{"uin":"GODHLIP24179V022324","name":"Arogya Sanjeevani Policy, Go Digit","url":"https://indiainsurances.com/policy/go-digit-general-insurance/arogya-sanjeevani-policy-go-digit-godhlip24179v022324","insurer":{"slug":"go-digit-general-insurance","name":"Go Digit General Insurance Limited","url":"https://indiainsurances.com/insurer/go-digit-general-insurance"},"line":"health","category":"health-indemnity","category_name":"Health insurance (hospitalisation)","irdai_type":"New","kind":"product","status":"active","approved_on":"2020-03-31","withdrawn_on":null,"summary":"Arogya Sanjeevani Policy, Go Digit is a one-year indemnity health policy on an individual or family floater basis, with sum insured from Rs 50,000 to Rs 3 crore and treatment in India only. It has a 5% co-payment on every claim, room rent capped at 2% of sum insured up to Rs 5,000 per day, a 30-day initial wait, 36 months for pre-existing diseases and a 5% cumulative bonus per claim-free year up to 50%.","analysis":{"state":"extracted","analysed_at":"2026-10-16 06:29:30.80678+00","note":"Every stated fact carries a verbatim quote found in the cited clause."},"facts":[{"key":"plan_variants","label":"Plans and variants","section":"Overview","meaning":"The named plans inside this product (not cover types or payout options). Facts can differ between them.","status":"not-stated","value":null,"display":null,"note":"No named plans are printed. The product is sold on an individual or a floater sum insured basis (cover types, not plans).","quote":null,"sources":[],"law":[]},{"key":"policy_term","label":"Policy term","section":"Eligibility","meaning":"How long one policy runs before it ends or must be renewed.","status":"cross-checked","value":"One year.","display":"1 year","note":null,"quote":"Policy Period | 1 year ... This Policy tenure shall be for a period of one year.","sources":[{"clause":null,"heading":"TABLE OF BENEFITS","page":19,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/arogya-sanjeevani-policy-go-digit-godhlip24179v022324/document/39#c-table-of-benefits"},{"clause":null,"heading":"What is the Policy tenure under this policy?","page":6,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/arogya-sanjeevani-policy-go-digit-godhlip24179v022324/document/40#c-what-is-the-policy-tenure-under-this-policy"}],"law":[]},{"key":"claim_intimation","label":"Claim intimation deadline","section":"Claims","meaning":"How soon you must tell the insurer about a claim or hospitalisation.","status":"cross-checked","value":"Within 24 hours of emergency hospitalisation or before discharge, whichever is earlier; at least 48 hours before admission for planned hospitalisation.","display":"Within 24 hours of emergency admission (or before discharge, if earlier); 48 hours before a planned admission","note":"Reimbursement documents are due within fifteen days of discharge (post-hospitalisation: within fifteen days of completing that treatment). Delay may be condoned if beyond the insured's control.","quote":"i) 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":"28","heading":"Claim Procedure","page":17,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/arogya-sanjeevani-policy-go-digit-godhlip24179v022324/document/39#c-28-2"}],"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":"cross-checked","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","Investigation/Diagnostic test reports supported by the prescription from attending medical practitioner","OT notes or Surgeon's certificate (for surgical cases)","Sticker/Invoice of the Implants, wherever applicable","MLR and FIR, wherever applicable","NEFT Details and cancelled cheque","KYC of the proposer, where claim liability is above Rs 1 Lakh","Legal heir/succession certificate, wherever applicable","Any other relevant document required by Company/TPA"],"display":"Claim form, photo ID, prescription advising admission, original bills, receipts, discharge summary, test reports, OT notes, implant invoice, MLR/FIR, NEFT details, KYC, legal heir certificate","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 test reports etc. supported by the prescription from 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/TPA for assessment of the claim.","sources":[{"clause":"28","heading":"Claim Procedure","page":17,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/arogya-sanjeevani-policy-go-digit-godhlip24179v022324/document/39#c-28-2"}],"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":"cross-checked","value":"The Company settles or rejects a claim within 15 days from submission of claim; delay beyond that carries interest at 2% above bank rate.","display":"Within 15 days of submission of the claim","note":"Even where investigation is needed, settlement or rejection is within 15 days of submission. Clause 28(d)(ii) counts interest from the date of receipt of intimation instead. CIS: cashless pre-authorisation within 1 hour, final bill authorisation within 3 hours.","quote":"The Company shall settle or reject a claim, as the case may be, within 15 days from submission of claim. ... In case of delay beyond stipulated 15 days, the company shall be liable to pay interest to the policyholder at a rate 2% above the bank rate from the date of submission of claim to the date of payment of claim. ... the claimant is entitled for interest at bank rate plus 2 percent from the date of receipt of intimation to till the date of payment","sources":[{"clause":"16(i)","heading":null,"page":15,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/arogya-sanjeevani-policy-go-digit-godhlip24179v022324/document/39#c-16-i"},{"clause":"16(iv)","heading":null,"page":15,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/arogya-sanjeevani-policy-go-digit-godhlip24179v022324/document/39#c-16-iv"},{"clause":"28(d)(ii)","heading":null,"page":18,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/arogya-sanjeevani-policy-go-digit-godhlip24179v022324/document/39#c-28-d-ii"}],"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":"cross-checked","value":["Pre-existing diseases for 36 months (Excl01)","Listed conditions for 24/36 months (Excl02)","Any illness within the first 30 days except accidents (Excl03)","Admission primarily for diagnostics and evaluation (Excl04)","Rest cure, rehabilitation and respite care (Excl05)","Cosmetic or plastic surgery (Excl08)","Professional hazardous or adventure sports (Excl09)","Alcoholism, drug or substance abuse (Excl12)","Sterility and infertility (Excl17)","Maternity expenses (Excl18)","War and war like occurrence","Nuclear, chemical or biological attack or weapons","Domiciliary Hospitalization and OPD treatment","Treatment taken outside the geographical limits of India"],"display":"PED for 36 months, listed conditions for 24/36 months, first 30 days, diagnostics-only admissions, rest cure, cosmetic surgery, adventure sports, substance abuse, infertility, maternity, war, nuclear/chemical/biological attack, domiciliary and OPD treatment, treatment outside India","note":"Items in List I of Annexure A are also not payable.","quote":"Pre-Existing Diseases (Code- Excl01) ... excluded until the expiry of 36months of continuous coverage ... Specific Waiting Period: (Code- Excl02) ... excluded until the expiry of 24/36 months of continuous coverage ... First Thirty Days Waiting Period (Code- Excl03) ... 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 ... Investigation & Evaluation (Code- Excl04) ... Expenses related to any admission primarily for diagnostics and evaluation purposes. ... Rest Cure, rehabilitation and respite care (Code- Excl05) ... Cosmetic or plastic Surgery: (Code- Excl08) ... Hazardous or Adventure sports: (Code- Excl09) ... Treatment for, Alcoholism, drug or substance abuse or any addictive condition and consequences thereof. ... Excl12 ... Sterility and Infertility: (Code- Excl17) ... Maternity Expenses (Code - Excl18) ... War (whether declared or not) and war like occurrence ... Nuclear, chemical or biological attack or weapons ... Any expenses incurred on Domiciliary Hospitalization and OPD treatment ... Treatment taken outside the geographical limits of India","sources":[{"clause":"1","heading":"Pre-Existing Diseases (Code- Excl01)","page":8,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/arogya-sanjeevani-policy-go-digit-godhlip24179v022324/document/39#c-1-3"},{"clause":"3","heading":"Specific Waiting Period: (Code- Excl02)","page":8,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/arogya-sanjeevani-policy-go-digit-godhlip24179v022324/document/39#c-3-2"},{"clause":"2","heading":"First Thirty Days Waiting Period (Code- Excl03)","page":8,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/arogya-sanjeevani-policy-go-digit-godhlip24179v022324/document/39#c-2-3"},{"clause":"4","heading":"Investigation & Evaluation (Code- Excl04)","page":9,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/arogya-sanjeevani-policy-go-digit-godhlip24179v022324/document/39#c-4-2"},{"clause":"5","heading":"Rest Cure, rehabilitation and respite care (Code- Excl05)","page":9,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/arogya-sanjeevani-policy-go-digit-godhlip24179v022324/document/39#c-5-3"},{"clause":null,"heading":"Cosmetic or plastic Surgery: (Code- Excl08)","page":9,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/arogya-sanjeevani-policy-go-digit-godhlip24179v022324/document/39#c-cosmetic-or-plastic-surgery-code-excl08"},{"clause":"9","heading":"Hazardous or Adventure sports: (Code- Excl09)","page":10,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/arogya-sanjeevani-policy-go-digit-godhlip24179v022324/document/39#c-9-2"},{"clause":"12","heading":null,"page":10,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/arogya-sanjeevani-policy-go-digit-godhlip24179v022324/document/39#c-12-2"},{"clause":"Excl12","heading":null,"page":10,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/arogya-sanjeevani-policy-go-digit-godhlip24179v022324/document/39#c-excl12"},{"clause":"17","heading":"Sterility and Infertility: (Code- Excl17)","page":10,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/arogya-sanjeevani-policy-go-digit-godhlip24179v022324/document/39#c-17-2"},{"clause":"18","heading":"Maternity Expenses (Code - Excl18)","page":10,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/arogya-sanjeevani-policy-go-digit-godhlip24179v022324/document/39#c-18-2"},{"clause":"II","heading":"SPECIFIC EXCLUSIONS","page":10,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/arogya-sanjeevani-policy-go-digit-godhlip24179v022324/document/39#c-ii-2"},{"clause":"II(c)","heading":"Biological attack or weapons","page":11,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/arogya-sanjeevani-policy-go-digit-godhlip24179v022324/document/39#c-ii-c"}],"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":"cross-checked","value":"Contact the company through its website, toll free 1-800-258-4242 or hello@godigit.com (seniors: seniors@godigit.com), or the grievance cell at any branch; if not satisfied, the grievance officer at grievance@godigit.com; then the Insurance Ombudsman.","display":"Company (website, 1-800-258-4242, hello@godigit.com or branch grievance cell), then grievance officer at grievance@godigit.com","note":"Complaints can also be registered on IRDAI's Bima Bharosa portal (https://bimabharosa.irdai.gov.in/). Ombudsman offices are in Annexure B.","quote":"In case of any grievance the insured person may contact the company through Website: https://www.godigit.com Toll Free: 1-800-258- 4242 Email: hello@godigit.com Senior citizens can contact us on 1-800-258-4242 or write to us at seniors@godigit.com Insured person may also approach the grievance cell at any of the company's branches with the details of grievance If Insured person is not satisfied with the redressal of grievance through one of the above methods, insured person may contact the grievance officer at grievance@godigit.com","sources":[{"clause":"17","heading":"REDRESSAL OF GRIEVANCE","page":15,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/arogya-sanjeevani-policy-go-digit-godhlip24179v022324/document/39#c-17-3"}],"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":"cross-checked","value":"From INR 50,000 up to INR 3 Crore, in multiples of INR 50,000.","display":"Rs 50,000 to Rs 3 crore, in multiples of Rs 50,000","note":null,"quote":"You can opt for a minimum Sum Insured of INR 50,000 and maximum up to INR 3 Crore in the multiples of INR 50,000.","sources":[{"clause":null,"heading":"What is the Sum Insured options under this Policy?","page":6,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/arogya-sanjeevani-policy-go-digit-godhlip24179v022324/document/40#c-what-is-the-sum-insured-options-under-this-polic"}],"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":"cross-checked","value":{"unit":"days","amount":30},"display":"30 days","note":"Does not apply if the insured has continuous coverage for more than twelve months; applies afresh to any 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":"2","heading":"First Thirty Days Waiting Period (Code- Excl03)","page":8,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/arogya-sanjeevani-policy-go-digit-godhlip24179v022324/document/39#c-2-3"}],"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":"cross-checked","value":{"unit":"months","amount":36},"display":"36 months","note":"Cover after 36 months only for PEDs declared and accepted. Reduced by prior continuous coverage under portability; applies afresh to an enhanced sum insured.","quote":"Expenses related to the treatment of a pre-existing Disease (PED) and its direct complications shall be excluded until the expiry of 36months of continuous coverage after the date of inception of the first policy with us.","sources":[{"clause":"1","heading":"Pre-Existing Diseases (Code- Excl01)","page":8,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/arogya-sanjeevani-policy-go-digit-godhlip24179v022324/document/39#c-1-3"}],"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":"cross-checked","value":{"unit":"months","amount":24},"display":"24 months (36 months for some)","note":"36 months for joint replacement and age-related osteoarthritis and osteoporosis. Not applicable to accidents.","quote":"This exclusion shall not be applicable for claims arising due to an accident. ... i) 24 Months waiting period ... ii) 36Months waiting period\n1. Treatment for joint replacement unless arising from accident\n2. Age-related Osteoarthritis & Osteoporosis","sources":[{"clause":"3","heading":"Specific Waiting Period: (Code- Excl02)","page":8,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/arogya-sanjeevani-policy-go-digit-godhlip24179v022324/document/39#c-3-2"},{"clause":"3(e)(i)","heading":null,"page":8,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/arogya-sanjeevani-policy-go-digit-godhlip24179v022324/document/39#c-3-e-i"},{"clause":"3(e)(ii)","heading":null,"page":9,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/arogya-sanjeevani-policy-go-digit-godhlip24179v022324/document/39#c-3-e-ii"}],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 12","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 1.7","url":"https://indiainsurances.com/law/irdai-products-regs-2024"}]},{"key":"specific_waiting_list","label":"Illnesses with a specific waiting period","section":"Waiting periods","meaning":"The named illnesses and procedures that carry the specific waiting period.","status":"cross-checked","value":["Benign ENT disorders","Tonsillectomy","Adenoidectomy","Mastoidectomy","Tympanoplasty","Hysterectomy","All internal and external benign tumours, 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 (36 months)","Age-related Osteoarthritis & Osteoporosis (36 months)"],"display":"Benign ENT disorders, tonsillectomy, hernia, cataract, piles, calculi, varicose veins and others (24 months); joint replacement and age-related osteoarthritis (36 months)","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 and external benign tumours, 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) 36Months waiting period\n1. Treatment for joint replacement unless arising from accident\n2. Age-related Osteoarthritis & Osteoporosis","sources":[{"clause":"3(e)(i)","heading":null,"page":8,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/arogya-sanjeevani-policy-go-digit-godhlip24179v022324/document/39#c-3-e-i"},{"clause":"3(e)(ii)","heading":null,"page":9,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/arogya-sanjeevani-policy-go-digit-godhlip24179v022324/document/39#c-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":"cross-checked","value":{"unit":"months","amount":60},"display":"60 months","note":"Applies to the first policy's sum insured; for an enhanced sum insured the sixty months run from the enhancement, on the enhanced limits only.","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.","sources":[{"clause":null,"heading":"Moratorium Period","page":14,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/arogya-sanjeevani-policy-go-digit-godhlip24179v022324/document/39#c-moratorium-period"}],"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":"cross-checked","value":"Yes. The policyholder can port to another insurer and transfer credits for sum insured, No Claim Bonus, specific waiting periods, pre-existing disease waiting period and moratorium period.","display":"Yes, with credit for waiting periods","note":"Migration to another policy of the same insurer is also allowed with the same credits.","quote":"a) A Policyholder has the choice to port his/ her policies from one Insurer to another. ... d) The policyholder is entitled to transfer the credits gained to the extent of the Sum Insured, No Claim Bonus, specific waiting periods, waiting period for pre-existing disease , Moratorium period etc from the Existing Insurer to the Acquiring Insurer in the previous policy","sources":[{"clause":"8(a)","heading":null,"page":13,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/arogya-sanjeevani-policy-go-digit-godhlip24179v022324/document/39#c-8-a"},{"clause":"8(d)","heading":null,"page":13,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/arogya-sanjeevani-policy-go-digit-godhlip24179v022324/document/39#c-8-d"}],"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":"cross-checked","value":true,"display":"Yes, no age limit for renewals","note":"Renewal may be refused on grounds of fraud or misrepresentation (prospectus adds moral hazard).","quote":"*there is no age limit for renewals ... The policy shall ordinarily be renewable except on grounds of fraud, misrepresentation by the insured person.","sources":[{"clause":null,"heading":"What are the Minimum & Maximum Entry age for Adults & Children?","page":6,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/arogya-sanjeevani-policy-go-digit-godhlip24179v022324/document/40#c-what-are-the-minimum-maximum-entry-age-for-adult"},{"clause":"9","heading":"Renewal of Policy","page":13,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/arogya-sanjeevani-policy-go-digit-godhlip24179v022324/document/39#c-9-3"}],"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":"cross-checked","value":"No. No loading applies on renewals based on individual claims experience, and renewal is not denied because of claims.","display":"No loading for claims","note":null,"quote":"ii) Renewal shall not be denied on the ground that the insured had made a claim or claims in the preceding policy years. ... v) No Loading shall apply on renewals based on individual claims experience.","sources":[{"clause":"9","heading":"Renewal of Policy","page":13,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/arogya-sanjeevani-policy-go-digit-godhlip24179v022324/document/39#c-9-3"}],"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":"cross-checked","value":["Investigation & Evaluation (Excl04)","Rest Cure, rehabilitation and respite care (Excl05)","Obesity/ Weight Control (Excl06)","Change-of-Gender treatments (Excl07)","Cosmetic or plastic Surgery (Excl08)","Hazardous or Adventure sports (Excl09)","Breach of law (Excl10)","Excluded Providers (Excl11)","Alcoholism, drug or substance abuse (Excl12)","Treatments in heath hydros, nature cure clinics, spas (Excl13)","Dietary supplements without prescription (Excl14)","Refractive Error (Excl15)","Unproven Treatments (Excl16)","Sterility and Infertility (Excl17)","Maternity Expenses (Excl18)","War and war like occurrence","Nuclear, chemical or biological attack or weapons","Domiciliary Hospitalization and OPD treatment","Treatment taken outside the geographical limits of India","Specified ICD codes for existing diseases disclosed and mentioned in the policy schedule"],"display":"Standard exclusions Excl04 to Excl18, plus war, nuclear/chemical/biological attack, domiciliary and OPD treatment, treatment outside India, and ICD codes named in the schedule","note":"Excl15 is quoted from the CIS because the wording prints the code as 'Exc115'. Refractive error is excluded below 7.5 dioptres; cosmetic surgery is payable for reconstruction after accident, burns or cancer.","quote":"Investigation & Evaluation (Code- Excl04) ... Rest Cure, rehabilitation and respite care (Code- Excl05) ... Obesity/ Weight Control (Code- Excl06) ... Change-of-Gender treatments: (Code- Excl07) ... Cosmetic or plastic Surgery: (Code- Excl08) ... Hazardous or Adventure sports: (Code- Excl09) ... Breach of law: (Code- Excl10) ... Excluded Providers: (Code-Excl11) ... Treatment for, Alcoholism, drug or substance abuse or any addictive condition and consequences thereof. ... Excl12 ... Treatments received in heath hydros, nature cure clinics, spas or similar establishments ... (Code- Excl13) ... Dietary supplements and substances that can be purchased without prescription ... (Code- Excl14) ... 15. Refractive Error: Code- Excl15 ... Unproven Treatments:(Code - Excl16) ... Sterility and Infertility: (Code- Excl17) ... Maternity Expenses (Code - Excl18) ... War (whether declared or not) and war like occurrence ... Nuclear, chemical or biological attack or weapons ... Any expenses incurred on Domiciliary Hospitalization and OPD treatment ... Treatment taken outside the geographical limits of India ... In respect of the existing diseases, disclosed by the insured and mentioned in the policy schedule (based on insured's consent), policyholder is not entitled to get the coverage for specified ICD codes.","sources":[{"clause":"4","heading":"Investigation & Evaluation (Code- Excl04)","page":9,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/arogya-sanjeevani-policy-go-digit-godhlip24179v022324/document/39#c-4-2"},{"clause":"5","heading":"Rest Cure, rehabilitation and respite care (Code- Excl05)","page":9,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/arogya-sanjeevani-policy-go-digit-godhlip24179v022324/document/39#c-5-3"},{"clause":"6","heading":"Obesity/ Weight Control (Code- Excl06)","page":9,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/arogya-sanjeevani-policy-go-digit-godhlip24179v022324/document/39#c-6-3"},{"clause":null,"heading":"Change-of-Gender treatments: (Code- Excl07)","page":9,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/arogya-sanjeevani-policy-go-digit-godhlip24179v022324/document/39#c-change-of-gender-treatments-code-excl07"},{"clause":null,"heading":"Cosmetic or plastic Surgery: (Code- Excl08)","page":9,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/arogya-sanjeevani-policy-go-digit-godhlip24179v022324/document/39#c-cosmetic-or-plastic-surgery-code-excl08"},{"clause":"9","heading":"Hazardous or Adventure sports: (Code- Excl09)","page":10,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/arogya-sanjeevani-policy-go-digit-godhlip24179v022324/document/39#c-9-2"},{"clause":"10","heading":"Breach of law: (Code- Excl10)","page":10,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/arogya-sanjeevani-policy-go-digit-godhlip24179v022324/document/39#c-10-2"},{"clause":"11","heading":"Excluded Providers: (Code-Excl11)","page":10,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/arogya-sanjeevani-policy-go-digit-godhlip24179v022324/document/39#c-11-2"},{"clause":"12","heading":null,"page":10,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/arogya-sanjeevani-policy-go-digit-godhlip24179v022324/document/39#c-12-2"},{"clause":"Excl12","heading":null,"page":10,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/arogya-sanjeevani-policy-go-digit-godhlip24179v022324/document/39#c-excl12"},{"clause":"13","heading":null,"page":10,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/arogya-sanjeevani-policy-go-digit-godhlip24179v022324/document/39#c-13-2"},{"clause":"14","heading":null,"page":10,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/arogya-sanjeevani-policy-go-digit-godhlip24179v022324/document/39#c-14-2"},{"clause":"6(I)","heading":null,"page":2,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/arogya-sanjeevani-policy-go-digit-godhlip24179v022324/document/41#c-6-i"},{"clause":"16","heading":"Unproven Treatments:(Code - Excl16)","page":10,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/arogya-sanjeevani-policy-go-digit-godhlip24179v022324/document/39#c-16-2"},{"clause":"17","heading":"Sterility and Infertility: (Code- Excl17)","page":10,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/arogya-sanjeevani-policy-go-digit-godhlip24179v022324/document/39#c-17-2"},{"clause":"18","heading":"Maternity Expenses (Code - Excl18)","page":10,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/arogya-sanjeevani-policy-go-digit-godhlip24179v022324/document/39#c-18-2"},{"clause":"II","heading":"SPECIFIC EXCLUSIONS","page":10,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/arogya-sanjeevani-policy-go-digit-godhlip24179v022324/document/39#c-ii-2"},{"clause":"II(c)","heading":"Biological attack or weapons","page":11,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/arogya-sanjeevani-policy-go-digit-godhlip24179v022324/document/39#c-ii-c"}],"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":"cross-checked","value":"You may cancel at any time with 7 days' written notice; for a policy of up to one year with no claim made, proportionate premium for the unexpired period is refunded.","display":"Proportionate premium for the unexpired period, if no claim was made","note":"The wording does not say what is refunded if a claim was made. The prospectus also carries a stray line '15 days' written notice' before repeating the 7 days' notice terms.","quote":"You may cancel your policy at any time during the term, by giving 7 days’ notice to us in writing. We shall\na) Refund proportionate premium for unexpired policy period, if the term of policy is upto one year and there is no claim (s) made during the policy period.","sources":[{"clause":null,"heading":"A. Cancellation by You","page":13,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/arogya-sanjeevani-policy-go-digit-godhlip24179v022324/document/39#c-a-cancellation-by-you"}],"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":"cross-checked","value":"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. ... Treatment taken outside the geographical limits of India","sources":[{"clause":"21","heading":"Territorial Limit","page":16,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/arogya-sanjeevani-policy-go-digit-godhlip24179v022324/document/39#c-21-2"},{"clause":"II(c)","heading":"Biological attack or weapons","page":11,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/arogya-sanjeevani-policy-go-digit-godhlip24179v022324/document/39#c-ii-c"}],"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":"cross-checked","value":{"unit":"days","amount":30},"display":"30 days","note":"New individual policies only, not renewals or porting/migration. Refund is premium less medical examination and stamp duty costs (or proportionate risk premium if risk has started), if no claim made. CIS says '30 days from the beginning of the policy'.","quote":"The insured person shall be allowed free look period of thirty(30)from date of receipt of the policy document, whether received electronically or otherwise","sources":[{"clause":"12","heading":"Free look period","page":14,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/arogya-sanjeevani-policy-go-digit-godhlip24179v022324/document/39#c-12-3"}],"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":"cross-checked","value":{"unit":"days","amount":30},"display":"30 days (15 days for monthly premiums)","note":"Fifteen days where premium is paid monthly.","quote":"The grace period for payment of the premium for all types of insurance policies shall be: fifteen days where premium payment mode is monthly and thirty days in all other cases.","sources":[{"clause":null,"heading":"Premium Payment in Instalments","page":13,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/arogya-sanjeevani-policy-go-digit-godhlip24179v022324/document/39#c-premium-payment-in-instalments"}],"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":"cross-checked","value":"Adults from 18 years with no maximum entry age; dependent children from 3 months to 25 years.","display":"18 years to no limit (children 3 months to 25 years)","note":"A child above 18 who is financially independent becomes ineligible at subsequent renewals.","quote":"Proposer | 18yrs | No Limit\nDependent Child | 3 months | 25 years\nAdult Insured | 18yrs | No Limit","sources":[{"clause":null,"heading":"What are the Minimum & Maximum Entry age for Adults & Children?","page":6,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/arogya-sanjeevani-policy-go-digit-godhlip24179v022324/document/40#c-what-are-the-minimum-maximum-entry-age-for-adult"}],"law":[]},{"key":"premium_modes","label":"Premium payment options","section":"Premium","meaning":"How often you can pay: yearly, half-yearly, quarterly, monthly.","status":"cross-checked","value":["Half Yearly","Quarterly","Monthly"],"display":"Half-yearly, quarterly or monthly instalments","note":"These are the instalment options; the documents do not name the yearly mode as such. A claim makes all remaining instalments due immediately.","quote":"If the insured person has opted for Payment of Premium on an instalment basis i.e. Half Yearly, Quarterly or Monthly","sources":[{"clause":null,"heading":"Premium Payment in Instalments","page":13,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/arogya-sanjeevani-policy-go-digit-godhlip24179v022324/document/39#c-premium-payment-in-instalments"}],"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":"No optional covers are described; the covers are stated to be inbuilt policy benefits.","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":"cross-checked","value":"No. Coverage is not available during the grace period, though continuity of benefits is kept if renewed within it.","display":"Not covered during grace period","note":"The Grace Period definition (B.17) says insurers shall offer coverage during the grace period if premium is paid in instalments, which contradicts the instalment clause.","quote":"iv) At the end of the Policy Period, the policy shall terminate and can be renewed within the Grace Period of 30days to maintain continuity of benefits without Break in Policy. Coverage is not available during the grace period. ... ii. During such grace period, Coverage will not be available from the due date of instalment premium till the date of receipt of premium by Company.","sources":[{"clause":"9","heading":"Renewal of Policy","page":13,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/arogya-sanjeevani-policy-go-digit-godhlip24179v022324/document/39#c-9-3"},{"clause":null,"heading":"Premium Payment in Instalments","page":13,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/arogya-sanjeevani-policy-go-digit-godhlip24179v022324/document/39#c-premium-payment-in-instalments"}],"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":"cross-checked","value":"Room rent, boarding and nursing up to 2% of the sum insured, maximum Rs 5,000 per day.","display":"2% of sum insured, up to Rs 5,000 per day","note":"Higher room: other expenses (except pharmacy and consumables, implants and devices, diagnostics) are cut in proportion.","quote":"i) 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. ... with the exception of (a) cost of pharmacy and consumables, (b) cost of implants and medical devices, (c) cost of diagnostics, shall be effected in the same proportion","sources":[{"clause":"1","heading":"Hospitalization","page":6,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/arogya-sanjeevani-policy-go-digit-godhlip24179v022324/document/39#c-1-2"},{"clause":"1.1(v)","heading":null,"page":6,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/arogya-sanjeevani-policy-go-digit-godhlip24179v022324/document/39#c-1-1-v"}],"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-stated","value":null,"display":null,"note":"The limit is a rupee amount (2% of sum insured, up to Rs 5,000 per day), not a room type.","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":"cross-checked","value":"ICU/ICCU expenses up to 5% of the sum insured, maximum Rs 10,000 per day.","display":"5% of sum insured, up to Rs 10,000 per day","note":null,"quote":"ii) 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":"1","heading":"Hospitalization","page":6,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/arogya-sanjeevani-policy-go-digit-godhlip24179v022324/document/39#c-1-2"}],"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":"cross-checked","value":"Yes. Above the room/ICU limits, all other hospital expenses except pharmacy and consumables, implants and medical devices, and diagnostics are paid in the same proportion; not applied where the hospital does not follow differential billing.","display":"Yes, except pharmacy, consumables, implants, devices and diagnostics","note":null,"quote":"2. In case of admission to a room/ICU/ICCU at rates exceeding the aforesaid limits, the reimbursement/payment of all other expenses incurred at the Hospital, with the exception of (a) cost of pharmacy and consumables, (b) cost of implants and medical devices, (c) cost of diagnostics, shall be effected in the same proportion as the admissible rate per day bears to the actual rate per day of Room Rent/ICU/ICCU charges.\n3. Proportionate deductions will not apply in respect of the hospitals which do not follow differential billing or for those expenses in respect of which differential billing is not adopted based on the room category.","sources":[{"clause":"1.1(v)","heading":null,"page":6,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/arogya-sanjeevani-policy-go-digit-godhlip24179v022324/document/39#c-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":"cross-checked","value":"5% co-payment on each and every admissible claim, for all insured persons.","display":"5% on every claim","note":null,"quote":"c) Co-payment Each and every claim under the Policy shall be subject to a Co-payment of 5% applicable to claim amount admissible and payable as per the terms and conditions of the Policy.","sources":[{"clause":"28","heading":"Claim Procedure","page":17,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/arogya-sanjeevani-policy-go-digit-godhlip24179v022324/document/39#c-28-2"}],"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":"cross-checked","value":"No deductible.","display":"None","note":"Stated in the prospectus.","quote":"There is no deductible under this policy.","sources":[{"clause":null,"heading":"What is the Deductible/ Co-payments under this Policy?","page":8,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/arogya-sanjeevani-policy-go-digit-godhlip24179v022324/document/40#c-what-is-the-deductible-co-payments-under-this-po"}],"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":"cross-checked","value":["Cataract: 25% of Sum Insured or Rs.40,000, whichever is lower, per eye per policy year","Listed modern treatments (robotic surgery, oral chemotherapy, immunotherapy, stem cell therapy and others): up to 50% of Sum Insured","Road ambulance: Rs.2000 per hospitalisation"],"display":"Cataract 25% of SI or Rs 40,000 per eye; modern treatments 50% of SI; ambulance Rs 2,000","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. ... in a hospital up to 50% of Sum Insured ... G. Robotic surgeries ... D. Oral chemotherapy E. Immunotherapy ... L. Stem cell therapy ... v) Expenses incurred on road Ambulance subject to a maximum of Rs.2000/- per hospitalisation.","sources":[{"clause":null,"heading":"Cataract Treatment","page":6,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/arogya-sanjeevani-policy-go-digit-godhlip24179v022324/document/39#c-cataract-treatment"},{"clause":"6","heading":null,"page":7,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/arogya-sanjeevani-policy-go-digit-godhlip24179v022324/document/39#c-6-2"},{"clause":"6(I)","heading":null,"page":7,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/arogya-sanjeevani-policy-go-digit-godhlip24179v022324/document/39#c-6-i"},{"clause":"1.1(v)","heading":null,"page":6,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/arogya-sanjeevani-policy-go-digit-godhlip24179v022324/document/39#c-1-1-v"}],"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":"cross-checked","value":{"unit":"days","amount":30},"display":"30 days","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":null,"heading":"Pre-Hospitalization","page":7,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/arogya-sanjeevani-policy-go-digit-godhlip24179v022324/document/39#c-pre-hospitalization"}],"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":"cross-checked","value":{"unit":"days","amount":60},"display":"60 days","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","sources":[{"clause":"5","heading":"Post Hospitalisation","page":7,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/arogya-sanjeevani-policy-go-digit-godhlip24179v022324/document/39#c-5-2"}],"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":"cross-checked","value":"All day care treatments are covered.","display":"All day care treatments","note":null,"quote":"iv) All day care treatments ... However, the time limit shall not apply in respect of Day Care Treatment","sources":[{"clause":"1.1(iv)","heading":null,"page":6,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/arogya-sanjeevani-policy-go-digit-godhlip24179v022324/document/39#c-1-1-iv"},{"clause":"1.1(v)","heading":null,"page":6,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/arogya-sanjeevani-policy-go-digit-godhlip24179v022324/document/39#c-1-1-v"}],"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":"cross-checked","value":"No. Domiciliary hospitalisation is excluded.","display":"Not covered","note":null,"quote":"21. Any expenses incurred on Domiciliary Hospitalization and OPD treatment","sources":[{"clause":"II(c)","heading":"Biological attack or weapons","page":11,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/arogya-sanjeevani-policy-go-digit-godhlip24179v022324/document/39#c-ii-c"}],"law":[]},{"key":"ayush","label":"AYUSH treatment","section":"Cover","meaning":"Ayurveda, Yoga, Unani, Siddha and Homeopathy treatment in a recognised hospital, and any limit.","status":"cross-checked","value":"In-patient AYUSH treatment in any AYUSH Hospital is covered up to the sum insured.","display":"Covered up to sum insured (in-patient, 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":"2","heading":"AYUSH Treatment","page":6,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/arogya-sanjeevani-policy-go-digit-godhlip24179v022324/document/39#c-2-2"}],"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":"cross-checked","value":"Listed procedures (UAE and HIFU, balloon sinuplasty, deep brain stimulation, oral chemotherapy, immunotherapy, intra vitreal injections, robotic surgeries, stereotactic radio surgeries, bronchial thermoplasty, prostate vaporisation, IONM, stem cell therapy) are covered as in-patient or day care up to 50% of the sum insured.","display":"Covered up to 50% of sum insured","note":"Stem cell therapy only for haematopoietic stem cells for bone marrow transplant for haematological conditions.","quote":"The following procedures will be covered (wherever medically indicated) either 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) Bronchial Thermoplasty J. Vaporisation of the prostrate (Green laser treatment or holmium laser treatment) K. IONM - (Intra Operative Neuro Monitoring) L. Stem cell therapy: Hematopoietic stem cells for bone marrow transplant for haematological conditions to be covered.","sources":[{"clause":"6","heading":null,"page":7,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/arogya-sanjeevani-policy-go-digit-godhlip24179v022324/document/39#c-6-2"},{"clause":"6(I)","heading":null,"page":7,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/arogya-sanjeevani-policy-go-digit-godhlip24179v022324/document/39#c-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":"No organ donor cover is described; Donor Screening Charges appear in List V of non-payable items.","quote":null,"sources":[],"law":[]},{"key":"ambulance","label":"Ambulance cover","section":"Cover","meaning":"Road (and air) ambulance cover and its limit.","status":"cross-checked","value":"Road ambulance up to Rs 2,000 per hospitalisation.","display":"Road ambulance up to Rs 2,000 per hospitalisation","note":"Air ambulance is not mentioned.","quote":"v) Expenses incurred on road Ambulance subject to a maximum of Rs.2000/- per hospitalisation.","sources":[{"clause":"1.1(v)","heading":null,"page":6,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/arogya-sanjeevani-policy-go-digit-godhlip24179v022324/document/39#c-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":"No restoration or recharge of sum insured is described.","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":"cross-checked","value":"Cumulative bonus of 5% of sum insured for each claim-free policy year, up to 50%; after a claim the bonus is reduced at the same rate it accrued.","display":"5% per claim-free year, up to 50%; reduced by 5% after a claim","note":"Only if renewed within the grace period. On floater policies a claim by any member reduces the bonus.","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.","sources":[{"clause":"II","heading":"CUMULATIVE BONUS (CB)","page":7,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/arogya-sanjeevani-policy-go-digit-godhlip24179v022324/document/39#c-ii"}],"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":"cross-checked","value":"No. Items in List I of Annexure A, such as unsterilized gloves, masks and nebulizer kits, are not payable, and List V adds further non-payable items such as syringes and examination gloves.","display":"Not covered: listed consumables are not payable (Annexure A)","note":"Some items are payable in specific cases (sterilized gloves, belts after spine surgery); items in Lists II to IV are subsumed into room, procedure or treatment charges.","quote":"The expenses that are not covered in this policy are placed under List-I of Annexure-A. ... 38. | NEBULIZER KIT (Not Payable) ... 56. | GLOVES (Sterilized Gloves Payable / Unsterilized Gloves not payable) ... 60. | MASK (Not Payable) ... List V – Additional Non Payable Items ... Band Aids, Bandages, Sterile Injections, Needles, Syringes ... Examination Gloves","sources":[{"clause":"7","heading":null,"page":7,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/arogya-sanjeevani-policy-go-digit-godhlip24179v022324/document/39#c-7-2"},{"clause":"Row 3","heading":"BEAUTY SERVICES (Not Payable)","page":20,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/arogya-sanjeevani-policy-go-digit-godhlip24179v022324/document/39#c-row-3"},{"clause":null,"heading":"List V – Additional Non Payable Items","page":23,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/arogya-sanjeevani-policy-go-digit-godhlip24179v022324/document/39#c-list-v-additional-non-payable-items"}],"law":[]},{"key":"maternity","label":"Maternity cover","section":"Cover","meaning":"Whether childbirth costs are covered, the limit and the waiting period.","status":"cross-checked","value":"No. Childbirth, caesarean, miscarriage and termination of pregnancy expenses are excluded (except ectopic pregnancy).","display":"Not covered","note":null,"quote":"Maternity Expenses (Code - Excl18) ... i) Medical treatment expenses traceable to childbirth (including complicated deliveries and caesarean sections incurred during hospitalization) except ectopic pregnancy; ... ii) expenses towards miscarriage (unless due to an accident) and lawful medical termination of pregnancy during the policy period.","sources":[{"clause":"18","heading":"Maternity Expenses (Code - Excl18)","page":10,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/arogya-sanjeevani-policy-go-digit-godhlip24179v022324/document/39#c-18-2"}],"law":[]},{"key":"newborn","label":"Newborn baby cover","section":"Cover","meaning":"Whether a newborn is covered from birth and for what.","status":"not-stated","value":null,"display":null,"note":"No newborn cover is described; maternity is excluded and dependent children are covered from 3 months of age. Baby charges are listed as not payable.","quote":null,"sources":[],"law":[]},{"key":"mental_illness","label":"Mental illness","section":"Cover","meaning":"Cover for in-patient treatment of mental illness.","status":"not-stated","value":null,"display":null,"note":null,"quote":null,"sources":[],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 3","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch III I","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"The Mental Healthcare Act, 2017","section":"Section 21(4)","url":"https://indiainsurances.com/law/mental-healthcare-act-2017"},{"title":"The Mental Healthcare Act, 2017","section":"Section 2(1)(s)","url":"https://indiainsurances.com/law/mental-healthcare-act-2017"},{"title":"The Mental Healthcare Act, 2017","section":"Section 21(1)","url":"https://indiainsurances.com/law/mental-healthcare-act-2017"}]},{"key":"health_checkup","label":"Health check-up","section":"Cover","meaning":"Free preventive check-ups and how often.","status":"not-stated","value":null,"display":null,"note":"Only pre-policy medical check-up costs for accepted proposals are borne by the insurer; no preventive check-up benefit is described.","quote":null,"sources":[],"law":[]},{"key":"opd","label":"Out-patient (OPD) cover","section":"Cover","meaning":"Doctor consultations, tests and medicines without admission, and the limit.","status":"cross-checked","value":"No. OPD treatment is excluded.","display":"Not covered","note":null,"quote":"21. Any expenses incurred on Domiciliary Hospitalization and OPD treatment","sources":[{"clause":"II(c)","heading":"Biological attack or weapons","page":11,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/arogya-sanjeevani-policy-go-digit-godhlip24179v022324/document/39#c-ii-c"}],"law":[]},{"key":"zone_pricing","label":"Zone or city-based premium","section":"Premium","meaning":"Whether premium or co-pay depends on the city you are treated in.","status":"not-stated","value":null,"display":null,"note":"Premium is stated to depend on age, number of family members and sum insured; no zone or city factor is mentioned.","quote":null,"sources":[],"law":[]},{"key":"cashless","label":"Cashless treatment","section":"Claims","meaning":"Whether and where the insurer pays the hospital directly instead of you paying and claiming back.","status":"cross-checked","value":"Yes, at network providers, subject to pre-authorisation by the Company or its authorised TPA.","display":"Yes, at network hospitals with pre-authorisation","note":"CIS: pre-authorisation within 1 hour, final bill authorisation within 3 hours.","quote":"i) Treatment may be taken in a network provider and is subject to preauthorization by the Company or its authorized TPA.","sources":[{"clause":"28","heading":"Claim Procedure","page":17,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/arogya-sanjeevani-policy-go-digit-godhlip24179v022324/document/39#c-28-2"}],"law":[]},{"key":"claims_handled_by","label":"Claims handled by","section":"Claims","meaning":"The insurer itself or a third-party administrator (TPA).","status":"cross-checked","value":"The Company or its authorised TPA; a TPA may service claims but cannot settle or reject them.","display":"Company or its authorised TPA","note":null,"quote":"i) Treatment may be taken in a network provider and is subject to preauthorization by the Company or its authorized TPA. ... The services offered by a TPA shall not include\ni) Claim settlement and claim rejection;","sources":[{"clause":"28","heading":"Claim Procedure","page":17,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/arogya-sanjeevani-policy-go-digit-godhlip24179v022324/document/39#c-28-2"},{"clause":"28(d)(ii)","heading":null,"page":18,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/arogya-sanjeevani-policy-go-digit-godhlip24179v022324/document/39#c-28-d-ii"}],"law":[]},{"key":"family_floater","label":"Family floater available","section":"Cover","meaning":"Whether one sum insured can be shared by the whole family.","status":"cross-checked","value":true,"display":"Yes","note":null,"quote":"Yes, this Product can be opted either on Individual Sum Insured basis or Family Floater Basis.","sources":[{"clause":null,"heading":"Can the Policy be opted on Floater Basis?","page":6,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/arogya-sanjeevani-policy-go-digit-godhlip24179v022324/document/40#c-can-the-policy-be-opted-on-floater-basis"}],"law":[]}],"documents":[{"kind":"wording","label":"Policy Wordings - Arogya Sanjeevani Policy, Go Digit - GODHLIP24179V022324","pages":25,"fetched_at":"2026-10-16 06:29:30.625358+00","source_url":"https://www.godigit.com/content/dam/godigit/directportal/en/downloads/health/policy-wordings-arogya-sanjeevani-policy-go-digit.pdf","url":"https://indiainsurances.com/policy/go-digit-general-insurance/arogya-sanjeevani-policy-go-digit-godhlip24179v022324/document/39"},{"kind":"prospectus","label":"Prospectus - Arogya Sanjeevani Policy, Go Digit - GODHLIP24179V022324","pages":13,"fetched_at":"2026-10-16 06:29:30.625358+00","source_url":"https://www.godigit.com/content/dam/godigit/directportal/en/downloads/health/prospectus-arogya-sanjeevani-policy-go-digit.pdf","url":"https://indiainsurances.com/policy/go-digit-general-insurance/arogya-sanjeevani-policy-go-digit-godhlip24179v022324/document/40"},{"kind":"cis","label":"CIS - Arogya Sanjeevani Policy, Go Digit - GODHLIP24179V022324","pages":4,"fetched_at":"2026-10-16 06:29:30.625358+00","source_url":"https://www.godigit.com/content/dam/godigit/directportal/en/downloads/health/cis-arogaya-sanjeevani-policy-go-digit.pdf","url":"https://indiainsurances.com/policy/go-digit-general-insurance/arogya-sanjeevani-policy-go-digit-godhlip24179v022324/document/41"}],"versions":[{"uin":"GODHLIP20168V011920","version":null,"approved_on":null},{"uin":"GODHLIP24179V022324","version":null,"approved_on":null}],"where_to_buy":[],"claims_and_complaints":[],"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, Go Digit (UIN GODHLIP24179V022324), IndiaInsurances, https://indiainsurances.com/policy/go-digit-general-insurance/arogya-sanjeevani-policy-go-digit-godhlip24179v022324"}