{"uin":"GCIHLGP27047V062627","name":"Poorna Suraksha – Group","url":"https://indiainsurances.com/policy/generali-central-insurance/poorna-suraksha-group-gcihlgp27047v062627","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":null,"kind":"product","status":"active","approved_on":null,"withdrawn_on":null,"summary":"Poorna Suraksha – Group is a group health policy with selectable Hospital Cash, Inpatient Hospitalization Expenses, Personal Accident, Critical Illness, Hospital Cash Lump Sum and EMI Protection sections. Entry age is 6 months to 65 years, and the policy term is a minimum of 1 year for non-loan borrowers and up to 5 years or the loan period for credit-linked policies.","analysis":{"state":"machine","analysed_at":"2026-10-19 20:02:54.802776+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":"No named plan variants are stated; the policy instead lets the policyholder choose covers and says the Schedule will specify the covers opted.","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":"Minimum 1 year for persons who are not loan borrowers of financial institutions. For credit-linked policies, the maximum term is up to 5 years or up to the loan period, whichever is less.","display":"Minimum 1 year; credit-linked policies up to 5 years or up to the loan period, whichever is less","note":null,"quote":"a) The Policy can be issued for a minimum tenure of 1 year to those who are not loan borrowers of financial institutions.\nb) The Policy can be issued for a maximum term of up to 5 years or up to the loan period, whichever is less, in case of credit linked policies.","sources":[{"clause":"6(V)","heading":null,"page":37,"url":"https://indiainsurances.com/policy/generali-central-insurance/poorna-suraksha-group-gcihlgp27047v062627/document/6150#c-6-v"}],"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":"Hospital Cash claims must be intimated immediately and within 48 hours of hospitalisation. Inpatient hospitalization reimbursement must be notified immediately and within 48 hours of commencement of illness or injury; Personal Accident has section-specific wording of not later than 30 days from occurrence, while another Personal Accident settlement clause says within 15 days; Critical Illness notification is within 90 days of first diagnosis or surgical procedure but after the 28-day survival period.","display":"Hospital cash: within 48 hours of hospitalisation; inpatient reimbursement: within 48 hours of commencement; PA: 30 days, with another clause saying 15 days; CI: within 90 days after 28-day survival period","note":"The 30-day and 15-day Personal Accident intimation provisions are both within the same policy wording.","quote":"Insured Person or someone claiming on Insured Person’s behalf must inform Us in writing immediately, and in any event within 48 hours of hospitalisation. ... We must be given Notification of Claim in writing immediately and in any event within 48 hours of the commencement of the Illness or Injury. ... the Injury as described above shall be intimated to the Company as soon as possible but not later than 30 days from the date of its occurrence. ... Insured Person or someone claiming on Insured Person’s behalf must give Notification of Claim to us in writing immediately, and in any event within 90 days of the first diagnosis of the Illness, date of surgical procedure but after the Survival Period of 28 days. ... The Insured Person or someone claiming on his/her behalf must inform Us in writing immediately and in any event within 15 days.","sources":[{"clause":"6(VIII)(a)","heading":null,"page":38,"url":"https://indiainsurances.com/policy/generali-central-insurance/poorna-suraksha-group-gcihlgp27047v062627/document/6150#c-6-viii-a-2"},{"clause":"6(VIII)(b)(i)","heading":null,"page":40,"url":"https://indiainsurances.com/policy/generali-central-insurance/poorna-suraksha-group-gcihlgp27047v062627/document/6150#c-6-viii-b-i"},{"clause":"6(VIII)(k)(i)","heading":null,"page":41,"url":"https://indiainsurances.com/policy/generali-central-insurance/poorna-suraksha-group-gcihlgp27047v062627/document/6150#c-6-viii-k-i"},{"clause":"6(VIII)(c)","heading":null,"page":42,"url":"https://indiainsurances.com/policy/generali-central-insurance/poorna-suraksha-group-gcihlgp27047v062627/document/6150#c-6-viii-c-4"},{"clause":"6(VIII)(a)","heading":null,"page":43,"url":"https://indiainsurances.com/policy/generali-central-insurance/poorna-suraksha-group-gcihlgp27047v062627/document/6150#c-6-viii-a-8"}],"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":["Completely filled Poorna Suraksha Claim form (original) and signed by the claimant or a family member","First consultation letter","First prescription from the Medical Practitioner","Original vouchers","Original Hospital bills giving a detailed break up of all expense heads mentioned in the bill","Original Money receipt duly signed with a revenue stamp","Photocopy of Birth/death certificate (as applicable)","Original Hospital discharge card","All original laboratory and diagnostic test Reports such as X-Ray, E.C.G, USG, MRI Scan, Haemogram etc.","prescription from the Medical Practitioner and the supporting original medicine bill from the chemist","prescription from the Medical Practitioner advising the tests, the actual original test reports and original bill from the diagnostic center for the tests"],"display":"Claim form, first consultation letter and prescription, vouchers, hospital bills, money receipt, birth/death certificate if applicable, discharge card, diagnostic reports, and supporting medicine or test bills where paid in cash","note":"This list is for Section II Inpatient Hospitalization Expenses reimbursement claims.","quote":"including but not limited to the following, and other information We ask for, to investigate the claim for Our obligation to make payment for it: ... a) Completely filled Poorna Suraksha Claim form (original) and signed by the claimant or a family member; ... b) First consultation letter; ... c) First prescription from the Medical Practitioner; ... d) Original vouchers; ... e) Original Hospital bills giving a detailed break up of all expense heads mentioned in the bill; ... f) Original Money receipt duly signed with a revenue stamp; ... g) Photocopy of Birth/death certificate (as applicable); ... h) Original Hospital discharge card; ... i) All original laboratory and diagnostic test Reports such as X-Ray, E.C.G, USG, MRI Scan, Haemogram etc.; ... prescription from the Medical Practitioner and the supporting original medicine bill from the chemist ... prescription from the Medical Practitioner advising the tests, the actual original test reports and original bill from the diagnostic center for the tests.","sources":[{"clause":"6(VIII)(b)(iii)","heading":null,"page":40,"url":"https://indiainsurances.com/policy/generali-central-insurance/poorna-suraksha-group-gcihlgp27047v062627/document/6150#c-6-viii-b-iii"},{"clause":"6(VIII)(a)","heading":null,"page":40,"url":"https://indiainsurances.com/policy/generali-central-insurance/poorna-suraksha-group-gcihlgp27047v062627/document/6150#c-6-viii-a-4"},{"clause":"6(VIII)(b)","heading":null,"page":40,"url":"https://indiainsurances.com/policy/generali-central-insurance/poorna-suraksha-group-gcihlgp27047v062627/document/6150#c-6-viii-b-4"},{"clause":"6(VIII)(c)","heading":null,"page":40,"url":"https://indiainsurances.com/policy/generali-central-insurance/poorna-suraksha-group-gcihlgp27047v062627/document/6150#c-6-viii-c-3"},{"clause":"6(VIII)(d)","heading":null,"page":40,"url":"https://indiainsurances.com/policy/generali-central-insurance/poorna-suraksha-group-gcihlgp27047v062627/document/6150#c-6-viii-d-2"},{"clause":"6(VIII)(e)","heading":null,"page":40,"url":"https://indiainsurances.com/policy/generali-central-insurance/poorna-suraksha-group-gcihlgp27047v062627/document/6150#c-6-viii-e-2"},{"clause":"6(VIII)(f)","heading":null,"page":40,"url":"https://indiainsurances.com/policy/generali-central-insurance/poorna-suraksha-group-gcihlgp27047v062627/document/6150#c-6-viii-f-2"},{"clause":"6(VIII)(g)","heading":null,"page":40,"url":"https://indiainsurances.com/policy/generali-central-insurance/poorna-suraksha-group-gcihlgp27047v062627/document/6150#c-6-viii-g-2"},{"clause":"6(VIII)(h)","heading":null,"page":40,"url":"https://indiainsurances.com/policy/generali-central-insurance/poorna-suraksha-group-gcihlgp27047v062627/document/6150#c-6-viii-h-2"},{"clause":"6(VIII)(i)","heading":null,"page":40,"url":"https://indiainsurances.com/policy/generali-central-insurance/poorna-suraksha-group-gcihlgp27047v062627/document/6150#c-6-viii-i-2"},{"clause":"6(VIII)(j)","heading":null,"page":40,"url":"https://indiainsurances.com/policy/generali-central-insurance/poorna-suraksha-group-gcihlgp27047v062627/document/6150#c-6-viii-j"},{"clause":"6(VIII)(k)","heading":null,"page":40,"url":"https://indiainsurances.com/policy/generali-central-insurance/poorna-suraksha-group-gcihlgp27047v062627/document/6150#c-6-viii-k"}],"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 needed, it must be completed within 30 days from receipt of the last necessary document and the claim settled or rejected within 45 days; delay attracts interest at 2% above the bank rate.","display":"15 days from last necessary document; investigation cases within 45 days, with interest at 2% above bank rate for delay","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. ... ln case of delay beyond stipulated 45 days, the Company shall be liable to pay interest to the policyholder at a rate 2% above the bank rate from the date of receipt of last necessary document to the date of payment of claim.","sources":[{"clause":"6(VIII)(a)","heading":null,"page":43,"url":"https://indiainsurances.com/policy/generali-central-insurance/poorna-suraksha-group-gcihlgp27047v062627/document/6150#c-6-viii-a-6"},{"clause":"6(VIII)(c)","heading":null,"page":43,"url":"https://indiainsurances.com/policy/generali-central-insurance/poorna-suraksha-group-gcihlgp27047v062627/document/6150#c-6-viii-c-5"},{"clause":"6(VIII)(d)","heading":null,"page":43,"url":"https://indiainsurances.com/policy/generali-central-insurance/poorna-suraksha-group-gcihlgp27047v062627/document/6150#c-6-viii-d-3"}],"law":[{"title":"The Insurance Act, 1938","section":"Section 64UM(4) to (6)","url":"https://indiainsurances.com/law/insurance-act-1938"},{"title":"Master Circular on General Insurance Business, 2024","section":"Ch I, Para 10","url":"https://indiainsurances.com/law/irdai-general-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 15","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 16","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 22","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, V.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, V.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, V.3(i), V.3(ii)","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, V.3(iii)","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part C, V.3","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part C, V.4","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Para 23","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"The Motor Vehicles Act, 1988: Chapter XI, insurance of motor vehicles against third party risks","section":"Section 149","url":"https://indiainsurances.com/law/motor-vehicles-act-1988"}]},{"key":"exclusions_main","label":"Main exclusions","section":"Exclusions","meaning":"What the policy does not pay for, in the policy's own words.","status":"quote-verified","value":["Pre-Existing Diseases - Code- Excl01","Specified disease/procedure waiting period- Code- Excl02","30-day waiting period- Code- Excl03","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.","Birth control, Sterility and Infertility: Code- Excl17","Maternity: Code- Excl 18","Treatment received outside India.","Intentional self-Injury"],"display":"Waiting periods for PED, specified diseases and 30 days; exclusions include investigation, rest cure, change of gender, cosmetic surgery, hazardous sports, breach of law, alcohol or drug abuse, infertility, maternity, treatment outside India and intentional self-injury","note":null,"quote":"a) Pre-Existing Diseases - Code- Excl01 ... b) Specified disease/procedure waiting period- Code- Excl02 ... c) 30-day waiting period- Code- Excl03 ... a) Investigation & Evaluation- Code- Excl04 ... b) Rest Cure, rehabilitation and respite care- Code- Excl05 ... d) Change-of-Gender treatments: Code- Excl07 ... e) Cosmetic or Plastic Surgery: Code- Excl08 ... f) Hazardous or Adventure sports: Code- Excl09 ... g) Breach of law: Code- Excl10 ... i) Code- Excl12 Treatment for, Alcoholism, drug or substance abuse or any addictive condition and consequences thereof. ... n) Birth control, Sterility and Infertility: Code- Excl17 ... o) Maternity: Code- Excl 18 ... t) Intentional self-Injury ... cc) Treatment received outside India.","sources":[{"clause":"1","heading":"Waiting Periods - Applicable to Hospital cash benefit, Hospital Cash Lump Sum Benefit, EMI","page":26,"url":"https://indiainsurances.com/policy/generali-central-insurance/poorna-suraksha-group-gcihlgp27047v062627/document/6150#c-1-6"},{"clause":"2","heading":"Exclusions - Applicable to Hospi cash, In-patient Hospitalization, Hospital Cash Lump Sum","page":28,"url":"https://indiainsurances.com/policy/generali-central-insurance/poorna-suraksha-group-gcihlgp27047v062627/document/6150#c-2-2"},{"clause":"2(b)(iv)","heading":null,"page":29,"url":"https://indiainsurances.com/policy/generali-central-insurance/poorna-suraksha-group-gcihlgp27047v062627/document/6150#c-2-b-iv"},{"clause":"2(b)(v)","heading":null,"page":30,"url":"https://indiainsurances.com/policy/generali-central-insurance/poorna-suraksha-group-gcihlgp27047v062627/document/6150#c-2-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 to the Grievance Redressal Cell, or branch grievance cell. If not satisfied, contact the grievance officer at GCIGRO@generalicentral.com or 7900197777 before approaching the Insurance Ombudsman or IRDAI Bima Bharosa.","display":"Company website/toll-free/email/courier or branch first; then grievance officer; then Ombudsman or IRDAI Bima Bharosa","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 limited. ... Insured person may also approach the grievance cell at any of the company's branches with the details of grievance. ... lf insured 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 ... the insured person may also approach the office of lnsurance Ombudsman ... Grievance may also be lodged at IRDAI Bima Bharosa (an Integrated Grievance Management System) - https://bimabharosa.irdai.gov.in/","sources":[{"clause":"6","heading":"Redressal of Grievance","page":34,"url":"https://indiainsurances.com/policy/generali-central-insurance/poorna-suraksha-group-gcihlgp27047v062627/document/6150#c-6-2"}],"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 repeatedly says the amount or sum insured is as specified in the Policy Schedule, but it does not state selectable sum insured 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 30-day waiting period applies to Hospital Cash Benefit, Hospital Cash Lump Sum Benefit, EMI Protection Benefit and In-patient Hospitalization Expense covers. Critical Illness has a separate 90-day waiting period.","quote":"c) 30-day waiting period- Code- Excl03\ni) 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. ... Claim related to any listed Critical illness/ procedures within 90 days from the first policy commencement date shall be excluded.","sources":[{"clause":"1","heading":"Waiting Periods - Applicable to Hospital cash benefit, Hospital Cash Lump Sum Benefit, EMI","page":26,"url":"https://indiainsurances.com/policy/generali-central-insurance/poorna-suraksha-group-gcihlgp27047v062627/document/6150#c-1-6"},{"clause":"3(a)(i)","heading":null,"page":31,"url":"https://indiainsurances.com/policy/generali-central-insurance/poorna-suraksha-group-gcihlgp27047v062627/document/6150#c-3-a-i"}],"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":"The 36-month PED waiting period is stated for Hospital Cash Benefit, Hospital Cash Lump Sum Benefit, EMI Protection Benefit and In-patient Hospitalization Expense covers. Critical Illness has a specific exclusion for insured events arising from pre-existing illness or disease related to specified critical illnesses.","quote":"a) Pre-Existing Diseases - Code- Excl01\ni) 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. ... Coverage under the policy after the expiry of 36 months for any pre-existing disease is subject to the same being declared at the time of application and accepted by us. ... Any Insured Event arising on account of or in connection with any Pre-Existing Illness/ Disease related to specified Critical Illnesses","sources":[{"clause":"1","heading":"Waiting Periods - Applicable to Hospital cash benefit, Hospital Cash Lump Sum Benefit, EMI","page":26,"url":"https://indiainsurances.com/policy/generali-central-insurance/poorna-suraksha-group-gcihlgp27047v062627/document/6150#c-1-6"},{"clause":null,"heading":"B. Specific exclusion :-","page":32,"url":"https://indiainsurances.com/policy/generali-central-insurance/poorna-suraksha-group-gcihlgp27047v062627/document/6150#c-b-specific-exclusion"}],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 8","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 12","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 1.6","url":"https://indiainsurances.com/law/irdai-products-regs-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 7","url":"https://indiainsurances.com/law/irdai-products-regs-2024"}]},{"key":"specific_waiting","label":"Specific illness waiting period","section":"Waiting periods","meaning":"Waiting period for a list of named illnesses and procedures (cataract, hernia, joint replacement...). With several tiers (24 and 36 months), the shortest in the answer, the others in the note.","status":"quote-verified","value":{"unit":"months","amount":24},"display":"24 months; 36 months for some listed conditions","note":"The specified disease/procedure list is split into 24 months and 36 months.","quote":"b) Specified disease/procedure waiting period- Code- Excl02\ni) Expenses related to the treatment of the listed Conditions, surgeries/treatments shall be excluded until the expiry of 24/ 36 months of continuous coverage after the date of inception of the first policy with us.","sources":[{"clause":"1","heading":"Waiting Periods - Applicable to Hospital cash benefit, Hospital Cash Lump Sum Benefit, EMI","page":26,"url":"https://indiainsurances.com/policy/generali-central-insurance/poorna-suraksha-group-gcihlgp27047v062627/document/6150#c-1-6"}],"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":["Cataracts","Benign Prostatic Hypertrophy","Hernia of all types","Hydrocele","Para nasal sinuses","Deviated Nasal Septum","Fistulae","Hemorrhoids","Fissure in ano","Dysfunctional Uterine Bleeding","Fibromyoma","Endometriosis","Hysterectomy","all internal or external tumors/ cysts/ nodules/ polyps of any kind including breast lumps with exception of malignant tumor or growth","Surgery for prolapsed inter vertebral disc unless arising from Accident","Surgery of Varicose Veins, Varicose Ulcers","Any types of gastric or duodenal Ulcers","Stones in the Urinary and Biliary systems","Surgery on ears/ tonsils/ adenoids","Maternity expenses where self and spouse are covered.","Organ transplant and Organ Donor Expenses","Joint replacement Surgery due to Degenerative condition","Age related Osteoarthritis and Osteoporosis unless such joint replacement Surgery is necessitated by Accidental Bodily Injury","Maternity expenses where only self is covered."],"display":"Cataract, BPH, hernia, hydrocele, sinus and DNS, fistula, piles/fissure, DUB, fibromyoma, endometriosis, hysterectomy, benign tumours/cysts/nodules/polyps, disc prolapse surgery, varicose veins/ulcers, gastric or duodenal ulcers, urinary and biliary stones, ear/tonsil/adenoid surgery, maternity, organ transplant/donor expenses, degenerative joint replacement, age-related osteoarthritis and osteoporosis","note":null,"quote":"• 24 months waiting period:\ni. Cataracts\nii. Benign Prostatic Hypertrophy\niii. Hernia of all types\niv. Hydrocele\nv. Para nasal sinuses\nvi. Deviated Nasal Septum\nvii) Fistulae\nviii) Hemorrhoids\nix) Fissure in ano\nx) Dysfunctional Uterine Bleeding\nxi) Fibromyoma\nxii) Endometriosis\nxiii) Hysterectomy\nxiv) all internal or external tumors/ cysts/ nodules/ polyps of any kind including breast lumps with exception of malignant tumor or growth\nxv) Surgery for prolapsed inter vertebral disc unless arising from Accident\nxvi) Surgery of Varicose Veins, Varicose Ulcers\nxvii) Any types of gastric or duodenal Ulcers\nxviii) Stones in the Urinary and Biliary systems\nxix) Surgery on ears/ tonsils/ adenoids\nxx) Maternity expenses where self and spouse are covered.\n• 36 months waiting period:\ni. Organ transplant and Organ Donor Expenses\nii. Joint replacement Surgery due to Degenerative condition\niii. Age related Osteoarthritis and Osteoporosis unless such joint replacement Surgery is necessitated by Accidental Bodily Injury\niv. Maternity expenses where only self is covered.","sources":[{"clause":"1","heading":"Waiting Periods - Applicable to Hospital cash benefit, Hospital Cash Lump Sum Benefit, EMI","page":26,"url":"https://indiainsurances.com/policy/generali-central-insurance/poorna-suraksha-group-gcihlgp27047v062627/document/6150#c-1-6"}],"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":"The wording mentions transfer of credit for Moratorium period on migration, but does not state the moratorium period itself.","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 states migration to other health insurance products/plans offered by the same company, but does not state portability to another insurer.","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":"not-stated","value":null,"display":null,"note":null,"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 Health Insurance Business, 2024","section":"Ch II D.II","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, IV.5","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 9","url":"https://indiainsurances.com/law/irdai-products-regs-2024"},{"title":"Review of revision in premium rates under health insurance policies for senior citizens, 2025","section":"Para 7","url":"https://indiainsurances.com/law/irdai-senior-premium-2025"}]},{"key":"claim_loading","label":"Premium loading after claims","section":"Renewal and rights","meaning":"Whether the premium can go up at renewal because you made a claim.","status":"quote-verified","value":"The policy does not state an individual premium loading after a claim. It states that premium rates or loadings for the product would not be changed without Authority approval, and that product performance will be reviewed annually with further pricing on experience basis.","display":"No individual claim loading stated; product pricing may be reviewed annually on experience basis","note":null,"quote":"The premium rates or loadings for the product would not be changed without approval from Authority. However, the performance of the product will be reviewed annually and further pricing will be done on experience basis","sources":[{"clause":"6(VIII)(c)","heading":null,"page":44,"url":"https://indiainsurances.com/policy/generali-central-insurance/poorna-suraksha-group-gcihlgp27047v062627/document/6150#c-6-viii-c-8"}],"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 policyholder may cancel by giving 15 days written notice. For one-year single-instalment policies, the refund is 75% up to one month, 50% up to three months, 25% up to six months and nil after six months; for policy periods exceeding one year, refund is pro-rata if no claim has been made, subject to a minimum retention of 25%, while instalment policies have separate monthly, quarterly and half-yearly refund rules and no refund where any claim has been admitted, lodged or any benefit availed.","display":"15 days’ written notice; one-year single premium refunds 75%, 50%, 25% or nil by time on risk; >1 year pro-rata with minimum 25% retention if no claim; instalment refunds vary; no refund if a claim is admitted, lodged or benefit availed","note":null,"quote":"The policyholder may cancel this policy by giving 15 days written notice and in such an event, the Company shall refund premium for the unexpired policy period as detailed below ... Up to one month | 75% of annual rate\nUp to three months | 50% of annual rate\nUp to six months | 25% of annual rate\nExceeding six months | Nil ... if no claim has been made, then We shall refund premium on a pro-rata basis by reference to the time period for which cover is provided, subject to a minimum retention of premium of 25%. ... Monthly | Anytime | No Refund ... Quarterly | 1st Quarter | 12.5% of the respective quarter premium ... Half-Yearly | Up to 3 months | 25% of the half-yearly instalment premium ... Notwithstanding anything contained herein or otherwise, no refunds of premium shall be made in respect of Cancellation where, any claim has been admitted or has been lodged or any benefit has been availed by the insured person under the Policy.","sources":[{"clause":"6(III)","heading":null,"page":36,"url":"https://indiainsurances.com/policy/generali-central-insurance/poorna-suraksha-group-gcihlgp27047v062627/document/6150#c-6-iii-2"},{"clause":"6(III)(a)","heading":null,"page":36,"url":"https://indiainsurances.com/policy/generali-central-insurance/poorna-suraksha-group-gcihlgp27047v062627/document/6150#c-6-iii-a"},{"clause":"6(III)(b)","heading":null,"page":36,"url":"https://indiainsurances.com/policy/generali-central-insurance/poorna-suraksha-group-gcihlgp27047v062627/document/6150#c-6-iii-b"},{"clause":"6(III)(a)","heading":null,"page":36,"url":"https://indiainsurances.com/policy/generali-central-insurance/poorna-suraksha-group-gcihlgp27047v062627/document/6150#c-6-iii-a-2"},{"clause":"6(III)(b)","heading":null,"page":37,"url":"https://indiainsurances.com/policy/generali-central-insurance/poorna-suraksha-group-gcihlgp27047v062627/document/6150#c-6-iii-b-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":"Hospital Cash Benefit, Inpatient Hospitalization and Critical Illness covers are India only. Personal Accident cover applies anywhere in the world, subject to Indian Government travel and other restrictions, but all payments are within India and in Indian Rupees only.","display":"Hospital Cash, Inpatient Hospitalization and Critical Illness: India only; Personal Accident: worldwide, with payment in India in Indian Rupees only","note":null,"quote":"a) For the purpose of Hospital Cash benefit, Inpatient Hospitalization and Critical Illness Covers, we cover expenses due to Accidental Bodily Injury or Illness sustained by the Insured Person during the Policy Period anywhere in India only.\nb) For the purpose of Personal Accident cover, We cover expenses due to Accidental Bodily Injury sustained by the Insured Person during the Policy Period anywhere in the World (subject to the travel and other restrictions that the Indian Government may impose),\nc) For all the covers We will make payment within India and in Indian Rupees only.","sources":[{"clause":"6(VII)","heading":null,"page":38,"url":"https://indiainsurances.com/policy/generali-central-insurance/poorna-suraksha-group-gcihlgp27047v062627/document/6150#c-6-vii"}],"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":"quote-verified","value":{"unit":"days","amount":15},"display":"15 days for monthly mode; 30 days in all other cases","note":"The displayed answer varies by premium payment mode.","quote":"The grace period for payment of the premium for all types of insurance policies shall be: fifteen days where premium payment mode is monthly and thirty days in all other cases.","sources":[{"clause":"1(b)(ii)","heading":null,"page":2,"url":"https://indiainsurances.com/policy/generali-central-insurance/poorna-suraksha-group-gcihlgp27047v062627/document/6150#c-1-b-ii"}],"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":"Persons between ages 6 months to 65 years and named as Insured in the Schedule can avail the policy benefits.","display":"6 months to 65 years","note":null,"quote":"Only those persons between ages 6 months to 65 years and who are named as Insured in the Schedule will be able to avail the benefits under the Policy, subject to the terms, conditions and exclusions of the Policy.","sources":[{"clause":null,"heading":"Preamble","page":1,"url":"https://indiainsurances.com/policy/generali-central-insurance/poorna-suraksha-group-gcihlgp27047v062627/document/6150#c-preamble"}],"law":[]},{"key":"premium_modes","label":"Premium payment options","section":"Premium","meaning":"How often you can pay: yearly, half-yearly, quarterly, monthly.","status":"quote-verified","value":["Single Instalment","Half Yearly","Quarterly","Monthly"],"display":"Single instalment, Half Yearly, Quarterly or Monthly","note":null,"quote":"A. Premium paid in Single Instalment ... If the policy holder has opted payment of premium on an instalment basis i.e Half Yearly, Quarterly or Monthly, as specified in the Schedule","sources":[{"clause":"6(III)","heading":null,"page":36,"url":"https://indiainsurances.com/policy/generali-central-insurance/poorna-suraksha-group-gcihlgp27047v062627/document/6150#c-6-iii-2"},{"clause":"6(IV)","heading":null,"page":37,"url":"https://indiainsurances.com/policy/generali-central-insurance/poorna-suraksha-group-gcihlgp27047v062627/document/6150#c-6-iv-2"}],"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":["Convalescence Benefit","Maternity Benefit","Pre-Hospitalisation Medical Expenses","Post-Hospitalisation Medical expenses","Personal Accident Cover","Permanent Partial Disablement","Temporary Total Disablement","Repatriation and Funeral Benefit (Above the inbuilt cover)","Child Education Support Cover (Above the inbuilt cover)","Accidental Medical Expenses Cover","Accidental Hospitalization Cover","Critical illness Cover","Hospital Cash Lump Sum Benefit","EMI Protection Benefit"],"display":"Convalescence, maternity, pre- and post-hospitalisation, PA optional benefits and extensions, Critical Illness, Hospital Cash Lump Sum and EMI Protection","note":null,"quote":"1.3 Convalescence Benefit\nThis is an optional cover which can be opted on payment of additional premium ... 1.5 Maternity Benefit\nThis is an optional cover which can be obtained on payment of additional premium ... c) Pre-Hospitalisation Medical Expenses – This is an optional cover ... d) Post-Hospitalisation Medical expenses – This is an optional cover ... 3 Section III: Personal Accident Cover\nThis is an optional cover which can be opted on payment of additional premium ... • Optional covers\niii) Permanent Partial Disablement\niv) Temporary Total Disablement ... i) Repatriation and Funeral Benefit (Above the inbuilt cover) This is an optional cover which can be obtained on payment of additional premium ... Child Education Support Cover (Above the inbuilt cover) This is an optional cover which can be obtained on payment of additional premium ... Accidental Medical Expenses Cover This is an optional cover which can be obtained on payment of additional premium ... Accidental Hospitalization Cover This is an optional cover which can be obtained on payment of additional premium ... 4 Section IV: Critical illness Cover\nThis is an optional cover which can be opted on payment of additional premium ... 5 Section V: Hospital Cash Lump Sum Benefit\nThis is an optional cover which can be opted on payment of an additional premium ... 6 Section VI: EMI Protection Benefit\nThis is an optional cover which can be opted on payment of an additional premium","sources":[{"clause":"1.3","heading":"Convalescence Benefit","page":7,"url":"https://indiainsurances.com/policy/generali-central-insurance/poorna-suraksha-group-gcihlgp27047v062627/document/6150#c-1-3"},{"clause":"1.5","heading":"Maternity Benefit","page":8,"url":"https://indiainsurances.com/policy/generali-central-insurance/poorna-suraksha-group-gcihlgp27047v062627/document/6150#c-1-5"},{"clause":"2(c)","heading":"Pre-Hospitalisation Medical Expenses – This","page":9,"url":"https://indiainsurances.com/policy/generali-central-insurance/poorna-suraksha-group-gcihlgp27047v062627/document/6150#c-2-c"},{"clause":"2(d)","heading":"Post-Hospitalisation Medical expenses – This","page":9,"url":"https://indiainsurances.com/policy/generali-central-insurance/poorna-suraksha-group-gcihlgp27047v062627/document/6150#c-2-d"},{"clause":"3","heading":"Section III: Personal Accident Cover","page":11,"url":"https://indiainsurances.com/policy/generali-central-insurance/poorna-suraksha-group-gcihlgp27047v062627/document/6150#c-3"},{"clause":null,"heading":"Primary Covers","page":11,"url":"https://indiainsurances.com/policy/generali-central-insurance/poorna-suraksha-group-gcihlgp27047v062627/document/6150#c-primary-covers"},{"clause":"3.1(b)(i)","heading":null,"page":14,"url":"https://indiainsurances.com/policy/generali-central-insurance/poorna-suraksha-group-gcihlgp27047v062627/document/6150#c-3-1-b-i"},{"clause":"3.1(b)","heading":null,"page":14,"url":"https://indiainsurances.com/policy/generali-central-insurance/poorna-suraksha-group-gcihlgp27047v062627/document/6150#c-3-1-b-2"},{"clause":"4","heading":"Section IV: Critical illness Cover","page":15,"url":"https://indiainsurances.com/policy/generali-central-insurance/poorna-suraksha-group-gcihlgp27047v062627/document/6150#c-4"},{"clause":"5","heading":"Section V: Hospital Cash Lump Sum Benefit","page":26,"url":"https://indiainsurances.com/policy/generali-central-insurance/poorna-suraksha-group-gcihlgp27047v062627/document/6150#c-5"},{"clause":"6","heading":"Section VI: EMI Protection Benefit","page":26,"url":"https://indiainsurances.com/policy/generali-central-insurance/poorna-suraksha-group-gcihlgp27047v062627/document/6150#c-6"}],"law":[]},{"key":"grace_cover","label":"Cover during the grace period","section":"Renewal and rights","meaning":"Whether a claim during the grace period is paid.","status":"quote-verified","value":"Coverage need not be available during the period for which no premium is received. However, the insurer shall offer coverage during the grace period if the premium is paid in installments during the policy period.","display":"Coverage need not be available without premium; coverage is offered during grace period for instalment premiums during the policy period","note":null,"quote":"Coverage need not be available during the period for which no premium is received. The grace period for payment of the premium for all types of insurance policies shall be: fifteen days where premium payment mode is monthly and thirty days in all other cases. Provided the insurer shall offer coverage during the grace period, if the premium is paid in installments during policy period.","sources":[{"clause":"1(b)(ii)","heading":null,"page":2,"url":"https://indiainsurances.com/policy/generali-central-insurance/poorna-suraksha-group-gcihlgp27047v062627/document/6150#c-1-b-ii"}],"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":null,"quote":null,"sources":[],"law":[]},{"key":"maternity","label":"Maternity cover","section":"Cover","meaning":"Childbirth cover and any waiting period.","status":"not-stated","value":null,"display":null,"note":null,"quote":null,"sources":[],"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":"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":"not-stated","value":null,"display":null,"note":null,"quote":null,"sources":[],"law":[]},{"key":"claims_handled_by","label":"Claims handled by","section":"Claims","meaning":"The insurer itself or a third-party administrator (TPA).","status":"not-stated","value":null,"display":null,"note":null,"quote":null,"sources":[],"law":[]},{"key":"family_floater","label":"Family floater available","section":"Cover","meaning":"Whether one sum insured can be shared by the whole family.","status":"not-stated","value":null,"display":null,"note":null,"quote":null,"sources":[],"law":[]}],"documents":[{"kind":"wording","label":"Poorna Suraksha – Group Policy Wordings","pages":57,"fetched_at":"2026-10-17 19:46:23+00","source_url":"https://www.generalicentralinsurance.com/downloads/commercial-insurance/poorna-suraksha-group/policy-wording/poorna-suraksha-group-policy-wordings.pdf","url":"https://indiainsurances.com/policy/generali-central-insurance/poorna-suraksha-group-gcihlgp27047v062627/document/6150"}],"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":"Poorna Suraksha – Group (UIN GCIHLGP27047V062627), IndiaInsurances, https://indiainsurances.com/policy/generali-central-insurance/poorna-suraksha-group-gcihlgp27047v062627"}