat (ENT) disorders and surgeries (including but not limited to Adenoidectomy, Mastoidectomy, Tonsillectomy and Tympanoplasty), Nasal Septum Deviation, Sinusitis and related disorders.","Parkinson's or Alzheimer's disease or Dementia, Essential tremor, Dystonia and Epilepsy.","Diseases of immune system including but not limited to (Rheumatoid arthritis,Crohns Disease,Ulcerative disease,SLE) and Multiple Sclerosis.","Age-related macular degeneration (ARMD), Diabetic retinopathy and Retinal vein occlusion.","Benign Prostatic Hypertrophy"],"display":"Listed degenerative/joint and spinal disorders, cataract and age-related eye ailments, piles/fissure/fistula and ulcers, genito-urinary surgery, hernia/hydrocele, benign tumours/cysts/polyps, calculi, varicose veins/ulcers, genetic disorders, fibroid/uterus treatments, benign ENT surgeries, Parkinson’s/Alzheimer’s/dementia and related disorders, immune system diseases, ARMD/diabetic retinopathy/retinal vein occlusion and benign prostatic hypertrophy","note":null,"quote":"List of specific diseases/ procedures:\nAny treatment related to Degenerative Arthritis (if non-infective), Osteoarthritis and Osteoporosis, Gout, Spinal Disorders(unless caused by accident), Prolapse inter Vertebral Disc (unless caused by accident), Joint Replacement Surgery(unless caused by accident), Arthroscopic Knee Surgeries/ACL Reconstruction/Meniscal and Ligament Repair 2 Cataract and age related eye ailments 3 Fissure/ Fistula in anus, Hemorrhoids / Piles, Pilonidal Sinus, Gastric and Duodenal Ulcers 4 Surgery of Genito-urinary system unless necessitated by malignancy 5 All types of Hernia & Hydrocele 6 All External & Internal Benign tumours, cysts, skin tumours, nodules, polyps including breast lumps (each of any kind) unless malignant 7 Calculi in urinary system, Gall Bladder and Bile duct, excluding malignancy 8 Varicose veins and varicose ulcers 9 Genetic disorders 10 Treatment of fibroid of uterus/adenomyosis or Hysterectomy for menorrhagia or Fibromyoma or prolapse of uterus unless necessitated by malignancy. 11 Surgical treatments for Benign ear, nose and throat (ENT) disorders and surgeries (including but not limited to Adenoidectomy, Mastoidectomy, Tonsillectomy and Tympanoplasty), Nasal Septum Deviation, Sinusitis and related disorders. 12 Parkinson's or Alzheimer's disease or Dementia, Essential tremor, Dystonia and Epilepsy. 13 Diseases of immune system including but not limited to (Rheumatoid arthritis,Crohns Disease,Ulcerative disease,SLE) and Multiple Sclerosis. 14 Age-related macular degeneration (ARMD), Diabetic retinopathy and Retinal vein occlusion. 15 Benign Prostatic Hypertrophy","sources":[{"clause":"4.1(a)(ii)","heading":"Specific Waiting Period","page":28,"url":"https://indiainsurances.com/policy/care-health-insurance/care-advantage-chihlip27062v052627/document/19437#c-4-1-a-ii"}],"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":"years","amount":5},"display":"five continuous years","note":"For enhanced sums insured, five continuous years is counted from the date of enhancement for the enhanced limits.","quote":"After completion of five continuous years under the policy no look back to be applied. This period of five years is called as moratorium period. ... After the expiry of Moratorium Period no health insurance claim shall be contestable except for proven fraud and permanent exclusions specified in the policy contract.","sources":[{"clause":"5.1.12","heading":"Moratorium Period","page":40,"url":"https://indiainsurances.com/policy/care-health-insurance/care-advantage-chihlip27062v052627/document/19437#c-5-1-12"}],"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":"The insured person may port the entire policy with all family members to another insurer by applying at least 30 days before, but not earlier than 60 days from, the policy renewal date; accrued continuity benefits are given as per IRDAI portability guidelines.","display":"Allowed, with waiting-period credit as per IRDAI portability guidelines","note":null,"quote":"The insured person will have the option to port the policy to other insurers by applying to such insurer to port the entire policy along with all the members of the family, if any, at least 30 days before, but not earlier than 60 days from the policy renewal date as per IRDAI guidelines related to portability. ... the proposed insured person will get the accrued continuity benefits as per IRDAI guidelines on portability.","sources":[{"clause":"5.1.9","heading":"Portability","page":39,"url":"https://indiainsurances.com/policy/care-health-insurance/care-advantage-chihlip27062v052627/document/19437#c-5-1-9"}],"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 exit age","note":"Child is ported to an individual policy and treated as an adult insured person upon attaining 25 years at renewal.","quote":"Exit Age | No Exit age ... Entry Age – Maximum | Adult: Lifelong Child: 24 years","sources":[{"clause":"1","heading":"ELIGIBILITY CRITERIA","page":1,"url":"https://indiainsurances.com/policy/care-health-insurance/care-advantage-chihlip27062v052627/document/19482#c-1"}],"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":"No loading shall apply on renewals based on individual claims experience.","display":"No loading on renewals based on individual claims experience","note":null,"quote":"No loading shall apply on renewals based on individual claims experience","sources":[{"clause":"5.1.10","heading":"Renewal Terms","page":39,"url":"https://indiainsurances.com/policy/care-health-insurance/care-advantage-chihlip27062v052627/document/19437#c-5-1-10"}],"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":["Investigation & Evaluation: (Code- Excl04)","Rest Cure, rehabilitation and respite care: (Code- Excl05)","Obesity/ Weight Control: (Code- Excl06)","Change-of-Gender treatments: (Code- Excl07)","Cosmetic or plastic Surgery: (Code- Excl08)","Hazardous or Adventure sports: (Code- Excl09)","Breach of law: (Code- Excl10)","Excluded Providers: (Code- Excl11)","Treatment for Alcoholism, drug or substance abuse or any addictive condition and consequences thereof. (Code- Excl12)","Treatments received in heath hydros, nature cure clinics, spas or similar establishments or private beds registered as a nursing home attached to such establishments or where admission is arranged wholly or partly for domestic reasons. (Code- Excl13)","Dietary supplements and substances that can be purchased without prescription, including but not limited to Vitamins, minerals and organic substances unless prescribed by a medical practitioner as part of hospitalization claim or day care procedure (Code- Excl14)","Refractive Error: (Code- Excl15)","Unproven Treatments: (Code- Excl16)","Sterility and Infertility: (Code- Excl17)","Maternity: (Code Excl18)","Any item or condition or treatment specified in List of Non-Medical Items (Annexure – II to Policy Terms & Conditions).","Non-Allopathic Treatment or treatment related to any unrecognized systems of medicine.","Act of self-destruction or self-inflicted Injury, attempted suicide or suicide while sane or insane.","Any Illness or Injury attributable to consumption, use, misuse or abuse of tobacco, intoxicating drugs, alcohol, hallucinogens, smoking."],"display":"Permanent exclusions include Excl04 to Excl18 and product-specific exclusions such as non-medical items, non-allopathic/unrecognised treatment, self-inflicted injury/suicide attempt and tobacco/intoxicant-related illness or injury","note":null,"quote":"Investigation & Evaluation: (Code- Excl04) ... Rest Cure, rehabilitation and respite care: (Code- Excl05) ... Obesity/ Weight Control: (Code- Excl06) ... Change-of-Gender treatments: (Code- Excl07) ... Cosmetic or plastic Surgery: (Code- Excl08) ... Hazardous or Adventure sports: (Code- Excl09) ... Breach of law: (Code- Excl10) ... Excluded Providers: (Code- Excl11) ... Treatment for Alcoholism, drug or substance abuse or any addictive condition and consequences thereof. (Code- Excl12) ... (Code- Excl13) ... (Code- Excl14) ... Refractive Error: (Code- Excl15) ... Unproven Treatments: (Code- Excl16) ... Sterility and Infertility: (Code- Excl17) ... Maternity: (Code Excl18) ... Any item or condition or treatment specified in List of Non-Medical Items (Annexure – II to Policy Terms & Conditions). ... Non-Allopathic Treatment or treatment related to any unrecognized systems of medicine. ... Act of self-destruction or self-inflicted Injury, attempted suicide or suicide while sane or insane. ... Any Illness or Injury attributable to consumption, use, misuse or abuse of tobacco, intoxicating drugs, alcohol, hallucinogens, smoking.","sources":[{"clause":null,"heading":"1 Investigation & Evaluation: (Code- Excl04)","page":30,"url":"https://indiainsurances.com/policy/care-health-insurance/care-advantage-chihlip27062v052627/document/19437#c-1-investigation-evaluation-code-excl04"},{"clause":null,"heading":"2 Rest Cure, rehabilitation and respite care: (Code- Excl05)","page":30,"url":"https://indiainsurances.com/policy/care-health-insurance/care-advantage-chihlip27062v052627/document/19437#c-2-rest-cure-rehabilitation-and-respite-care-code"},{"clause":null,"heading":"3 Obesity/ Weight Control: (Code- Excl06)","page":30,"url":"https://indiainsurances.com/policy/care-health-insurance/care-advantage-chihlip27062v052627/document/19437#c-3-obesity-weight-control-code-excl06"},{"clause":null,"heading":"4 Change-of-Gender treatments: (Code- Excl07)","page":31,"url":"https://indiainsurances.com/policy/care-health-insurance/care-advantage-chihlip27062v052627/document/19437#c-4-change-of-gender-treatments-code-excl07"},{"clause":null,"heading":"5 Cosmetic or plastic Surgery: (Code- Excl08)","page":31,"url":"https://indiainsurances.com/policy/care-health-insurance/care-advantage-chihlip27062v052627/document/19437#c-5-cosmetic-or-plastic-surgery-code-excl08"},{"clause":null,"heading":"6 Hazardous or Adventure sports: (Code- Excl09)","page":31,"url":"https://indiainsurances.com/policy/care-health-insurance/care-advantage-chihlip27062v052627/document/19437#c-6-hazardous-or-adventure-sports-code-excl09"},{"clause":null,"heading":"7 Breach of law: (Code- Excl10)","page":31,"url":"https://indiainsurances.com/policy/care-health-insurance/care-advantage-chihlip27062v052627/document/19437#c-7-breach-of-law-code-excl10"},{"clause":null,"heading":"8 Excluded Providers: (Code- Excl11)","page":31,"url":"https://indiainsurances.com/policy/care-health-insurance/care-advantage-chihlip27062v052627/document/19437#c-8-excluded-providers-code-excl11"},{"clause":null,"heading":"12 Refractive Error: (Code- Excl15)","page":32,"url":"https://indiainsurances.com/policy/care-health-insurance/care-advantage-chihlip27062v052627/document/19437#c-12-refractive-error-code-excl15"},{"clause":"Excl16","heading":"Unproven Treatments: (Code- Excl16)","page":32,"url":"https://indiainsurances.com/policy/care-health-insurance/care-advantage-chihlip27062v052627/document/19437#c-excl16"},{"clause":null,"heading":"14 Sterility and Infertility: (Code- Excl17)","page":32,"url":"https://indiainsurances.com/policy/care-health-insurance/care-advantage-chihlip27062v052627/document/19437#c-14-sterility-and-infertility-code-excl17"},{"clause":null,"heading":"15 Maternity: (Code Excl18)","page":32,"url":"https://indiainsurances.com/policy/care-health-insurance/care-advantage-chihlip27062v052627/document/19437#c-15-maternity-code-excl18"},{"clause":"4.2(a)","heading":null,"page":33,"url":"https://indiainsurances.com/policy/care-health-insurance/care-advantage-chihlip27062v052627/document/19437#c-4-2-a"}],"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":"The policyholder may cancel by giving 7 days' written notice, and the company refunds proportionate premium for the unexpired policy period. No refund is made if any claim has been admitted or lodged or any benefit availed; pre-policy medical examination and similar expenses may be deducted if risk has commenced.","display":"Proportionate premium refund for unexpired period after 7 days' written notice; no refund if claim admitted/lodged/benefit availed","note":null,"quote":"The policyholder may cancel this policy by giving 7days' written notice and in such an event, the Company shall refund proportionate premium for the unexpired policy period. ... no refunds of premium shall be made in respect of Cancellation where, any claim has been admitted or has been lodged or any benefit has been availed by the Insured person under the Policy. ... the expenses such as pre- policy medical examination etc. incurred by the Company will also be deducted before refunding of premium.","sources":[{"clause":"5.1.7(a)","heading":null,"page":37,"url":"https://indiainsurances.com/policy/care-health-insurance/care-advantage-chihlip27062v052627/document/19437#c-5-1-7-a"},{"clause":"5.1.7(b)","heading":null,"page":38,"url":"https://indiainsurances.com/policy/care-health-insurance/care-advantage-chihlip27062v052627/document/19437#c-5-1-7-b"},{"clause":"5.1.7(c)","heading":null,"page":38,"url":"https://indiainsurances.com/policy/care-health-insurance/care-advantage-chihlip27062v052627/document/19437#c-5-1-7-c"}],"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":"The policy covers only medical treatment taken entirely within India, with payments in Indian Rupees and within India.","display":"India only","note":null,"quote":"This Policy covers only medical treatment taken entirely within India. All payments under this Policy shall be made in Indian Rupees and within India.","sources":[{"clause":"6.1.7(a)","heading":null,"page":51,"url":"https://indiainsurances.com/policy/care-health-insurance/care-advantage-chihlip27062v052627/document/19437#c-6-1-7-a"}],"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":"Applicable on new individual health insurance policies and not on renewals or at the time of porting/migrating the policy.","quote":"The insured person shall be allowed free look period of 30 days from date of receipt of the policy document to review the terms and conditions of the policy, and to return the same if not acceptable.","sources":[{"clause":"5.1.15","heading":"Free Look Period","page":41,"url":"https://indiainsurances.com/policy/care-health-insurance/care-advantage-chihlip27062v052627/document/19437#c-5-1-15"}],"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; 15 days for monthly mode","note":"For monthly premium payment mode the grace period is fifteen days; in all other cases it is thirty days.","quote":"The grace period for payment of the premium for all types of insurance policies shall be: fifteen days where premium payment mode is monthly and thirty days in all other cases.","sources":[{"clause":"2.1.16","heading":"Grace Period","page":5,"url":"https://indiainsurances.com/policy/care-health-insurance/care-advantage-chihlip27062v052627/document/19437#c-2-1-16"}],"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":"Minimum entry age is 5 years for individual cover and 91 days for floater with at least one insured person aged 18 years or above. Maximum entry age is lifelong for adults and 24 years for children.","display":"Minimum: Individual 5 years; Floater 91 days with at least 1 insured aged 18+. Maximum: Adult lifelong; Child 24 years","note":"From the prospectus eligibility criteria.","quote":"Entry Age – Minimum | Individual: 5 years Floater: 91 days with at least 1 Insured Person of age 18 years or above\nEntry Age – Maximum | Adult: Lifelong Child: 24 years","sources":[{"clause":"1","heading":"ELIGIBILITY CRITERIA","page":1,"url":"https://indiainsurances.com/policy/care-health-insurance/care-advantage-chihlip27062v052627/document/19482#c-1"}],"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":["Single","Monthly","Quarterly","Half-yearly"],"display":"Single, Monthly, Quarterly, Half-yearly","note":null,"quote":"Premium Payment Term | Single/ Monthly/ Quarterly/ Half-yearly Option to pay entire premium in any mode within a policy year","sources":[{"clause":null,"heading":"Wait Periods","page":24,"url":"https://indiainsurances.com/policy/care-health-insurance/care-advantage-chihlip27062v052627/document/19482#c-wait-periods"}],"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":"quote-verified","value":["No Claims Bonus Super","Air Ambulance Cover","Deductible Option","Smart Select","Reduction in PED Wait Period","Co-payment Option","Annual Health Check-up","Room Rent Modification","Daily Allowance","Additional Sum Insured for Accidental Hospitalization","Unlimited Automatic Recharge","Unlimited E-Consultations","Pre-Post Hospitalization Expenses Modification"],"display":"13 optional covers: NCB Super, Air Ambulance, Deductible, Smart Select, PED wait reduction, Co-payment, Annual Health Check-up, Room Rent Modification, Daily Allowance, Accidental Additional SI, Unlimited Recharge, Unlimited E-Consultations and Pre/Post modification","note":null,"quote":"The Policy provides the following Optional Covers which can be opted either at the inception of the policy or at the time of renewal. ... Optional Cover 1: No Claims Bonus Super ... Optional Cover 2: Air Ambulance Cover ... Optional Cover 3: Deductible Option ... Optional Cover 4: Smart Select ... Optional Cover 5: Reduction in PED Wait Period ... Optional Cover 6: Co-payment Option ... Optional Cover 7: Annual Health Check-up ... Optional Cover 8: Room Rent Modification ... Optional Cover 9: Daily Allowance ... Optional Cover 10: Additional Sum Insured for Accidental Hospitalization ... Optional Cover 11: Unlimited Automatic Recharge ... Optional Cover 12 : Unlimited E-Consultations ... Optional Cover 13 : Pre-Post Hospitalization Expenses Modification","sources":[{"clause":"3.2","heading":"Optional Covers","page":20,"url":"https://indiainsurances.com/policy/care-health-insurance/care-advantage-chihlip27062v052627/document/19437#c-3-2"},{"clause":"3.2.1","heading":"Optional Cover 1: No Claims Bonus Super","page":21,"url":"https://indiainsurances.com/policy/care-health-insurance/care-advantage-chihlip27062v052627/document/19437#c-3-2-1"},{"clause":"3.2.2","heading":"Optional Cover 2: Air Ambulance Cover","page":21,"url":"https://indiainsurances.com/policy/care-health-insurance/care-advantage-chihlip27062v052627/document/19437#c-3-2-2"},{"clause":"3.2.3","heading":"Optional Cover 3: Deductible Option","page":22,"url":"https://indiainsurances.com/policy/care-health-insurance/care-advantage-chihlip27062v052627/document/19437#c-3-2-3"},{"clause":"3.2.4","heading":"Optional Cover 4: Smart Select","page":23,"url":"https://indiainsurances.com/policy/care-health-insurance/care-advantage-chihlip27062v052627/document/19437#c-3-2-4"},{"clause":"3.2.5","heading":"Optional Cover 5: Reduction in PED Wait Period","page":23,"url":"https://indiainsurances.com/policy/care-health-insurance/care-advantage-chihlip27062v052627/document/19437#c-3-2-5"},{"clause":"3.2.6","heading":"Optional Cover 6: Co-payment Option","page":24,"url":"https://indiainsurances.com/policy/care-health-insurance/care-advantage-chihlip27062v052627/document/19437#c-3-2-6"},{"clause":"3.2.7","heading":"Optional Cover 7: Annual Health Check-up","page":24,"url":"https://indiainsurances.com/policy/care-health-insurance/care-advantage-chihlip27062v052627/document/19437#c-3-2-7"},{"clause":"3.2.8","heading":"Optional Cover 8: Room Rent Modification","page":26,"url":"https://indiainsurances.com/policy/care-health-insurance/care-advantage-chihlip27062v052627/document/19437#c-3-2-8"},{"clause":"3.2.9","heading":"Optional Cover 9: Daily Allowance","page":26,"url":"https://indiainsurances.com/policy/care-health-insurance/care-advantage-chihlip27062v052627/document/19437#c-3-2-9"},{"clause":"3.2.10","heading":"Optional Cover 10: Additional Sum Insured for Accidental","page":27,"url":"https://indiainsurances.com/policy/care-health-insurance/care-advantage-chihlip27062v052627/document/19437#c-3-2-10"},{"clause":"3.2.11","heading":"Optional Cover 11: Unlimited Automatic Recharge","page":27,"url":"https://indiainsurances.com/policy/care-health-insurance/care-advantage-chihlip27062v052627/document/19437#c-3-2-11"},{"clause":"3.2.12","heading":"Optional Cover 12 : Unlimited E-Consultations","page":27,"url":"https://indiainsurances.com/policy/care-health-insurance/care-advantage-chihlip27062v052627/document/19437#c-3-2-12"},{"clause":"3.2.13","heading":"Optional Cover 13 : Pre-Post Hospitalization Expenses Modification","page":27,"url":"https://indiainsurances.com/policy/care-health-insurance/care-advantage-chihlip27062v052627/document/19437#c-3-2-13"}],"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 is not available during the renewal grace period. For installment premiums during the policy period, coverage shall be available during the grace period if the premium is paid in installments during the policy period.","display":"No cover during renewal grace period; cover during installment grace period if premium is paid in instalments during the policy period","note":"The first quoted rule is for renewal after policy period end; the second is for installment premium due during the policy period.","quote":"Coverage is not available during the grace period ... During such grace period, coverage shall be available, if the premium is paid in instalments during the policy period","sources":[{"clause":"5.1.10","heading":"Renewal Terms","page":39,"url":"https://indiainsurances.com/policy/care-health-insurance/care-advantage-chihlip27062v052627/document/19437#c-5-1-10"},{"clause":"5.1.13","heading":"Premium Payment in Installments","page":40,"url":"https://indiainsurances.com/policy/care-health-insurance/care-advantage-chihlip27062v052627/document/19437#c-5-1-13"}],"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":"There is no separate restriction on room/boarding and nursing expenses in case of hospitalisation under the base cover.","display":"No sub-limit","note":"Optional Cover 8 can modify the limit to Single Private Room.","quote":"Eligibility of Room Category of the insured person is ‘no sub-limit’, which means that there is no separate restriction on Room/ Boarding and nursing expenses in case of Hospitalization.","sources":[{"clause":"3.1.1(a)","heading":null,"page":15,"url":"https://indiainsurances.com/policy/care-health-insurance/care-advantage-chihlip27062v052627/document/19437#c-3-1-1-a"}],"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 base cover states no sub-limit on room category, meaning there is no separate restriction on room/boarding and nursing expenses. If the Room Rent Modification optional cover is chosen, the room category is limited to Single Private Room.","display":"Base: no sub-limit; Optional Room Rent Modification: Single Private Room","note":"Single Private Room applies only if Optional Cover 8 is chosen.","quote":"Eligibility of Room Category of the insured person is ‘no sub-limit’ ... by choosing this Optional Cover the Room Rent/Room Category shall be limited to ‘Single Private Room’","sources":[{"clause":"3.1.1(a)","heading":null,"page":15,"url":"https://indiainsurances.com/policy/care-health-insurance/care-advantage-chihlip27062v052627/document/19437#c-3-1-1-a"},{"clause":"3.2.8","heading":"Optional Cover 8: Room Rent Modification","page":26,"url":"https://indiainsurances.com/policy/care-health-insurance/care-advantage-chihlip27062v052627/document/19437#c-3-2-8"}],"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":"There is no separate restriction on ICU charges incurred towards stay in ICU during hospitalisation.","display":"No sub-limit","note":null,"quote":"Eligibility of ICU Charges of the Insured Person is ‘no sub-limit’, which means that there is no separate restriction on ICU Charges incurred towards stay in ICU during Hospitalization.","sources":[{"clause":"3.1.1(b)","heading":null,"page":15,"url":"https://indiainsurances.com/policy/care-health-insurance/care-advantage-chihlip27062v052627/document/19437#c-3-1-1-b"}],"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":"quote-verified","value":"There is no proportionate deduction under the base room limit because the base room category is no sub-limit. If the Room Rent Modification optional cover is chosen and a higher room than Single Private Room is used, the insured bears the ratable proportion of associated medical expenses.","display":"Base: none due to no room sub-limit; Optional Room Rent Modification: ratable proportion above Single Private Room","note":"The ratable proportion rule applies only if Optional Cover 8 Room Rent Modification is opted.","quote":"Eligibility of Room Category of the insured person is ‘no sub-limit’ ... If the insured person is admitted in a Hospital room where the Room Category opted or Room Rent incurred is higher than the Single Private Room. Then the Insured Person shall bear the ratable proportion of the total Associate Medical Expenses","sources":[{"clause":"3.1.1(a)","heading":null,"page":15,"url":"https://indiainsurances.com/policy/care-health-insurance/care-advantage-chihlip27062v052627/document/19437#c-3-1-1-a"},{"clause":"3.2.8(ii)","heading":null,"page":26,"url":"https://indiainsurances.com/policy/care-health-insurance/care-advantage-chihlip27062v052627/document/19437#c-3-2-8-ii"}],"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-payment applies if specified in the Policy Schedule. Optional Co-payment Option can be chosen as 5%, 10%, 15% or 20% per claim, and Smart Select adds 20% co-payment for treatment outside listed hospitals.","display":"As specified in schedule; optional 5%/10%/15%/20%; Smart Select 20% outside listed hospitals","note":"The policy wording does not state a mandatory base co-pay percentage; it says co-payment is applicable if specified in the Policy Schedule.","quote":"The Co-payment proportion (if applicable) as specified in the Policy Schedule shall be borne by the Policyholder / Insured Person on each Claim ... If this Optional Cover is opted, then the Insured Person will have an option to bear a Co-payment, as specified in the Policy Schedule ... Co-Payment Option | Option to opt 5%/ 10%/ 15%/ 20% per claim ... If the Insured Person takes Medical Treatment in hospitals other than those listed in Annexure – IV to the Policy Terms and Conditions, then the Policyholder/ Insured Person shall bear a Co-Payment of 20% on each and every Claim","sources":[{"clause":"3","heading":"Benefits Covered Under The Policy GENERAL CONDITIONS APPLICABLE TO ALL THE BENEFITS AND","page":13,"url":"https://indiainsurances.com/policy/care-health-insurance/care-advantage-chihlip27062v052627/document/19437#c-3"},{"clause":"3.2.6","heading":"Optional Cover 6: Co-payment Option","page":24,"url":"https://indiainsurances.com/policy/care-health-insurance/care-advantage-chihlip27062v052627/document/19437#c-3-2-6"},{"clause":null,"heading":"9. SCHEDULE OF BENEFITS","page":23,"url":"https://indiainsurances.com/policy/care-health-insurance/care-advantage-chihlip27062v052627/document/19482#c-9-schedule-of-benefits"},{"clause":"3.2.4(i)","heading":null,"page":23,"url":"https://indiainsurances.com/policy/care-health-insurance/care-advantage-chihlip27062v052627/document/19437#c-3-2-4-i"}],"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":"not-stated","value":null,"display":null,"note":null,"quote":null,"sources":[],"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 include a general clause for diseases or procedures with specified sub-limits, but do not state any named disease or procedure sub-limit for this product.","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":30},"display":"30 days","note":"Optional Cover 13 can modify pre-hospitalisation to 60 days, 90 days or no limit of days.","quote":"Under Pre-hospitalization Medical Expenses, for a period of 30 days immediately prior to the Insured Person’s date of admission to the Hospital","sources":[{"clause":"3.1.2(i)","heading":null,"page":16,"url":"https://indiainsurances.com/policy/care-health-insurance/care-advantage-chihlip27062v052627/document/19437#c-3-1-2-i"}],"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":60},"display":"60 days","note":"Optional Cover 13 can modify post-hospitalisation to 180 days or no limit of days.","quote":"Under Post-hospitalization Medical Expenses, for a period of 60 days immediately after the Insured Person’s date of discharge from the Hospital.","sources":[{"clause":"3.1.2(ii)","heading":null,"page":16,"url":"https://indiainsurances.com/policy/care-health-insurance/care-advantage-chihlip27062v052627/document/19437#c-3-1-2-ii"}],"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 is covered through cashless or reimbursement facility up to the Sum Insured, provided the treatment is listed in Annexure-I and the treatment period in the hospital/day care centre does not exceed 24 hours.","display":"Listed day-care treatments covered up to Sum Insured","note":null,"quote":"The Company will indemnify the Insured Person for Medical Expenses incurred on Day Care Treatment through Cashless or Reimbursement Facility, maximum up to the Sum Insured ,as specified in the Policy Schedule, provided that the Day Care Treatment is listed as per the Annexure-I to Policy Terms & Conditions and period of treatment of the Insured Person in the Hospital/ Day Care Centre does not exceed 24 hours","sources":[{"clause":"3.1.1(ii)","heading":"Day Care Treatment","page":15,"url":"https://indiainsurances.com/policy/care-health-insurance/care-advantage-chihlip27062v052627/document/19437#c-3-1-1-ii"}],"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":"not-stated","value":null,"display":null,"note":"The wording defines domiciliary hospitalisation but does not state a domiciliary treatment benefit or limit.","quote":null,"sources":[],"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":"AYUSH treatment is covered through cashless or reimbursement facility up to the Sum Insured for medical treatment at AYUSH hospitals or health care facilities for Ayurveda, Yoga, Naturopathy, Sidha, Unani and Homeopathy, within India and if the Hospitalization Expenses claim is admissible.","display":"Covered up to Sum Insured for listed AYUSH treatments in India","note":"A claim is admissible under this benefit only if the claim is admissible under Hospitalization Expenses, and treatment must be within India.","quote":"The Company will indemnify the Insured Person, through Cashless or Reimbursement Facility, up to the Sum Insured, as specified in the Policy Schedule, towards Medical Expenses incurred with respect to the Insured Person’s medical treatment undergone at any AYUSH Hospitals or health care facilities for any of the listed AYUSH treatments namely Ayurveda, Yoga, Naturopathy, Sidha , Unani and Homeopathy","sources":[{"clause":"3.1.7","heading":"Benefit 7: AYUSH Treatment","page":20,"url":"https://indiainsurances.com/policy/care-health-insurance/care-advantage-chihlip27062v052627/document/19437#c-3-1-7"}],"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":"Advanced technology methods are covered under Hospitalization Expenses, including uterine artery embolization and HIFU, balloon sinuplasty, deep brain stimulation, oral chemotherapy, immunotherapy monoclonal antibody injection, intra vitreal injections, robotic surgeries, stereotactic radio surgeries, bronchial thermoplasty, green/holmium laser prostate vaporisation, IONM and hematopoietic stem cell therapy for bone marrow transplant for haematological conditions.","display":"Listed advanced technology methods covered under Hospitalization Expenses, up to Sum Insured","note":"Hospitalization Expenses are payable maximum up to the Sum Insured as specified in the Policy Schedule.","quote":"The Company will indemnify the Insured Person for expenses incurred under Benefit 1 (Hospitalization Expenses) for treatment taken through following advance technology methods:\nA Uterine Artery Embolization and HIFU B Balloon Sinuplasty C Deep Brain stimulation D Oral chemotherapy E Immunotherapy - Monoclonal Antibody to be given as injection F Intra vitreal injections G Robotic surgeries H Stereotactic radio surgeries I Bronchical Thermoplasty J Vaporisation of the prostrate (Green laser treatment or holmium laser treatment) K IONM - (Intra Operative Neuro Monitoring) L Stem cell therapy: Hematopoietic stem cells for bone marrow transplant for haematological conditions to be covered.","sources":[{"clause":"3.1.1(b)","heading":null,"page":15,"url":"https://indiainsurances.com/policy/care-health-insurance/care-advantage-chihlip27062v052627/document/19437#c-3-1-1-b"}],"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 medical expenses for organ transplant surgery are covered through cashless or reimbursement facility up to the amount specified in the Policy Schedule; the prospectus schedule states up to Sum Insured.","display":"Covered up to Sum Insured","note":"The donor must be eligible under the Transplantation of Human Organs Act, 1994 and other applicable laws; pre- and post-hospitalisation medical expenses for the donor are not payable.","quote":"The Company will indemnify the Insured Person, through Cashless or Reimbursement Facility, up to the amount specified against this Benefit in the Policy Schedule, for the Medical Expenses incurred in respect of the donor, for any organ transplant surgery during the Policy Year ... Benefit 4 - Organ Donor Cover | Up to SI","sources":[{"clause":"3.1.4","heading":"Benefit 4: Organ Donor Cover","page":17,"url":"https://indiainsurances.com/policy/care-health-insurance/care-advantage-chihlip27062v052627/document/19437#c-3-1-4"},{"clause":null,"heading":"9. SCHEDULE OF BENEFITS","page":23,"url":"https://indiainsurances.com/policy/care-health-insurance/care-advantage-chihlip27062v052627/document/19482#c-9-schedule-of-benefits"}],"law":[]},{"key":"ambulance","label":"Ambulance cover","section":"Cover","meaning":"Road (and air) ambulance cover and its limit.","status":"quote-verified","value":"Road ambulance cover is available through cashless or reimbursement facility up to the amount specified in the Policy Schedule; the prospectus schedule states up to Sum Insured. Air ambulance is an optional cover up to Rs. 5 Lacs.","display":"Road ambulance: up to Sum Insured; optional air ambulance: up to Rs 5 Lacs","note":"Road ambulance must relate to an illness or injury for which a Hospitalization Expenses claim is accepted; air ambulance applies only if Optional Cover 2 is chosen.","quote":"The Company will indemnify the Insured Person, through Cashless or Reimbursement Facility, up to the amount specified against this Benefit in the Policy Schedule ... Benefit 3 - Ambulance Cover | Up to SI ... Optional Cover 2 - Air Ambulance Cover | Up to Rs 5 Lacs","sources":[{"clause":"3.1.3","heading":"Benefit 3: Ambulance Cover","page":16,"url":"https://indiainsurances.com/policy/care-health-insurance/care-advantage-chihlip27062v052627/document/19437#c-3-1-3"},{"clause":null,"heading":"9. SCHEDULE OF BENEFITS","page":23,"url":"https://indiainsurances.com/policy/care-health-insurance/care-advantage-chihlip27062v052627/document/19482#c-9-schedule-of-benefits"}],"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":"Automatic Recharge reinstates up to the base Sum Insured once in a policy year, valid for that policy year only, and can be used for the same illness as well as different illnesses after specified sums are exhausted. Optional Unlimited Automatic Recharge makes the recharge available unlimited times during the policy year, subject to a single-claim payout cap of the base Sum Insured.","display":"Automatic recharge up to base Sum Insured once per policy year; usable for same or different illness; optional unlimited recharge","note":"Recharge is used only after base Sum Insured, No Claims Bonus, No Claims Bonus Super and accidental additional sum insured, where applicable, are exhausted.","quote":"the Company agrees to automatically make the re-instatement of up to the base Sum Insured once in a policy year which is valid for that Policy Year only ... Recharge amount can be utilized for same illness as well as different Illnesses. ... ‘Unlimited Automatic Recharge’ is an extension to Benefit 6 (Automatic Recharge) ... the Recharge shall be available unlimited times during the Policy Year. However, in case of a single claim payout, the maximum liability of the Company shall not exceed the base Sum Insured.","sources":[{"clause":"3.1.6","heading":"Benefit 6: Automatic Recharge","page":19,"url":"https://indiainsurances.com/policy/care-health-insurance/care-advantage-chihlip27062v052627/document/19437#c-3-1-6"},{"clause":"3.2.11","heading":"Optional Cover 11: Unlimited Automatic Recharge","page":27,"url":"https://indiainsurances.com/policy/care-health-insurance/care-advantage-chihlip27062v052627/document/19437#c-3-2-11"}],"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":"No Claims Bonus increases the Sum Insured by 10% flat for each completed and continuous claim-free policy year, up to 50% of Sum Insured. If a claim occurs, the accrued No Claims Bonus is reduced at the same rate at the next policy year.","display":"10% per claim-free year, maximum 50%; reduced at same rate after a claim","note":"Optional No Claims Bonus Super can add 50% per claim-free year up to 100% of Sum Insured if chosen.","quote":"At the end of each Policy Year, the Company will enhance the Sum Insured by 10% flat, on a cumulative basis, as a No Claims Bonus for each completed and continuous Policy Year, provided that no Claim has been paid ... the accrued No Claims Bonus, shall not exceed 50% of the Sum Insured ... In the event of a Claim occurring during any Policy Year, the accrued No Claims Bonus will be reduced at same rate at which it is accrued at the commencement of next Policy Year","sources":[{"clause":"3.1.5","heading":"Benefit 5: No Claims Bonus","page":17,"url":"https://indiainsurances.com/policy/care-health-insurance/care-advantage-chihlip27062v052627/document/19437#c-3-1-5"},{"clause":"3.1.5(i)","heading":null,"page":17,"url":"https://indiainsurances.com/policy/care-health-insurance/care-advantage-chihlip27062v052627/document/19437#c-3-1-5-i"},{"clause":"3.1.5(vii)","heading":null,"page":18,"url":"https://indiainsurances.com/policy/care-health-insurance/care-advantage-chihlip27062v052627/document/19437#c-3-1-5-vii"}],"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":"Non-medical items listed in Annexure II are excluded, and some items are stated to be subsumed into room charges, procedure charges or costs of treatment rather than paid separately. Gloves are listed among optional non-medical items.","display":"Non-medical items excluded; some items subsumed into room/procedure/treatment charges","note":null,"quote":"Any item or condition or treatment specified in List of Non-Medical Items (Annexure – II to Policy Terms & Conditions). ... List of Expenses Generally Excluded (\"Non-medical\") ... Gloves ... List II – Items That Are To Be Subsumed Into Room Charges ... List III – Items That Are To Be subsumed into Procedure Charges ... List iv – Items that are to be subsumed into costs of treatment","sources":[{"clause":"4.2(a)","heading":null,"page":33,"url":"https://indiainsurances.com/policy/care-health-insurance/care-advantage-chihlip27062v052627/document/19437#c-4-2-a"},{"clause":"Annexure II","heading":"List of Expenses Generally Excluded (\"Non-medical\")","page":76,"url":"https://indiainsurances.com/policy/care-health-insurance/care-advantage-chihlip27062v052627/document/19437#c-annexure-ii"}],"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 expenses are excluded, except ectopic pregnancy; miscarriage is excluded unless due to an accident, and lawful medical termination of pregnancy during the policy period is excluded.","display":"Excluded, except ectopic pregnancy; miscarriage covered only if due to accident","note":"Health Services/Discount Connect may give discounts on maternity services, but the insurance maternity expense exclusion remains.","quote":"Maternity: (Code Excl18)\na Medical treatment expenses traceable to childbirth (including complicated deliveries and caesarean sections incurred during hospitalization) except ectopic pregnancy; b Expenses towards miscarriage (unless due to an accident) and lawful medical termination of pregnancy during the policy period.","sources":[{"clause":null,"heading":"15 Maternity: (Code Excl18)","page":32,"url":"https://indiainsurances.com/policy/care-health-insurance/care-advantage-chihlip27062v052627/document/19437#c-15-maternity-code-excl18"}],"law":[]},{"key":"newborn","label":"Newborn baby cover","section":"Cover","meaning":"Whether a newborn is covered from birth and for what.","status":"not-stated","value":null,"display":null,"note":"The wording defines newborn baby and allows mid-term inclusion upon child birth, but does not state newborn baby cover from birth.","quote":null,"sources":[],"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 documents define mental illness and exclude mental retardation/intellectual disability, but do not state inpatient mental illness cover.","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":"Annual Health Check-up is available only if Optional Cover 7 is opted. It is arranged through cashless facility at the company’s network in India once during a policy year per insured person, for listed tests.","display":"Optional annual health check-up, once per policy year per insured person","note":"This is an optional cover, not a base benefit.","quote":"If this Optional Cover is opted ... the Company will arrange for the Insured Person’s Annual Health Check-up for the list of medical tests specified below at its Network to provide the services, in India ... This Benefit shall be available only once during a Policy Year per Insured Person","sources":[{"clause":"3.2.7","heading":"Optional Cover 7: Annual Health Check-up","page":24,"url":"https://indiainsurances.com/policy/care-health-insurance/care-advantage-chihlip27062v052627/document/19437#c-3-2-7"},{"clause":"3.2.7(i)","heading":null,"page":24,"url":"https://indiainsurances.com/policy/care-health-insurance/care-advantage-chihlip27062v052627/document/19437#c-3-2-7-i"},{"clause":"3.2.7(a)","heading":null,"page":24,"url":"https://indiainsurances.com/policy/care-health-insurance/care-advantage-chihlip27062v052627/document/19437#c-3-2-7-a"}],"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":"The base Health Services benefit gives access to special rates for OPD, diagnostics, maternity and pharmacy through the network. Optional Unlimited E-Consultations gives unlimited consultations with qualified general physicians at the company’s network within India during the policy year.","display":"Discounts for OPD/diagnostics/pharmacy; optional unlimited e-consultations","note":"The documents state access to special rates, not reimbursement of ordinary OPD bills.","quote":"Discount Connect: The Insured Person may access to Special rates for OPD, Diagnostics, maternity, Pharmacy etc. through Network as available on the Company’s website. ... By choosing this Optional Cover , the Company shall offer unlimited e-consultations with qualified General Physicians at Company’s Network (within India) during the Policy Year","sources":[{"clause":"3.1.8","heading":"Benefit 8: Health Services","page":20,"url":"https://indiainsurances.com/policy/care-health-insurance/care-advantage-chihlip27062v052627/document/19437#c-3-1-8"},{"clause":"3.2.12","heading":"Optional Cover 12 : Unlimited E-Consultations","page":27,"url":"https://indiainsurances.com/policy/care-health-insurance/care-advantage-chihlip27062v052627/document/19437#c-3-2-12"}],"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":"The product uses pricing zones: Zone 1 Delhi NCR, Surat, Mathura, Aligarh; Zone 2 Telangana; Zone 3 Mumbai including MMR, Indore; Zone 4 Nashik; Zone 5 Pune, Bengaluru Urban, Rest of Gujarat; Zone 6 Howrah, Kolkata, Chennai, Ernakulam, Vishakapatnam; Zone 7 Rest of India.","display":"Yes, pricing zones 1 to 7","note":"Cities include adjoining cities; Delhi-NCR and Mumbai (MMR) are as defined by Government.","quote":"Pricing Zones | Zone 1 - Delhi NCR, Surat, Mathura, Aligarh Zone 2 - Telangana Zone 3 - Mumbai (incl. MMR), Indore Zone 4 - Nashik Zone 5 - Pune, Bengaluru Urban, Rest of Gujarat Zone 6 - Howrah, Kolkata, Chennai, Ernakulam, Vishakapatnam Zone 7 - Rest of India","sources":[{"clause":"1","heading":"ELIGIBILITY CRITERIA","page":1,"url":"https://indiainsurances.com/policy/care-health-insurance/care-advantage-chihlip27062v052627/document/19482#c-1"}],"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 facility is available at network providers, subject to pre-authorization approval by the company. If authorised, the insured need not pay covered medical expenses up to the amount authorised in writing.","display":"Available at network providers with company pre-authorisation","note":null,"quote":"The Company extends Cashless Facility as a mode to indemnify the medical expenses incurred by the Insured Person at a Network Provider. ... Only upon due approval from the Company, Cashless Facility can be availed at any Network Hospital. ... If the request for availing Cashless Facility is authorized by the Company, then payment for the Medical Expenses incurred in respect of the Insured Person shall not have to be made","sources":[{"clause":"6.1.2(a)","heading":null,"page":45,"url":"https://indiainsurances.com/policy/care-health-insurance/care-advantage-chihlip27062v052627/document/19437#c-6-1-2-a"},{"clause":"6.1.2(a)(i)","heading":"Submission of Pre-authorization Form","page":45,"url":"https://indiainsurances.com/policy/care-health-insurance/care-advantage-chihlip27062v052627/document/19437#c-6-1-2-a-i"},{"clause":"6.1.2(a)","heading":null,"page":45,"url":"https://indiainsurances.com/policy/care-health-insurance/care-advantage-chihlip27062v052627/document/19437#c-6-1-2-a-2"}],"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 incurred in India are dealt with directly by the company.","display":"Care Health Insurance directly","note":null,"quote":"All claims incurred in India are dealt by the Company directly.","sources":[{"clause":"6.1.6","heading":"Claim Assessment","page":50,"url":"https://indiainsurances.com/policy/care-health-insurance/care-advantage-chihlip27062v052627/document/19437#c-6-1-6"}],"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 available","note":"Floater combinations are listed in the prospectus eligibility criteria.","quote":"How can You cover Yourself | Individual basis/ Family Floater ... Coverage opted on family floater basis with overall Sum Insured (only one Sum Insured is available for the entire family)","sources":[{"clause":"1","heading":"ELIGIBILITY CRITERIA","page":1,"url":"https://indiainsurances.com/policy/care-health-insurance/care-advantage-chihlip27062v052627/document/19482#c-1"},{"clause":"Annexure VI","heading":null,"page":51,"url":"https://indiainsurances.com/policy/care-health-insurance/care-advantage-chihlip27062v052627/document/19482#c-annexure-vi"}],"law":[]}],"documents":[{"kind":"wording","label":"Care Advantage - Policy Terms & Condition (effective from 02-Jun-2026)","pages":103,"fetched_at":"2026-10-20 01:57:53+00","source_url":"https://cms.careinsurance.com/cms/public/uploads/download_center/care-advantage---policy-terms-&-condition-(effective-from-02-jun-2026).pdf","url":"https://indiainsurances.com/policy/care-health-insurance/care-advantage-chihlip27062v052627/document/19437"},{"kind":"wording","label":"Care Advantage (IRDAI copy)","pages":70,"fetched_at":"2026-10-20 02:32:22+00","source_url":"https://irdai.gov.in/documents/37343/931203/RHIHLIP21015V012021_2020-2021.pdf/27b30b33-94cb-47e7-e7d2-b57ebba1d306?version=1.1&t=1668751813541&download=true","url":"https://indiainsurances.com/policy/care-health-insurance/care-advantage-chihlip27062v052627/document/28690"},{"kind":"prospectus","label":"Care Advantage (Health Insurance Product) -Prospectus cum Sales Literature","pages":56,"fetched_at":"2026-10-20 01:59:59+00","source_url":"https://cms.careinsurance.com/cms/public/uploads/download_center/care-advantage-(health-insurance-product)--prospectus-cum-sales-literature.pdf","url":"https://indiainsurances.com/policy/care-health-insurance/care-advantage-chihlip27062v052627/document/19482"},{"kind":"cis","label":"care advantage - customer information sheet","pages":16,"fetched_at":"2026-10-20 01:56:07+00","source_url":"https://cms.careinsurance.com/cms/public/uploads/download_center/care-advantage---customer-information-sheet.pdf","url":"https://indiainsurances.com/policy/care-health-insurance/care-advantage-chihlip27062v052627/document/19398"},{"kind":"brochure","label":"Care Advantage (Health Insurance Product) - Brochure","pages":6,"fetched_at":"2026-10-20 02:00:27+00","source_url":"https://cms.careinsurance.com/cms/public/uploads/download_center/care-advantage-(health-insurance-product)---brochure.pdf","url":"https://indiainsurances.com/policy/care-health-insurance/care-advantage-chihlip27062v052627/document/19488"}],"versions":[{"uin":"RHIHLIP21015V012021","version":null,"approved_on":null},{"uin":"CHIHLIP27062V052627","version":null,"approved_on":null}],"where_to_buy":[{"purpose":"buy","kind":"insurer","name":"Care Health Insurance official website","url":"https://www.careinsurance.com","note":"Website as listed by IRDAI. Not checked: the site blocks automated requests (bot wall) for our crawler on 2026-10-19; we do not bypass walls."},{"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":"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."}],"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":"care advantage (UIN CHIHLIP27062V052627), IndiaInsurances, https://indiainsurances.com/policy/care-health-insurance/care-advantage-chihlip27062v052627"}