{"uin":"FGIHGSP25029V012425","name":"Ayushman Bharat Pradhan Mantri Jan Arogya Yojna Chief Minister Health Insurance Scheme, Nagaland","url":"https://indiainsurances.com/policy/generali-central-insurance/ayushman-bharat-pradhan-mantri-jan-arogya-yojna-chief-minister-health-insurance--fgihgsp25029v012425","insurer":{"slug":"generali-central-insurance","name":"Generali Central Insurance Company Limited","url":"https://indiainsurances.com/insurer/generali-central-insurance"},"line":"health","category":"health-indemnity","category_name":"Health insurance (hospitalisation)","irdai_type":null,"kind":"product","status":"active","approved_on":null,"withdrawn_on":null,"summary":"AB PM-JAY CMHIS Nagaland is a cashless family floater health insurance scheme for eligible beneficiary family units in Nagaland. It provides Rs. 5,00,000 per family per annum for CMHIS (GEN), while CMHIS (EP) has Rs. 5,00,000 with an additional top up cover of Rs. 15,00,000.","analysis":{"state":"machine","analysed_at":"2026-10-19 19:59:50.78374+00","note":"First pass: one AI reading; every stated fact carries a verbatim quote found in the cited clause, but it has not been reviewed. Check the clause before relying on it."},"facts":[{"key":"plan_variants","label":"Plans and variants","section":"Overview","meaning":"The named plans inside this product (not cover types or payout options). Facts can differ between them.","status":"quote-verified","value":["CMHIS(GEN)","CMHIS (EP)"],"display":"CMHIS(GEN); CMHIS (EP)","note":null,"quote":"the benefits under the AB PM-JAY CMHIS shall be divided into two categories: (a) Benefits for the AB PM-JAY and general population beneficiaries hereinafter referred to as the CMHIS(GEN), where “GEN” connotes General population; and (b) Benefits for government employees and pensioners hereinafter referred to as the CMHIS (EP)","sources":[{"clause":"3.2","heading":null,"page":10,"url":"https://indiainsurances.com/policy/generali-central-insurance/ayushman-bharat-pradhan-mantri-jan-arogya-yojna-chief-minister-health-insurance--fgihgsp25029v012425/document/6093#c-3-2"}],"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":"The standard Policy Cover Period is 12 calendar months from the start of cover, or a lesser period as per the contract unless cancelled earlier.","display":"12 calendar months, or a lesser period as per contract unless cancelled earlier","note":null,"quote":"Policy Cover Period shall mean the standard period of 12 calendar months from the date of start of the Policy Cover or lesser period as per Contract entered between SHA and Insurer, unless cancelled earlier in accordance with this Insurance Contract.","sources":[{"clause":null,"heading":"44.Policy Cover Period","page":6,"url":"https://indiainsurances.com/policy/generali-central-insurance/ayushman-bharat-pradhan-mantri-jan-arogya-yojna-chief-minister-health-insurance--fgihgsp25029v012425/document/6093#c-44-policy-cover-period"}],"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":"Empanelled Health Care Providers must submit claims electronically as early as possible, and not later than 7 days after discharge of an AB PM-JAY CMHIS patient.","display":"EHCPs must submit claims electronically not later than 7 days after discharge","note":null,"quote":"The Insurer shall require the EHCPs to submit their Claims electronically as early as possible but not later than 7 (seven) days after discharge of a AB PM-JAY CMHIS patient in the defined format to be prescribed by the SHA.","sources":[{"clause":"11.1.1","heading":null,"page":23,"url":"https://indiainsurances.com/policy/generali-central-insurance/ayushman-bharat-pradhan-mantri-jan-arogya-yojna-chief-minister-health-insurance--fgihgsp25029v012425/document/6093#c-11-1-1"}],"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":"not-stated","value":null,"display":null,"note":"The wording refers to minimum documentation and proper claim documents, but does not list the claim documents.","quote":null,"sources":[],"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 insurer must honour claims from empanelled hospitals under the scheme within India and settle them within 30 days from receipt of the claims from the EHCPs.","display":"Within 30 days of receipt of claims from the EHCPs","note":null,"quote":"The Insurer is required to honour claims from any empanelled hospital under the Scheme within India and will settle claims within 30 (thirty) days of the receipt of such claims from the EHCPs.","sources":[{"clause":"10.3","heading":null,"page":22,"url":"https://indiainsurances.com/policy/generali-central-insurance/ayushman-bharat-pradhan-mantri-jan-arogya-yojna-chief-minister-health-insurance--fgihgsp25029v012425/document/6093#c-10-3"}],"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":["Condition that does not require hospitalization and can be treated under Outpatient Care, unless featuring in the NHBP 2024.","further expenses incurred at Hospital or Nursing Home primarily for evaluation / diagnostic purposes only during the hospitalized period and expenses on vitamins and tonics etc. unless forming part of treatment for injury or disease","Any dental treatment or surgery which is corrective, prosthetic, cosmetic procedure, filling of tooth cavity, root canal including wear and tear of teeth, periodontal diseases, dental implants etc. are excluded.","Any assisted reproductive techniques, or infertility related procedures, unless featuring in the NHBP 2024.","Vaccination and immunization","Surgeries related to ageing face & body, laser procedures for tattoo removals, augmentation surgeries and other purely cosmetic procedures","Circumcision for children less than 2 years of age shall be excluded","Persistent Vegetative State"],"display":"Outpatient care unless in NHBP 2024; evaluation/diagnostic-only expenses and vitamins/tonics unless part of treatment; specified dental treatment; assisted reproductive or infertility procedures unless in NHBP 2024; vaccination and immunization; cosmetic procedures; circumcision for children less than 2 years unless medically necessary or accident; Persistent Vegetative State","note":null,"quote":"a) Condition that does not require hospitalization and can be treated under Outpatient Care, unless featuring in the NHBP 2024.\nb) Except those expenses covered under pre and post hospitalisation expenses, further expenses incurred at Hospital or Nursing Home primarily for evaluation / diagnostic purposes only during the hospitalized period and expenses on vitamins and tonics etc. unless forming part of treatment for injury or disease as certified by the attending physician.\nc) Any dental treatment or surgery which is corrective, prosthetic, cosmetic procedure, filling of tooth cavity, root canal including wear and tear of teeth, periodontal diseases, dental implants etc. are excluded. Exception to the above would-be treatment needs arising from trauma / injury, neoplasia / tumour / cyst requiring hospitalisation for bone treatment.\nd) Any assisted reproductive techniques, or infertility related procedures, unless featuring in the NHBP 2024.\ne) Vaccination and immunization\nf) Surgeries related to ageing face & body, laser procedures for tattoo removals, augmentation surgeries and other purely cosmetic procedures such as fat grafting, neck lift, aesthetic rhinoplasty etc.\ng) Circumcision for children less than 2 years of age shall be excluded (unless necessary for treatment of a disease not excluded hereunder or as may be necessitated due to any accident).\nh) Persistent Vegetative State: a condition in which a medical patient is completely unresponsive to psychological and physical stimuli and displays no sign of higher brain function, being kept alive only by medical intervention.","sources":[{"clause":"29","heading":"Exclusions","page":40,"url":"https://indiainsurances.com/policy/generali-central-insurance/ayushman-bharat-pradhan-mantri-jan-arogya-yojna-chief-minister-health-insurance--fgihgsp25029v012425/document/6093#c-29"}],"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":"The SHA sets up grievance redressal committees at different levels in Nagaland. For a rejected claim, the EHCP may file a grievance with the District Grievance Nodal Officer within 15 days of rejection.","display":"SHA grievance redressal committees; for rejected claims, DGNO within 15 days","note":null,"quote":"The SHA shall set up a robust and strong grievance redressal mechanism with Grievance Redressal Committees at different levels within the state of Nagaland to attend to the grievances of various stakeholders at different levels. ... Such decision of the Insurer may be appealed by filing a grievance with the District Grievance Nodal Officer (DGNO) within 15 (fifteen) days of rejection of claim, in accordance with Clause 27 of this Insurance Contract.","sources":[{"clause":"17.1","heading":null,"page":30,"url":"https://indiainsurances.com/policy/generali-central-insurance/ayushman-bharat-pradhan-mantri-jan-arogya-yojna-chief-minister-health-insurance--fgihgsp25029v012425/document/6093#c-17-1"},{"clause":"11.2.1","heading":null,"page":25,"url":"https://indiainsurances.com/policy/generali-central-insurance/ayushman-bharat-pradhan-mantri-jan-arogya-yojna-chief-minister-health-insurance--fgihgsp25029v012425/document/6093#c-11-2-1"}],"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":"CMHIS (GEN) has Rs. 5,00,000 per family per annum on a family floater basis. CMHIS (EP) has Rs. 5,00,000 with an additional top up cover of Rs. 15,00,000 per family per annum.","display":"CMHIS (GEN): Rs. 5,00,000 per family per annum; CMHIS (EP): Rs. 5,00,000 plus Rs. 15,00,000 top up per family per annum","note":null,"quote":"the AB PM- JAY CMHIS Sum Insured in respect of the Risk Cover for each CMHIS (GEN) BFU shall be Rs. 5,00,000 (Rupees Five Lakhs Only) per family per annum on a family floater basis. ... the AB PM-JAY CMHIS Sum Insured in respect of the Risk Cover for each CMHIS (EP) Beneficiary Family Unit shall be Rs. 5,00,000 (Rupees Five Lakhs Only) with an additional top up cover of Rs. 15,00,000 (Rupees Fifteen Lakhs Only) per family per annum.","sources":[{"clause":"3.3","heading":"Sum Insured for CMHIS (GEN) BFU","page":10,"url":"https://indiainsurances.com/policy/generali-central-insurance/ayushman-bharat-pradhan-mantri-jan-arogya-yojna-chief-minister-health-insurance--fgihgsp25029v012425/document/6093#c-3-3"},{"clause":"3.4","heading":"Sum Insured for CMHIS (EP) Beneficiary Family Unit","page":10,"url":"https://indiainsurances.com/policy/generali-central-insurance/ayushman-bharat-pradhan-mantri-jan-arogya-yojna-chief-minister-health-insurance--fgihgsp25029v012425/document/6093#c-3-4"}],"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":"not-stated","value":null,"display":null,"note":"The wording states that pre-existing conditions are covered from the first day, but does not state a general initial illness waiting period.","quote":null,"sources":[],"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":0},"display":"Covered from the first day","note":null,"quote":"The Insurer shall ensure that the Policy covers all pre-existing conditions/diseases from the first day of the start of Policy","sources":[{"clause":"3.6","heading":"All pre-existing conditions/diseases to be covered","page":10,"url":"https://indiainsurances.com/policy/generali-central-insurance/ayushman-bharat-pradhan-mantri-jan-arogya-yojna-chief-minister-health-insurance--fgihgsp25029v012425/document/6093#c-3-6"}],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 8","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 12","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 1.6","url":"https://indiainsurances.com/law/irdai-products-regs-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 7","url":"https://indiainsurances.com/law/irdai-products-regs-2024"}]},{"key":"specific_waiting","label":"Specific illness waiting period","section":"Waiting periods","meaning":"Waiting period for a list of named illnesses and procedures (cataract, hernia, joint replacement...). With several tiers (24 and 36 months), the shortest in the answer, the others in the note.","status":"not-stated","value":null,"display":null,"note":null,"quote":null,"sources":[],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 12","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 1.7","url":"https://indiainsurances.com/law/irdai-products-regs-2024"}]},{"key":"specific_waiting_list","label":"Illnesses with a specific waiting period","section":"Waiting periods","meaning":"The named illnesses and procedures that carry the specific waiting period.","status":"not-stated","value":null,"display":null,"note":null,"quote":null,"sources":[],"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":"not-stated","value":null,"display":null,"note":null,"quote":null,"sources":[],"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":"not-stated","value":null,"display":null,"note":"The wording uses portability for access to benefits across the country, not for moving this policy to another insurer with waiting-period credit.","quote":null,"sources":[],"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":false,"display":"No; annual renewals are up to a maximum of 3 consecutive Policy years","note":null,"quote":"with the contract having a provision for annual renewals at the end of each Policy Year for upto a maximum of 3(three) consecutive Policy years","sources":[{"clause":"6.1.1","heading":"Duration of the contract","page":17,"url":"https://indiainsurances.com/policy/generali-central-insurance/ayushman-bharat-pradhan-mantri-jan-arogya-yojna-chief-minister-health-insurance--fgihgsp25029v012425/document/6093#c-6-1-1"}],"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":"not-stated","value":null,"display":null,"note":"The policy states premium arrangements between SHA and the insurer, but does not state premium loading at renewal because a beneficiary made a claim.","quote":null,"sources":[],"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":["Condition that does not require hospitalization and can be treated under Outpatient Care, unless featuring in the NHBP 2024.","further expenses incurred at Hospital or Nursing Home primarily for evaluation / diagnostic purposes only during the hospitalized period and expenses on vitamins and tonics etc.","Any dental treatment or surgery which is corrective, prosthetic, cosmetic procedure, filling of tooth cavity, root canal including wear and tear of teeth, periodontal diseases, dental implants etc. are excluded.","Any assisted reproductive techniques, or infertility related procedures, unless featuring in the NHBP 2024.","Vaccination and immunization","Surgeries related to ageing face & body, laser procedures for tattoo removals, augmentation surgeries and other purely cosmetic procedures","Circumcision for children less than 2 years of age shall be excluded","Persistent Vegetative State"],"display":"Outpatient care unless in NHBP 2024; evaluation/diagnostic-only expenses and vitamins/tonics unless part of treatment; specified dental treatment; assisted reproductive or infertility procedures unless in NHBP 2024; vaccination and immunization; cosmetic procedures; circumcision for children less than 2 years unless medically necessary or accident; Persistent Vegetative State","note":"The wording does not print standard IRDAI exclusion codes Excl04 to Excl18.","quote":"a) Condition that does not require hospitalization and can be treated under Outpatient Care, unless featuring in the NHBP 2024.\nb) Except those expenses covered under pre and post hospitalisation expenses, further expenses incurred at Hospital or Nursing Home primarily for evaluation / diagnostic purposes only during the hospitalized period and expenses on vitamins and tonics etc. unless forming part of treatment for injury or disease as certified by the attending physician.\nc) Any dental treatment or surgery which is corrective, prosthetic, cosmetic procedure, filling of tooth cavity, root canal including wear and tear of teeth, periodontal diseases, dental implants etc. are excluded. Exception to the above would-be treatment needs arising from trauma / injury, neoplasia / tumour / cyst requiring hospitalisation for bone treatment.\nd) Any assisted reproductive techniques, or infertility related procedures, unless featuring in the NHBP 2024.\ne) Vaccination and immunization\nf) Surgeries related to ageing face & body, laser procedures for tattoo removals, augmentation surgeries and other purely cosmetic procedures such as fat grafting, neck lift, aesthetic rhinoplasty etc.\ng) Circumcision for children less than 2 years of age shall be excluded (unless necessary for treatment of a disease not excluded hereunder or as may be necessitated due to any accident).\nh) Persistent Vegetative State: a condition in which a medical patient is completely unresponsive to psychological and physical stimuli and displays no sign of higher brain function, being kept alive only by medical intervention.","sources":[{"clause":"29","heading":"Exclusions","page":40,"url":"https://indiainsurances.com/policy/generali-central-insurance/ayushman-bharat-pradhan-mantri-jan-arogya-yojna-chief-minister-health-insurance--fgihgsp25029v012425/document/6093#c-29"}],"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":"On early termination, SHA pays pro rata premium for the period for which the insurer provided the policy. If excess premium has already been received, the insurer must refund the excess premium excluding the premium due for the pro rata period within 30 days of the end of the Policy Period.","display":"Pro rata premium for period provided; excess premium refund within 30 days of the end of the Policy Period","note":"This is the cancellation/termination refund wording for the SHA-insurer contract, not an individual beneficiary cancellation.","quote":"SHA will provide pro rata premium for the period for which the Insurer has provided the policy within 30 (thirty) days of effective date of termination and fulfilment of obligations of Insurer. In case excess premium with respect to pro rata policy has been already received by the Insurer, then the Insurer will need to refund the excess premium excluding the premium due for the pro rata period within 30 (thirty) days of the end of the Policy Period.","sources":[{"clause":"18.2","heading":"Conditions for Termination of the Agreement","page":31,"url":"https://indiainsurances.com/policy/generali-central-insurance/ayushman-bharat-pradhan-mantri-jan-arogya-yojna-chief-minister-health-insurance--fgihgsp25029v012425/document/6093#c-18-2"}],"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":"Benefits are portable across the country. The insurer must honour claims from empanelled hospitals under the scheme within India.","display":"Across India at empanelled hospitals","note":"CMHIS (GEN) portability outside Nagaland uses the benefit package of the state where treatment is sought.","quote":"The Insurer shall ensure that the benefits of AB PM-JAY CMHIS will be portable across the country and all Beneficiaries of CMHIS(GEN) in Beneficiary Categories 1, 2, and 5 of the Scheme get access to benefits under the Scheme in all AB PM-JAY empanelled hospitals across the country. ... The Insurer is required to honour claims from any empanelled hospital under the Scheme within India","sources":[{"clause":"10.1","heading":"For Beneficiary Categories 1,2 and 5","page":22,"url":"https://indiainsurances.com/policy/generali-central-insurance/ayushman-bharat-pradhan-mantri-jan-arogya-yojna-chief-minister-health-insurance--fgihgsp25029v012425/document/6093#c-10-1"},{"clause":"10.3","heading":null,"page":22,"url":"https://indiainsurances.com/policy/generali-central-insurance/ayushman-bharat-pradhan-mantri-jan-arogya-yojna-chief-minister-health-insurance--fgihgsp25029v012425/document/6093#c-10-3"}],"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":"not-stated","value":null,"display":null,"note":null,"quote":null,"sources":[],"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":"not-stated","value":null,"display":null,"note":null,"quote":null,"sources":[],"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":"There are no entry or exit age restrictions for members of a Beneficiary Family Unit.","display":"No entry or exit age restrictions","note":null,"quote":"no entry or exit age restrictions will apply to the members of a BFU","sources":[{"clause":"2.5","heading":"The Insurer further agrees that","page":9,"url":"https://indiainsurances.com/policy/generali-central-insurance/ayushman-bharat-pradhan-mantri-jan-arogya-yojna-chief-minister-health-insurance--fgihgsp25029v012425/document/6093#c-2-5"}],"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":["annual premium paid by SHA in instalments"],"display":"Annual premium, paid in instalments of 45%, 45% and 10%","note":"Premium is paid by the State Health Agency, not by individual beneficiaries.","quote":"Premium Per Annum Per Beneficiary Family Unit ... The payment of the premium to the Insurer by the SHA will be done as per the following schedule annually: ... 45% of the agreed annual Premium | 45% of the agreed annual Premium | 10% of the agreed annual Premium","sources":[{"clause":"7.1.1","heading":null,"page":18,"url":"https://indiainsurances.com/policy/generali-central-insurance/ayushman-bharat-pradhan-mantri-jan-arogya-yojna-chief-minister-health-insurance--fgihgsp25029v012425/document/6093#c-7-1-1"},{"clause":"7.1.3","heading":null,"page":19,"url":"https://indiainsurances.com/policy/generali-central-insurance/ayushman-bharat-pradhan-mantri-jan-arogya-yojna-chief-minister-health-insurance--fgihgsp25029v012425/document/6093#c-7-1-3"},{"clause":null,"heading":"Period)","page":19,"url":"https://indiainsurances.com/policy/generali-central-insurance/ayushman-bharat-pradhan-mantri-jan-arogya-yojna-chief-minister-health-insurance--fgihgsp25029v012425/document/6093#c-period"}],"law":[]},{"key":"optional_covers","label":"Optional covers","section":"Cover","meaning":"Covers you can add for an extra premium. They change the answers above only if you buy them.","status":"not-stated","value":null,"display":null,"note":"The Rs. 15,00,000 top up is category-based for CMHIS (EP), not stated as an optional cover for extra premium.","quote":null,"sources":[],"law":[]},{"key":"grace_cover","label":"Cover during the grace period","section":"Renewal and rights","meaning":"Whether a claim during the grace period is paid.","status":"not-stated","value":null,"display":null,"note":null,"quote":null,"sources":[],"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":"For CMHIS (EP), where prescribed treatment package rates are not available, room entitlement is Private ward Rs. 4,500 per day for Pay Level 15 and above, Semi-private ward Rs. 3,000 per day for Pay Level 10-14, General Ward Rs. 1,500 per day for Pay Level 9 and below, and Day Care Rs. 500 for all levels. CMHIS (GEN) package rates include bed charges, but no separate room-rent limit is stated.","display":"CMHIS (EP): Private ward Rs. 4,500/day; Semi-private ward Rs. 3,000/day; General Ward Rs. 1,500/day; Day Care Rs. 500; applies only where prescribed treatment package rates are not available","note":"Room entitlement is specifically stated for CMHIS (EP) government employees and pensioners.","quote":"Pay Level 15 and above | Private ward | 4500\nPay Level 10-14 | Semi-private ward | 3000\nPay Level 9 and below | General Ward | 1500\nAll levels | Day Care (6-8 hours) | 500 ... Room rent is applicable only where prescribed treatment package rates are not available. ... Bed charges","sources":[{"clause":"4.4.3","heading":null,"page":12,"url":"https://indiainsurances.com/policy/generali-central-insurance/ayushman-bharat-pradhan-mantri-jan-arogya-yojna-chief-minister-health-insurance--fgihgsp25029v012425/document/6093#c-4-4-3"},{"clause":"4.4.3(a)","heading":null,"page":12,"url":"https://indiainsurances.com/policy/generali-central-insurance/ayushman-bharat-pradhan-mantri-jan-arogya-yojna-chief-minister-health-insurance--fgihgsp25029v012425/document/6093#c-4-4-3-a"},{"clause":"4.3.3","heading":"For the purpose of Hospitalization expenses as package rates","page":11,"url":"https://indiainsurances.com/policy/generali-central-insurance/ayushman-bharat-pradhan-mantri-jan-arogya-yojna-chief-minister-health-insurance--fgihgsp25029v012425/document/6093#c-4-3-3"}],"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":"CMHIS (EP) room entitlement is Private ward for Pay Level 15 and above, Semi-private ward for Pay Level 10-14, and General Ward for Pay Level 9 and below.","display":"CMHIS (EP): Private ward for Pay Level 15 and above; Semi-private ward for Pay Level 10-14; General Ward for Pay Level 9 and below","note":"For pensioners, room entitlement is based on the employee classification level at which they retired.","quote":"Pay Level 15 and above | Private ward | 4500\nPay Level 10-14 | Semi-private ward | 3000\nPay Level 9 and below | General Ward | 1500","sources":[{"clause":"4.4.3","heading":null,"page":12,"url":"https://indiainsurances.com/policy/generali-central-insurance/ayushman-bharat-pradhan-mantri-jan-arogya-yojna-chief-minister-health-insurance--fgihgsp25029v012425/document/6093#c-4-4-3"}],"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":"For patients availing bundled health benefit packages, no separate room rent is admissible if the patient is treated in ICU/ICCU. The wording does not state a separate ICU per-day amount.","display":"No separate room rent for ICU/ICCU under bundled surgical packages","note":null,"quote":"For patients availing bundled health benefit packages (surgical packages), no separate room rent will be admissible if the patient is treated in ICU/ICCU.","sources":[{"clause":"4.4.3(b)","heading":null,"page":12,"url":"https://indiainsurances.com/policy/generali-central-insurance/ayushman-bharat-pradhan-mantri-jan-arogya-yojna-chief-minister-health-insurance--fgihgsp25029v012425/document/6093#c-4-4-3-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":"not-stated","value":null,"display":null,"note":"The wording refers to CGHS guidelines for higher or lower category accommodation, but does not state a proportionate deduction rule.","quote":null,"sources":[],"law":[]},{"key":"copay","label":"Co-payment","section":"Limits and co-pay","meaning":"The share of every admissible claim you pay yourself, and when it applies (age, zone, choice of hospital).","status":"not-stated","value":null,"display":null,"note":"The wording points to Schedule 5 for co-payment where expenses exceed the available Sum Insured, but Schedule 5 is not included in the extracted clauses.","quote":null,"sources":[],"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 wording refers to package rates and financial limits in Schedules 3A and 3B, but the named treatment sub-limit table is not printed in the extracted clauses.","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":3},"display":"3 days before admission","note":"For CMHIS (GEN)/PM-JAY, this is for consultation, diagnostic tests and medicines in the same hospital; CMHIS (EP) also states consultation, diagnostic tests and medicines 3 days before admission.","quote":"expenses incurred for consultation, diagnostic tests, and medicines 3(three) days before the admission of the patient in the same hospital","sources":[{"clause":"3.8.1","heading":"For Coverage under N-HBP 2024 for CMHIS(GEN)/PM-JAY","page":10,"url":"https://indiainsurances.com/policy/generali-central-insurance/ayushman-bharat-pradhan-mantri-jan-arogya-yojna-chief-minister-health-insurance--fgihgsp25029v012425/document/6093#c-3-8-1"}],"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":15},"display":"Up to 15 days after discharge","note":"CMHIS (GEN)/PM-JAY states diagnostic tests and medicines up to 15 days after discharge; CMHIS (EP) states post-hospitalization drugs, consumables and investigations up to 15 days as per prescribed rate limit in Schedule 3B.","quote":"cost of diagnostic tests and medicines up to 15 (fifteen) days of the discharge from the hospital for the same ailment/ surgery ... Post hospitalization charges up to 15 days covering drugs/consumables/investigations shall be paid separately as per prescribed rate limit as mentioned in Schedule 3B.","sources":[{"clause":"3.8.1","heading":"For Coverage under N-HBP 2024 for CMHIS(GEN)/PM-JAY","page":10,"url":"https://indiainsurances.com/policy/generali-central-insurance/ayushman-bharat-pradhan-mantri-jan-arogya-yojna-chief-minister-health-insurance--fgihgsp25029v012425/document/6093#c-3-8-1"},{"clause":"4.4.8(d)","heading":null,"page":13,"url":"https://indiainsurances.com/policy/generali-central-insurance/ayushman-bharat-pradhan-mantri-jan-arogya-yojna-chief-minister-health-insurance--fgihgsp25029v012425/document/6093#c-4-4-8-d"}],"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":"Defined day-care treatments, procedures and medical treatments listed in Schedule 3A and Schedule 3B are covered; CMHIS (GEN) covers limited day-care packages.","display":"Defined day-care treatments as per Schedule 3A and Schedule 3B; CMHIS (GEN) limited day-care packages","note":null,"quote":"The Insurer shall provide coverage for the defined day care treatments, procedures and medical treatments as given in Schedule 3A and Schedule 3B, including all its sub-schedules. ... The procedures will include both surgical and medical procedures and limited day-care packages, as listed in Schedule 3A of this Insurance Contract","sources":[{"clause":"3.7","heading":"Defined day-care treatments to be included in the Policy","page":10,"url":"https://indiainsurances.com/policy/generali-central-insurance/ayushman-bharat-pradhan-mantri-jan-arogya-yojna-chief-minister-health-insurance--fgihgsp25029v012425/document/6093#c-3-7"},{"clause":"4.3.1","heading":"Procedures","page":11,"url":"https://indiainsurances.com/policy/generali-central-insurance/ayushman-bharat-pradhan-mantri-jan-arogya-yojna-chief-minister-health-insurance--fgihgsp25029v012425/document/6093#c-4-3-1"}],"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":null,"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":"not-stated","value":null,"display":null,"note":null,"quote":null,"sources":[],"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":"not-stated","value":null,"display":null,"note":null,"quote":null,"sources":[],"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":"not-stated","value":null,"display":null,"note":"The wording mentions cost of organs in day-care treatment expenses, but does not state cover for an organ donor's hospital costs.","quote":null,"sources":[],"law":[]},{"key":"ambulance","label":"Ambulance cover","section":"Cover","meaning":"Road (and air) ambulance cover and its limit.","status":"not-stated","value":null,"display":null,"note":null,"quote":null,"sources":[],"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":"not-stated","value":null,"display":null,"note":null,"quote":null,"sources":[],"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":"not-stated","value":null,"display":null,"note":null,"quote":null,"sources":[],"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":"For CMHIS (EP), package rates include surgical disposables cost and medicines cost. Implants, stents, grafts, consumables and drugs not specifically mentioned in NHBP 2024 for CMHIS (EP) are paid at NPPA ceiling rates, or actual cost if no ceiling rates are available.","display":"CMHIS (EP): surgical disposables and medicines included; non-listed implants, stents, grafts, consumables and drugs paid at NPPA ceiling rates or actual if no ceiling rate","note":"The wording states this specifically in the CMHIS (EP) package construct.","quote":"Surgical disposables cost\n• Medicines cost ... For implants, stents, grafts, consumables, drugs, not specifically mentioned in the NHBP 2024 for CMHIS (EP) list, the NPPA (National Pharmaceutical Pricing Authority) ceiling rates shall be applicable. If no prescribed ceiling rates are available, the cost shall be paid as per actual.","sources":[{"clause":"4.4.8(b)","heading":"Package rate","page":13,"url":"https://indiainsurances.com/policy/generali-central-insurance/ayushman-bharat-pradhan-mantri-jan-arogya-yojna-chief-minister-health-insurance--fgihgsp25029v012425/document/6093#c-4-4-8-b"},{"clause":"4.4.8(c)","heading":null,"page":13,"url":"https://indiainsurances.com/policy/generali-central-insurance/ayushman-bharat-pradhan-mantri-jan-arogya-yojna-chief-minister-health-insurance--fgihgsp25029v012425/document/6093#c-4-4-8-c"}],"law":[]},{"key":"maternity","label":"Maternity cover","section":"Cover","meaning":"Whether childbirth costs are covered, the limit and the waiting period.","status":"not-stated","value":null,"display":null,"note":null,"quote":null,"sources":[],"law":[]},{"key":"newborn","label":"Newborn baby cover","section":"Cover","meaning":"Whether a newborn is covered from birth and for what.","status":"quote-verified","value":"New-born child/ children benefit is included among the cashless benefits under the Risk Cover.","display":"New-born child/ children benefit included","note":"The wording does not state a separate newborn limit.","quote":"which shall include:\na) Hospitalization expense benefits;\nb) Day care treatment benefits (as applicable);\nc) Follow-up care benefits;\nd) Pre- and post-hospitalization expense benefits; and\ne) New-born child/ children benefit","sources":[{"clause":"4.2","heading":null,"page":11,"url":"https://indiainsurances.com/policy/generali-central-insurance/ayushman-bharat-pradhan-mantri-jan-arogya-yojna-chief-minister-health-insurance--fgihgsp25029v012425/document/6093#c-4-2"}],"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":null,"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":"not-stated","value":null,"display":null,"note":"The wording mentions digital/physical health assessment for healthy-behaviour rewards, but does not state free preventive health check-ups.","quote":null,"sources":[],"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":"Out-patient care is excluded unless it features in the NHBP 2024.","display":"Excluded unless featuring in the NHBP 2024","note":null,"quote":"Condition that does not require hospitalization and can be treated under Outpatient Care, unless featuring in the NHBP 2024.","sources":[{"clause":"29","heading":"Exclusions","page":40,"url":"https://indiainsurances.com/policy/generali-central-insurance/ayushman-bharat-pradhan-mantri-jan-arogya-yojna-chief-minister-health-insurance--fgihgsp25029v012425/document/6093#c-29"}],"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":"not-stated","value":null,"display":null,"note":null,"quote":null,"sources":[],"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 access is provided at Empanelled Health Care Providers, with covered expenses paid directly by the insurer to the EHCP so beneficiaries are not required to pay those covered expenses.","display":"Cashless at Empanelled Health Care Providers; insurer pays covered expenses directly to the EHCP","note":null,"quote":"Cashless Access Service means a facility extended by the Insurer to the Beneficiaries where the payments of the expenses that are covered under the Risk Cover are directly made by the Insurer to the Empanelled Health Care Providers ... none of the Beneficiaries are required to pay any amount to the Empanelled Health Care Providers in respect of such expenses","sources":[{"clause":null,"heading":"15.Cashless Access Service","page":4,"url":"https://indiainsurances.com/policy/generali-central-insurance/ayushman-bharat-pradhan-mantri-jan-arogya-yojna-chief-minister-health-insurance--fgihgsp25029v012425/document/6093#c-15-cashless-access-service"}],"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":"The insurer has final responsibility for approval and rejection of claims. If a TPA is hired, it may process and recommend action, but cannot approve or reject claims on the insurer's behalf.","display":"Insurer decides claims; TPA may process only if hired","note":null,"quote":"In case the Insurer hires one or more Third Party Administrator (TPA), it shall ensure that the TPA does not approve or reject any Claim on its behalf and that the TPA is only engaged in the processing of Claims. The TPA may, however, recommend to the Insurer on the action to be taken in relation to a Claim. However, the final decision on approval and rejection of Claims shall be made by the Insurer.","sources":[{"clause":"11.1.19","heading":null,"page":24,"url":"https://indiainsurances.com/policy/generali-central-insurance/ayushman-bharat-pradhan-mantri-jan-arogya-yojna-chief-minister-health-insurance--fgihgsp25029v012425/document/6093#c-11-1-19"}],"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, on a family floater basis","note":null,"quote":"The Insurer shall ensure that the Scheme’s Risk Cover shall be provided to each BFU on a family floater basis covering all the members of the BFU including Senior Citizens","sources":[{"clause":"3.5","heading":"Risk cover to be provided on a family floater basis","page":10,"url":"https://indiainsurances.com/policy/generali-central-insurance/ayushman-bharat-pradhan-mantri-jan-arogya-yojna-chief-minister-health-insurance--fgihgsp25029v012425/document/6093#c-3-5"}],"law":[]}],"documents":[{"kind":"wording","label":"Ayushman Bharat Pradhan Mantri Jan Arogya Yojna Chief Minister Health Insurance Scheme, Nagaland Policy Wordings","pages":40,"fetched_at":"2026-10-17 19:45:22+00","source_url":"https://www.generalicentralinsurance.com/downloads/commercial-insurance/ayushman-bharat-pradhan-mantri-jan-arogya-yojna-chief-minister-health-insurance-scheme-nagaland/policy-wording/ayushman-bharat-pradhan-mantri-jan-arogya-yojna-chief-minister-health-insurance-scheme-nagaland-policy-wordings.pdf","url":"https://indiainsurances.com/policy/generali-central-insurance/ayushman-bharat-pradhan-mantri-jan-arogya-yojna-chief-minister-health-insurance--fgihgsp25029v012425/document/6093"}],"versions":[],"where_to_buy":[{"purpose":"buy","kind":"insurer","name":"Generali Central Insurance official website","url":"https://www.generalicentralinsurance.com/","note":"Buy directly from the insurer."},{"purpose":"buy","kind":"ours","name":"Get free help from IndiaInsurances","url":"/help","note":"Free. We do not sell insurance and earn no commission; your request is not passed to anyone."}],"claims_and_complaints":[{"purpose":"claim","kind":"insurer","name":"Motor claim process","url":"https://www.generalicentralinsurance.com/motor-insurance/motor-claim-process","note":null},{"purpose":"claim","kind":"insurer","name":"Other claim process","url":"https://www.generalicentralinsurance.com/other-claim-process","note":null},{"purpose":"claim","kind":"ours","name":"Get free help from IndiaInsurances","url":"/help","note":"Free. We do not sell insurance and earn no commission; your request is not passed to anyone."},{"purpose":"grievance","kind":"insurer","name":"Grievance redressal","url":"https://www.generalicentralinsurance.com/customer-service/grievance-redressal","note":null},{"purpose":"grievance","kind":"official","name":"Bima Bharosa (IRDAI grievance portal)","url":"https://bimabharosa.irdai.gov.in/","note":"Register and track a complaint against any insurer with IRDAI. Complain to the insurer first; escalate here if the reply is late or unsatisfactory."},{"purpose":"grievance","kind":"official","name":"e-Daakhil (consumer commission e-filing)","url":"https://edaakhil.nic.in/","note":"Not reachable from our crawler on 2026-10-19; use e-Jagriti if this link does not open."},{"purpose":"grievance","kind":"official","name":"e-Jagriti (consumer commission filing)","url":"https://e-jagriti.gov.in/","note":"Ministry of Consumer Affairs platform for consumer commission cases, a route for insurance disputes that the Ombudsman does not settle."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Ahmedabad","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Gujarat, Dadra & Nagar Haveli, Daman and Diu. Email: oio.ahmedabad@cioins.co.in. Phone: 079 - 25501201/02. Address: Office of the Insurance Ombudsman, Jeevan Prakash Building, 6th floor, Tilak Marg, Relief Road, AHMEDABAD – 380 001."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Bengaluru","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Karnataka. Email: oio.bengaluru@cioins.co.in. Phone: 080 - 26652048 / 26652049. Address: Office of the Insurance Ombudsman, Jeevan Soudha Building,PID No. 57-27-N-19 Ground Floor, 19/19, 24th Main Road, JP Nagar, Ist Phase, Bengaluru – 560 078."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Bhopal","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Madhya Pradesh, Chhattisgarh. Email: oio.bhopal@cioins.co.in. Phone: 0755 - 2769201 / 2769202 / 2769203. Address: Office of the Insurance Ombudsman, 1st floor,\"Jeevan Shikha\", 60-B,Hoshangabad Road, Opp. Gayatri Mandir,Arera Hills Bhopal – 462 011."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Bhubaneswar","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Odisha. Email: oio.bhubaneswar@cioins.co.in. Phone: 0674 - 2596461 /2596455/2596429/2596003. Address: Office of the Insurance Ombudsman, 62, Forest park, Bhubaneswar – 751 009."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Chandigarh","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Punjab, Haryana (excluding Gurugram, Faridabad, Sonepat and Bahadurgarh), Himachal Pradesh, Union Territories of Jammu & Kashmir,Ladakh & Chandigarh. Email: oio.chandigarh@cioins.co.in. Phone: 0172-2706468. Address: Office Of The Insurance Ombudsman, Jeevan Deep Building SCO 20-27, Ground Floor Sector- 17 A, Chandigarh – 160 017."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Chennai","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Tamil Nadu, PuducherryTown and Karaikal (which are part of Puducherry). Email: oio.chennai@cioins.co.in. Phone: 044 - 24333668 / 24333678. Address: Office of the Insurance Ombudsman, Fatima Akhtar Court, 4th Floor, 453, Anna Salai, Teynampet, CHENNAI – 600 018."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Delhi","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Delhi & following Districts of Haryana - Gurugram, Faridabad, Sonepat & Bahadurgarh. Email: oio.delhi@cioins.co.in. Phone: 011 - 46013992/23213504/23232481. Address: Office of the Insurance Ombudsman, 2/2 A, Universal Insurance Building, Asaf Ali Road, New Delhi – 110 002."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Guwahati","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Assam, Meghalaya, Manipur, Mizoram, Arunachal Pradesh, Nagaland and Tripura. Email: oio.guwahati@cioins.co.in. Phone: 0361 - 2632204 / 2602205 / 2631307. Address: Office of the Insurance Ombudsman, Jeevan Nivesh, 5th Floor, Near Pan Bazar , S.S. Road, Guwahati – 781001(ASSAM)."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Hyderabad","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Andhra Pradesh, Telangana, Yanam and part of Union Territory of Puducherry. Email: oio.hyderabad@cioins.co.in. Phone: 040 - 23312122 / 23376991 / 23376599 / 23328709 / 23325325. Address: Office of the Insurance Ombudsman, 6-2-46, 1st floor, \"Moin Court\", Lane Opp.Hyundai Showroom , A. C. Guards, Lakdi-Ka-Pool, Hyderabad - 500 004."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Jaipur","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Rajasthan. Email: oio.jaipur@cioins.co.in. Phone: 0141- 2740363. Address: Office of the Insurance Ombudsman, Jeevan Nidhi – II Bldg., Gr. Floor, Bhawani Singh Marg, Jaipur - 302 005."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Kochi","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Kerala, Lakshadweep, Mahe-a part of Union Territory of Puducherry. Email: oio.ernakulam@cioins.co.in. Phone: 0484 - 2358759. Address: Office of the Insurance Ombudsman, 10th Floor, Jeevan Prakash,LIC Building, Opp to Maharaja's College Ground,M.G.Road, Kochi - 682 011."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Kolkata","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: West Bengal, Sikkim, Andaman & Nicobar Islands. Email: oio.kolkata@cioins.co.in. Phone: 033 - 22124339 / 22124341. Address: Office of the Insurance Ombudsman, Hindustan Bldg. Annexe, 7th Floor, 4, C.R. Avenue, KOLKATA - 700 072."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Lucknow","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Districts of Uttar Pradesh : Lalitpur, Jhansi, Mahoba, Hamirpur, Banda, Chitrakoot, Allahabad, Mirzapur, Sonbhabdra, Fatehpur, Pratapgarh, Jaunpur,Varanasi, Gazipur, Jalaun, Kanpur, Lucknow, Unnao, Sitapur, Lakhimpur, Bahraich, Barabanki, Raebareli, Sravasti, Gonda, Faizabad, Amethi, Kaushambi, Balrampur, Basti, Ambedkarnagar, Sultanpur, Maharajgang, Santkabirnagar, Azamgarh, Kushinagar, Gorkhpur, Deoria, Mau, Ghazipur, Chandauli, Ballia, Sidharathnagar. Email: oio.lucknow@cioins.co.in. Phone: 0522 - 4002082 / 3500613. Address: Office of the Insurance Ombudsman, 6th Floor, Jeevan Bhawan, Phase-II, Nawal Kishore Road, Hazratganj, Lucknow - 226 001."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Mumbai","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: List of wards under Mumbai Metropolitan Region excluding wards in Mumbai – i.e M/E, M/W, N , S and T covered under Office of Insurance Ombudsman Thane and excluding areas of Navi Mumbai. Email: oio.mumbai@cioins.co.in. Phone: 022 - 69038800/27/29/31/32/33. Address: Office of the Insurance Ombudsman, 3rd Floor, Jeevan Seva Annexe, S. V. Road, Santacruz (W), Mumbai - 400 054."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Noida","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: State of Uttarakhand and the following Districts of Uttar Pradesh: Agra, Aligarh, Bagpat, Bareilly, Bijnor, Budaun, Bulandshehar, Etah, Kannauj, Mainpuri, Mathura, Meerut, Moradabad, Muzaffarnagar, Oraiyya, Pilibhit, Etawah, Farrukhabad, Firozbad, Gautam Buddh nagar, Ghaziabad, Hardoi, Shahjahanpur, Hapur, Shamli, Rampur, Kashganj, Sambhal, Amroha, Hathras, Kanshiramnagar, Saharanpur. Email: oio.noida@cioins.co.in. Phone: 0120-4027589. Address: Office of the Insurance Ombudsman, Bhagwan Sahai Palace 4th Floor, Main Road, Naya Bans, Sector 15, Distt: Gautam Buddh Nagar, U.P-201301."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman: offices and jurisdiction","url":"https://www.cioins.co.in/Ombudsman","note":"Addresses, phone numbers, e-mail and the states or districts each Ombudsman office covers."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Patna","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Bihar, Jharkhand. Email: oio.patna@cioins.co.in. Phone: 0612-2547068. Address: Office of the Insurance Ombudsman, 2nd Floor, Lalit Bhawan, Bailey Road, Patna 800 001."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Pune","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: State of Goa and State of Maharashtra excluding areas of Navi Mumbai, Thane district,Palghar District, Raigad district & Mumbai Metropolitan Region. Email: oio.pune@cioins.co.in. Phone: 020-24471175. Address: Office of the Insurance Ombudsman, Jeevan Darshan Bldg., 3rd Floor, C.T.S. No.s. 195 to 198, N.C. Kelkar Road, Narayan Peth, Pune – 411 030."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman: register a complaint online","url":"https://cioins.co.in/Complaint/Online","note":"Council for Insurance Ombudsmen. Free. For disputes with an insurer after its own grievance process; the office is chosen by where you live (see the offices list)."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Thane","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Area of Navi Mumbai, Thane District, Raigad District, Palghar District and wards of Mumbai , M/East, M/West, N, S and T. Email: oio.thane@cioins.co.in. Phone: 022-20812868/69. Address: Office of the Insurance Ombudsman, Jeevan Chintamani Building, 2nd Floor,Near New RTO Office, Louis Wadi,Vasantrao Naik Mahamarg, Thane (West)- 400604."},{"purpose":"grievance","kind":"official","name":"National Consumer Helpline","url":"https://consumerhelpline.gov.in/public/","note":"Government consumer helpline; can take up a complaint before you go to a consumer commission."},{"purpose":"port","kind":"ours","name":"Get free help from IndiaInsurances","url":"/help","note":"Free. We do not sell insurance and earn no commission; your request is not passed to anyone."},{"purpose":"renew","kind":"insurer","name":"Renewals","url":"https://www.generalicentralinsurance.com/renewals","note":null}],"notice":"Information, not advice. IndiaInsurances is not an insurer or an insurance intermediary, does not sell insurance and earns no commission. Policy terms change and your own policy schedule can differ: always confirm with the policy document and the insurer before you buy or claim.","cite_as":"Ayushman Bharat Pradhan Mantri Jan Arogya Yojna Chief Minister Health Insurance Scheme, Nagaland (UIN FGIHGSP25029V012425), IndiaInsurances, https://indiainsurances.com/policy/generali-central-insurance/ayushman-bharat-pradhan-mantri-jan-arogya-yojna-chief-minister-health-insurance--fgihgsp25029v012425"}