{"uin":"GODHLIP25039V022425","name":"Digit Health Insurance Policy","url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425","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":null,"kind":"product","status":"active","approved_on":null,"withdrawn_on":null,"summary":"Digit Health Insurance Policy is an indemnity health policy from Go Digit General Insurance with eight plans (Double Wallet, Infinity Wallet, Carry Forward Sum Insured, Worldwide Treatment, Early Start, Senior Priority, Even Protect and the modular BharatX), sum insured from Rs. 2,00,000 to Rs. 3,00,00,000 and policy terms of 1 to 5 years. Most plans have no room rent limit, include a 100% sum insured back-up, in-built personal accident cover and 25 optional covers, while new age treatments are capped at 50% of sum insured.","analysis":{"state":"extracted","analysed_at":"2026-10-16 06:29:31.536148+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":"cross-checked","value":["Double Wallet Plan","Infinity Wallet Plan","Carry Forward Sum Insured Plan","Worldwide Treatment Plan","Early Start Plan","Senior Priority Plan","Even Protect Plan","BharatX (modular plan)"],"display":"Double Wallet, Infinity Wallet, Carry Forward Sum Insured, Worldwide Treatment, Early Start, Senior Priority, Even Protect and BharatX plans","note":"Plan names in the wording plan chart header are split across columns; the full names of the Carry Forward Sum Insured and Worldwide Treatment plans are taken from the prospectus rate chart. Waiting periods, pre/post hospitalisation days, ambulance limits, health check-up, bonus and other benefits differ by plan.","quote":"Double Wallet Plan | Infinity Wallet Plan ... Early Start Plan | Senior Priority Plan | Even Protect Plan | BharatX ... Carry Forward Sum Insured Plan Zone 1 ... Worldwide Treatment Plan Zone 1 ... insured will have an option to choose a modular plan called BharatX. In this plan customer can pick and choose any of the coverages available in the product.","sources":[{"clause":"Annexure C","heading":null,"page":63,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/45#c-annexure-c-2"},{"clause":null,"heading":"Rate Chart of Base Coverage (Excluding GST)","page":50,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/46#c-rate-chart-of-base-coverage-excluding-gst"},{"clause":null,"heading":"OPTIONAL COVERAGES OTHER FEATURES","page":67,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/45#c-optional-coverages-other-features-2"}],"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":"The policy can be taken for 1, 2, 3, 4 or 5 years.","display":"1 to 5 years","note":"From the prospectus. Long-term discount of 7% (2 years), 10% (3 years), 12% (4 years) and 15% (5 years), not for instalment premium.","quote":"The Policy Period Options are 1 Year, 2 Years, 3 Years, 4 Years and 5 Years. ... Long-Term Discount: For 2 Years Policy: 7%; For 3 Years Policy: 10%; For 4 Years Policy:12% and For 5 years Policy: 15%. This Discount shall not be applicable in case of instalment premium.","sources":[{"clause":null,"heading":"What is the minimum and maximum policy period available under this policy?","page":32,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/46#c-what-is-the-minimum-and-maximum-policy-period-av"},{"clause":"1","heading":"Long-Term Discount","page":35,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/46#c-1-19"}],"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":"Cashless: notice at least 72 hours before a planned hospitalisation or within 24 hours of an emergency hospitalisation. Reimbursement: intimate within 48 hours of admission.","display":"72 hours before planned / 24 hours after emergency admission (cashless); 48 hours of admission (reimbursement)","note":"Delay can be condoned where the reason for delay is proved to the insurer's satisfaction.","quote":"We are given a notice at least 72 hours before any planned hospitalization or within 24 Hours of hospitalization in case of an emergency situation. ... We or Our Service Provider / Third Party Administrator (TPA) should be intimated within 48 hours of date of admission. ... condonation of delay can be done by waiver of conditions A.1, B.1 and B.2.a may be considered where the reason for delay is proved to our satisfaction.","sources":[{"clause":"1","heading":null,"page":54,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/45#c-1-23"},{"clause":"2(g)","heading":null,"page":54,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/45#c-2-g"},{"clause":"2(c)","heading":null,"page":55,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/45#c-2-c-3"}],"law":[{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, V.1","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, V.1","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part C, V.1","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Para 20, 21","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"}]},{"key":"claim_documents","label":"Claim documents","section":"Claims","meaning":"Documents the insurer asks for when you claim.","status":"cross-checked","value":["Duly Filled and Signed Claim form","Discharge Summary","Medical Records (Indoor case papers, OT notes, PAC notes etc., on need basis)","Original Hospital Main Bill","Original Hospital Bill Break Up","Original payment receipt","Original Pharmacy Bills","Prescriptions for the Medicines purchased and investigations done outside the Hospital","Consultation Papers","Investigation Reports","Digital Images/CDs of the Investigation Procedures (if required)","MLC/FIR Report (If applicable)","Original Invoice/Sticker (If applicable)","Post Mortem Report (If applicable)","Disability Certificate (If applicable)","Attending Physician Certificate (If applicable)","Ante-natal Record (If applicable)","Birth discharge Summary (If applicable)","Death Certificate (If applicable)","KYC (Photo ID card) (If applicable)","Address Proof","Bank Details with Cancelled Cheque"],"display":"Claim form, discharge summary, medical records, original hospital and pharmacy bills, prescriptions, investigation reports, KYC, address proof and cancelled cheque, among others","note":"List is for hospitalisation claims. Personal accident claims also need burial certificate, attested copies of witness statements, FIR / Panchnama / Inquest Panchnama and viscera report (if post-mortem done). KYC needed where the payout exceeds Rs. 1 Lakh per claim.","quote":"1 | Duly Filled and Signed Claim form | √ | √ ... 2 | Discharge Summary | √ | ×\n3 | Medical Records (Optional Documents may be asked on need basis: Indoor case papers, OT notes, PAC notes etc.) | √ | ×\n4 | Original Hospital Main Bill | √ | ×\n5 | Original Hospital Bill Break Up | √ | ×\n6 | Original payment receipt\n7 | Original Pharmacy Bills | √ | ×\n8 | Prescriptions for the Medicines purchased (except hospital supply) and investigations done outside the Hospital | √ | ×\n9 | Consultation Papers | √ | ×\n10 | Investigation Reports | √ | ×\n11 | Digital Images/CDs of the Investigation Procedures (if required) | √ | ×\n12 | MLC/FIR Report (If applicable) | √ | ×\n13 | Original Invoice/Sticker (If applicable) | √ | ×\n14 | Post Mortem Report (If applicable) | √ | √\n15 | Disability Certificate (If applicable) | √ | ×\n16 | Attending Physician Certificate (If applicable) | √ | ×\n17 | Ante-natal Record (If applicable) | √ | ×\n18 | Birth discharge Summary (If applicable) | √ | ×\n19 | Death Certificate (If applicable) | √ | √ ... 20 | Burial Certificate | × | √\n21 | Attested Copy of Statement of Witness, if any lodged with police authorities | × | √\n22 | Attested Copy of FIR / Panchnama / Inquest Panchnama | × | √\n23 | Attested Copy of Viscera report if any (Only if Post-mortem is conducted) | × | √\n24 | *KYC (Photo ID card) (If applicable) | √ | √\n25 | Address Proof\n26 | Bank Details with Cancelled Cheque | √ | √ ... *KYC documents shall be required at the claim settlement stage, where claims pay-out to the Insured Member exceeds a threshold limit of Rs. 1 Lakhs per claim, address and ID proof is required","sources":[{"clause":"Row 1","heading":"Duly Filled and Signed Claim form","page":54,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/45#c-row-1-2"},{"clause":"Row 2","heading":"Discharge Summary","page":54,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/45#c-row-2-2"},{"clause":null,"heading":"Insufficient Document","page":55,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/45#c-insufficient-document"}],"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 the claim; if late, interest at bank rate plus 2 percent is payable from the date of intimation.","display":"15 days from submission of claim","note":"CIS adds: cashless pre-authorisation within 1 hour of request and final bill authorisation within 3 hours of the discharge authorisation request.","quote":"a) The Company shall settle or reject a claim, as the case may be, within 15 days from submission of claim. ... b) In case the claim is not settled within the specified timelines, then 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. ... i) TAT for preauthorization of cashless facility: Within 1 hour of receipt of request ... ii) TAT for cashless final bill authorization: Within 3 hours of the receipt of discharge authorization request from the hospital.","sources":[{"clause":"12(a)","heading":null,"page":51,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/45#c-12-a"},{"clause":"12(b)","heading":null,"page":51,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/45#c-12-b"},{"clause":"25(g)(i)","heading":"TAT for preauthorization of cashless facility","page":4,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/47#c-25-g-i"},{"clause":"25(g)(ii)","heading":"TAT for cashless final bill authorization","page":4,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/47#c-25-g-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 until the waiting period in the schedule ends (Excl01)","Listed diseases and procedures until the specific waiting period ends (Excl02)","Any illness within 30 days of the first policy, except accidents (Excl03)","Admission primarily for investigation and evaluation (Excl04)","Obesity / weight control surgery not meeting the conditions (Excl06)","Cosmetic or plastic surgery (Excl08)","Professional hazardous or adventure sports (Excl09)","Alcoholism, drug or substance abuse (Excl12)","Unproven treatments (Excl16)","Sterility and infertility (Excl17)","Maternity expenses (Excl18), unless the maternity section or optional cover applies","Suicide, attempted suicide and intentional self-injury","Non-medical expenses (items in Annexure B), unless Consumables Cover is opted","War, terrorism and nuclear contamination","Cancer of oral, oropharynx and respiratory system in tobacco users"],"display":"Waiting-period exclusions, investigation-only admissions, cosmetic surgery, substance abuse, unproven treatment, infertility, maternity, self-injury, non-medical items, war, and others","note":"Full list in permanent_exclusions. Excl03 is 30 days in the wording but 7 days in four plans (see initial_waiting). Excl17 is deleted to the extent of Optional Cover 10 Infertility Treatment Cover if opted.","quote":"Pre-Existing Diseases - Code- Excl01 ... Specified disease/procedure waiting period- Code- Excl02 ... Initial Waiting Period- Code- Excl03 ... Investigation & Evaluation- Code- Excl04 ... Hazardous or Adventure sports: Code- Excl09 ... Substance Abuse – Code- Excl12 ... Expenses related to the treatment of a pre-existing Disease (PED) and its direct complications shall be excluded until the expiry of number of months, as per plan opted by You and specified in the Policy Schedule ... Expenses related to the treatment of the listed Conditions, surgeries/treatments shall be excluded until the expiry of number of months, as per plan opted by You and specified in the Policy Schedule ... 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 any admission primarily for diagnostics and evaluation purposes only are excluded. ... Obesity/ Weight Control: Code- Excl06 ... Cosmetic or plastic Surgery: Code- Excl08 ... Expenses related to any treatment necessitated due to participation as a professional in hazardous or adventure sports ... Treatment for, Alcoholism, drug or substance abuse or any addictive condition and consequences thereof. ... Unproven Treatments: Code- Excl16 ... Sterility and Infertility: Code- Excl17 ... Maternity: Code Excl18 ... Please note: This exclusion stands deleted to the extent of the coverage provided under SECTION 4. MATERNITY BENEFIT WALLET & NEWBORN COVER and or Optional cover 9. Maternity & Newborn Baby Cover, if opted by You. ... a) Suicide or attempted suicide, while sane or insane ... b) Intentional self-injury ... Expenses incurred on personal comfort during and related to hospitalisation as mentioned in Annexure B are covered only if the optional cover “Consumables Cover” is opted. ... War, invasion, acts of foreign enemy hostilities (whether or not War is declared) ... any acts of terrorism. Chemical contamination or contamination by radioactivity from any nuclear material ... b) Any claim in respect of Cancer of Oral, Oropharynx and respiratory system is specifically excluded in cases where Insured is a tobacco user.","sources":[{"clause":"1","heading":"Pre-Existing Diseases - Code- Excl01","page":42,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/45#c-1-20"},{"clause":"2","heading":"Specified disease/procedure waiting period- Code- Excl02","page":42,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/45#c-2-9"},{"clause":"3","heading":"Initial Waiting Period- Code- Excl03","page":43,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/45#c-3-8"},{"clause":"4","heading":"Investigation & Evaluation- Code- Excl04","page":43,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/45#c-4-7"},{"clause":"5","heading":"Rest Cure, rehabilitation and respite care- Code- Excl05","page":43,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/45#c-5-6"},{"clause":"6","heading":"Obesity/ Weight Control: Code- Excl06","page":43,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/45#c-6-6"},{"clause":"8","heading":"Cosmetic or plastic Surgery: Code- Excl08","page":44,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/45#c-8-6"},{"clause":"9","heading":"Hazardous or Adventure sports: Code- Excl09","page":44,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/45#c-9-5"},{"clause":"12","heading":"Substance Abuse – Code- Excl12","page":44,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/45#c-12-4"},{"clause":"16","heading":"Unproven Treatments: Code- Excl16","page":45,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/45#c-16-4"},{"clause":"17","heading":"Sterility and Infertility: Code- Excl17","page":45,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/45#c-17-3"},{"clause":"18","heading":"Maternity: Code Excl18","page":45,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/45#c-18-3"},{"clause":"18(b)","heading":null,"page":45,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/45#c-18-b"},{"clause":null,"heading":"20. Suicide and Self-Injury","page":46,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/45#c-20-suicide-and-self-injury"},{"clause":null,"heading":"25. Non-Medical Expenses","page":46,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/45#c-25-non-medical-expenses"},{"clause":null,"heading":"29. War and hazardous substances","page":47,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/45#c-29-war-and-hazardous-substances"},{"clause":null,"heading":"31. Substance abuse and Addictions by the Insured","page":47,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/45#c-31-substance-abuse-and-addictions-by-the-insured"}],"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 the website, toll free 1-800-258-4242 or hello@godigit.com (senior citizens: seniors@godigit.com), or the grievance cell at any branch. If not satisfied, write to the grievance officer at grievance@godigit.com, then approach the Insurance Ombudsman.","display":"Company (toll free / hello@godigit.com / branch), then grievance officer at grievance@godigit.com, then Ombudsman","note":"Complaints can also be registered on IRDAI's Bima Bharosa portal.","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 now 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 ... If Insured person is not satisfied with the redressal of grievance through above methods, the insured person may also approach the office of Insurance Ombudsman of the respective area/region ... The policyholder or the claimant also has the option to register the complaint on-line at IRDAl's Bima Bharosa","sources":[{"clause":"17","heading":"Customer Grievance Redressal Policy","page":52,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/45#c-17-4"}],"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":"Hospitalisation cover sum insured from Rs. 2,00,000 to Rs. 3,00,00,000; the rate chart lists 2, 3, 4, 5, 7.5, 9, 10, 12.5, 15, 20, 25, 30, 40, 50, 60 and 75 lakh and 1, 2 and 3 crore.","display":"Rs. 2,00,000 to Rs. 3,00,00,000","note":"From the prospectus. The wording plan chart says \"Upto INR 3 Crores\" for every plan. In-built personal accident cover is Rs. 50,000 to 1,00,000. Optional Sum Insured Multiplier (2, 3 or 4 times) can increase cover.","quote":"Section 1 - Hospitalization Cover | 2,00,000 | 3,00,00,000 ... Age | 2 Lakh | 3 Lakh | 4 Lakh | 5 Lakh | 7.5 Lakh | 9 Lakh | 10 Lakh | 12.5 Lakh | 15 Lakh ... Age | 20 Lakh | 25 Lakh | 30 Lakh | 40 Lakh | 50 Lakh | 60 Lakh | 75 Lakh | 1 Crore | 2 Crore | 3 Crore ... Section 7. In built Personal Accident | 50,000 | 1,00,000","sources":[{"clause":null,"heading":"What are the Sum Insured options under this Policy?","page":32,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/46#c-what-are-the-sum-insured-options-under-this-poli"},{"clause":null,"heading":"Rate Chart of Base Coverage (Excluding GST)","page":50,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/46#c-rate-chart-of-base-coverage-excluding-gst"}],"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 (7 days in some plans)","note":"Excl03 in the wording says 30 days, but the plan chart in the same wording shows 7 days for the Double Wallet, Infinity Wallet, Carry Forward Sum Insured and Worldwide Treatment plans, 30 days for Early Start, Senior Priority and Even Protect, and 7 or 30 days for BharatX. The prospectus lists options of 7, 15 or 30 days, and Optional Cover 3 can modify it. Accidents are not subject to it, and it does not apply after more than twelve months of continuous coverage.","quote":"a) 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. ... b) This exclusion shall not, however, apply if the Insured Person has Continuous Coverage for more than twelve months. ... 3 | Initial Waiting Period | 7 days | 7 days | 7 days | 7 days | 30 days | 30 days | 30 days | 7 days/ 30 days ... Initial Waiting Period Option | 7 days, 15 days, 30 days","sources":[{"clause":"3","heading":"Initial Waiting Period- Code- Excl03","page":43,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/45#c-3-8"},{"clause":"Row 3","heading":"Initial Waiting Period","page":67,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/45#c-row-3-4"},{"clause":null,"heading":"What are the waiting period and survival periods under this Policy?","page":33,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/46#c-what-are-the-waiting-period-and-survival-periods"}],"law":[]},{"key":"ped_waiting","label":"Pre-existing disease waiting period","section":"Waiting periods","meaning":"How long you wait before conditions you already had when you bought the policy are covered. The law caps it at 36 months.","status":"cross-checked","value":{"unit":"years","amount":3},"display":"3 years","note":"Excl01 refers to the number of months in the Policy Schedule. Plan chart: 3 years for all plans except Early Start Plan (1 year); BharatX 3 years or 1 year. Prospectus options: 0, 3, 6, 9 months, 1, 2 or 3 years (Optional Cover 3 can modify it; Optional Cover 18 Fast Track covers listed conditions after 30 days or from day one).","quote":"4 | Pre-existing Waiting Period | 3 years | 3 years | 3 years | 3 years | 1 year | 3 years | 3 years | 3 years/ 1 year ... Pre-existing Disease Waiting Period Options | 0 months, 3 months, 6 months, 9 months, 1 Year, 2 Years, 3 Years","sources":[{"clause":"Row 4","heading":"Pre-existing Waiting Period","page":67,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/45#c-row-4-3"},{"clause":null,"heading":"What are the waiting period and survival periods under this Policy?","page":33,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/46#c-what-are-the-waiting-period-and-survival-periods"}],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 8","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 12","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 1.6","url":"https://indiainsurances.com/law/irdai-products-regs-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 7","url":"https://indiainsurances.com/law/irdai-products-regs-2024"}]},{"key":"specific_waiting","label":"Specific illness waiting period","section":"Waiting periods","meaning":"Waiting period for a list of named illnesses and procedures (cataract, hernia, joint replacement...). With several tiers (24 and 36 months), the shortest in the answer, the others in the note.","status":"cross-checked","value":{"unit":"years","amount":2},"display":"2 years","note":"Excl02 refers to the number of months in the Policy Schedule. Plan chart: 2 years for all plans except Early Start Plan (1 year); BharatX 2 years or 1 year. Prospectus options: 0, 3, 6, 9 months, 1 or 2 years.","quote":"5 | Specific Disease Waiting Period | 2 years | 2 years | 2 years | 2 years | 1 year | 2 years | 2 years | 2 years/ 1 year ... Specific Waiting period | 0 months, 3 months, 6 months, 9 months, 1 Year, 2 years","sources":[{"clause":"Row 5","heading":"Specific Disease Waiting Period","page":67,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/45#c-row-5-3"},{"clause":null,"heading":"What are the waiting period and survival periods under this Policy?","page":33,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/46#c-what-are-the-waiting-period-and-survival-periods"}],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 12","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 1.7","url":"https://indiainsurances.com/law/irdai-products-regs-2024"}]},{"key":"specific_waiting_list","label":"Illnesses with a specific waiting period","section":"Waiting periods","meaning":"The named illnesses and procedures that carry the specific waiting period.","status":"cross-checked","value":["Non-infective arthritis, osteoarthritis and osteoporosis (if age related), connective tissue disorders, dorsopathies, spondylopathies, arthrosis and intervertebral disorders","Pancreatitis, gall bladder/biliary and urogenital stones, gastric and duodenal ulcers, GI varices, cirrhosis of liver, rectal prolapse","Cataract, glaucoma and disorder of retina","Hyperplasia of prostate, urethral strictures, hydrocele/varicocele and spermatocele","Abnormal utero-vaginal bleeding, female genital prolapse, endometriosis/adenomyosis, fibroids, ovarian cyst, pelvic inflammatory disease","Haemorrhoids, fissure, fistula and pilonidal sinus/cyst","Hernia of all sites","Varicose veins of lower extremities","Middle ear, mastoid, sinus, tonsil, adenoid, nasal septum, turbinate and nasal polyp conditions","Benign or in situ neoplasms/tumours, cysts, polyps, nodules, lumps including breast lumps","Internal congenital anomaly (not for new-born baby)","Psychiatric illness ICD F20-F29, F30-F39, F40-F48, F99","Neurodegenerative disorders including Alzheimer's and Parkinson's disease","Joint replacement, bariatric surgery and organ transplant"],"display":"Arthritis and spine disorders, stones and ulcers, cataract, prostate, gynaecological conditions, piles and fistula, hernia, varicose veins, ENT conditions, benign tumours, internal congenital anomaly, listed psychiatric illness, neurodegenerative disorders, joint replacement, bariatric surgery and organ transplant","note":"Accidents are not subject to this waiting period. If a listed condition is also pre-existing, the longer waiting period applies.","quote":"i) Non-infective arthritis, Osteoarthritis and Osteoporosis (if age related), Systemic Connective Tissue disorders, Dorsopathies, Spondylopathies, Inflammatory Polyarthropathies, Arthrosis and Intervertebral disorders (unless due to accident) ... ii) Pancreatitis, calculus disease of gall bladder/biliary tract and urogenital system, Gastric & Duodenal erosions/ulcers, Varices of GI tract, Cirrhosis of Liver, Rectal prolapse. ... iii) Cataract, Glaucoma and Disorder of retina ... iv) Hyperplasia of Prostate, Urethral strictures, Hydrocele/Varicocele and spermatocele ... v) All Abnormal Utero-vaginal bleeding, female genital Prolapse, Endometriosis/Adenomyosis, Fibroids, Ovarian Cyst, Pelvic Inflammatory disease ... vi) Haemorrhoids, Fissure, Fistula and pilonidal sinus/cyst and fistula. ... vii) Hernia of all sites, ... viii) Varicose veins of lower extremities, ... ix) Disease of middle ear and mastoid including otitis Media, Cholesteatoma, Perforation of Tympanic Membrane, Sinusitis, Tonsillitis, Adenoid hypertrophy, Nasal septum deviation, Turbinate hypertrophy, Nasal polyp, Mastoiditis, Nasal concha bullosa, ... x) All internal and external benign or In Situ Neoplasms/Tumours, Cyst, Sinus, Polyp, Nodules, Swelling, Mass or Lump including breast lumps (each of any kind unless malignant), ... xi) Internal Congenital Anomaly (not applicable for new-born baby), ... xii) Psychiatric illness and Disorders listed below: ... F20-F29 | Schizophrenia, schizotypal and delusional disorders\nF30-F39 | Mood [affective] disorders\nF40-F48 | Neurotic, stress-related and somatoform disorders\nF99-F99 | Unspecified mental disorder ... xiii) Neurodegenerative disorders including but not limited to Alzheimer’s disease and Parkinson’s disease ... xiv) Joint Replacement, Bariatric Surgery and Organ Transplant","sources":[{"clause":"2","heading":"Specified disease/procedure waiting period- Code- Excl02","page":42,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/45#c-2-9"}],"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":"For an enhanced sum insured, the sixty months run from the date of enhancement on the enhanced part.","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 any grounds of non-disclosure and/or misrepresentation, except on grounds of established fraud. This period of sixty continuous months is called as moratorium period.","sources":[{"clause":"7","heading":"Moratorium Period","page":50,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/45#c-7-7"}],"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. You can port the policy 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 Digit policy with similar credit transfer is also allowed.","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":"15(a)","heading":null,"page":52,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/45#c-15-a"},{"clause":"15(d)","heading":null,"page":52,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/45#c-15-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":"not-stated","value":null,"display":null,"note":"The wording says the policy 'shall ordinarily be renewable provided the product is not withdrawn' and renewal cannot be denied because of claims, and the prospectus sets no maximum entry age, but no document states lifelong renewal or a maximum renewal age.","quote":null,"sources":[],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 10","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch II D.II","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, IV.5","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 9","url":"https://indiainsurances.com/law/irdai-products-regs-2024"},{"title":"Review of revision in premium rates under health insurance policies for senior citizens, 2025","section":"Para 7","url":"https://indiainsurances.com/law/irdai-senior-premium-2025"}]},{"key":"claim_loading","label":"Premium loading after claims","section":"Renewal and rights","meaning":"Whether the premium can go up at renewal because you made a claim.","status":"cross-checked","value":"No. No loading applies on renewal based on individual claims experience, and renewal cannot be denied because of claims.","display":"No loading for claims","note":null,"quote":"iii) Renewal shall not be denied on the ground that the insured person had made a claim or claims in the preceding policy years. ... vi) No loading shall apply on renewals based on individual claims experience.","sources":[{"clause":"14","heading":"Renewal","page":52,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/45#c-14-5"}],"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)","Substance Abuse (Excl12)","Domestic Treatment (Excl13)","Non-prescribed Medicine (Excl14)","Refractive Error (Excl15)","Unproven Treatments (Excl16)","Sterility and Infertility (Excl17)","Maternity (Excl18)","Artificial Life Maintenance","Suicide and Self-Injury","Circumcision, Aesthetic reasons","External Congenital Anomaly","Defence Operation","Non-Medical Expenses","Preventive Treatment","Spectacles, Hearing aids & other Expenses","Unjustified or Unwarranted Hospitalization","War and hazardous substances","Legal Liability","Substance abuse and Addictions by the Insured","Ear, Eyesight & Optical Services","Prosthetics and other devices","Specific Treatments (above 5% of sum insured; predictive genome testing)","Dental Treatment","Organ Donor (except Section 2)","Weight loss Surgery","Charges to procure documents related to treatment","Hormone replacement therapy","Loss from an illegal act or violation of the law"],"display":"Standard exclusions Excl04 to Excl18 and the product's own exclusions 19 to 41","note":"Some are lifted by optional covers: Excl17 by Infertility Treatment Cover, Excl18 by the maternity section or Optional Cover 9, Non-Medical Expenses by Consumables Cover, Excl04 by Health Check-up Cover from Day One, Spectacles/Hearing aids and Prosthetics by Out-Patient or Medical Equipment Cover, Dental by Out-Patient Cover. Exclusions 32 to 41 are listed under \"can't be waived\". New age treatments are capped at 50% of sum insured and cochlear implants at 50% (see disease_sublimits).","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 ... Substance Abuse – Code- Excl12 ... Domestic Treatment- Code- Excl13 ... Non-prescribed Medicine – Code- Excl14 ... Refractive Error: Code- Excl15 ... Unproven Treatments: Code- Excl16 ... Sterility and Infertility: Code- Excl17 ... Maternity: Code Excl18 ... 19. Artificial Life Maintenance ... 20. Suicide and Self-Injury ... 21. Circumcision, Aesthetic reasons ... 22. External Congenital Anomaly ... 24. Defence Operation ... 25. Non-Medical Expenses ... 26. Preventive Treatment ... 27. Spectacles, Hearing aids & other Expenses ... 28. Unjustified or Unwarranted Hospitalization ... 29. War and hazardous substances ... 30. Legal Liability ... 31. Substance abuse and Addictions by the Insured ... 32. Ear, Eyesight & Optical Services ... 33. Prosthetics and other devices ... We will not pay for expenses related to administration of below medications or procedures in excess of 5% of Sum Insured opted under Section 1. Hospitalization Cover: ... a) Predictive Genome testing ... 36. Dental Treatment ... The Expenses incurred by You on organ donation, except for those covered under SECTION 2. ORGAN DONOR EXPENSES. ... 38. Weight loss Surgery ... 39. Any charges incurred to procure documents related to treatment or illness pertaining to any period of Hospitalization or Illness.\n40. Hormone replacement therapy.\n41. Any loss arising out of the Insured Person’s actual or attempted commission of or willful participation in an illegal act or any violation or attempted violation of the law.","sources":[{"clause":"4","heading":"Investigation & Evaluation- Code- Excl04","page":43,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/45#c-4-7"},{"clause":"5","heading":"Rest Cure, rehabilitation and respite care- Code- Excl05","page":43,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/45#c-5-6"},{"clause":"6","heading":"Obesity/ Weight Control: Code- Excl06","page":43,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/45#c-6-6"},{"clause":"7","heading":"Change-of-Gender treatments: Code- Excl07","page":44,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/45#c-7-6"},{"clause":"8","heading":"Cosmetic or plastic Surgery: Code- Excl08","page":44,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/45#c-8-6"},{"clause":"9","heading":"Hazardous or Adventure sports: Code- Excl09","page":44,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/45#c-9-5"},{"clause":"10","heading":"Breach of law: Code- Excl10","page":44,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/45#c-10-5"},{"clause":"11","heading":"Excluded Providers: Code- Excl11","page":44,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/45#c-11-4"},{"clause":"12","heading":"Substance Abuse – Code- Excl12","page":44,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/45#c-12-4"},{"clause":"13","heading":"Domestic Treatment- Code- Excl13","page":45,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/45#c-13-4"},{"clause":"14","heading":"Non-prescribed Medicine – Code- Excl14","page":45,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/45#c-14-4"},{"clause":"15","heading":"Refractive Error: Code- Excl15","page":45,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/45#c-15-4"},{"clause":"16","heading":"Unproven Treatments: Code- Excl16","page":45,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/45#c-16-4"},{"clause":"17","heading":"Sterility and Infertility: Code- Excl17","page":45,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/45#c-17-3"},{"clause":"18","heading":"Maternity: Code Excl18","page":45,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/45#c-18-3"},{"clause":null,"heading":"19. Artificial Life Maintenance","page":46,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/45#c-19-artificial-life-maintenance"},{"clause":null,"heading":"20. Suicide and Self-Injury","page":46,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/45#c-20-suicide-and-self-injury"},{"clause":null,"heading":"21. Circumcision, Aesthetic reasons","page":46,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/45#c-21-circumcision-aesthetic-reasons"},{"clause":null,"heading":"22. External Congenital Anomaly","page":46,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/45#c-22-external-congenital-anomaly"},{"clause":null,"heading":"24. Defence Operation","page":46,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/45#c-24-defence-operation"},{"clause":null,"heading":"25. Non-Medical Expenses","page":46,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/45#c-25-non-medical-expenses"},{"clause":null,"heading":"26. Preventive Treatment","page":46,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/45#c-26-preventive-treatment"},{"clause":null,"heading":"27. Spectacles, Hearing aids & other Expenses","page":47,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/45#c-27-spectacles-hearing-aids-other-expenses"},{"clause":null,"heading":"28. Unjustified or Unwarranted Hospitalization","page":47,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/45#c-28-unjustified-or-unwarranted-hospitalization"},{"clause":null,"heading":"29. War and hazardous substances","page":47,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/45#c-29-war-and-hazardous-substances"},{"clause":null,"heading":"30. Legal Liability","page":47,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/45#c-30-legal-liability"},{"clause":null,"heading":"31. Substance abuse and Addictions by the Insured","page":47,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/45#c-31-substance-abuse-and-addictions-by-the-insured"},{"clause":null,"heading":"32. Ear, Eyesight & Optical Services","page":47,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/45#c-32-ear-eyesight-optical-services"},{"clause":null,"heading":"33. Prosthetics and other devices","page":47,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/45#c-33-prosthetics-and-other-devices"},{"clause":"1","heading":null,"page":48,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/45#c-1-21"},{"clause":"2(a)","heading":null,"page":48,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/45#c-2-a"},{"clause":null,"heading":"36. Dental Treatment","page":48,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/45#c-36-dental-treatment"},{"clause":null,"heading":"37. Organ Donor","page":48,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/45#c-37-organ-donor"},{"clause":null,"heading":"38. Weight loss Surgery","page":48,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/45#c-38-weight-loss-surgery"}],"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 can cancel any time with 7 days written notice. For a term up to one year, proportionate premium for the unexpired period is refunded if no claim was made. For terms over 1 year, premium for policy years whose cover has not started is refunded.","display":"Proportionate refund for unexpired period if no claim (7 days notice)","note":null,"quote":"A. Cancellation by You 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.\nb) Refund premium for the unexpired policy period, in respect of policies with term more than 1 year and risk coverage for such policy years has not commenced.","sources":[{"clause":"8","heading":"Cancellation","page":50,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/45#c-8-7"}],"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. Under plans with Worldwide Coverage (Worldwide Treatment Plan, optional in BharatX), hospitalisation, day care and organ donor expenses abroad are paid on reimbursement if the illness was diagnosed in India and you travel only for treatment.","display":"India; worldwide treatment under the Worldwide Treatment Plan","note":"Air ambulance is limited to India; sum insured back-up and Sum Insured Multiplier are for hospitalisation in India only.","quote":"This Policy covers all treatments received within India. However, based on the plan opted, the Geographical limits will be extended to places outside India. ... We will pay You for the Medical Expenses incurred by You outside India. ... Section 1 | Hospitalization Cover\n1.1 | In-Patient Hospitalization\n1.2 | Day Care Procedures\nSection 2 | Organ Donor Expenses ... Claims will be payable on reimbursement basis only. For Cashless it will be decided on case-to-case basis. ... Medical expenses under this cover will be payable if diagnosis is made in India and insured travels outside India only for the purpose of treatment. ... V | Worldwide Coverage | Not Applicable | Not Applicable | Not Applicable | Upto Base Sum Insured | Not Applicable | Not Applicable | Not Applicable | Upto Base Sum Insured/ Not Applicable","sources":[{"clause":null,"heading":"23. Geographical Limits","page":46,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/45#c-23-geographical-limits"},{"clause":"Section 5","heading":"WORLDWIDE COVERAGE","page":20,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/45#c-section-5"},{"clause":"1","heading":null,"page":20,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/45#c-1-14"},{"clause":"2","heading":null,"page":20,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/45#c-2-4"},{"clause":null,"heading":"Plan BASE COVERAGES","page":64,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/45#c-plan-base-coverages"}],"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 ported/migrated policies. Refund less medical examination and stamp duty costs, or less proportionate risk premium if cover has started. The CIS counts the 30 days from the beginning of the policy rather than receipt of the document.","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, to review the terms and conditions of the policy, and to return the same if not acceptable. ... Free Look Period- You may cancel the insurance policy if you do not want it, within 30 days from the beginning of the policy. ... The Free Look Period shall be applicable on new individual health insurance policies and not on renewals or at the time of porting/migrating the policy. ... i) a refund of the premium paid less any expenses incurred by the Company on medical examination of the insured person and the stamp duty charges or ... ii) where the risk has already commenced and the option of return of the policy is exercised by the insured person, a deduction towards the proportionate risk premium for period of cover or","sources":[{"clause":"9","heading":"Free Look Period","page":50,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/45#c-9-6"},{"clause":null,"heading":"12. THINGS TO REMEMBER","page":4,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/47#c-12-things-to-remember"},{"clause":"9(i)","heading":null,"page":50,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/45#c-9-i"},{"clause":"9(ii)","heading":null,"page":50,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/45#c-9-ii"}],"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 premium)","note":"15 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":"18","heading":"Grace Period","page":4,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/45#c-18"},{"clause":"4","heading":"Special Conditions Applicable for Policies issued with premium Payment on Instalment basis","page":49,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/45#c-4-8"}],"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":"Proposer from 18 years with no maximum age; children from 91 days with no maximum.","display":"18 years (proposer) / 91 days (child) to no upper limit","note":"From the prospectus. A financially independent person should not be covered as a child.","quote":"Hospitalization Cover | Proposer | 18yrs | No Limit\nChild* | 91days | No Limit\nThere is no maximum limit on proposer age. ... *Maximum limit on child entry age is not required. However, someone who is financially independent should not be covered as child and should buy their own policy.","sources":[{"clause":null,"heading":"What are the Minimum & Maximum Entry age for Adults & Children?","page":32,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/46#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":"Instalments: half-yearly, quarterly or monthly","note":"Instalment payment is an option; the full premium can otherwise be paid for the policy period. The long-term discount does not apply to instalment premium.","quote":"If the insured person has opted for Payment of Premium on an instalment basis i.e. Half Yearly, Quarterly or Monthly ... This Discount shall not be applicable in case of instalment premium.","sources":[{"clause":"4","heading":"Special Conditions Applicable for Policies issued with premium Payment on Instalment basis","page":49,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/45#c-4-8"},{"clause":"1","heading":"Long-Term Discount","page":35,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/46#c-1-19"}],"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":"cross-checked","value":["Consumables Cover","Network Hospital Discount","Pre-existing Disease/Specific Disease/Initial Waiting Period Modification","Sum Insured Multiplier","Health Check-up cover from Day One","Advance Care","Support Plus","Advance Heart Ambulance","Maternity & Newborn Baby Cover","Infertility Treatment Cover","Daily Hospital Cash Cover","Daily Cash for accompanying an insured child","Loss of Income Cover","Long Hospitalization Cash Benefit Cover","Out-Patient Benefit Cover","Second Medical Opinion","Smart Save","Fast track","Cumulative Bonus Protection Cover","Infinite Cumulative Bonus","Room Rent Modification Cover","NRI Benefit","Policy Tenure Multiplier","Premium Refund","Medical Equipment Cover"],"display":"25 optional covers, from Consumables Cover to Medical Equipment Cover","note":"Availability differs by plan (for example Maternity & New Born Baby Cover is not available in the Early Start and Senior Priority plans; Sum Insured Multiplier, Cumulative Bonus Protection and Infinite Cumulative Bonus are not available in the Carry Forward Sum Insured Plan; NRI Benefit not in the Worldwide Treatment Plan). Some covers (Network Hospital Discount, Room Rent Modification, Smart Save, NRI Benefit) reduce premium in exchange for restrictions.","quote":"1 | Consumables Cover | Section 1 - Hospitalization Cover ... 2 | Network Hospital Discount | Section 1 - Hospitalization Cover\n3 | Pre-existing Disease/Specific Disease/Initial Waiting Period Modification | Section 1 – Hospitalization Cover Section 2 – Organ Donor Expenses Section 3 – Emergency Ambulance Section 5 – Worldwide Coverage\n4 | Sum Insured Multiplier | Section 1 - Hospitalization Cover\n5 | Health Check-up cover from Day One\n6 | Advance Care | Section 1 - Hospitalization Cover\n7 | Support Plus | Section 1 - Hospitalization Cover\n8 | Advance Heart Ambulance | Section 1 - Hospitalization Cover\n9 | Maternity & Newborn Baby Cover\n10 | Infertility Treatment Cover | Section 1 - Hospitalization Cover\n11 | Daily Hospital Cash Cover | Section 1 - Hospitalization Cover\n12 | Daily Cash for accompanying an insured child | Section 1 - Hospitalization Cover\n13 | Loss of Income Cover | Section 1 - Hospitalization Cover\n14 | Long Hospitalization Cash Benefit Cover | Section 1 - Hospitalization Cover\n15 | Out-Patient Benefit Cover\n16 | Second Medical Opinion | Section 1 - Hospitalization Cover\n17 | Smart Save | Section 1 - Hospitalization Cover\n18 | Fast track | Section 1 - Hospitalization Cover\n19 | Cumulative Bonus Protection Cover | Section 1 - Hospitalization Cover\n20 | Infinite Cumulative Bonus | Section 1 - Hospitalization Cover\n21 | Room Rent Modification Cover | Section 1 - Hospitalization Cover\n22 | NRI Benefit\n23 | Policy Tenure Multiplier\n24 | Premium Refund\n25 | Medical Equipment Cover | Section 1 - Hospitalization Cover","sources":[{"clause":"Row 1","heading":"Consumables Cover","page":22,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/45#c-row-1"},{"clause":"Row 2","heading":"Network Hospital Discount","page":22,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/45#c-row-2"}],"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":"For instalment premiums, cover continues during the grace period from the due date until the premium is received. For renewal premiums, cover need not be available for the period in which no premium is received, though continuity is kept if paid within the grace period.","display":"Covered for instalment premiums; renewal grace period may not be covered","note":null,"quote":"Coverage need not be available during the period for which no premium is received. ... Provided the insurers shall offer coverage during the grace period, if the premium is paid in instalments during the policy period. ... ii) During such Grace Period, Coverage will be available from the instalment premium payment due date till the date of receipt of premium by company.","sources":[{"clause":"18","heading":"Grace Period","page":4,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/45#c-18"},{"clause":"4","heading":"Special Conditions Applicable for Policies issued with premium Payment on Instalment basis","page":49,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/45#c-4-8"}],"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":"No room rent limit for most plans; the Even Protect Plan allows a Single Private AC Room.","display":"No limit (Even Protect Plan: Single Private AC Room)","note":"BharatX: no restriction or Single Private AC Room. The optional Room Rent Modification Cover lets you accept a limit (single private AC room, shared room, shared up to INR 5000, 1% of SI per day, general ward) for a lower premium.","quote":"Under Section 1.1 In-Patient Hospitalisation, there is no restriction on accommodation/ room rent which can in a ward, shared or private room. ... i | Inpatient Hospitalizati on Cover | No Restriction on Room Rent | No Restriction on Room Rent | No Restriction on Room Rent | No Restriction on Room Rent | No Restriction on Room Rent | No Restriction on Room Rent | Single Private AC Room | No Restriction on Room Rent/ Single Private AC Room ... 3 | Single Private AC room | No Restriction\n4 | Shared Accommodation | No Restriction\n5 | Shared Accommodation max up to INR 5000 | No Restriction\n6 | 1% of SI* | 2% of SI*\n7 | General Ward | Not Applicable","sources":[{"clause":null,"heading":"21) Optional Cover 21: Room Rent Modification Cover","page":33,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/45#c-21-optional-cover-21-room-rent-modification-cove"},{"clause":null,"heading":"Plan BASE COVERAGES","page":64,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/45#c-plan-base-coverages"}],"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":"cross-checked","value":"Any room for the Double Wallet, Infinity Wallet, Carry Forward Sum Insured, Worldwide Treatment, Early Start and Senior Priority plans; Single Private AC Room for the Even Protect Plan; either for BharatX.","display":"Any room; Single Private AC Room under Even Protect Plan","note":"Room Rent Modification Cover (optional) can restrict the room category in return for a premium reduction.","quote":"i | Inpatient Hospitalizati on Cover | No Restriction on Room Rent | No Restriction on Room Rent | No Restriction on Room Rent | No Restriction on Room Rent | No Restriction on Room Rent | No Restriction on Room Rent | Single Private AC Room | No Restriction on Room Rent/ Single Private AC Room","sources":[{"clause":null,"heading":"Plan BASE COVERAGES","page":64,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/45#c-plan-base-coverages"}],"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 charges are paid as part of in-patient hospitalisation up to the sum insured; no separate per-day ICU limit is printed.","display":"No separate limit (up to sum insured)","note":"Same in every plan; the Even Protect Plan's Single Private AC Room limit is for the room, not ICU. Under the optional Room Rent Modification Cover, option 6 limits ICU to 2% of SI; other options leave ICU unrestricted. Proportionate deductions do not apply to ICU charges.","quote":"We will pay You all Reasonable and Customary Charges that are Medically Necessary and Incurred by You in respect of an admissible claim upto the Sum Insured ... ICU | Intensive Care Unit when you require continuous monitoring or life support ... 6 | 1% of SI* | 2% of SI* ... b) Proportionate deductions are not applicable for ICU charges.","sources":[{"clause":"1.1","heading":"In-Patient Hospitalization","page":12,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/45#c-1-1"},{"clause":null,"heading":"21) Optional Cover 21: Room Rent Modification Cover","page":33,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/45#c-21-optional-cover-21-room-rent-modification-cove"},{"clause":"Row 7(b)","heading":null,"page":33,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/45#c-row-7-b"}],"law":[]},{"key":"proportionate_deduction","label":"Proportionate deduction","section":"Limits and co-pay","meaning":"If you choose a room above your limit, whether the insurer reduces associated charges (doctor fees, tests, procedures) by the same proportion.","status":"cross-checked","value":"Only if the optional Room Rent Modification Cover is chosen and you take a higher room category: you then bear a rateable share of associated medical expenses. Not applied to ICU charges or to hospitals without differential billing.","display":"Only under the optional Room Rent Modification Cover","note":"Associated medical expenses exclude pharmacy, consumables, implants, medical devices and diagnostics. The wording does not say what happens if a room above the Even Protect Plan's Single Private AC Room is taken.","quote":"Under Section 1.1 In-Patient Hospitalisation, there is no restriction on accommodation/ room rent ... i) If the Insured Person is admitted in a higher room category (S. No 1 is highest room category while S. No 7 is lowest in the above table) than the one opted and specified in the Policy Schedule, then the Insured Person shall bear a rateable proportion of the total Associated medical expenses (including surcharges or taxes thereon) in the proportion of the difference between room rent of the entitled room category to the room rent actually incurred. ... b) Proportionate deductions are not applicable for ICU charges. ... c) Proportionate deductions shall not be applicable for hospitals which do not follow differential billing","sources":[{"clause":null,"heading":"21) Optional Cover 21: Room Rent Modification Cover","page":33,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/45#c-21-optional-cover-21-room-rent-modification-cove"},{"clause":"Row 7(i)","heading":null,"page":33,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/45#c-row-7-i"},{"clause":"Row 7(b)","heading":null,"page":33,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/45#c-row-7-b"},{"clause":"Row 7(c)","heading":null,"page":33,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/45#c-row-7-c"}],"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":"No standard co-payment on the hospitalisation cover. A 10% co-pay applies if you are hospitalised in a higher zone than the zone you paid for and cannot show address proof matching the proposal (not for accidents).","display":"None, except 10% zone co-pay in some cases","note":"Optional Network Hospital Discount: 20% (Silver) or 15% (Standard) co-pay, or no payment (Gold), for treatment outside the preferred network, except accidents and life-threatening cases. Optional Out-Patient Benefit Cover: 25% then 10% co-pay under Basis 1.","quote":"Hospitalization Cover | Yes | 2500 | 50,000 | NA | NA | NA ... In the absence of Address proof provided which validates the pricing zone opted, and if the place of hospitalization belongs to Higher Zone Category – then Co-pay of 10% would be applicable on admissible claim amount. ... Zone based Co-Pay, as mentioned above, will not be applicable in case of Accidental Injury. ... b. Silver Preferred Provider Network | 10% | 20% Copayment\nc. Standard Preferred Provider Network | 12.5% | 15% Copayment ... Basis 1: Co-payment of 25% in the First Year of this Optional cover being Opted, 10% on First Renewal.","sources":[{"clause":"Section 1","heading":"Hospitalization Cover | Yes | 2500 | 50,000 | NA | NA | NA","page":35,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/46#c-section-1-3"},{"clause":null,"heading":"18. Zone wise Classification","page":53,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/45#c-18-zone-wise-classification"},{"clause":null,"heading":"A discount! Add this cover for a discount on your policy!","page":23,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/45#c-a-discount-add-this-cover-for-a-discount-on-your"},{"clause":null,"heading":"You are not hospitalized are covered under this!","page":29,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/45#c-you-are-not-hospitalized-are-covered-under-this"}],"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":"None unless a deductible is chosen for a premium discount; the optional deductible ranges from 2500 to 50,000 per claim.","display":"None unless opted (2500 to 50,000 per claim)","note":"From the prospectus. The optional deductible applies to each claim under sections 1, 2, 3 and 5.","quote":"Hospitalization Cover | Yes | 2500 | 50,000 | NA | NA | NA ... Small Fixed Deductible Discount: Discounts will be offered on the Policy premium basis the deductible opted by the proposer. ... The deductible shall be applicable on each claim under section 1,2,3 and 5.","sources":[{"clause":"Section 1","heading":"Hospitalization Cover | Yes | 2500 | 50,000 | NA | NA | NA","page":35,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/46#c-section-1-3"},{"clause":"10","heading":"Small Fixed Deductible Discount","page":36,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/46#c-10-3"}],"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":["New age treatments (uterine artery embolization 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): up to 50% of Sum Insured","Cochlear Implant Procedure: 50% of the Sum Insured","Hyaluronic acid, Remicade or similar medications and intra-articular/intra thecal or cortico-steroid injections: up to 5% of Sum Insured"],"display":"New age treatments 50% of SI; cochlear implant 50% of SI; some injections 5% of SI","note":"Optional Advance Care removes the 50% cap on new age treatments. Optional Smart Save applies caps (amounts in the schedule) on cataract, knee and hip replacement, angiography, angioplasty, hernia, CABG, hysterectomy, kidney/bladder stone and oral chemotherapy for a premium discount. Donor pre and post hospitalisation is limited to 5% of the harvesting claim (see organ_donor). Same in every plan.","quote":"Our Maximum Liability in respect of the following procedures or new age treatments 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 opted under Section 1. Hospitalization Cover:\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 ... c) Our Maximum Liability in respect of Cochlear Implant Procedure will be restricted to 50% of the Sum Insured opted under Section 1. Hospitalization Cover ... We will not pay for expenses related to administration of below medications or procedures in excess of 5% of Sum Insured opted under Section 1. Hospitalization Cover:\na) Hyaluronic acid, Remicade or similar medications\nb) Intra-articular/intra thecal or cortico-steroid injections. ... On opting Optional cover 6- Advance Care, this exclusion shall be deleted. ... If you have opted for this Optional cover, then it is hereby agreed and declared that Sum Insured capping will be applied on specific aliment listed below","sources":[{"clause":null,"heading":"35. New Age Treatment","page":48,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/45#c-35-new-age-treatment"},{"clause":"2(I)","heading":null,"page":48,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/45#c-2-i-2"},{"clause":null,"heading":"32. Ear, Eyesight & Optical Services","page":47,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/45#c-32-ear-eyesight-optical-services"},{"clause":"1","heading":null,"page":48,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/45#c-1-21"},{"clause":null,"heading":"17) Optional Cover 17: Smart Save","page":30,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/45#c-17-optional-cover-17-smart-save"}],"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 (60, 90 or 120 days in some plans)","note":"Plan chart: Double Wallet 30, Infinity Wallet 60, Carry Forward Sum Insured 90, Worldwide Treatment 60, Early Start 30, Senior Priority 30, Even Protect 60, BharatX 30/60/90/120 days. Expenses must be for the same condition and the in-patient claim must be admissible.","quote":"iii | Pre- Hospitalizati on | 30 days | 60 days | 90 days | 60 days | 30 days | 30 days | 60 days | 30days/60 days/ 90 days/120 days**","sources":[{"clause":null,"heading":"Plan BASE COVERAGES","page":64,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/45#c-plan-base-coverages"}],"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 (90 or 180 days in some plans)","note":"Plan chart: Double Wallet 60, Infinity Wallet 180, Carry Forward Sum Insured 180, Worldwide Treatment 180, Early Start 60, Senior Priority 60, Even Protect 90, BharatX 60/90/120/180 days. The CIS template shows 30/60/90/120/180 days.","quote":"iv | Post Hospitalizati on | 60 days | 180 days | 180 days | 180 days | 60 days | 60 days | 90 days | 60 days/ 90 days/ 120 days/ 180 days ... Post-Hospitalization: <<30/60/90/120/180>> days post hospitalization, as per the plan opted","sources":[{"clause":null,"heading":"Plan BASE COVERAGES","page":64,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/45#c-plan-base-coverages"},{"clause":"1.4","heading":"Post-Hospitalization","page":1,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/47#c-1-4"}],"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":"Day care procedures done under anaesthesia in less than 24 hours are covered up to the sum insured; there is no closed list. Treatment normally taken as out-patient is not covered.","display":"Covered up to sum insured (no list)","note":null,"quote":"due to which You need to undergo medical treatment and/or surgical procedure as an inpatient under General or Local Anaesthesia in a hospital/day care centre for stay less than 24 hrs because of technological advancement, We will pay the Medial Expenses Incurred for such Day Care Procedures ... Note - This is NOT OPD: Treatment normally taken on an out-patient basis is NOT included in the scope of this Cover. ... ii | Day Care Procedures | Upto Sum Insured","sources":[{"clause":"1.2","heading":"Day Care Procedures","page":12,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/45#c-1-2-2"},{"clause":null,"heading":"Plan BASE COVERAGES","page":64,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/45#c-plan-base-coverages"}],"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":"Covered up to the hospitalisation sum insured when the patient cannot be moved to hospital or no hospital room is available, if treatment lasts at least 3 days. Asthma, bronchitis, diabetes, hypertension, influenza, arthritis and some other listed conditions are excluded.","display":"Covered up to sum insured (minimum 3 days)","note":null,"quote":"We will pay the Medial Expenses incurred by You for any illness or Injury requiring medical treatment taken at home, which would otherwise have required Hospitalization, provided that: ... a) The condition of the patient is such that she/he is not in a condition to be moved to a Hospital or ... b) The patient takes treatment at home on account of non-availability of room in a Hospital, and ... c) The condition for which the medical treatment is required continues for at least 3 days ... Asthma, Bronchitis, Tonsillitis, Upper Respiratory Tract Infection including Laryngitis and Pharyngitis, Cough and Cold, Influenza, Arthritis, Gout and Rheumatism, Chronic Nephritis and Nephritic Syndrome, Diarrhoea and all types of Dysenteries including Gastroenteritis, Diabetes Mellitus and Insipidus, Epilepsy, Hypertension ... ix | Home (Domiciliary) Expenses | Upto Sum Insured","sources":[{"clause":"1.9","heading":"Home (Domiciliary) Hospitalization","page":16,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/45#c-1-9"},{"clause":"1.9(a)","heading":null,"page":16,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/45#c-1-9-a"},{"clause":"1.9(b)","heading":null,"page":16,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/45#c-1-9-b"},{"clause":"1.9(c)","heading":null,"page":16,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/45#c-1-9-c"},{"clause":"1.9(d)","heading":null,"page":16,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/45#c-1-9-d"},{"clause":null,"heading":"Plan BASE COVERAGES","page":64,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/45#c-plan-base-coverages"}],"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 treatment under Ayurveda, Unani, Siddha or Homeopathy in an Ayush hospital is covered up to the sum insured. Out-patient and preventive or rejuvenation treatments are not covered, and the hospital must hold NABH pre-entry level or NQAS state level certification.","display":"Covered up to sum insured (in-patient)","note":null,"quote":"We will pay the Medical Expenses for Your In-patient Treatment, taken under Ayurveda, Unani, Siddha or Homeopathy. This is paid provided that treatment has been undergone in an Ayush Hospital. ... a) Outpatient Medical Expenses. ... b) All Preventive and Rejuvenation Treatments (non-curative in nature) ... Claim will be payable under this section only if AYUSH Hospitals and AYUSH Day Care Centres have obtained pre-entry level certificate (or higher level of certificate) issued by National Accreditation Board for Hospitals and Healthcare Providers (NABH) or State Level Certificate (or higher level of certificate) under National Quality Assurance Standards (NQAS) ... x | Ayush Hospitalizati on | Upto Sum Insured","sources":[{"clause":"1.10","heading":"Ayush Hospitalization","page":16,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/45#c-1-10"},{"clause":"1.10(a)","heading":null,"page":16,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/45#c-1-10-a"},{"clause":"1.10(b)","heading":null,"page":16,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/45#c-1-10-b"},{"clause":null,"heading":"Plan BASE COVERAGES","page":64,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/45#c-plan-base-coverages"}],"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":"Covered up to 50% of the hospitalisation sum insured: uterine artery embolization and HIFU, balloon sinuplasty, deep brain stimulation, oral chemotherapy, immunotherapy, intra vitreal injections, robotic surgeries, stereotactic radio surgeries, bronchial thermoplasty, prostate vaporisation, IONM and stem cell therapy. Up to 100% with the optional Advance Care cover.","display":"Up to 50% of sum insured (100% with Advance Care)","note":null,"quote":"Our Maximum Liability in respect of the following procedures or new age treatments 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 opted under Section 1. Hospitalization Cover:\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 ... If You have opted for this Optional cover, our maximum liability in respect of the following procedures or new age treatments will be up to 100% of the sum insured as opted under Section 1.1 In-Patient Hospitalization of the policy:","sources":[{"clause":null,"heading":"35. New Age Treatment","page":48,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/45#c-35-new-age-treatment"},{"clause":"2(I)","heading":null,"page":48,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/45#c-2-i-2"},{"clause":"6","heading":"Optional Cover 6: Advance Care","page":25,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/45#c-6-3"}],"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":"cross-checked","value":"Yes. Organ harvesting costs are paid up to the hospitalisation sum insured, plus the donor's pre and post hospitalisation expenses up to 5% of the approved harvesting claim. Not available in the Senior Priority Plan.","display":"Covered up to sum insured; donor pre/post up to 5%","note":"The specific waiting period applies. Other medical treatment of the donor after harvesting is not paid; the Transplantation of Human Organs Act must be complied with.","quote":"a) For the harvesting of the donated organ subject to plan opted and availability of the Sum Insured under Section ... c) We will pay the donor’s Pre and Post Hospitalization expenses. This is up to 5% of the claim amount approved in respect of harvesting expenses. ... e) This also has a waiting period. Waiting period shall be as per the “Specific Waiting Period” stated in Your Schedule ... II | Organ Donor Expenses | Upto Sum Insured | Upto Sum Insured | Upto Sum Insured | Upto Sum Insured | Upto Sum Insured | Not Applicable | Upto Sum Insured | Upto Sum Insured / NA","sources":[{"clause":"Section 2","heading":"ORGAN DONOR EXPENSES","page":17,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/45#c-section-2"},{"clause":"1","heading":null,"page":17,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/45#c-1-12"},{"clause":null,"heading":"Plan BASE COVERAGES","page":64,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/45#c-plan-base-coverages"}],"law":[]},{"key":"ambulance","label":"Ambulance cover","section":"Cover","meaning":"Road (and air) ambulance cover and its limit.","status":"cross-checked","value":"Road ambulance in an emergency: 1% of sum insured up to INR 10,000 (INR 15,000 in the Infinity Wallet Plan, INR 20,000 in the Carry Forward Sum Insured Plan) per policy year. Emergency air ambulance within India up to the sum insured in the Infinity Wallet, Carry Forward Sum Insured and Worldwide Treatment plans.","display":"1% of sum insured, max INR 10,000 to 20,000 (road); air ambulance in some plans","note":"Road ambulance only after an Emergency and an accepted in-patient claim. Air ambulance needs prior approval and is optional in BharatX. Optional Advance Heart Ambulance cover for cardiac emergencies.","quote":"v | Road Ambulance | 1% of Sum Insured max upto INR 10,000 | 1% of Sum Insured max upto INR 15,000 | 1% of Sum Insured max upto INR 20,000 | 1% of Sum Insured max upto INR 10,000 ... b) The maximum liability per Policy Year is restricted to the amount as mentioned in Your Policy Schedule. ... III | Emergency Air Ambulance | Not Applicable | Upto Sum Insured | Upto Sum Insured | Upto Sum Insured | Not Applicable | Not Applicable | Not Applicable | Upto Sum Insured / Not Applicable ... 3. The Air ambulance services will be limited within India only and NOT overseas in any condition whatsoever.","sources":[{"clause":null,"heading":"Plan BASE COVERAGES","page":64,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/45#c-plan-base-coverages"},{"clause":"1.5","heading":"Road Ambulance","page":13,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/45#c-1-5"},{"clause":null,"heading":"Conditions applicable to Emergency Air Ambulance","page":18,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/45#c-conditions-applicable-to-emergency-air-ambulance"}],"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":"cross-checked","value":"Sum Insured Back Up gives 100% of the sum insured again in the policy year, for related or unrelated illness: once a year in most plans, unlimited times in the Infinity Wallet and Carry Forward Sum Insured plans, and once for unrelated illness only in the Senior Priority Plan. It cannot be used for the same hospitalisation that exhausted the sum insured, and only in India.","display":"100% of sum insured; once or unlimited times by plan","note":"Any single claim is capped at the base sum insured. Floater policies use the back-up on a floater basis. BharatX: unlimited or once in a policy period, as chosen.","quote":"We shall provide you 100% of the Sum Insured as a backup under Section 1. Hospitalization Cover for that particular Policy Year ... a) The backup Sum Insured would be utilized if the cause of the Hospitalization is related or not related (as per plan opted) to or arising out of earlier Hospitalization ... c) If the first claim amount exceeds the Sum Insured under Section 1. Hospitalization Cover, the backup Sum Insured will not be utilized for the same hospitalisation. ... f) The Backup Sum Insured can only be utilized for hospitalization in India only. ... VI | Sum Insured Back-up | Upto Sum Insured Once in a policy period - related and unrelated illness | Upto Sum Insured Unlimited Reinstate ment in a policy period - related and unrelated illness | Upto Sum Insured Unlimited Reinstate ment in a policy period - related and unrelated illness | Upto Sum Insured Once in a policy period - related and unrelated illness | Upto Sum Insured Once in a policy period - related and unrelated illness | Upto Sum Insured Once in a policy period - Unrelated illness | Upto Sum Insured Once in a policy period - related and unrelated illness","sources":[{"clause":"Section 6","heading":"SUM INSURED BACK UP","page":21,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/45#c-section-6"},{"clause":"1","heading":null,"page":21,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/45#c-1-15"},{"clause":null,"heading":"Plan BASE COVERAGES","page":64,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/45#c-plan-base-coverages"}],"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 for each year with no claim under the hospitalisation cover: 10% of sum insured (Double Wallet, Early Start, Senior Priority), 20% (Even Protect) or 50% (Infinity Wallet, Worldwide Treatment), up to 100%; or a no claim discount on renewal premium instead. After a claim the bonus reduces the same way it accrued.","display":"10% to 50% of sum insured per claim-free year, max 100% (by plan)","note":"Not applicable to the Carry Forward Sum Insured Plan, which carries forward unused sum insured (up to 100% of base) instead. BharatX offers options from 5% up to 25% to 100% up to 600%. Optional Cumulative Bonus Protection and Infinite Cumulative Bonus covers change this.","quote":"If You’ve been safe and healthy and have had No Claims made under the Section 1. Hospitalization Cover in the expiring Policy Period, you would be eligible for Cumulative Bonus at the time of renewal ... In the event of a claim in the expiring policy period, the Cumulative Bonus will reduce in the same way as it was accrued in the policy at the time of renewal. ... 1 | Cumulative Bonus / No Claim Discount | 10% of sum insured per claim free year, Max upto | 50% of sum insured per claim free year, Max upto | Not Applicable / Discount on renewal premium | 50% of Sum Insured per claim free year, Max up to | 10% of sum insured per claim free year, Max upto | 10% of sum insured per claim free year, Max upto | 20% of sum insured per claim free year, Max upto ... 100%/ Discount on renewal premium","sources":[{"clause":null,"heading":"Cumulative Bonus","page":38,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/45#c-cumulative-bonus"},{"clause":"3","heading":null,"page":38,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/45#c-3-7"},{"clause":"Row 1","heading":"Cumulative Bonus / No Claim Discount","page":66,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/45#c-row-1-9"}],"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":"Not covered in the base policy; non-medical items listed in Annexure B are paid only if the optional Consumables Cover is bought.","display":"Not covered unless Consumables Cover is opted","note":"Consumables Cover pays up to the % of sum insured in the schedule and does not apply to worldwide treatment.","quote":"Expenses incurred on personal comfort during and related to hospitalisation as mentioned in Annexure B are covered only if the optional cover “Consumables Cover” is opted. ... we will compensate for non-medical expenses incurred by You (You can check them under Annexure B below) during the Policy period directly related to the Your medical or surgical treatment of illness/disease/injury. ... iii) Consumable cover should not be applicable for worldwide treatment.","sources":[{"clause":null,"heading":"25. Non-Medical Expenses","page":46,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/45#c-25-non-medical-expenses"},{"clause":"1","heading":"Optional Cover 1: Consumables Cover","page":23,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/45#c-1-17"}],"law":[]},{"key":"maternity","label":"Maternity cover","section":"Cover","meaning":"Whether childbirth costs are covered, the limit and the waiting period.","status":"cross-checked","value":"Under the Early Start Plan (and optionally BharatX), the Maternity Benefit Wallet pays delivery, complications and lawful termination: INR 15,000 in the first year, rising by INR 10,000 each claim-free year up to INR 1,00,000, after a 9-month waiting period, for up to two childbirths. Other plans exclude maternity unless Optional Cover 9 is bought.","display":"Early Start Plan: INR 15,000 rising to INR 1,00,000, 9-month wait","note":"After a maternity claim the wallet goes back to INR 15,000. Pre and post-natal expenses are not covered under the wallet. Optional Cover 9 (sum insured 30,000 to 5,00,000, waiting period 0 days to 4 years as chosen) is available in the other plans except Senior Priority.","quote":"We will pay the Maternity Expenses incurred towards the delivery of a baby and/or treatment related to any complication of pregnancy or medically necessary and lawful termination. ... Waiting period of 9 months shall apply from the date of inception of the first policy with us ... c) The maternity benefit in this policy is limited to cover up to two childbirth events. ... i) Maternity Sum Insured under this section will be INR 15,000 for First Policy Year. ... iii) Third year onwards if no claim has been made under this section, then the Maternity Sum Insured will increase every year by INR 10,000 per policy year, subject to maximum of INR 1,00,000. ... iv) In case of a claim under this section, Maternity Sum Insured on renewal/ next policy year will go back to INR 15,000. ... IV | Maternity Benefit Wallet and New-born Cover | Not Applicable | Not Applicable | Not Applicable | Not Applicable | INR 15,000 it will increase by INR 10,000 per year maximum upto INR 1,00,000 | Not Applicable | Not Applicable | INR 15,000 it will increase by INR 10,000 per year maximum upto INR 1,00,000/ Not Applicable ... 9 | Maternity & New Born Baby Cover | Available | Available | Available | Available | Not Available | Not Available | Available | Available/ Not Available ... Optional Cover 9: Maternity Benefit and New- Born Baby Cover | 0 days, 6 months, 9 months, 1 year, 2 years, 3 years and 4 years. ... 9. Maternity & New Born Cover | 30,000 | 5,00,000 ... Maternity: Code Excl18 ... Please note: This exclusion stands deleted to the extent of the coverage provided under SECTION 4. MATERNITY BENEFIT WALLET & NEWBORN COVER and or Optional cover 9. Maternity & Newborn Baby Cover, if opted by You.","sources":[{"clause":null,"heading":"A. Maternity Benefit Wallet","page":18,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/45#c-a-maternity-benefit-wallet"},{"clause":"Section 4(e)(i)","heading":null,"page":19,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/45#c-section-4-e-i"},{"clause":"Section 4(e)(iii)","heading":null,"page":19,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/45#c-section-4-e-iii"},{"clause":"Section 4(e)(iv)","heading":null,"page":19,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/45#c-section-4-e-iv"},{"clause":"18","heading":"Maternity: Code Excl18","page":45,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/45#c-18-3"},{"clause":"18(b)","heading":null,"page":45,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/45#c-18-b"},{"clause":null,"heading":"Plan BASE COVERAGES","page":64,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/45#c-plan-base-coverages"},{"clause":"Row 2","heading":"Network Hospital Discount","page":65,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/45#c-row-2-6"},{"clause":null,"heading":"OPTIONAL COVERS","page":32,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/46#c-optional-covers-3"},{"clause":null,"heading":"What are the waiting period and survival periods under this Policy?","page":33,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/46#c-what-are-the-waiting-period-and-survival-periods"}],"law":[]},{"key":"newborn","label":"Newborn baby cover","section":"Cover","meaning":"Whether a newborn is covered from birth and for what.","status":"cross-checked","value":"Only where the Maternity Benefit Wallet applies (Early Start Plan, or BharatX if chosen) and a maternity claim is accepted: treatment of the newborn during the delivery stay, hospitalisation for complications and vaccinations, up to 90 days from delivery, within the maternity sum insured. After 90 days the baby must be added to the policy.","display":"Early Start Plan only: up to 90 days from delivery, within the maternity wallet","note":"Not covered in the Double Wallet, Infinity Wallet, Carry Forward Sum Insured, Worldwide Treatment, Senior Priority and Even Protect plans unless Optional Cover 9 Maternity & Newborn Baby Cover is bought (not available in Senior Priority); under Optional Cover 9, vaccinations continue until age 5 once the baby is added as an insured person.","quote":"Under this cover, we will also pay the Medical Expenses, within the limit of the Sum Insured available under the Section 4.A Maternity Benefit Wallet Section of the Policy, provided that We have accepted a claim under Section 4.A Maternity Benefit Wallet, incurred towards:\na) The medical treatment of the Insured Person’s New Born Baby while the Insured Person is hospitalised as an inpatient for delivery.\nb) The New Born Baby’s hospitalisation charges as a result of any medical complications, up to 90 Days from the date of delivery.\nc) Reasonable and Customary Charges for the Vaccinations of the New Born Baby as per National Immunization Schedule as defined by Government of India, up to 90 Days from the date of delivery. ... e) After 90 Days from the date of delivery, the New Born Baby will be covered under the existing Policy only if it is Endorsed with the New Born Baby as an Insured Person. ... once the New Born Baby is added as an Insured Person under the Policy, We will pay the Reasonable and Customary Charges for the Vaccinations of the New Born Baby as per National Immunization Schedule as defined by Government of India until the New Born Baby attains 5 Years of age ... IV | Maternity Benefit Wallet and New-born Cover | Not Applicable | Not Applicable | Not Applicable | Not Applicable | INR 15,000 it will increase by INR 10,000 per year maximum upto INR 1,00,000 | Not Applicable | Not Applicable | INR 15,000 it will increase by INR 10,000 per year maximum upto INR 1,00,000/ Not Applicable","sources":[{"clause":null,"heading":"B. New-born Cover","page":19,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/45#c-b-new-born-cover"},{"clause":"9(c)","heading":null,"page":27,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/45#c-9-c-2"},{"clause":null,"heading":"Plan BASE COVERAGES","page":64,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/45#c-plan-base-coverages"}],"law":[]},{"key":"mental_illness","label":"Mental illness","section":"Cover","meaning":"Cover for in-patient treatment of mental illness.","status":"cross-checked","value":"In-patient treatment of psychiatric illness is covered up to the sum insured when first diagnosed and hospitalised during the policy period. The specific waiting period applies to listed disorders, and prior approval is needed except in emergencies.","display":"Covered in-patient, up to sum insured","note":"Out-patient psychiatric consultation is covered only under the optional Out-Patient Benefit Cover.","quote":"We will pay for the Medical Expenses, related to Psychiatric Illness, provided that: ... a) The first diagnosis and Hospitalization, as an inpatient, was during the Policy Period. ... b) Waiting period for this cover for the below mentioned ICD codes shall be as per the ‘“Specific Waiting Period’” stated in Your Schedule ... d) Hospitalization under this benefit shall be subject to prior approval from Us, except in cases of emergencies. ... vii | Psychiatric Illness | Upto Sum Insured","sources":[{"clause":"1.7","heading":"Psychiatric Illness","page":15,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/45#c-1-7"},{"clause":"1.7(a)","heading":null,"page":15,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/45#c-1-7-a"},{"clause":"1.7(b)","heading":null,"page":15,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/45#c-1-7-b"},{"clause":"1.7(d)","heading":null,"page":15,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/45#c-1-7-d"},{"clause":null,"heading":"Plan BASE COVERAGES","page":64,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/45#c-plan-base-coverages"}],"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":"cross-checked","value":"0.25% of sum insured, up to INR 1,000 every two years (Double Wallet, Even Protect, BharatX), INR 1,500 every year (Infinity Wallet, Early Start, Senior Priority) or INR 2,000 every year (Carry Forward Sum Insured, Worldwide Treatment). Paid in addition to the sum insured; unused amounts lapse.","display":"0.25% of sum insured, up to INR 1,000 to 2,000, yearly or every two years by plan","note":"Optional Health Check-up Cover from Day One adds a package (Package 1 to 6) from the first day.","quote":"viii | Health Check-up | 0.25% of Sum Insured max upto INR 1,000 after every two year | 0.25% of Sum Insured max upto INR 1,500 after every year | 0.25% of Sum Insured max upto INR 2,000 after every year | 0.25% of Sum Insured max upto INR 2,000 after every year | 0.25% of Sum Insured max upto INR 1,500 after every year | 0.25% of Sum Insured max upto INR 1,500 after every year | 0.25% of Sum Insured max upto INR 1,000 after every two year | 0.25% of Sum Insured max upto INR 1,000 after every two year ... Please Note- Payment under this benefit won’t be deducted from Your Sum Insured. It is additional. ... a) This benefit will not be carried forward if not utilized.","sources":[{"clause":null,"heading":"Plan BASE COVERAGES","page":64,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/45#c-plan-base-coverages"},{"clause":"1.8","heading":"Health Check Up","page":15,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/45#c-1-8"}],"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":"Not covered in the base policy. The optional Out-Patient Benefit Cover pays consultations, diagnostics, minor procedures, medicines, dental, hearing aids and psychiatric consultation from network practitioners, with a sum insured of 2500 to 50000.","display":"Not covered unless Out-Patient Benefit Cover is opted","note":null,"quote":"Note - This is NOT OPD: Treatment normally taken on an out-patient basis is NOT included in the scope of this Cover. ... If You have opted for this Optional Cover, We will pay the Reasonable and Customary Charges for below mentioned expenses incurred by You as an Allopathic Out-patient when treatment is taken from a Network Medical Practitioner ... 15. Out - Patient Benefit Cover | 2500 | 50000","sources":[{"clause":"1.2","heading":"Day Care Procedures","page":12,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/45#c-1-2-2"},{"clause":null,"heading":"You are not hospitalized are covered under this!","page":29,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/45#c-you-are-not-hospitalized-are-covered-under-this"},{"clause":null,"heading":"OPTIONAL COVERS","page":32,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/46#c-optional-covers-3"}],"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":"cross-checked","value":"Yes. Premium depends on the zone of residence: Zone 1 is Delhi/NCR, Mumbai (with Navi Mumbai, Thane and Kalyan) and Greater Hyderabad; Zone 2 is the rest of India, with a 10% City Discount. A 10% co-pay applies if you are treated in a higher zone without address proof matching the zone paid for (not for accidents).","display":"Yes, two zones; 10% co-pay for treatment in a higher zone in some cases","note":"You may upgrade your zone at inception or renewal but may not downgrade it.","quote":"Based on your city of residence, we have classified you within two Zones. ... Zone 1 Delhi/NCR, Mumbai including (Navi Mumbai, Thane and Kalyan), Greater Hyderabad Area Zone 2 Rest of India apart from Zone 1 cities are classified as Zone 2. ... In the absence of Address proof provided which validates the pricing zone opted, and if the place of hospitalization belongs to Higher Zone Category – then Co-pay of 10% would be applicable on admissible claim amount. ... Zone based Co-Pay, as mentioned above, will not be applicable in case of Accidental Injury. ... City Discount: 10% discount will be offered on Policy premium, if proposer opts for Zone 2","sources":[{"clause":null,"heading":"18. Zone wise Classification","page":53,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/45#c-18-zone-wise-classification"},{"clause":"7","heading":"City Discount","page":35,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/46#c-7-4"}],"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 hospitals only, through the insurer's Service Provider / TPA, after pre-authorisation. Reimbursement is available at any hospital in India. Treatment abroad is reimbursement only (cashless case by case).","display":"Yes, at network hospitals","note":null,"quote":"Cashless Facility can be availed from our network hospitals only. This is facilitated by our Service Provider / Third Party Administrator (TPA) and we would make a direct payment to the Network Hospital to the extent of Our Liability ... Reimbursement Facility can be availed from any hospital within India ... Claims will be payable on reimbursement basis only. For Cashless it will be decided on case-to-case basis.","sources":[{"clause":null,"heading":"23. Claims Notification and Procedure","page":54,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/45#c-23-claims-notification-and-procedure"},{"clause":"2(g)","heading":null,"page":54,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/45#c-2-g"},{"clause":"1","heading":null,"page":20,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/45#c-1-14"}],"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":"Claims are processed through the insurer's Service Provider / Third Party Administrator (TPA); the company settles or rejects the claim.","display":"Service Provider / TPA","note":"The TPA is not named; its contact details are on the health card / e-card.","quote":"This is facilitated by our Service Provider / Third Party Administrator (TPA) ... submit the documents to Service Provider / Third Party Administrator (TPA) for processing the reimbursement of the claim amount ... a) The Company shall settle or reject a claim, as the case may be, within 15 days from submission of claim.","sources":[{"clause":null,"heading":"23. Claims Notification and Procedure","page":54,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/45#c-23-claims-notification-and-procedure"},{"clause":"2(g)","heading":null,"page":54,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/45#c-2-g"},{"clause":"12(a)","heading":null,"page":51,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/45#c-12-a"}],"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":"Rate chart covers family compositions up to 2 adults and 4 children.","quote":"Sum Insured means the amount as per plan opted by You and stated in the Policy Schedule for each insured person including cumulative bonus (if any) for Individual Sum Insured Policy and aggregately for all insured members for a Floater Policy. ... Individual Sum Insured / Floater Sum Insured ... Family Composition - 2A+4C","sources":[{"clause":"2","heading":null,"page":7,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/45#c-2-2"},{"clause":"4","heading":"SUM INSURED BASIS","page":1,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/47#c-4"},{"clause":null,"heading":"Rate Chart of Base Coverage (Excluding GST)","page":50,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/46#c-rate-chart-of-base-coverage-excluding-gst"}],"law":[]}],"documents":[{"kind":"wording","label":"Policy Wordings - Digit Health Insurance Policy - GODHLIP25039V022425","pages":67,"fetched_at":"2026-10-16 06:29:31.193621+00","source_url":"https://www.godigit.com/content/dam/godigit/directportal/en/downloads/health/policy-wordings-digit-health-insurance-policy.pdf","url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/45"},{"kind":"prospectus","label":"Prospectus - Digit Health Insurance Policy - GODHLIP25039V022425","pages":119,"fetched_at":"2026-10-16 06:29:31.193621+00","source_url":"https://www.godigit.com/content/dam/godigit/directportal/en/downloads/health/prospectus-digit-health-insurance-policy.pdf","url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/46"},{"kind":"cis","label":"CIS - Digit Health Insurance Policy - GODHLIP25039V022425","pages":5,"fetched_at":"2026-10-16 06:29:31.193621+00","source_url":"https://www.godigit.com/content/dam/godigit/directportal/en/downloads/health/cis-digit-health-insurance-policy.pdf","url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425/document/47"}],"versions":[],"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":"Digit Health Insurance Policy (UIN GODHLIP25039V022425), IndiaInsurances, https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-insurance-policy-godhlip25039v022425"}