{"uin":"GCIHLGP21165V022021","name":"Group Health Insurance (Revised)","url":"https://indiainsurances.com/policy/generali-central-insurance/group-health-insurance-revised-gcihlgp21165v022021","insurer":{"slug":"generali-central-insurance","name":"Generali Central Insurance Company Limited","url":"https://indiainsurances.com/insurer/generali-central-insurance"},"line":"health","category":"group-health","category_name":"Group health","irdai_type":"Revision","kind":"product","status":"active","approved_on":"2020-08-24","withdrawn_on":null,"summary":"This is a group health indemnity policy for employees or members and eligible family members, with entry from birth/90 days for dependent children up to age 80 and lifelong renewability subject to continuous renewal of the group policy. It covers hospitalisation in India, has 30-day initial, 36-month pre-existing disease and 12-month specified disease waiting periods in the base cover, and offers optional maternity, waiver of waiting periods, OPD and other extensions.","analysis":{"state":"machine","analysed_at":"2026-10-19 20:01:08.355578+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":null,"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":"The policy can be issued for a minimum tenure of 1 year. Credit linked policies can be issued for a maximum tenure of 5 years or up to the loan period, whichever is less.","display":"Minimum 1 year; credit linked policies up to 5 years or loan period, whichever is less","note":null,"quote":"The Policy can be issued for minimum tenure of 1 year ... In case of Credit Linked Policies, the Policy can be issued for a maximum tenure of 5 years or up to the loan period, whichever is less.","sources":[{"clause":"8(a)","heading":null,"page":15,"url":"https://indiainsurances.com/policy/generali-central-insurance/group-health-insurance-revised-gcihlgp21165v022021/document/6116#c-8-a-5"},{"clause":"8(b)","heading":null,"page":15,"url":"https://indiainsurances.com/policy/generali-central-insurance/group-health-insurance-revised-gcihlgp21165v022021/document/6116#c-8-b-5"}],"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":"Claim intimation should be given within 48 hrs of admission or before discharge. For reimbursement where cashless is denied, treatment is at a non-network hospital or cashless is not used, written notification must be given immediately and in any event within 48 hours of the illness or bodily injury.","display":"Within 48 hrs of admission or before discharge; for reimbursement, immediately and within 48 hours of illness or bodily injury","note":null,"quote":"Notification of the Claim intimation should be given within 48 hrs of Admission or before Discharge from Hospital/ Nursing Home. ... Insured Person must give Notification of Claim, in writing, immediately, and in any event within 48 hours of the aforesaid Illness or Bodily Injury.","sources":[{"clause":"8(b)","heading":null,"page":13,"url":"https://indiainsurances.com/policy/generali-central-insurance/group-health-insurance-revised-gcihlgp21165v022021/document/6116#c-8-b"},{"clause":"8(a)","heading":null,"page":14,"url":"https://indiainsurances.com/policy/generali-central-insurance/group-health-insurance-revised-gcihlgp21165v022021/document/6116#c-8-a-3"}],"law":[{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, V.1","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, V.1","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part C, V.1","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Para 20, 21","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"}]},{"key":"claim_documents","label":"Claim documents","section":"Claims","meaning":"Documents the insurer asks for when you claim.","status":"quote-verified","value":["Claim form","Original discharge summary","Original set of investigation reports","Original bills and receipts","Pharmacy bills in original with prescriptions","first consultation letter","birth/death certificate (as applicable)","post mortem report (if any)"],"display":"Claim form; original discharge summary; original investigation reports; original bills and receipts; pharmacy bills with prescriptions; first consultation letter; birth/death certificate if applicable; post mortem report if any","note":null,"quote":"Following is the ‘necessary’ document list for claim submission:\n• Claim form\n• Original discharge summary\n• Original set of investigation reports\n• Original bills and receipts\n• Pharmacy bills in original with prescriptions ... including but not limited to first consultation letter, original vouchers, bills and receipts, birth/death certificate (as applicable) ... send the Company a copy of the post mortem report (if any) within 14 days.","sources":[{"clause":"8(a)","heading":null,"page":14,"url":"https://indiainsurances.com/policy/generali-central-insurance/group-health-insurance-revised-gcihlgp21165v022021/document/6116#c-8-a-4"},{"clause":"8(b)","heading":null,"page":14,"url":"https://indiainsurances.com/policy/generali-central-insurance/group-health-insurance-revised-gcihlgp21165v022021/document/6116#c-8-b-3"},{"clause":"8(c)","heading":null,"page":14,"url":"https://indiainsurances.com/policy/generali-central-insurance/group-health-insurance-revised-gcihlgp21165v022021/document/6116#c-8-c-3"}],"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 receipt of the last necessary document. If investigation is warranted, it must complete investigation not later than 30 days from receipt of the last necessary document and settle or reject within 45 days from receipt of the last necessary document.","display":"15 days from last necessary document; 45 days if investigation is warranted","note":null,"quote":"The Company shall settle or reject a claim, as the case may be, within 15 days from the date of 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 30 days from the date of receipt of last necessary document- ln such cases, the Company shall settle or reject the claim within 45 days from the date of receipt of last necessary document.","sources":[{"clause":"8(c)(i)","heading":null,"page":14,"url":"https://indiainsurances.com/policy/generali-central-insurance/group-health-insurance-revised-gcihlgp21165v022021/document/6116#c-8-c-i"},{"clause":"8(c)(iii)","heading":null,"page":14,"url":"https://indiainsurances.com/policy/generali-central-insurance/group-health-insurance-revised-gcihlgp21165v022021/document/6116#c-8-c-iii"}],"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 Disease- Excl 01","Specified disease/procedure waiting period- Code- Excl02","30 days waiting period Excl -03","Investigation & Evaluation- Code- Excl04","Rest Cure, rehabilitation and respite care- Code- Excl05","Change-of-Gender treatments: Code- Excl07","Cosmetic or Plastic Surgery: Code- Excl08","Hazardous or Adventure sports: Code- Excl09","Breach of law: Code- Excl10","Code- Excl12 Treatment for, Alcoholism, drug or substance abuse or any addictive condition and consequences thereof.","Maternity: Code Excl 18","Injury or Disease directly or indirectly caused by or arising from or attributable to War, Invasion, Act of Foreign Enemy, War like operations","Outpatient Diagnostic, Medical and Surgical procedures or treatments (OPD treatment)","Intentional self-injury.","Injury or Disease directly or indirectly caused by or contributed to by nuclear weapons/ materials."],"display":"PED, specified disease/procedure and 30-day waiting-period exclusions, plus investigation/evaluation, rest cure, gender-change, cosmetic surgery, hazardous sports, breach of law, substance abuse, maternity, war, OPD, self-injury and nuclear exclusions","note":null,"quote":"Pre-Existing Disease- Excl 01 ... Specified disease/procedure waiting period- Code- Excl02 ... 30 days waiting period Excl -03 ... Investigation & Evaluation- Code- Excl04 ... Rest Cure, rehabilitation and respite care- Code- Excl05 ... Change-of-Gender treatments: Code- Excl07 ... Cosmetic or Plastic Surgery: Code- Excl08 ... Hazardous or Adventure sports: Code- Excl09 ... Breach of law: Code- Excl10 ... Code- Excl12 Treatment for, Alcoholism, drug or substance abuse or any addictive condition and consequences thereof. ... Maternity: Code Excl 18 ... Injury or Disease directly or indirectly caused by or arising from or attributable to War, Invasion, Act of Foreign Enemy, War like operations ... Outpatient Diagnostic, Medical and Surgical procedures or treatments (OPD treatment), ... Intentional self-injury. ... Injury or Disease directly or indirectly caused by or contributed to by nuclear weapons/ materials.","sources":[{"clause":null,"heading":"1. Waiting Periods","page":7,"url":"https://indiainsurances.com/policy/generali-central-insurance/group-health-insurance-revised-gcihlgp21165v022021/document/6116#c-1-waiting-periods"},{"clause":null,"heading":"2. Standard Exclusions","page":8,"url":"https://indiainsurances.com/policy/generali-central-insurance/group-health-insurance-revised-gcihlgp21165v022021/document/6116#c-2-standard-exclusions"},{"clause":"6(b)(iv)","heading":null,"page":9,"url":"https://indiainsurances.com/policy/generali-central-insurance/group-health-insurance-revised-gcihlgp21165v022021/document/6116#c-6-b-iv"},{"clause":null,"heading":"3. Specific Exclusions","page":10,"url":"https://indiainsurances.com/policy/generali-central-insurance/group-health-insurance-revised-gcihlgp21165v022021/document/6116#c-3-specific-exclusions"},{"clause":"6(b)(v)","heading":null,"page":10,"url":"https://indiainsurances.com/policy/generali-central-insurance/group-health-insurance-revised-gcihlgp21165v022021/document/6116#c-6-b-v"}],"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 the company through its website, toll-free numbers, email, courier or branch grievance cell. If not satisfied, contact the grievance officer at GCIGRO@generalicentral.com or call 7900197777 before approaching the Insurance Ombudsman.","display":"Company website/toll-free/email/courier/branch first; then grievance officer at GCIGRO@generalicentral.com or 7900197777","note":null,"quote":"In case of any grievance the insured person may contact the company through Website: https://generalicentralinsurance.com Toll Free: 1800-220-233 / 1860-500-3333 / 022-67837800 Email: GCIcare@generalicentral.com Courier: Grievance Redressal Cell, Generali Central Insurance Company Ltd. ... Insured person may also approach the grievance cell at any of the company's branches with the details of grievance.\nlf lnsured person is not satisfied with the redressal of grievance through one of the above methods, insured person may contact the grievance officer at GCIGRO@generalicentral.com or call at: 7900197777","sources":[{"clause":"8","heading":"Redressal of Grievance","page":12,"url":"https://indiainsurances.com/policy/generali-central-insurance/group-health-insurance-revised-gcihlgp21165v022021/document/6116#c-8-2"}],"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":"not-stated","value":null,"display":null,"note":"The wording refers to the sum insured as mentioned in the schedule, but does not print selectable cover amounts.","quote":null,"sources":[],"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":"The exclusion does not apply to accident claims, and does not apply 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":null,"heading":"1. Waiting Periods","page":7,"url":"https://indiainsurances.com/policy/generali-central-insurance/group-health-insurance-revised-gcihlgp21165v022021/document/6116#c-1-waiting-periods"}],"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":"If the sum insured is enhanced, the exclusion applies afresh to the increased sum insured; portability credit can reduce the waiting period.","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 us.","sources":[{"clause":null,"heading":"1. Waiting Periods","page":7,"url":"https://indiainsurances.com/policy/generali-central-insurance/group-health-insurance-revised-gcihlgp21165v022021/document/6116#c-1-waiting-periods"}],"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":12},"display":"12 months","note":"Accident claims are excepted. If the specified disease or procedure is also pre-existing, the longer pre-existing disease waiting period applies.","quote":"Expenses related to the treatment of the listed Conditions, surgeries/treatments shall be excluded until the expiry of 12months of continuous coverage after the date of inception of the first policy with us. This exclusion shall not be applicable for claims arising due to an accident. ... If any of the specified disease/procedure falls under the waiting period specified for pre-Existing diseases, then the longer of the two waiting periods shall apply.","sources":[{"clause":null,"heading":"1. Waiting Periods","page":7,"url":"https://indiainsurances.com/policy/generali-central-insurance/group-health-insurance-revised-gcihlgp21165v022021/document/6116#c-1-waiting-periods"}],"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":["Cataract","Benign Prostatic Hypertrophy","Hysterectomy/ myomectomy for menorrhagia or fibromyoma or prolapse of uterus","Hernia","Hydrocele","Fistula in anus, piles","Sinusitis and related disorders","Surgery for prolapsed inter vertebral disc unless arising from accident","Surgery of varicose veins and varicose ulcers","Joint Replacement due to Degenerative condition, Age related osteoarthritis and Osteoporosis."],"display":"Cataract; Benign Prostatic Hypertrophy; Hysterectomy/myomectomy; Hernia; Hydrocele; Fistula in anus, piles; Sinusitis; prolapsed inter vertebral disc surgery; varicose veins and ulcers surgery; degenerative/age-related joint replacement","note":null,"quote":"Waiting period of 12 months:\na) Cataract\nb) Benign Prostatic Hypertrophy\nc) Hysterectomy/ myomectomy for menorrhagia or fibromyoma or prolapse of uterus\nd) Hernia\ne) Hydrocele\nf) Fistula in anus, piles\ng) Sinusitis and related disorders\nh) Surgery for prolapsed inter vertebral disc unless arising from accident\ni) Surgery of varicose veins and varicose ulcers\nj) Joint Replacement due to Degenerative condition, Age related osteoarthritis and Osteoporosis.","sources":[{"clause":null,"heading":"1. Waiting Periods","page":7,"url":"https://indiainsurances.com/policy/generali-central-insurance/group-health-insurance-revised-gcihlgp21165v022021/document/6116#c-1-waiting-periods"}],"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":"quote-verified","value":"Portability is defined as the right of individual health insurance policyholders, including family cover, to transfer credit for pre-existing conditions and time bound exclusions from one insurer to another. The waiting periods for PED and specified diseases are reduced by prior continuous coverage under applicable IRDAI portability norms.","display":"Yes, credit for pre-existing conditions and time-bound exclusions can transfer from one insurer to another under portability norms","note":"The portability definition is for individual health insurance policyholders including members under family cover.","quote":"Portability means the right accorded to an individual health insurance policyholders (including all members under family cover), to transfer the credit gained for pre-existing conditions and time bound exclusions, from one insurer to another insurer. ... If the Insured Person is continuously covered without any break as defined under the applicable norms on portability stipulated by IRDAI, then waiting period for the same would be reduced to the extent of prior coverage.","sources":[{"clause":"35","heading":"Portability","page":5,"url":"https://indiainsurances.com/policy/generali-central-insurance/group-health-insurance-revised-gcihlgp21165v022021/document/6116#c-35"},{"clause":null,"heading":"1. Waiting Periods","page":7,"url":"https://indiainsurances.com/policy/generali-central-insurance/group-health-insurance-revised-gcihlgp21165v022021/document/6116#c-1-waiting-periods"}],"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, lifelong renewability subject to continuous renewal of the group policy","note":null,"quote":"The Insured Person is eligible to be covered under this policy from birth/90 days (as a dependent child) up to the age of 80 years with lifelong renewability subject to continuous renewal of the group policy.","sources":[{"clause":null,"heading":"I. Preamble","page":2,"url":"https://indiainsurances.com/policy/generali-central-insurance/group-health-insurance-revised-gcihlgp21165v022021/document/6116#c-i-preamble"}],"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 wording says product performance will be reviewed annually and pricing will be done on experience basis, but it does not state whether an individual claim changes renewal premium.","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":"not-stated","value":null,"display":null,"note":null,"quote":null,"sources":[],"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 insured person may cancel by giving at least 7 days written notice. If no claim has been made, the company refunds premium on a pro-rata basis for the unexpired policy period.","display":"7 days written notice; pro-rata refund for unexpired period if no claim has been made","note":null,"quote":"The Insured Person may cancel this insurance by giving the Company at least 7 days written notice, and if no claim has been made then the Company shall refund a pro-rata premium for the unexpired Policy Period ... In case the Policy Period exceeds one year, this Policy may be cancelled by the Insured Person at any time by giving at least 7 days written notice to Us and if no claim has been made, We will refund premium on a pro-rata basis.","sources":[{"clause":"8(d)","heading":null,"page":15,"url":"https://indiainsurances.com/policy/generali-central-insurance/group-health-insurance-revised-gcihlgp21165v022021/document/6116#c-8-d-3"},{"clause":"8(e)","heading":null,"page":15,"url":"https://indiainsurances.com/policy/generali-central-insurance/group-health-insurance-revised-gcihlgp21165v022021/document/6116#c-8-e-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":"All medical or surgical treatments and expenses must be taken in India, and admissible claims are payable in Indian Rupees.","display":"India only; claims payable in Indian Rupees","note":null,"quote":"All medical/ surgical treatments/ expenses under this policy shall have to be taken in India and admissible claims thereof shall be payable in Indian currency (Indian Rupees).","sources":[{"clause":"9","heading":"Territorial limit","page":16,"url":"https://indiainsurances.com/policy/generali-central-insurance/group-health-insurance-revised-gcihlgp21165v022021/document/6116#c-9-2"}],"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":"The wording defines renewal with a provision of grace period, but does not state the number of days.","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":"Insured persons are eligible from birth/90 days as a dependent child up to age 80 years.","display":"Birth/90 days as a dependent child to 80 years","note":null,"quote":"The Insured Person is eligible to be covered under this policy from birth/90 days (as a dependent child) up to the age of 80 years with lifelong renewability subject to continuous renewal of the group policy.","sources":[{"clause":null,"heading":"I. Preamble","page":2,"url":"https://indiainsurances.com/policy/generali-central-insurance/group-health-insurance-revised-gcihlgp21165v022021/document/6116#c-i-preamble"}],"law":[]},{"key":"premium_modes","label":"Premium payment options","section":"Premium","meaning":"How often you can pay: yearly, half-yearly, quarterly, monthly.","status":"not-stated","value":null,"display":null,"note":"The wording says the premium is payable in advance, but does not print yearly, half-yearly, quarterly or monthly payment modes.","quote":null,"sources":[],"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":["EXTENSION FOR ROOM RENT","EXTENSION FOR MATERNITY AND CHILD COVER","EXTENSION FOR VACCINATION COVER","EXTENSION FOR WAIVER OF WAITING PERIODS","EXTENSION FOR EMERGENCY AMBULANCE","EXTENSION FOR EMERGENCY AIR AMBULANCE","EXTENSION FOR DEDUCTIBLE OR CO-PAYMENT","EXTENSION FOR AYUSH COVER","EXTENSION FOR SUM INSURED GETS DOUBLED IN CASE OF NAMED ILLNESS","EXTENSION FOR COVERAGE FOR NON-MEDICAL EXPENSES/ DEVICES","EXTENSION FOR ORGAN DONOR EXPENSES COVER","EXTENSION FOR HOSPITAL DAILY CASH ALLOWANCE","EXTENSION FOR ATTENDENTS/ AYAH/ NURSING CHARGES FOR POST HOSPITALISATION PERIOD","EXTENSION FOR DENTAL COVER","EXTENSION FOR VISION COVER","EXTENSION FOR HEALTH CHECK-UP","EXTENSION FOR OPD TREATMENT COVER","EXTENSION FOR SPECIAL COVERS","EXTENSION FOR WELLNESS CARE","EXTENSION FOR HOME HEALTH CARE","EXTENSION FOR CORPORATE BUFFER","EXTENSION FOR CRITICAL ILLNESS COVER","EXTENSION FOR TOP-UP COVER","EXTENSION FOR WAIVER OF SPECIFIC EXCLUSIONS"],"display":"Room rent, maternity and child, vaccination, waiver of waiting periods, emergency ambulance, air ambulance, deductible/co-payment, AYUSH, named illness doubling, non-medical expenses/devices, organ donor, hospital daily cash, post-hospitalisation nursing, dental, vision, health check-up, OPD, special covers, wellness, home health care, corporate buffer, critical illness, top-up and waiver of specific exclusions","note":"All are optional covers available on payment of additional premium.","quote":"Optional Covers are available on payment of additional premium, the details of optional covers are mentioned in Annexure II. ... EXTENSION FOR ROOM RENT ... EXTENSION FOR MATERNITY AND CHILD COVER ... EXTENSION FOR VACCINATION COVER ... EXTENSION FOR WAIVER OF WAITING PERIODS ... EXTENSION FOR EMERGENCY AMBULANCE ... EXTENSION FOR EMERGENCY AIR AMBULANCE ... EXTENSION FOR DEDUCTIBLE OR CO-PAYMENT ... EXTENSION FOR AYUSH COVER ... EXTENSION FOR SUM INSURED GETS DOUBLED IN CASE OF NAMED ILLNESS ... EXTENSION FOR COVERAGE FOR NON-MEDICAL EXPENSES/ DEVICES ... EXTENSION FOR ORGAN DONOR EXPENSES COVER ... EXTENSION FOR HOSPITAL DAILY CASH ALLOWANCE ... EXTENSION FOR ATTENDENTS/ AYAH/ NURSING CHARGES FOR POST HOSPITALISATION\nPERIOD ... EXTENSION FOR DENTAL COVER ... EXTENSION FOR VISION COVER ... EXTENSION FOR HEALTH CHECK-UP ... EXTENSION FOR OPD TREATMENT COVER ... EXTENSION FOR SPECIAL COVERS ... EXTENSION FOR WELLNESS CARE ... EXTENSION FOR HOME HEALTH CARE ... EXTENSION FOR CORPORATE BUFFER ... EXTENSION FOR CRITICAL ILLNESS COVER ... EXTENSION FOR TOP-UP COVER ... EXTENSION FOR WAIVER OF SPECIFIC EXCLUSIONS","sources":[{"clause":"6","heading":"OPTIONAL COVERS","page":7,"url":"https://indiainsurances.com/policy/generali-central-insurance/group-health-insurance-revised-gcihlgp21165v022021/document/6116#c-6-2"},{"clause":"1","heading":"EXTENSION FOR ROOM RENT","page":29,"url":"https://indiainsurances.com/policy/generali-central-insurance/group-health-insurance-revised-gcihlgp21165v022021/document/6116#c-1-5"},{"clause":"2","heading":"EXTENSION FOR MATERNITY AND CHILD COVER","page":30,"url":"https://indiainsurances.com/policy/generali-central-insurance/group-health-insurance-revised-gcihlgp21165v022021/document/6116#c-2-5"},{"clause":"3","heading":"EXTENSION FOR VACCINATION COVER","page":31,"url":"https://indiainsurances.com/policy/generali-central-insurance/group-health-insurance-revised-gcihlgp21165v022021/document/6116#c-3-5"},{"clause":"4","heading":"EXTENSION FOR WAIVER OF WAITING PERIODS","page":32,"url":"https://indiainsurances.com/policy/generali-central-insurance/group-health-insurance-revised-gcihlgp21165v022021/document/6116#c-4-5"},{"clause":"5","heading":"EXTENSION FOR EMERGENCY AMBULANCE","page":33,"url":"https://indiainsurances.com/policy/generali-central-insurance/group-health-insurance-revised-gcihlgp21165v022021/document/6116#c-5-5"},{"clause":"6","heading":"EXTENSION FOR EMERGENCY AIR AMBULANCE","page":34,"url":"https://indiainsurances.com/policy/generali-central-insurance/group-health-insurance-revised-gcihlgp21165v022021/document/6116#c-6-5"},{"clause":"7","heading":"EXTENSION FOR DEDUCTIBLE OR CO-PAYMENT","page":35,"url":"https://indiainsurances.com/policy/generali-central-insurance/group-health-insurance-revised-gcihlgp21165v022021/document/6116#c-7-4"},{"clause":"8","heading":"EXTENSION FOR AYUSH COVER","page":36,"url":"https://indiainsurances.com/policy/generali-central-insurance/group-health-insurance-revised-gcihlgp21165v022021/document/6116#c-8-4"},{"clause":"9","heading":"EXTENSION FOR SUM INSURED GETS DOUBLED IN CASE OF NAMED ILLNESS","page":37,"url":"https://indiainsurances.com/policy/generali-central-insurance/group-health-insurance-revised-gcihlgp21165v022021/document/6116#c-9-4"},{"clause":"10","heading":"EXTENSION FOR COVERAGE FOR NON-MEDICAL EXPENSES/ DEVICES","page":38,"url":"https://indiainsurances.com/policy/generali-central-insurance/group-health-insurance-revised-gcihlgp21165v022021/document/6116#c-10-3"},{"clause":"11","heading":"EXTENSION FOR ORGAN DONOR EXPENSES COVER","page":39,"url":"https://indiainsurances.com/policy/generali-central-insurance/group-health-insurance-revised-gcihlgp21165v022021/document/6116#c-11-3"},{"clause":"12","heading":"EXTENSION FOR HOSPITAL DAILY CASH ALLOWANCE","page":40,"url":"https://indiainsurances.com/policy/generali-central-insurance/group-health-insurance-revised-gcihlgp21165v022021/document/6116#c-12-3"},{"clause":"13","heading":"EXTENSION FOR ATTENDENTS/ AYAH/ NURSING CHARGES FOR POST HOSPITALISATION","page":41,"url":"https://indiainsurances.com/policy/generali-central-insurance/group-health-insurance-revised-gcihlgp21165v022021/document/6116#c-13-3"},{"clause":"14","heading":"EXTENSION FOR DENTAL COVER","page":42,"url":"https://indiainsurances.com/policy/generali-central-insurance/group-health-insurance-revised-gcihlgp21165v022021/document/6116#c-14-3"},{"clause":"15","heading":"EXTENSION FOR VISION COVER","page":43,"url":"https://indiainsurances.com/policy/generali-central-insurance/group-health-insurance-revised-gcihlgp21165v022021/document/6116#c-15-3"},{"clause":"16","heading":"EXTENSION FOR HEALTH CHECK-UP","page":44,"url":"https://indiainsurances.com/policy/generali-central-insurance/group-health-insurance-revised-gcihlgp21165v022021/document/6116#c-16-3"},{"clause":"17","heading":"EXTENSION FOR OPD TREATMENT COVER","page":45,"url":"https://indiainsurances.com/policy/generali-central-insurance/group-health-insurance-revised-gcihlgp21165v022021/document/6116#c-17-3"},{"clause":"18","heading":"EXTENSION FOR SPECIAL COVERS","page":46,"url":"https://indiainsurances.com/policy/generali-central-insurance/group-health-insurance-revised-gcihlgp21165v022021/document/6116#c-18-3"},{"clause":"19","heading":"EXTENSION FOR WELLNESS CARE","page":47,"url":"https://indiainsurances.com/policy/generali-central-insurance/group-health-insurance-revised-gcihlgp21165v022021/document/6116#c-19-3"},{"clause":"20","heading":"EXTENSION FOR HOME HEALTH CARE","page":48,"url":"https://indiainsurances.com/policy/generali-central-insurance/group-health-insurance-revised-gcihlgp21165v022021/document/6116#c-20-3"},{"clause":"21","heading":"EXTENSION FOR CORPORATE BUFFER","page":49,"url":"https://indiainsurances.com/policy/generali-central-insurance/group-health-insurance-revised-gcihlgp21165v022021/document/6116#c-21-3"},{"clause":"22","heading":"EXTENSION FOR CRITICAL ILLNESS COVER","page":50,"url":"https://indiainsurances.com/policy/generali-central-insurance/group-health-insurance-revised-gcihlgp21165v022021/document/6116#c-22-3"},{"clause":"23","heading":"EXTENSION FOR TOP-UP COVER","page":53,"url":"https://indiainsurances.com/policy/generali-central-insurance/group-health-insurance-revised-gcihlgp21165v022021/document/6116#c-23-3"},{"clause":"24","heading":"EXTENSION FOR WAIVER OF SPECIFIC EXCLUSIONS","page":54,"url":"https://indiainsurances.com/policy/generali-central-insurance/group-health-insurance-revised-gcihlgp21165v022021/document/6116#c-24-3"}],"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":"The wording defines break in policy by reference to the grace period and says expenses during the break period are not admissible, but does not state whether claims during the grace period are paid.","quote":null,"sources":[],"law":[]},{"key":"room_rent","label":"Room rent limit","section":"Limits and co-pay","meaning":"Daily room limit, if any.","status":"not-stated","value":null,"display":null,"note":"The wording refers to an eligible room rent limit as specified in the Policy Schedule, but does not print a daily room rent limit.","quote":null,"sources":[],"law":[]},{"key":"maternity","label":"Maternity cover","section":"Cover","meaning":"Childbirth cover and any waiting period.","status":"quote-verified","value":"Maternity expenses are excluded in the base policy. If the optional maternity and child cover is bought, it covers hospital or nursing home treatment arising from or traceable to pregnancy and childbirth including normal or caesarean section, with a 9 months waiting period unless waived by additional premium.","display":"Excluded in base cover; optional maternity cover has 9 months waiting period unless waived by additional premium","note":"Optional maternity has conditions including delivery claims for only first two children and pre-natal/post-natal treatment only within maternity limits as inpatient.","quote":"Maternity: Code Excl 18\ni. Medical treatment expenses traceable to child birth (including complicated deliveries and caesarean section incurred during hospitalization) except ectopic pregnancy; ... This is an optional cover which can be obtained on payment of additional premium for all the Insured Persons under the Policy. When Maternity Expenses Benefit is opted for in the policy, Exclusion IV.2.o of the policy stands deleted. ... This benefit covers treatment taken in Hospital/ Nursing Home arising from or traceable to pregnancy, child birth including Normal/ Caesarean section. ... A waiting period of 9 months is applicable for payment of any claim related to normal delivery, caesarean section and complications of maternity (including and not limited to medical complications). The waiting period stands waived if additional premium is paid for the same.","sources":[{"clause":"6(b)(iv)","heading":null,"page":9,"url":"https://indiainsurances.com/policy/generali-central-insurance/group-health-insurance-revised-gcihlgp21165v022021/document/6116#c-6-b-iv"},{"clause":"2","heading":"EXTENSION FOR MATERNITY AND CHILD COVER","page":30,"url":"https://indiainsurances.com/policy/generali-central-insurance/group-health-insurance-revised-gcihlgp21165v022021/document/6116#c-2-5"},{"clause":null,"heading":"Special conditions applicable to Maternity Expenses Benefit Extension","page":30,"url":"https://indiainsurances.com/policy/generali-central-insurance/group-health-insurance-revised-gcihlgp21165v022021/document/6116#c-special-conditions-applicable-to-maternity-expen"}],"law":[]},{"key":"ped_cover_group","label":"Pre-existing diseases","section":"Waiting periods","meaning":"Whether pre-existing diseases are covered from day one for the group.","status":"quote-verified","value":"Pre-existing disease treatment and direct complications are excluded for 36 months in the base policy. Day-one PED cover is available only if the optional waiver of pre-existing disease waiting period is bought.","display":"No in base cover: 36 months PED waiting; can be waived by optional cover","note":null,"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 us. ... This is an optional cover which can be obtained on payment of additional premium under the Policy. ... In consideration of additional premium received by the Company from the Policyholder, notwithstanding anything to the contrary contained in any term, condition or exclusion of the policy or endorsement(s) here to, the scope of cover under the policy is widened so as to pay claims arising out of a Pre-Existing Condition.","sources":[{"clause":null,"heading":"1. Waiting Periods","page":7,"url":"https://indiainsurances.com/policy/generali-central-insurance/group-health-insurance-revised-gcihlgp21165v022021/document/6116#c-1-waiting-periods"},{"clause":"4","heading":"EXTENSION FOR WAIVER OF WAITING PERIODS","page":32,"url":"https://indiainsurances.com/policy/generali-central-insurance/group-health-insurance-revised-gcihlgp21165v022021/document/6116#c-4-5"},{"clause":"4(a)","heading":null,"page":32,"url":"https://indiainsurances.com/policy/generali-central-insurance/group-health-insurance-revised-gcihlgp21165v022021/document/6116#c-4-a"}],"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 treatment is available only at a Network Provider. With approved pre-authorisation, the insured person will not be required to directly pay the medical expenses in the network hospital that the company is liable to indemnify.","display":"Yes, only at a Network Provider with pre-authorisation","note":"Pre-authorisation does not guarantee that all costs and expenses will be covered.","quote":"Cashless facility Cashless facility means a facility extended by the insurer to the insured where the payments, of the costs of treatment undergone by the insured in accordance with the policy terms and conditions, are directly made to the network provider by the insurer to the extent pre-authorization is approved. ... Cashless treatment is only available at a Network Provider. ... If the procedure above is followed, Insured Person will not be required to directly pay for the Medical Expenses in the Network Hospital that the Company is liable to indemnify under this Policy","sources":[{"clause":"6","heading":"Cashless facility Cashless facility","page":3,"url":"https://indiainsurances.com/policy/generali-central-insurance/group-health-insurance-revised-gcihlgp21165v022021/document/6116#c-6"},{"clause":"8(e)","heading":null,"page":13,"url":"https://indiainsurances.com/policy/generali-central-insurance/group-health-insurance-revised-gcihlgp21165v022021/document/6116#c-8-e"},{"clause":"8(c)","heading":null,"page":14,"url":"https://indiainsurances.com/policy/generali-central-insurance/group-health-insurance-revised-gcihlgp21165v022021/document/6116#c-8-c-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 are handled by the company's in-house service administrator, Generali Central Health (GCH).","display":"Company’s in-house service administrator, Generali Central Health (GCH)","note":null,"quote":"Claims procedure for policies serviced by in-house service administrator (Generali Central Health (GCH) ... Insured Person will submit the claim papers to in-house service administrator ... The Company’s In-house service administrator doctors will scrutinize the claims","sources":[{"clause":null,"heading":"3. Administration of Policy","page":13,"url":"https://indiainsurances.com/policy/generali-central-insurance/group-health-insurance-revised-gcihlgp21165v022021/document/6116#c-3-administration-of-policy"},{"clause":"8(a)","heading":null,"page":14,"url":"https://indiainsurances.com/policy/generali-central-insurance/group-health-insurance-revised-gcihlgp21165v022021/document/6116#c-8-a-4"},{"clause":"8(b)","heading":null,"page":14,"url":"https://indiainsurances.com/policy/generali-central-insurance/group-health-insurance-revised-gcihlgp21165v022021/document/6116#c-8-b-4"}],"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, individual or floater Sum Insured is referred to","note":"The wording refers to individual or floater sum insured in the optional corporate buffer clause.","quote":"The individual or floater Sum Insured would be first exhausted followed by the corporate buffer amount which would be availed as per the floater/ individual Sum Insured.","sources":[{"clause":"21","heading":"EXTENSION FOR CORPORATE BUFFER","page":49,"url":"https://indiainsurances.com/policy/generali-central-insurance/group-health-insurance-revised-gcihlgp21165v022021/document/6116#c-21-3"}],"law":[]}],"documents":[{"kind":"wording","label":"Group Health Insurance (Revised) Policy Wordings","pages":54,"fetched_at":"2026-10-17 19:46:01+00","source_url":"https://www.generalicentralinsurance.com/downloads/commercial-insurance/group-health-insurance-revised/policy-wording/group-health-insurance-revised-policy-wording.pdf","url":"https://indiainsurances.com/policy/generali-central-insurance/group-health-insurance-revised-gcihlgp21165v022021/document/6116"},{"kind":"wording","label":"Group Health Insurance(Revised ) (IRDAI copy)","pages":48,"fetched_at":"2026-10-20 01:50:11+00","source_url":"https://irdai.gov.in/documents/37343/931203/FGIHLGP21165V022021_2020-2021.pdf/31b9b937-4dbc-ddda-b33d-d0195eafdf4b?version=1.1&t=1668578906592&download=true","url":"https://indiainsurances.com/policy/generali-central-insurance/group-health-insurance-revised-gcihlgp21165v022021/document/27448"}],"versions":[{"uin":"FGIHLGP21165V022021","version":null,"approved_on":null},{"uin":"GCIHLGP21165V022021","version":null,"approved_on":null}],"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":"Group Health Insurance (Revised) (UIN GCIHLGP21165V022021), IndiaInsurances, https://indiainsurances.com/policy/generali-central-insurance/group-health-insurance-revised-gcihlgp21165v022021"}