{"uin":"GCIHLIP20160V011920","name":"Arogya Sanjeevani Policy, Generali Central Insurance Company Limited.","url":"https://indiainsurances.com/policy/generali-central-insurance/arogya-sanjeevani-policy-generali-central-insurance-company-limited-gcihlip20160v011920","insurer":{"slug":"generali-central-insurance","name":"Generali Central Insurance Company Limited","url":"https://indiainsurances.com/insurer/generali-central-insurance"},"line":"health","category":"health-indemnity","category_name":"Health insurance (hospitalisation)","irdai_type":null,"kind":"product","status":"active","approved_on":null,"withdrawn_on":null,"summary":"Arogya Sanjeevani Policy is an indemnity health policy available on individual or floater basis with a 1 year policy period and sum insured options from INR 50000 to 10 Lacs. It has a 30 days initial waiting period, 36 months pre-existing disease waiting period, 5% co-pay on all claims, and room rent up to 2% of the sum insured subject to Rs. 5000 per day.","analysis":{"state":"machine","analysed_at":"2026-10-19 19:56:39.569716+00","note":"First pass: one AI reading; every stated fact carries a verbatim quote found in the cited clause, but it has not been reviewed. Check the clause before relying on it."},"facts":[{"key":"plan_variants","label":"Plans and variants","section":"Overview","meaning":"The named plans inside this product (not cover types or payout options). Facts can differ between them.","status":"quote-verified","value":["Individual","Floater"],"display":"Individual/ Floater","note":null,"quote":"Product Type | Individual/ Floater","sources":[{"clause":"8","heading":"TABLE OF BENEFITS","page":19,"url":"https://indiainsurances.com/policy/generali-central-insurance/arogya-sanjeevani-policy-generali-central-insurance-company-limited-gcihlip20160v011920/document/5735#c-8-2"}],"law":[]},{"key":"policy_term","label":"Policy term","section":"Eligibility","meaning":"How long one policy runs before it ends or must be renewed.","status":"quote-verified","value":"1 year","display":"1 year","note":"The wording also defines policy period as one, two or three policy years as mentioned in the schedule and cancellation clauses refer to 1/2/3 years Policy Term.","quote":"Policy Period | 1 year","sources":[{"clause":"8","heading":"TABLE OF BENEFITS","page":19,"url":"https://indiainsurances.com/policy/generali-central-insurance/arogya-sanjeevani-policy-generali-central-insurance-company-limited-gcihlip20160v011920/document/5735#c-8-2"}],"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":"For emergency hospitalization, notice with full particulars must be sent within 24 hours from the date of emergency hospitalization required or before discharge, whichever is earlier. For planned hospitalization, notice must be sent at least 48 hours prior to admission.","display":"Emergency: within 24 hours or before discharge, whichever is earlier; planned: at least 48 hours prior to admission","note":null,"quote":"Notice with full particulars shall be sent to the Company as under:\ni) Within 24 hours from the date of emergency hospitalization required or before the Insured Person’s discharge from Hospital, whichever is earlier.\nii) At least 48 hours prior to admission in Hospital in case of a planned Hospitalization.","sources":[{"clause":"3","heading":"Notification of Claim","page":18,"url":"https://indiainsurances.com/policy/generali-central-insurance/arogya-sanjeevani-policy-generali-central-insurance-company-limited-gcihlip20160v011920/document/5735#c-3-55"}],"law":[{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, V.1","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, V.1","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part C, V.1","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Para 20, 21","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"}]},{"key":"claim_documents","label":"Claim documents","section":"Claims","meaning":"Documents the insurer asks for when you claim.","status":"quote-verified","value":["Duly completed claim form","Photo identity proof of the patient","Medical practitioner’s prescription advising admission","Original bills with itemized break-up","Payment receipts","Discharge summary including complete medical history of the patient along with other details","Investigation/ Diagnostic tests reports etc. supported by the prescription form attending medical practitioner","OT notes or Surgeon’s certificate giving details of the operation performed (for surgical cases)","Sticker/ Invoice of the Implants, wherever applicable","MLR (Medico Legal Report) copy if carried out and FIR (First Information Report) if registered, wherever applicable","NEFT Details (to enable direct credit of claim amount in bank account) and cancelled cheque","KYC (Identity proof with address) of the proposer, where claim liability is above Rs. 1 Lakh as per AML guidelines","Legal heir/ succession certificate, wherever applicable","Any other relevant document required by Company for assessment of the claim."],"display":"Claim form, photo ID, admission prescription, bills, receipts, discharge summary, reports, OT notes, implant invoice, MLR/FIR, NEFT and cancelled cheque, KYC above Rs. 1 Lakh, legal heir certificate and any other relevant document","note":null,"quote":"i) Duly completed claim form\nii) Photo identity proof of the patient\niii) Medical practitioner’s prescription advising admission\niv) Original bills with itemized break-up\nv) Payment receipts\nvi) Discharge summary including complete medical history of the patient along with other details\nvii) Investigation/ Diagnostic tests reports etc. supported by the prescription form attending medical practitioner\nviii) OT notes or Surgeon’s certificate giving details of the operation performed (for surgical cases)\nix) Sticker/ Invoice of the Implants, wherever applicable\nx) MLR (Medico Legal Report) copy if carried out and FIR (First Information Report) if registered, wherever applicable\nxi) NEFT Details (to enable direct credit of claim amount in bank account) and cancelled cheque\nxii) KYC (Identity proof with address) of the proposer, where claim liability is above Rs. 1 Lakh as per AML guidelines\nxiii) Legal heir/ succession certificate, wherever applicable\nxiv) Any other relevant document required by Company for assessment of the claim.","sources":[{"clause":"4","heading":"Documents to be submitted","page":18,"url":"https://indiainsurances.com/policy/generali-central-insurance/arogya-sanjeevani-policy-generali-central-insurance-company-limited-gcihlip20160v011920/document/5735#c-4-8"}],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 17","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 22","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 23","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, V.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, V.3(iii)","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part C, V.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"}]},{"key":"claim_settlement_time","label":"Claim settlement time promised","section":"Claims","meaning":"How quickly the policy says a claim is decided or paid, and from when that is counted (intimation or last document).","status":"quote-verified","value":"The Company shall settle or reject a claim within 15 days from the date of receipt of the last necessary document. If investigation is warranted, it shall complete investigation not later than 15 days from receipt of the last necessary document and settle or reject the claim within 45 days from that date.","display":"15 days from receipt of last necessary document; 45 days if investigation is warranted","note":"Delay attracts interest at 2% above the bank rate.","quote":"i) 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. ... iii) However, where the circumstances of a claim warrant an investigation in the opinion of the Company, it shall initiate and complete such investigation at the earliest, in any case not later than 15 days from the date of receipt of last necessary document. In such cases, the Company shall settle or reject the claim within 45 days from the date of receipt of last necessary document.","sources":[{"clause":"6(i)","heading":null,"page":19,"url":"https://indiainsurances.com/policy/generali-central-insurance/arogya-sanjeevani-policy-generali-central-insurance-company-limited-gcihlip20160v011920/document/5735#c-6-i"},{"clause":"6(iii)","heading":null,"page":19,"url":"https://indiainsurances.com/policy/generali-central-insurance/arogya-sanjeevani-policy-generali-central-insurance-company-limited-gcihlip20160v011920/document/5735#c-6-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":["Expenses related to the treatment of a pre-existing Disease (PED) and its direct complications shall be excluded until the expiry of 36 months","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","Expenses related to the treatment of the listed Conditions, surgeries/treatments shall be excluded until the expiry of 24/ 36 months","Investigation & Evaluation (Code- Excl04)","Rest Cure, rehabilitation and respite care (Code- Excl05)","Obesity/ Weight Control (Code- Excl06)","Change-of-Gender treatments: (Code- Excl07)","Cosmetic or Plastic Surgery: (Code- Excl08)","Hazardous or Adventure sports: (Code- Excl09)","Breach of law: (Code- Excl10)","Excluded Providers: (Code- Excl11)","Treatment for, Alcoholism, drug or substance abuse or any addictive condition and consequences thereof. (Code- Excl12)","Outpatient Diagnostic, Medical and Surgical Procedures or OPD treatments","Domiciliary hospitalization/ treatment.","Treatment received outside India."],"display":"PED 36 months, first 30 days illness waiting, specific 24/36 months waiting, investigation/evaluation, rest cure, obesity/weight control, change of gender, cosmetic/plastic surgery, hazardous/adventure sports, breach of law, excluded providers, alcoholism/drug abuse, OPD, domiciliary treatment and treatment outside India","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 ... 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 ... Expenses related to the treatment of the listed Conditions, surgeries/treatments shall be excluded until the expiry of 24/ 36 months ... 7.1 Investigation & Evaluation (Code- Excl04) ... 7.2 Rest Cure, rehabilitation and respite care (Code- Excl05) ... 7.3 Obesity/ Weight Control (Code- Excl06) ... 7.4 Change-of-Gender treatments: (Code- Excl07) ... 7.5 Cosmetic or Plastic Surgery: (Code- Excl08) ... 7.6 Hazardous or Adventure sports: (Code- Excl09) ... 7.7 Breach of law: (Code- Excl10) ... 7.8 Excluded Providers: (Code- Excl11) ... Treatment for, Alcoholism, drug or substance abuse or any addictive condition and\nconsequences thereof. (Code- Excl12) ... Outpatient Diagnostic, Medical and Surgical Procedures or OPD treatments ... Domiciliary hospitalization/ treatment. ... Treatment received outside India.","sources":[{"clause":"6.1","heading":"Pre-Existing Diseases (Code – Excl01)","page":9,"url":"https://indiainsurances.com/policy/generali-central-insurance/arogya-sanjeevani-policy-generali-central-insurance-company-limited-gcihlip20160v011920/document/5735#c-6-1"},{"clause":"6.2","heading":"First Thirty Days Waiting Period (Code – Excl03)","page":9,"url":"https://indiainsurances.com/policy/generali-central-insurance/arogya-sanjeevani-policy-generali-central-insurance-company-limited-gcihlip20160v011920/document/5735#c-6-2"},{"clause":"6.3","heading":"Specific Waiting Period: (Code – Excl02)","page":9,"url":"https://indiainsurances.com/policy/generali-central-insurance/arogya-sanjeevani-policy-generali-central-insurance-company-limited-gcihlip20160v011920/document/5735#c-6-3"},{"clause":"7.1","heading":"Investigation & Evaluation (Code- Excl04)","page":10,"url":"https://indiainsurances.com/policy/generali-central-insurance/arogya-sanjeevani-policy-generali-central-insurance-company-limited-gcihlip20160v011920/document/5735#c-7-1"},{"clause":"7.2","heading":"Rest Cure, rehabilitation and respite care (Code- Excl05)","page":10,"url":"https://indiainsurances.com/policy/generali-central-insurance/arogya-sanjeevani-policy-generali-central-insurance-company-limited-gcihlip20160v011920/document/5735#c-7-2"},{"clause":"7.3","heading":"Obesity/ Weight Control (Code- Excl06)","page":10,"url":"https://indiainsurances.com/policy/generali-central-insurance/arogya-sanjeevani-policy-generali-central-insurance-company-limited-gcihlip20160v011920/document/5735#c-7-3"},{"clause":"7.4","heading":"Change-of-Gender treatments: (Code- Excl07)","page":10,"url":"https://indiainsurances.com/policy/generali-central-insurance/arogya-sanjeevani-policy-generali-central-insurance-company-limited-gcihlip20160v011920/document/5735#c-7-4"},{"clause":"7.5","heading":"Cosmetic or Plastic Surgery: (Code- Excl08)","page":10,"url":"https://indiainsurances.com/policy/generali-central-insurance/arogya-sanjeevani-policy-generali-central-insurance-company-limited-gcihlip20160v011920/document/5735#c-7-5"},{"clause":"7.6","heading":"Hazardous or Adventure sports: (Code- Excl09)","page":10,"url":"https://indiainsurances.com/policy/generali-central-insurance/arogya-sanjeevani-policy-generali-central-insurance-company-limited-gcihlip20160v011920/document/5735#c-7-6"},{"clause":"7.7","heading":"Breach of law: (Code- Excl10)","page":10,"url":"https://indiainsurances.com/policy/generali-central-insurance/arogya-sanjeevani-policy-generali-central-insurance-company-limited-gcihlip20160v011920/document/5735#c-7-7"},{"clause":"7.8","heading":"Excluded Providers: (Code- Excl11)","page":11,"url":"https://indiainsurances.com/policy/generali-central-insurance/arogya-sanjeevani-policy-generali-central-insurance-company-limited-gcihlip20160v011920/document/5735#c-7-8"},{"clause":"7.9","heading":"Treatment for, Alcoholism, drug or substance abuse or any addictive condition and","page":11,"url":"https://indiainsurances.com/policy/generali-central-insurance/arogya-sanjeevani-policy-generali-central-insurance-company-limited-gcihlip20160v011920/document/5735#c-7-9"},{"clause":"7.18","heading":"Outpatient Diagnostic, Medical and Surgical Procedures or OPD treatments","page":11,"url":"https://indiainsurances.com/policy/generali-central-insurance/arogya-sanjeevani-policy-generali-central-insurance-company-limited-gcihlip20160v011920/document/5735#c-7-18"},{"clause":"7.19","heading":null,"page":11,"url":"https://indiainsurances.com/policy/generali-central-insurance/arogya-sanjeevani-policy-generali-central-insurance-company-limited-gcihlip20160v011920/document/5735#c-7-19"},{"clause":"7.20","heading":null,"page":11,"url":"https://indiainsurances.com/policy/generali-central-insurance/arogya-sanjeevani-policy-generali-central-insurance-company-limited-gcihlip20160v011920/document/5735#c-7-20"}],"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, office address or branch grievance cell. If not satisfied, contact the grievance officer at GCIGRO@generalicentral.com or 7900197777 before approaching the Insurance Ombudsman.","display":"Company website/toll-free/email/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 GENERALI CENTRAL INSURANCE COMPANY LIMITED Unit No. Unit No. 301, 3rd Floor Part, Building No. 8, Mindspace IT/ITES SEZ, MIDC Industrial Area, Airavali, Navi Mumbai, Thane District – 400 708.\nInsured 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":"16","heading":"Redressal of Grievance","page":16,"url":"https://indiainsurances.com/policy/generali-central-insurance/arogya-sanjeevani-policy-generali-central-insurance-company-limited-gcihlip20160v011920/document/5735#c-16"}],"law":[{"title":"Consumer Protection (Jurisdiction of the District Commission, the State Commission and the National Commission) Rules, 2021","section":"Rule 3","url":"https://indiainsurances.com/law/consumer-jurisdiction-rules-2021"},{"title":"Consumer Protection (Jurisdiction of the District Commission, the State Commission and the National Commission) Rules, 2021","section":"Rule 4","url":"https://indiainsurances.com/law/consumer-jurisdiction-rules-2021"},{"title":"Consumer Protection (Jurisdiction of the District Commission, the State Commission and the National Commission) Rules, 2021","section":"Rule 5","url":"https://indiainsurances.com/law/consumer-jurisdiction-rules-2021"},{"title":"The Consumer Protection Act, 2019","section":"Section 2(11)","url":"https://indiainsurances.com/law/consumer-protection-act-2019"},{"title":"The Consumer Protection Act, 2019","section":"Section 2(42)","url":"https://indiainsurances.com/law/consumer-protection-act-2019"},{"title":"The Consumer Protection Act, 2019","section":"Section 34","url":"https://indiainsurances.com/law/consumer-protection-act-2019"},{"title":"The Consumer Protection Act, 2019","section":"Section 69","url":"https://indiainsurances.com/law/consumer-protection-act-2019"},{"title":"The Insurance Act, 1938","section":"Section 38","url":"https://indiainsurances.com/law/insurance-act-1938"},{"title":"Master Circular on General Insurance Business, 2024","section":"Ch I, Para 12","url":"https://indiainsurances.com/law/irdai-general-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 19","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 20","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Life Insurance Products, 2024","section":"Chapter 1, Para 13","url":"https://indiainsurances.com/law/irdai-life-products-2024"},{"title":"Master Circular on Life Insurance Products, 2024","section":"Chapter 1, Para 2","url":"https://indiainsurances.com/law/irdai-life-products-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 5(5), 5(6)","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 5(9)","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 25","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, VI.1","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, VI.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, VI.3","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Para 26","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 11","url":"https://indiainsurances.com/law/irdai-products-regs-2024"},{"title":"Review of revision in premium rates under health insurance policies for senior citizens, 2025","section":"Para 3","url":"https://indiainsurances.com/law/irdai-senior-premium-2025"},{"title":"Insurance Ombudsman Rules, 2017","section":"Rule 13","url":"https://indiainsurances.com/law/ombudsman-rules-2017"},{"title":"Insurance Ombudsman Rules, 2017","section":"Rule 14","url":"https://indiainsurances.com/law/ombudsman-rules-2017"}]},{"key":"sum_insured_options","label":"Sum insured options","section":"Cover","meaning":"The cover amounts you can choose from.","status":"quote-verified","value":"INR 50000, 1 Lac, 1.5 Lacs, 2 Lacs, 2.5 Lacs, 3 Lacs, 3.5 Lacs, 4 Lacs, 4.5 Lacs, 5 Lacs, 5.5 Lacs, 6 Lacs, 6.5 Lacs, 7 Lacs, 7.5 Lacs, 8 Lacs, 8.5 Lacs, 9 Lacs, 9.5 Lacs, 10 Lacs.","display":"INR 50000 to 10 Lacs in 50,000 steps","note":null,"quote":"Sum Insured options available in the product are: INR 50000, 1 Lac, 1.5 Lacs, 2 Lacs, 2.5 Lacs, 3 Lacs, 3.5 Lacs, 4 Lacs, 4.5 Lacs, 5 Lacs, 5.5 Lacs, 6 Lacs, 6.5 Lacs, 7 Lacs, 7.5 Lacs, 8 Lacs, 8.5 Lacs, 9 Lacs, 9.5 Lacs, 10 Lacs.","sources":[{"clause":"10","heading":"SUM INSURED","page":21,"url":"https://indiainsurances.com/policy/generali-central-insurance/arogya-sanjeevani-policy-generali-central-insurance-company-limited-gcihlip20160v011920/document/5736#c-10"}],"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":"Does not apply if the Insured Person has Continuous Coverage for more than twelve months; applies afresh to enhanced sum insured.","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":"6.2","heading":"First Thirty Days Waiting Period (Code – Excl03)","page":9,"url":"https://indiainsurances.com/policy/generali-central-insurance/arogya-sanjeevani-policy-generali-central-insurance-company-limited-gcihlip20160v011920/document/5735#c-6-2"}],"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":"Coverage after 36 months is subject to declaration at application and acceptance by the insurer; 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":"6.1","heading":"Pre-Existing Diseases (Code – Excl01)","page":9,"url":"https://indiainsurances.com/policy/generali-central-insurance/arogya-sanjeevani-policy-generali-central-insurance-company-limited-gcihlip20160v011920/document/5735#c-6-1"}],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 8","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 12","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 1.6","url":"https://indiainsurances.com/law/irdai-products-regs-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 7","url":"https://indiainsurances.com/law/irdai-products-regs-2024"}]},{"key":"specific_waiting","label":"Specific illness waiting period","section":"Waiting periods","meaning":"Waiting period for a list of named illnesses and procedures (cataract, hernia, joint replacement...). With several tiers (24 and 36 months), the shortest in the answer, the others in the note.","status":"quote-verified","value":{"unit":"months","amount":24},"display":"24 months","note":"Some listed conditions have a 36 months waiting period; not applicable for claims arising due to an accident.","quote":"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 the insurer.","sources":[{"clause":"6.3","heading":"Specific Waiting Period: (Code – Excl02)","page":9,"url":"https://indiainsurances.com/policy/generali-central-insurance/arogya-sanjeevani-policy-generali-central-insurance-company-limited-gcihlip20160v011920/document/5735#c-6-3"}],"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":["Benign ENT disorders","Tonsillectomy","Adenoidectomy","Mastoidectomy","Tympanoplasty","Hysterectomy","All internal or external benign tumors, cysts, polyps of any kind, including benign breast lumps","Benign Prostate Hypertrophy","Cataract and age related eye ailments","Gastric/ Duodenal Ulcer","Gout and Rheumatism","Hernia of all types","Hydrocele","Non Infective Arthritis","Piles, Fissures and Fistula in anus","Pilonidal sinus, Sinusitis and related disorders","Prolapse inter Vertebral Disc and Spinal Diseases unless arising from accident","Calculi in urinary system, Gall Bladder and bile duct, excluding malignancy","Varicose Veins and Varicose Ulcers","Treatment for joint replacement unless arising from accident","Age-related Osteoarthritis & Osteoporosis"],"display":"24 months list plus 36 months for joint replacement and age-related osteoarthritis/osteoporosis","note":null,"quote":"i) 24 months waiting period\n1. Benign ENT disorders\n2. Tonsillectomy\n3. Adenoidectomy\n4. Mastoidectomy\n5. Tympanoplasty\n6. Hysterectomy\n7. All internal or external benign tumors, cysts, polyps of any kind, including benign breast lumps\n8. Benign Prostate Hypertrophy\n9. Cataract and age related eye ailments\n10. Gastric/ Duodenal Ulcer\n11. Gout and Rheumatism\n12. Hernia of all types\n13. Hydrocele\n14. Non Infective Arthritis\n15. Piles, Fissures and Fistula in anus\n16. Pilonidal sinus, Sinusitis and related disorders\n17. Prolapse inter Vertebral Disc and Spinal Diseases unless arising from accident\n18. Calculi in urinary system, Gall Bladder and bile duct, excluding malignancy\n19. Varicose Veins and Varicose Ulcers ... ii) 36 months waiting period\n1. Treatment for joint replacement unless arising from accident\n2. Age-related Osteoarthritis & Osteoporosis","sources":[{"clause":"6.3(e)(i)","heading":null,"page":9,"url":"https://indiainsurances.com/policy/generali-central-insurance/arogya-sanjeevani-policy-generali-central-insurance-company-limited-gcihlip20160v011920/document/5735#c-6-3-e-i"},{"clause":"6.3(e)(ii)","heading":null,"page":10,"url":"https://indiainsurances.com/policy/generali-central-insurance/arogya-sanjeevani-policy-generali-central-insurance-company-limited-gcihlip20160v011920/document/5735#c-6-3-e-ii"}],"law":[]},{"key":"moratorium","label":"Moratorium period","section":"Renewal and rights","meaning":"After this many months of continuous cover, the insurer cannot reject a claim for non-disclosure, except for proven fraud or permanent exclusions. The law sets 60 months.","status":"quote-verified","value":{"unit":"months","amount":60},"display":"sixty continuous months","note":"For enhanced sum insured, sixty continuous months applies from the date of enhancement on the enhanced limits.","quote":"After completion of sixty continuous months of coverage (including portability and migration) in health insurance policy, no policy and claim shall be contestable by the insurer on grounds of non-disclosure, misrepresentation, except on grounds of established fraud. This period of sixty continuous months is called as moratorium period.","sources":[{"clause":"12","heading":"Moratorium Period","page":15,"url":"https://indiainsurances.com/policy/generali-central-insurance/arogya-sanjeevani-policy-generali-central-insurance-company-limited-gcihlip20160v011920/document/5735#c-12"}],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 13","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, IV.8","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 8","url":"https://indiainsurances.com/law/irdai-products-regs-2024"}]},{"key":"portability","label":"Portability","section":"Renewal and rights","meaning":"Whether you can move this policy to another insurer and keep waiting-period credit.","status":"quote-verified","value":"The insured person may port the policy to other insurers at renewal by applying at least 30 days before but not earlier than 60 days from the due date for renewal. Credit for sum insured, no claim bonus, specific waiting periods, PED waiting period, moratorium period and similar benefits is transferred to this policy from the existing insurer when conditions are met.","display":"Allowed at renewal; apply at least 30 days before and not earlier than 60 days from renewal due date; continuity credits transferred","note":null,"quote":"The insured person will have the option to port the policy to other insurers at the time of renewal by applying to such insurer to port the entire policy along with all the members of the family, if any, at least 30 days before, but not earlier than 60 days from the due date for renewal as per IRDAI guidelines related to portability. lf the Policyholder (including all members under family cover) is presently covered and has been continuously covered without any lapses under the health insurance policy with existing Indian General/Health Insurer, then the credit gained to the extent of the Sum Insured, No Claim Bonus, Specific Waiting periods, waiting period for pre-existing diseases, Moratorium period etc. in the previous policy, shall be transferred from the existing Insurer to Our Company.","sources":[{"clause":null,"heading":"4. Portability","page":12,"url":"https://indiainsurances.com/policy/generali-central-insurance/arogya-sanjeevani-policy-generali-central-insurance-company-limited-gcihlip20160v011920/document/5735#c-4-portability"}],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 11","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 12","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, IV.6","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, VII.3","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Para 24","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 1.4 and 1.5","url":"https://indiainsurances.com/law/irdai-products-regs-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 10","url":"https://indiainsurances.com/law/irdai-products-regs-2024"}]},{"key":"lifelong_renewal","label":"Lifelong renewal","section":"Renewal and rights","meaning":"Whether the policy can be renewed for life without a maximum age.","status":"quote-verified","value":true,"display":"Yes, lifelong","note":null,"quote":"Renewal | Lifelong","sources":[{"clause":"8","heading":"ELIGIBILITY","page":20,"url":"https://indiainsurances.com/policy/generali-central-insurance/arogya-sanjeevani-policy-generali-central-insurance-company-limited-gcihlip20160v011920/document/5736#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 Health Insurance Business, 2024","section":"Ch II D.II","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, IV.5","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 9","url":"https://indiainsurances.com/law/irdai-products-regs-2024"},{"title":"Review of revision in premium rates under health insurance policies for senior citizens, 2025","section":"Para 7","url":"https://indiainsurances.com/law/irdai-senior-premium-2025"}]},{"key":"claim_loading","label":"Premium loading after claims","section":"Renewal and rights","meaning":"Whether the premium can go up at renewal because you made a claim.","status":"quote-verified","value":"No loading shall apply on renewals based on individual claims experience.","display":"No loading on renewals based on individual claims experience","note":null,"quote":"No loading shall apply on renewals based on individual claims experience","sources":[{"clause":"13","heading":"Renewal of Policy","page":15,"url":"https://indiainsurances.com/policy/generali-central-insurance/arogya-sanjeevani-policy-generali-central-insurance-company-limited-gcihlip20160v011920/document/5735#c-13"}],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 10","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, IV.5","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 9","url":"https://indiainsurances.com/law/irdai-products-regs-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 4","url":"https://indiainsurances.com/law/irdai-products-regs-2024"},{"title":"Review of revision in premium rates under health insurance policies for senior citizens, 2025","section":"Para 7","url":"https://indiainsurances.com/law/irdai-senior-premium-2025"}]},{"key":"permanent_exclusions","label":"Permanent exclusions","section":"Exclusions","meaning":"Conditions or treatments that are never covered: the standard IRDAI exclusion codes Excl04 to Excl18 and the product's own permanent exclusions. Excl01 to Excl03 are waiting periods, not permanent exclusions.","status":"quote-verified","value":["Investigation & Evaluation (Code- Excl04)","Rest Cure, rehabilitation and respite care (Code- Excl05)","Obesity/ Weight Control (Code- Excl06)","Change-of-Gender treatments: (Code- Excl07)","Cosmetic or Plastic Surgery: (Code- Excl08)","Hazardous or Adventure sports: (Code- Excl09)","Breach of law: (Code- Excl10)","Excluded Providers: (Code- Excl11)","Treatment for, Alcoholism, drug or substance abuse or any addictive condition and consequences thereof. (Code- Excl12)","Treatments received in heath hydros, nature cure clinics, spas or similar establishments","Dietary supplements and substances which are available naturally and that can be purchased without prescription","Expenses related to the treatment for correction of eye sight due to refractive error less than 7.5 dioptres. (Code- Excl15)","Expenses related to any unproven treatment, services and supplies for or in connection with any treatment. (Code- Excl16)","Sterility and Infertility: (Code- Excl17)","Maternity Expenses: (Code- Excl18)","Injury or Disease directly or indirectly caused by or arising from or attributable to War","Injury or Disease directly or indirectly caused by or contributed to by nuclear weapons/ materials.","Outpatient Diagnostic, Medical and Surgical Procedures or OPD treatments","Domiciliary hospitalization/ treatment.","Treatment received outside India.","specified ICD codes"],"display":"Standard exclusions Excl04 to Excl18, plus war, nuclear, OPD, domiciliary treatment, treatment outside India and specified ICD-code exclusions","note":null,"quote":"7.1 Investigation & Evaluation (Code- Excl04) ... 7.2 Rest Cure, rehabilitation and respite care (Code- Excl05) ... 7.3 Obesity/ Weight Control (Code- Excl06) ... 7.4 Change-of-Gender treatments: (Code- Excl07) ... 7.5 Cosmetic or Plastic Surgery: (Code- Excl08) ... 7.6 Hazardous or Adventure sports: (Code- Excl09) ... 7.7 Breach of law: (Code- Excl10) ... 7.8 Excluded Providers: (Code- Excl11) ... Treatment for, Alcoholism, drug or substance abuse or any addictive condition and\nconsequences thereof. (Code- Excl12) ... Treatments received in heath hydros, nature cure clinics, spas or similar establishments ... Dietary supplements and substances which are available naturally and that can be purchased\nwithout prescription ... Expenses related to the treatment for correction of eye sight due to refractive error less than 7.5 dioptres. (Code- Excl15) ... Expenses related to any unproven treatment, services and supplies for or in connection with any treatment. Unproven treatments are treatments, procedures or supplies that lack significant medical documentation to support their effectiveness. (Code- Excl16) ... 7.14 Sterility and Infertility: (Code- Excl17) ... 7.15 Maternity Expenses: (Code- Excl18) ... Injury or Disease directly or indirectly caused by or arising from or attributable to War, Invasion, Act of Foreign Enemy, War like operations (whether war be declared or not). ... Injury or Disease directly or indirectly caused by or contributed to by nuclear weapons/\nmaterials. ... Outpatient Diagnostic, Medical and Surgical Procedures or OPD treatments ... Domiciliary hospitalization/ treatment. ... Treatment received outside India. ... policyholder is not entitled to get the coverage for specified ICD codes.","sources":[{"clause":"7.1","heading":"Investigation & Evaluation (Code- Excl04)","page":10,"url":"https://indiainsurances.com/policy/generali-central-insurance/arogya-sanjeevani-policy-generali-central-insurance-company-limited-gcihlip20160v011920/document/5735#c-7-1"},{"clause":"7.2","heading":"Rest Cure, rehabilitation and respite care (Code- Excl05)","page":10,"url":"https://indiainsurances.com/policy/generali-central-insurance/arogya-sanjeevani-policy-generali-central-insurance-company-limited-gcihlip20160v011920/document/5735#c-7-2"},{"clause":"7.3","heading":"Obesity/ Weight Control (Code- Excl06)","page":10,"url":"https://indiainsurances.com/policy/generali-central-insurance/arogya-sanjeevani-policy-generali-central-insurance-company-limited-gcihlip20160v011920/document/5735#c-7-3"},{"clause":"7.4","heading":"Change-of-Gender treatments: (Code- Excl07)","page":10,"url":"https://indiainsurances.com/policy/generali-central-insurance/arogya-sanjeevani-policy-generali-central-insurance-company-limited-gcihlip20160v011920/document/5735#c-7-4"},{"clause":"7.5","heading":"Cosmetic or Plastic Surgery: (Code- Excl08)","page":10,"url":"https://indiainsurances.com/policy/generali-central-insurance/arogya-sanjeevani-policy-generali-central-insurance-company-limited-gcihlip20160v011920/document/5735#c-7-5"},{"clause":"7.6","heading":"Hazardous or Adventure sports: (Code- Excl09)","page":10,"url":"https://indiainsurances.com/policy/generali-central-insurance/arogya-sanjeevani-policy-generali-central-insurance-company-limited-gcihlip20160v011920/document/5735#c-7-6"},{"clause":"7.7","heading":"Breach of law: (Code- Excl10)","page":10,"url":"https://indiainsurances.com/policy/generali-central-insurance/arogya-sanjeevani-policy-generali-central-insurance-company-limited-gcihlip20160v011920/document/5735#c-7-7"},{"clause":"7.8","heading":"Excluded Providers: (Code- Excl11)","page":11,"url":"https://indiainsurances.com/policy/generali-central-insurance/arogya-sanjeevani-policy-generali-central-insurance-company-limited-gcihlip20160v011920/document/5735#c-7-8"},{"clause":"7.9","heading":"Treatment for, Alcoholism, drug or substance abuse or any addictive condition and","page":11,"url":"https://indiainsurances.com/policy/generali-central-insurance/arogya-sanjeevani-policy-generali-central-insurance-company-limited-gcihlip20160v011920/document/5735#c-7-9"},{"clause":"7.10","heading":null,"page":11,"url":"https://indiainsurances.com/policy/generali-central-insurance/arogya-sanjeevani-policy-generali-central-insurance-company-limited-gcihlip20160v011920/document/5735#c-7-10"},{"clause":"7.11","heading":"Dietary supplements and substances which are available naturally and that can be purchased","page":11,"url":"https://indiainsurances.com/policy/generali-central-insurance/arogya-sanjeevani-policy-generali-central-insurance-company-limited-gcihlip20160v011920/document/5735#c-7-11"},{"clause":"6.12","heading":null,"page":11,"url":"https://indiainsurances.com/policy/generali-central-insurance/arogya-sanjeevani-policy-generali-central-insurance-company-limited-gcihlip20160v011920/document/5736#c-6-12"},{"clause":"7.13","heading":null,"page":11,"url":"https://indiainsurances.com/policy/generali-central-insurance/arogya-sanjeevani-policy-generali-central-insurance-company-limited-gcihlip20160v011920/document/5735#c-7-13"},{"clause":"7.14","heading":"Sterility and Infertility: (Code- Excl17)","page":11,"url":"https://indiainsurances.com/policy/generali-central-insurance/arogya-sanjeevani-policy-generali-central-insurance-company-limited-gcihlip20160v011920/document/5735#c-7-14"},{"clause":"7.15","heading":"Maternity Expenses: (Code- Excl18)","page":11,"url":"https://indiainsurances.com/policy/generali-central-insurance/arogya-sanjeevani-policy-generali-central-insurance-company-limited-gcihlip20160v011920/document/5735#c-7-15"},{"clause":"7.16","heading":null,"page":11,"url":"https://indiainsurances.com/policy/generali-central-insurance/arogya-sanjeevani-policy-generali-central-insurance-company-limited-gcihlip20160v011920/document/5735#c-7-16"},{"clause":"7.17","heading":"Injury or Disease directly or indirectly caused by or contributed to by nuclear weapons/","page":11,"url":"https://indiainsurances.com/policy/generali-central-insurance/arogya-sanjeevani-policy-generali-central-insurance-company-limited-gcihlip20160v011920/document/5735#c-7-17"},{"clause":"7.18","heading":"Outpatient Diagnostic, Medical and Surgical Procedures or OPD treatments","page":11,"url":"https://indiainsurances.com/policy/generali-central-insurance/arogya-sanjeevani-policy-generali-central-insurance-company-limited-gcihlip20160v011920/document/5735#c-7-18"},{"clause":"7.19","heading":null,"page":11,"url":"https://indiainsurances.com/policy/generali-central-insurance/arogya-sanjeevani-policy-generali-central-insurance-company-limited-gcihlip20160v011920/document/5735#c-7-19"},{"clause":"7.20","heading":null,"page":11,"url":"https://indiainsurances.com/policy/generali-central-insurance/arogya-sanjeevani-policy-generali-central-insurance-company-limited-gcihlip20160v011920/document/5735#c-7-20"},{"clause":"7.21","heading":"In respect of the existing diseases, disclosed by the insured and mentioned in the policy","page":11,"url":"https://indiainsurances.com/policy/generali-central-insurance/arogya-sanjeevani-policy-generali-central-insurance-company-limited-gcihlip20160v011920/document/5735#c-7-21"}],"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 with 7 days written notice. If no claims are reported, the company refunds proportionate premium for the unexpired policy or instalment period on prorate basis; if claims are reported, no refund is made for a 1 year single premium current policy year or for the unexpired instalment period, while unutilized subsequent policy years may be refunded for 2/3 year single premium policies.","display":"7 days written notice; no-claim cancellation gives prorate refund; claim-reported cancellation gives no refund for current policy year/instalment period, with later 2/3 year years refunded if any","note":null,"quote":"a) The policyholder may cancel this policy by giving 7 days written notice.\nb) In case the Policyholder requests for cancellation of the Policy, where no claims are reported under the Policy, the Company shall refund premium for the unexpired policy/ instalment period as detailed below:\ni) Single Premium Payment (1/2/3 years Policy Term) – There shall be refund of proportionate premium for the unexpired policy period on prorate basis.\nii) Premium paid in multiple instalments (1/2/3 years Policy Term) - There shall be refund of proportionate premium for the unexpired instalment period on prorate basis. ... i) Single Premium Payment\n1) 1 year Policy Term - There shall be no refund of premium for the unexpired policy period.\n2) 2/3 years Policy Term – There shall be no refund of premium for the current Policy Year in which the claim got reported. However, the premium for the unutilized subsequent Policy Years (if any), shall be refunded. ... ii) Premium paid in multiple instalments –\n1) 1/2/3 years Policy Term - There shall be no refund of premium for the unexpired instalment period.","sources":[{"clause":"9","heading":"Cancellation","page":13,"url":"https://indiainsurances.com/policy/generali-central-insurance/arogya-sanjeevani-policy-generali-central-insurance-company-limited-gcihlip20160v011920/document/5735#c-9"},{"clause":"9(c)(i)","heading":null,"page":13,"url":"https://indiainsurances.com/policy/generali-central-insurance/arogya-sanjeevani-policy-generali-central-insurance-company-limited-gcihlip20160v011920/document/5735#c-9-c-i"},{"clause":"9(c)(ii)","heading":null,"page":14,"url":"https://indiainsurances.com/policy/generali-central-insurance/arogya-sanjeevani-policy-generali-central-insurance-company-limited-gcihlip20160v011920/document/5735#c-9-c-ii"}],"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 treatment for the purpose of this insurance has to be taken in India only.","display":"India only","note":null,"quote":"All medical treatment for the purpose of this insurance will have to be taken in India only.","sources":[{"clause":null,"heading":"4. Territorial Limit","page":17,"url":"https://indiainsurances.com/policy/generali-central-insurance/arogya-sanjeevani-policy-generali-central-insurance-company-limited-gcihlip20160v011920/document/5735#c-4-territorial-limit"}],"law":[]},{"key":"free_look","label":"Free-look period","section":"Renewal and rights","meaning":"Days after you receive the policy in which you can return it for a refund if you do not agree with its terms.","status":"quote-verified","value":{"unit":"days","amount":30},"display":"thirty days","note":"Applies on new individual health insurance policies, not on renewals or at the time of porting/migrating the policy.","quote":"The insured person shall be allowed free look period of thirty days from date of receipt of the policy document to review the terms and conditions of the policy, and to return the same if not acceptable.","sources":[{"clause":null,"heading":"3. Free Look Period","page":12,"url":"https://indiainsurances.com/policy/generali-central-insurance/arogya-sanjeevani-policy-generali-central-insurance-company-limited-gcihlip20160v011920/document/5735#c-3-free-look-period"}],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 5","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Life Insurance Products, 2024","section":"Chapter 1, Para 5","url":"https://indiainsurances.com/law/irdai-life-products-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 20(1), 20(2)","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 20(3) to 20(5)","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 20(6)","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, II.8","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, III.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, III.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"}]},{"key":"grace_period","label":"Grace period","section":"Renewal and rights","meaning":"Days you get after the due date to pay without losing cover or continuity.","status":"quote-verified","value":{"unit":"days","amount":15},"display":"15 days for monthly instalment premium; 30 days for quarterly / Half Yearly installment premiums","note":"Renewal clause also says the policy can be renewed within the Grace Period of 30 days to maintain continuity.","quote":"Grace Period of 15 days would be given to pay in case of monthly instalment premium and grace period of 30 days shall be given to pay in case of quarterly / Half Yearly installment premiums, due for the policy.","sources":[{"clause":"10","heading":"Premium Payment in instalments","page":15,"url":"https://indiainsurances.com/policy/generali-central-insurance/arogya-sanjeevani-policy-generali-central-insurance-company-limited-gcihlip20160v011920/document/5735#c-10"}],"law":[{"title":"The Insurance Act, 1938","section":"Section 50","url":"https://indiainsurances.com/law/insurance-act-1938"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 8","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 9","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Life Insurance Products, 2024","section":"Chapter 1, Para 8","url":"https://indiainsurances.com/law/irdai-life-products-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, IV.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, IV.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Para 3","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule I, Para 1.2","url":"https://indiainsurances.com/law/irdai-products-regs-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 1.3","url":"https://indiainsurances.com/law/irdai-products-regs-2024"}]},{"key":"eligibility_entry_age","label":"Entry age","section":"Eligibility","meaning":"The youngest and oldest age at which you can buy this policy.","status":"quote-verified","value":"Minimum age at entry is 3 months for child and 18 years for adults. Maximum age at entry is 25 years for child and 65 years for adults.","display":"3 months to 25 years for child; 18 years to 65 years for adults","note":null,"quote":"Minimum Age at entry | 3 months (for child) 18 years (for adults)\nMaximum Age at entry | 25 years (for child) 65 Years (for adults)","sources":[{"clause":"8","heading":"ELIGIBILITY","page":20,"url":"https://indiainsurances.com/policy/generali-central-insurance/arogya-sanjeevani-policy-generali-central-insurance-company-limited-gcihlip20160v011920/document/5736#c-8"}],"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 Premium Payment","Half Yearly","Quarterly","Monthly"],"display":"Single Premium Payment, Half Yearly, Quarterly or Monthly","note":null,"quote":"Single Premium Payment (1/2/3 years Policy Term) ... Payment of Premium on an instalment basis i.e. Half Yearly, Quarterly or Monthly","sources":[{"clause":"9","heading":"Cancellation","page":13,"url":"https://indiainsurances.com/policy/generali-central-insurance/arogya-sanjeevani-policy-generali-central-insurance-company-limited-gcihlip20160v011920/document/5735#c-9"},{"clause":"10","heading":"Premium Payment in instalments","page":15,"url":"https://indiainsurances.com/policy/generali-central-insurance/arogya-sanjeevani-policy-generali-central-insurance-company-limited-gcihlip20160v011920/document/5735#c-10"}],"law":[]},{"key":"optional_covers","label":"Optional covers","section":"Cover","meaning":"Covers you can add for an extra premium. They change the answers above only if you buy them.","status":"not-stated","value":null,"display":null,"note":null,"quote":null,"sources":[],"law":[]},{"key":"grace_cover","label":"Cover during the grace period","section":"Renewal and rights","meaning":"Whether a claim during the grace period is paid.","status":"quote-verified","value":"Coverage is not available during the renewal grace period. For installment premiums during the policy period, the insurer shall offer coverage during the grace period if the premium is paid in installments.","display":"No cover during renewal grace period; installment grace coverage is offered during policy period","note":"The wording distinguishes renewal grace period from installment premium grace during the policy period.","quote":"Coverage is not available during the grace period. ... Provided the insurer shall offer coverage during the grace period, if the premium is paid in installments during policy period.","sources":[{"clause":"13","heading":"Renewal of Policy","page":15,"url":"https://indiainsurances.com/policy/generali-central-insurance/arogya-sanjeevani-policy-generali-central-insurance-company-limited-gcihlip20160v011920/document/5735#c-13"},{"clause":"3.17","heading":"Grace period","page":3,"url":"https://indiainsurances.com/policy/generali-central-insurance/arogya-sanjeevani-policy-generali-central-insurance-company-limited-gcihlip20160v011920/document/5735#c-3-17"}],"law":[]},{"key":"room_rent","label":"Room rent limit","section":"Limits and co-pay","meaning":"The most the policy pays per day for the hospital room, or the room category allowed. If you take a costlier room, other bills can be cut in proportion.","status":"quote-verified","value":"Room Rent, Boarding and Nursing Expenses are covered up to 2% of the sum insured, subject to a maximum of Rs. 5000/- per day.","display":"Up to 2% of sum insured, max Rs. 5000/- per day","note":null,"quote":"Room Rent, Boarding, Nursing Expenses as provided by the Hospital / Nursing Home up to 2% of the sum insured subject to maximum of Rs. 5000/-, per day.","sources":[{"clause":"4.1","heading":"Hospitalization","page":6,"url":"https://indiainsurances.com/policy/generali-central-insurance/arogya-sanjeevani-policy-generali-central-insurance-company-limited-gcihlip20160v011920/document/5735#c-4-1"}],"law":[]},{"key":"room_category","label":"Room category allowed","section":"Limits and co-pay","meaning":"Shared room, single private room or any room, by plan, when the limit is a room type rather than a rupee amount.","status":"not-applicable","value":null,"display":null,"note":"The policy has a percentage/rupee room-rent limit, not a room category limit.","quote":null,"sources":[],"law":[]},{"key":"icu_limit","label":"ICU limit","section":"Limits and co-pay","meaning":"The most the policy pays per day for intensive care.","status":"quote-verified","value":"ICU/ICCU expenses are covered up to 5% of sum insured, subject to a maximum of Rs, 10,000/- per day.","display":"Up to 5% of sum insured, max Rs, 10,000/- per day","note":null,"quote":"Intensive Care Unit (ICU) / Intensive Cardiac Care Unit (ICCU) expenses up to 5% of sum insured subject to maximum of Rs, 10,000/- per day.","sources":[{"clause":"4.1","heading":"Hospitalization","page":6,"url":"https://indiainsurances.com/policy/generali-central-insurance/arogya-sanjeevani-policy-generali-central-insurance-company-limited-gcihlip20160v011920/document/5735#c-4-1"}],"law":[]},{"key":"proportionate_deduction","label":"Proportionate deduction","section":"Limits and co-pay","meaning":"If you choose a room above your limit, whether the insurer reduces associated charges (doctor fees, tests, procedures) by the same proportion.","status":"quote-verified","value":"If admitted to a room at rates exceeding the room-rent limits, reimbursement/payment of all other hospital expenses except pharmacy, consumables, implants, medical devices and diagnostics is reduced in the same proportion as the admissible room rate bears to the actual room rent. Proportionate deduction does not apply for ICU room limit excess or for hospitals without differential billing by room category.","display":"Yes, for non-ICU room rent above limit; pharmacy, consumables, implants, medical devices and diagnostics excluded from the deduction","note":null,"quote":"In case of admission to a room at rates exceeding the aforesaid limits, the reimbursement/ payment of all other expenses incurred at the Hospital, with the exception of cost of pharmacy, consumables, implants, medical devices and diagnostics shall be effected in the same proportion as the admissible rate per day bears to the actual rate per day of Room Rent charges.\n3. Proportionate deductions is not applicable in case of admission in an ICU room with rates exceeding the defined limit.\n4. Proportionate deductions for opting a Non –ICU room with higher room rent limit is not applicable for those hospitals where differential billing based on the room category is not adopted.","sources":[{"clause":"4.1.1(v)","heading":null,"page":7,"url":"https://indiainsurances.com/policy/generali-central-insurance/arogya-sanjeevani-policy-generali-central-insurance-company-limited-gcihlip20160v011920/document/5735#c-4-1-1-v"}],"law":[]},{"key":"copay","label":"Co-payment","section":"Limits and co-pay","meaning":"The share of every admissible claim you pay yourself, and when it applies (age, zone, choice of hospital).","status":"quote-verified","value":"Each and every claim is subject to a 5% copayment applicable to the admissible and payable claim amount.","display":"5% on each and every claim","note":null,"quote":"Each and every claim under the Policy shall be subject to a Copayment of 5% applicable to claim amount admissible and payable as per the terms and conditions of the Policy. The amount payable shall be after deduction of the copayment.","sources":[{"clause":"5","heading":"Co-payment","page":19,"url":"https://indiainsurances.com/policy/generali-central-insurance/arogya-sanjeevani-policy-generali-central-insurance-company-limited-gcihlip20160v011920/document/5735#c-5-2"}],"law":[]},{"key":"deductible","label":"Deductible","section":"Limits and co-pay","meaning":"An amount of each claim or each year that you bear before the policy pays.","status":"quote-verified","value":"Not applicable.","display":"Not Applicable","note":"The explicit statement is in the Customer Information Sheet.","quote":"iii. Deductible- (It is a specified amount up to which an insurance company will not pay any claim, and which will be deducted from total claim amount (if claim amount is more than the specified amount) | Not Applicable | Not Applicable","sources":[{"clause":null,"heading":"AROGYA SANJEEVANI POLICY, Generali Central Insurance Company Limited","page":1,"url":"https://indiainsurances.com/policy/generali-central-insurance/arogya-sanjeevani-policy-generali-central-insurance-company-limited-gcihlip20160v011920/document/5738#c-arogya-sanjeevani-policy-generali-central-insura-2"}],"law":[]},{"key":"disease_sublimits","label":"Disease or procedure sub-limits","section":"Limits and co-pay","meaning":"Caps on what is paid for named treatments (cataract, knee replacement...), even if the sum insured is higher.","status":"quote-verified","value":["Cataract: 25% of Sum Insured or Rs. 40,000/-, whichever is lower, per each eye in one policy year","Modern treatment procedures: up to 50% of Sum Insured during the policy period"],"display":"Cataract: 25% of SI or Rs. 40,000/- per eye, whichever is lower; modern treatments: 50% of SI","note":null,"quote":"The Company shall indemnify medical expenses incurred for treatment of Cataract, subject to a limit of 25% of Sum Insured or Rs. 40,000/-, whichever is lower, per each eye in one policy year. ... The following procedures will be covered (wherever medically indicated) whether as in patient or as part of day care treatment in a hospital up to 50% of Sum Insured, specified in the policy schedule, during the policy period:","sources":[{"clause":"4.3","heading":"Cataract Treatment","page":7,"url":"https://indiainsurances.com/policy/generali-central-insurance/arogya-sanjeevani-policy-generali-central-insurance-company-limited-gcihlip20160v011920/document/5735#c-4-3"},{"clause":"4.6","heading":null,"page":7,"url":"https://indiainsurances.com/policy/generali-central-insurance/arogya-sanjeevani-policy-generali-central-insurance-company-limited-gcihlip20160v011920/document/5735#c-4-6"}],"law":[]},{"key":"pre_hospitalisation","label":"Pre-hospitalisation cover","section":"Cover","meaning":"Medical costs in the days before admission that are paid if related to the hospitalisation.","status":"quote-verified","value":{"unit":"days","amount":30},"display":"30 days prior to the date of admissible hospitalization","note":null,"quote":"The Company shall indemnify pre-hospitalization medical expenses incurred, related to an admissible hospitalization requiring inpatient care, for a fixed period of 30 days prior to the date of admissible hospitalization covered under the policy.","sources":[{"clause":"4.4","heading":"Pre Hospitalization","page":7,"url":"https://indiainsurances.com/policy/generali-central-insurance/arogya-sanjeevani-policy-generali-central-insurance-company-limited-gcihlip20160v011920/document/5735#c-4-4"}],"law":[]},{"key":"post_hospitalisation","label":"Post-hospitalisation cover","section":"Cover","meaning":"Medical costs in the days after discharge that are paid if related to the hospitalisation.","status":"quote-verified","value":{"unit":"days","amount":60},"display":"60 days from the date of discharge","note":null,"quote":"The Company shall indemnify post hospitalization medical expenses incurred, related to an admissible hospitalization requiring inpatient care, for a fixed period of 60 days from the date of discharge from the Hospital, following an admissible hospitalization covered under the policy.","sources":[{"clause":"4.5","heading":"Post Hospitalization","page":7,"url":"https://indiainsurances.com/policy/generali-central-insurance/arogya-sanjeevani-policy-generali-central-insurance-company-limited-gcihlip20160v011920/document/5735#c-4-5"}],"law":[]},{"key":"day_care","label":"Day-care treatments","section":"Cover","meaning":"Treatments needing less than 24 hours in hospital (chemotherapy, dialysis, cataract) and whether all or only listed ones are covered.","status":"quote-verified","value":"All day care treatments are covered. Day care treatment is treatment or surgical procedure undertaken under anesthesia in a hospital/day care centre in less than 24 hrs because of technological advancement and which would otherwise have required hospitalization of more than 24 hours; OPD treatment is excluded from this definition.","display":"All day care treatments covered; less than 24 hrs because of technological advancement","note":null,"quote":"iv) All the day care treatments ... Day care treatment means medical treatment, and/or surgical procedure which is:\na) undertaken under General or Local Anesthesia in a hospital/day care centre in less than 24 hrs because of technological advancement, and\nb) which would have otherwise required hospitalization of more than 24 hours. Treatment normally taken on an out-patient basis is not included in the scope of this definition.","sources":[{"clause":"4.1.1(iv)","heading":null,"page":7,"url":"https://indiainsurances.com/policy/generali-central-insurance/arogya-sanjeevani-policy-generali-central-insurance-company-limited-gcihlip20160v011920/document/5735#c-4-1-1-iv"},{"clause":"3.12","heading":"Day care treatment","page":2,"url":"https://indiainsurances.com/policy/generali-central-insurance/arogya-sanjeevani-policy-generali-central-insurance-company-limited-gcihlip20160v011920/document/5735#c-3-12"}],"law":[]},{"key":"domiciliary","label":"Treatment at home","section":"Cover","meaning":"Whether treatment at home is covered when hospital admission is not possible or a doctor advises it.","status":"quote-verified","value":"Domiciliary hospitalization/treatment is excluded.","display":"Not covered: domiciliary hospitalization/ treatment","note":"Although domiciliary hospitalization is defined, it is listed under specific exclusions.","quote":"Domiciliary hospitalization/ treatment.","sources":[{"clause":"7.19","heading":null,"page":11,"url":"https://indiainsurances.com/policy/generali-central-insurance/arogya-sanjeevani-policy-generali-central-insurance-company-limited-gcihlip20160v011920/document/5735#c-7-19"}],"law":[]},{"key":"ayush","label":"AYUSH treatment","section":"Cover","meaning":"Ayurveda, Yoga, Unani, Siddha and Homeopathy treatment in a recognised hospital, and any limit.","status":"quote-verified","value":"Inpatient care treatment under Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homeopathy systems of medicines is covered during each policy year up to the sum insured in any AYUSH Hospital.","display":"Covered up to sum insured in any AYUSH Hospital","note":null,"quote":"The Company shall indemnify medical expenses incurred for inpatient care treatment under Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homeopathy systems of medicines during each Policy Year up to the limit of sum insured as specified in the policy schedule in any AYUSH Hospital.","sources":[{"clause":"4.2","heading":"AYUSH Treatment","page":7,"url":"https://indiainsurances.com/policy/generali-central-insurance/arogya-sanjeevani-policy-generali-central-insurance-company-limited-gcihlip20160v011920/document/5735#c-4-2"}],"law":[{"title":"Guidelines on providing AYUSH coverage in Health Insurance policies, 2024","section":"Para 1","url":"https://indiainsurances.com/law/irdai-ayush-2024"},{"title":"Guidelines on providing AYUSH coverage in Health Insurance policies, 2024","section":"Para 2","url":"https://indiainsurances.com/law/irdai-ayush-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 1","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch II A.I(1)","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 5","url":"https://indiainsurances.com/law/irdai-products-regs-2024"}]},{"key":"modern_treatments","label":"Modern treatments","section":"Cover","meaning":"Robotic surgery, immunotherapy, oral chemotherapy, stem cell therapy and the like, and any cap on them.","status":"quote-verified","value":"Listed modern treatment methods and advancements are covered, wherever medically indicated, as inpatient or day care treatment up to 50% of the Sum Insured during the policy period. The listed procedures include uterine artery embolization and HIFU, balloon sinuplasty, deep brain stimulation, oral chemotherapy, immunotherapy monoclonal antibody injection, intra vitreal injections, robotic surgeries, stereotactic radio surgeries, bronchial thermoplasty, vaporisation of the prostate, IONM and hematopoietic stem cell therapy for bone marrow transplant for haematological conditions.","display":"Listed modern treatments covered up to 50% of Sum Insured","note":null,"quote":"The following procedures will be covered (wherever medically indicated) whether as in patient or as part of day care treatment in a hospital up to 50% of Sum Insured, specified in the policy schedule, during the policy period:\nA. Uterine Artery Embolization and HIFU (High Intensity Focused Ultrasound) B. Balloon Sinuplasty C. Deep Brain stimulation D. Oral chemotherapy E. Immunotherapy- Monoclonal Antibody to be given as injection F. Intra vitreal injections G. Robotic surgeries H. Stereotactic radio surgeries ... I) Bronchical Thermoplasty J. Vaporisation of the prostrate (Green laser treatment or holmium laser treatment) K. IONM - (Intra Operative Neuro Monitoring) L. Stem cell therapy: Hematopoietic stem cells for bone marrow transplant for haematological conditions to be covered.\nIn case there are multiple claims falling for the procedures mentioned above, the maximum liability will be restricted to 50% of Sum Insured for all claims put together.","sources":[{"clause":"4.6","heading":null,"page":7,"url":"https://indiainsurances.com/policy/generali-central-insurance/arogya-sanjeevani-policy-generali-central-insurance-company-limited-gcihlip20160v011920/document/5735#c-4-6"},{"clause":"4.6(I)","heading":null,"page":8,"url":"https://indiainsurances.com/policy/generali-central-insurance/arogya-sanjeevani-policy-generali-central-insurance-company-limited-gcihlip20160v011920/document/5735#c-4-6-i"}],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 2","url":"https://indiainsurances.com/law/irdai-health-mc-2024"}]},{"key":"organ_donor","label":"Organ donor expenses","section":"Cover","meaning":"Whether the donor's hospital costs for an organ transplant are paid.","status":"not-stated","value":null,"display":null,"note":null,"quote":null,"sources":[],"law":[]},{"key":"ambulance","label":"Ambulance cover","section":"Cover","meaning":"Road (and air) ambulance cover and its limit.","status":"quote-verified","value":"Road ambulance expenses are covered subject to a maximum of Rs. 2000/- per hospitalization.","display":"Road Ambulance: max Rs. 2000/- per hospitalization","note":null,"quote":"Expenses incurred on road Ambulance subject to a maximum of Rs. 2000/- per hospitalization.","sources":[{"clause":"4.1.1(v)","heading":null,"page":7,"url":"https://indiainsurances.com/policy/generali-central-insurance/arogya-sanjeevani-policy-generali-central-insurance-company-limited-gcihlip20160v011920/document/5735#c-4-1-1-v"}],"law":[]},{"key":"restoration","label":"Restoration of sum insured","section":"Cover","meaning":"Whether the sum insured is refilled after it is used up in a year, how much, how often, and whether it works for the same illness.","status":"not-stated","value":null,"display":null,"note":null,"quote":null,"sources":[],"law":[]},{"key":"no_claim_bonus","label":"No-claim or cumulative bonus","section":"Cover","meaning":"How much the cover grows each year, the maximum, whether it depends on not claiming, and what happens after a claim.","status":"quote-verified","value":"Cumulative Bonus increases by 5% for each claim-free policy year if renewed without a break, subject to a maximum of 50% of the sum insured. If a claim is made, the accrued cumulative bonus is reduced at the same rate at which it accrued, but sum insured is maintained and not reduced in the policy year.","display":"5% per claim-free year, max 50%; reduced at same rate after a claim","note":null,"quote":"Cumulative Bonus will be increased by 5% in respect of each claim free policy year (where no claims are reported), provided the policy is renewed with the company without a break subject to maximum of 50% of the sum insured under the current policy year. If a claim is made in any particular year, the cumulative bonus accrued shall be reduced at the same rate at which it has accrued. However, sum insured will be maintained and will not be reduced in the policy year.","sources":[{"clause":"5","heading":"Cumulative Bonus (CB)","page":8,"url":"https://indiainsurances.com/policy/generali-central-insurance/arogya-sanjeevani-policy-generali-central-insurance-company-limited-gcihlip20160v011920/document/5735#c-5"}],"law":[]},{"key":"consumables","label":"Consumables and non-medical items","section":"Cover","meaning":"Gloves, PPE, syringes and other items hospitals bill that standard policies exclude; whether this policy pays them.","status":"quote-verified","value":"The policy does not cover items placed under List I of Annexure A, including gloves and mask. Other lists are to be subsumed into room charges, procedure charges or cost of treatment.","display":"Not covered for List I items such as GLOVES and MASK","note":null,"quote":"The expenses that are not covered in this policy are placed under List-I of Annexure-A. The list of expenses that are to be subsumed into room charges, or procedure charges or costs of treatment are placed under List-II, List-III and List-IV of Annexure-A respectively. ... List I – Items for which coverage is not available in the Policy ... 56. | GLOVES ... 60. | MASK","sources":[{"clause":"4.7","heading":null,"page":8,"url":"https://indiainsurances.com/policy/generali-central-insurance/arogya-sanjeevani-policy-generali-central-insurance-company-limited-gcihlip20160v011920/document/5735#c-4-7"},{"clause":"Annexure A","heading":null,"page":21,"url":"https://indiainsurances.com/policy/generali-central-insurance/arogya-sanjeevani-policy-generali-central-insurance-company-limited-gcihlip20160v011920/document/5735#c-annexure-a"}],"law":[]},{"key":"maternity","label":"Maternity cover","section":"Cover","meaning":"Whether childbirth costs are covered, the limit and the waiting period.","status":"quote-verified","value":"Maternity expenses are excluded, including childbirth, complicated deliveries and caesarean sections during hospitalization, except ectopic pregnancy. 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Under cashless facility, payments for covered treatment are made directly to the network provider to the extent pre-authorization is approved.","display":"Available at network providers, subject to Company pre-authorization","note":null,"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. ... Treatment may be taken in a network provider and is subject to pre authorization by the Company.","sources":[{"clause":"3.6","heading":"Cashless facility Cashless facility","page":2,"url":"https://indiainsurances.com/policy/generali-central-insurance/arogya-sanjeevani-policy-generali-central-insurance-company-limited-gcihlip20160v011920/document/5735#c-3-6"},{"clause":"1","heading":"Procedure for Cashless claims","page":17,"url":"https://indiainsurances.com/policy/generali-central-insurance/arogya-sanjeevani-policy-generali-central-insurance-company-limited-gcihlip20160v011920/document/5735#c-1-2"}],"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 submitted to and authorized by the Company.","display":"Company","note":null,"quote":"The Company upon getting cashless request form and related medical information from the insured person/ network provider will issue pre-authorization letter to the hospital after verification. ... For reimbursement of claims the insured person may submit the necessary documents to Company within the prescribed time limit as specified hereunder","sources":[{"clause":"1","heading":"Procedure for Cashless claims","page":17,"url":"https://indiainsurances.com/policy/generali-central-insurance/arogya-sanjeevani-policy-generali-central-insurance-company-limited-gcihlip20160v011920/document/5735#c-1-2"},{"clause":"2","heading":"Procedure for reimbursement of claims","page":18,"url":"https://indiainsurances.com/policy/generali-central-insurance/arogya-sanjeevani-policy-generali-central-insurance-company-limited-gcihlip20160v011920/document/5735#c-2-2"}],"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, Floater basis","note":null,"quote":"Product Type | Individual/ Floater ... On Floater basis – SI shall apply to the entire family","sources":[{"clause":"8","heading":"TABLE OF BENEFITS","page":19,"url":"https://indiainsurances.com/policy/generali-central-insurance/arogya-sanjeevani-policy-generali-central-insurance-company-limited-gcihlip20160v011920/document/5735#c-8-2"}],"law":[]}],"documents":[{"kind":"wording","label":"Arogya Sanjeevani Policy, Generali Central Insurance Company Limited. Policy Wordings","pages":26,"fetched_at":"2026-10-17 19:32:02+00","source_url":"https://www.generalicentralinsurance.com/downloads/health-insurance/aarogya-sanjeevani-policy/policy-wording/arogya-sanjeevani-policy-gci-policy-wording.pdf","url":"https://indiainsurances.com/policy/generali-central-insurance/arogya-sanjeevani-policy-generali-central-insurance-company-limited-gcihlip20160v011920/document/5735"},{"kind":"prospectus","label":"Arogya Sanjeevani Policy, Generali Central Insurance Company Limited. Prospectus Form","pages":23,"fetched_at":"2026-10-17 19:32:05+00","source_url":"https://www.generalicentralinsurance.com/downloads/health-insurance/aarogya-sanjeevani-policy/prospectus-forms/arogya-sanjeevani-policy-gci-prospectus.pdf","url":"https://indiainsurances.com/policy/generali-central-insurance/arogya-sanjeevani-policy-generali-central-insurance-company-limited-gcihlip20160v011920/document/5736"},{"kind":"cis","label":"Arogya Sanjeevani Policy, Generali Central Insurance Company Limited. Customer Information Sheet","pages":8,"fetched_at":"2026-10-17 19:32:06+00","source_url":"https://www.generalicentralinsurance.com/downloads/health-insurance/aarogya-sanjeevani-policy/customer-information-sheet/arogya-sanjeevani-policy-cis-retail.pdf","url":"https://indiainsurances.com/policy/generali-central-insurance/arogya-sanjeevani-policy-generali-central-insurance-company-limited-gcihlip20160v011920/document/5738"},{"kind":"brochure","label":"Arogya Sanjeevani Policy, Generali Central Insurance Company Limited. Product Brochure","pages":12,"fetched_at":"2026-10-17 19:32:03+00","source_url":"https://www.generalicentralinsurance.com/downloads/health-insurance/aarogya-sanjeevani-policy/product-brochures/arogya-sanjeevani-policy-brochure.pdf","url":"https://indiainsurances.com/policy/generali-central-insurance/arogya-sanjeevani-policy-generali-central-insurance-company-limited-gcihlip20160v011920/document/5741"}],"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":"Arogya Sanjeevani Policy, Generali Central Insurance Company Limited. (UIN GCIHLIP20160V011920), IndiaInsurances, https://indiainsurances.com/policy/generali-central-insurance/arogya-sanjeevani-policy-generali-central-insurance-company-limited-gcihlip20160v011920"}