{"uin":"GODHLIP27048V052627","name":"Digit Health Care Plus Policy","url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-care-plus-policy-godhlip27048v052627","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":"Group","kind":"product","status":"active","approved_on":"2018-05-02","withdrawn_on":null,"summary":"Digit Health Care Plus Policy is a modular indemnity health policy from Go Digit General Insurance with 30 sections the buyer chooses, led by a Hospitalization Cover (accident and illness, or accident only) with sum insured from Rs. 10,000 to unlimited. Waiting periods, room rent limit, deductible and co-pay are chosen by the buyer, cover is India only unless extended for extra premium, and policy terms run 1 to 5 years.","analysis":{"state":"extracted","analysed_at":"2026-10-16 06:29:32.529534+00","note":"Every stated fact carries a verbatim quote found in the cited clause."},"facts":[{"key":"plan_variants","label":"Plans and variants","section":"Overview","meaning":"The named plans inside this product (not cover types or payout options). Facts can differ between them.","status":"not-stated","value":null,"display":null,"note":"No named plans: the buyer picks any of 30 sections. 'Plan A' to 'Plan F' in Annexure B only set which critical illnesses optional Sections 17 and 18 cover, and Health Check-up Packages 1 to 6 apply to optional Section 22.","quote":null,"sources":[],"law":[]},{"key":"policy_term","label":"Policy term","section":"Eligibility","meaning":"How long one policy runs before it ends or must be renewed.","status":"cross-checked","value":"1, 2, 3, 4 or 5 years.","display":"1 to 5 years","note":"Long-term discount: 7% for 2 years, 10% for 3, 12% for 4, 15% for 5 years (not with instalment premium).","quote":"The Policy Period Options are 1 Year, 2 Years, 3 Years, 4 Years and 5 Years.","sources":[{"clause":null,"heading":"What is the minimum and maximum policy period available under this policy?","page":46,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-care-plus-policy-godhlip27048v052627/document/52#c-what-is-the-minimum-and-maximum-policy-period-av"}],"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: at least 72 hours before a planned hospitalisation, or within 24 hours of an emergency admission. Reimbursement: 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.","sources":[{"clause":"7","heading":"Claims Notification and Procedure","page":59,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-care-plus-policy-godhlip27048v052627/document/51#c-7-7"},{"clause":"7(g)","heading":null,"page":59,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-care-plus-policy-godhlip27048v052627/document/51#c-7-g"}],"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","Original Hospital Main Bill","Original Hospital Bill Break Up","Original Pharmacy Bills","Prescriptions for the Medicines purchased (except hospital supply) 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)","Bank Details with Cancelled Cheque"],"display":"Claim form, discharge summary, medical records, original bills, prescriptions, reports, bank details and others","note":"List for a hospitalisation claim; OPD, critical illness/cancer and daily hospital cash claims need fewer documents. KYC needed where the payout exceeds Rs. 1 lakh per claim.","quote":"Duly Filled and Signed Claim form ... Discharge Summary ... Medical Records (Optional Documents may be asked on need basis: Indoor case papers, OT notes, PAC notes etc.) ... Original Hospital Main Bill ... Original Hospital Bill Break Up ... Original Pharmacy Bills ... Prescriptions for the Medicines purchased (except hospital supply) 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) ... Bank Details with Cancelled Cheque","sources":[{"clause":"Row 1","heading":"Duly Filled and Signed Claim form","page":60,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-care-plus-policy-godhlip27048v052627/document/51#c-row-1"},{"clause":"Row 2","heading":"Discharge Summary","page":60,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-care-plus-policy-godhlip27048v052627/document/51#c-row-2"}],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 17","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 22","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 23","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, V.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, V.3(iii)","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part C, V.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"}]},{"key":"claim_settlement_time","label":"Claim settlement time promised","section":"Claims","meaning":"How quickly the policy says a claim is decided or paid, and from when that is counted (intimation or last document).","status":"cross-checked","value":"The insurer settles or rejects a claim within 15 days from submission of the claim; if late, interest at bank rate plus 2 percent from the date of intimation.","display":"15 days from submission of claim","note":"CIS: cashless pre-authorisation within 1 hour of request; cashless final bill authorisation within 3 hours of the discharge request.","quote":"The Company shall settle or reject a claim, as the case may be, within 15 days from submission of claim. ... the claimant is entitled for interest at bank rate plus 2 percent from the date of receipt of intimation to till the date of payment.","sources":[{"clause":"12(a)","heading":null,"page":56,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-care-plus-policy-godhlip27048v052627/document/51#c-12-a"},{"clause":"12(b)","heading":null,"page":56,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-care-plus-policy-godhlip27048v052627/document/51#c-12-b"}],"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 (Excl01)","Specified disease/procedure waiting period (Excl02)","30-day waiting period/ Initial Waiting Period (Excl03)","Investigation & Evaluation (Excl04)","Cosmetic or plastic Surgery (Excl08)","Hazardous or Adventure sports (Excl09)","Breach of law (Excl10)","Alcoholism, drug or substance abuse or any addictive condition (Excl12)","Unproven Treatments (Excl16)","Sterility and Infertility (Excl17)","Maternity (Excl18)","Suicide and Self-Injury","Non-Medical Expenses","War and hazardous substances","Treatment outside India (Geographical Limits)"],"display":"Waiting-period exclusions, standard IRDAI exclusions and the policy's own (non-medical items, war, suicide, treatment abroad and others)","note":"Rest cure (Excl05), obesity (Excl06), change of gender (Excl07), defence operations and others are also excluded. Excl17 and Excl18 are deleted to the extent Sections 7 and 6 are bought; non-medical expenses are paid if Section 10 Consumable Cover is bought; cover abroad can be added for extra premium.","quote":"Pre-Existing Diseases - Code- Excl01 ... Specified disease/procedure waiting period- Code- Excl02 ... 3. 30-day waiting period/ Initial Waiting Period- Code- Excl03 ... Investigation & Evaluation- Code- Excl04 ... Cosmetic or plastic Surgery: Code- Excl08 ... Hazardous or Adventure sports: Code- Excl09 ... Breach of law: Code- Excl10 ... Treatment for, Alcoholism, drug or substance abuse or any addictive condition and consequences thereof. Code- ... Excl12 ... Unproven Treatments: Code- Excl16 ... Sterility and Infertility: Code- Excl17 ... Maternity: Code Excl18 ... 20. Suicide and Self-Injury ... 25. Non-Medical Expenses ... 31. War and hazardous substances ... This Policy covers all treatments received within India","sources":[{"clause":"1","heading":"Pre-Existing Diseases - Code- Excl01","page":48,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-care-plus-policy-godhlip27048v052627/document/51#c-1-7"},{"clause":"2","heading":"Specified disease/procedure waiting period- Code- Excl02","page":48,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-care-plus-policy-godhlip27048v052627/document/51#c-2-7"},{"clause":null,"heading":"3. 30-day waiting period/ Initial Waiting Period- Code- Excl03","page":49,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-care-plus-policy-godhlip27048v052627/document/51#c-3-30-day-waiting-period-initial-waiting-period-c"},{"clause":"4","heading":"Investigation & Evaluation- Code- Excl04","page":49,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-care-plus-policy-godhlip27048v052627/document/51#c-4-6"},{"clause":"8","heading":"Cosmetic or plastic Surgery: Code- Excl08","page":50,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-care-plus-policy-godhlip27048v052627/document/51#c-8-5"},{"clause":"9","heading":"Hazardous or Adventure sports: Code- Excl09","page":50,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-care-plus-policy-godhlip27048v052627/document/51#c-9-5"},{"clause":"10","heading":"Breach of law: Code- Excl10","page":50,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-care-plus-policy-godhlip27048v052627/document/51#c-10-5"},{"clause":"12","heading":null,"page":50,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-care-plus-policy-godhlip27048v052627/document/51#c-12-4"},{"clause":"Excl12","heading":null,"page":50,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-care-plus-policy-godhlip27048v052627/document/51#c-excl12"},{"clause":"16","heading":"Unproven Treatments: Code- Excl16","page":50,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-care-plus-policy-godhlip27048v052627/document/51#c-16-4"},{"clause":"17","heading":"Sterility and Infertility: Code- Excl17","page":50,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-care-plus-policy-godhlip27048v052627/document/51#c-17-4"},{"clause":"18","heading":"Maternity: Code Excl18","page":50,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-care-plus-policy-godhlip27048v052627/document/51#c-18-3"},{"clause":null,"heading":"20. Suicide and Self-Injury","page":51,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-care-plus-policy-godhlip27048v052627/document/51#c-20-suicide-and-self-injury"},{"clause":null,"heading":"25. Non-Medical Expenses","page":51,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-care-plus-policy-godhlip27048v052627/document/51#c-25-non-medical-expenses"},{"clause":null,"heading":"31. War and hazardous substances","page":52,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-care-plus-policy-godhlip27048v052627/document/51#c-31-war-and-hazardous-substances"},{"clause":null,"heading":"23. Geographical Limits","page":51,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-care-plus-policy-godhlip27048v052627/document/51#c-23-geographical-limits"}],"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 Digit through the website, toll free 1-800-258-4242, hello@godigit.com (seniors@godigit.com for senior citizens) or any branch grievance cell; if not satisfied, the grievance officer at grievance@godigit.com; then the Insurance Ombudsman.","display":"Digit customer care (1-800-258-4242, hello@godigit.com), then grievance officer (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 ... the insured person may also approach the office of Insurance Ombudsman","sources":[{"clause":"17","heading":"Customer Grievance Redressal Policy","page":57,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-care-plus-policy-godhlip27048v052627/document/51#c-17-5"}],"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":"Hospitalization Cover (Section 1A or 1B): from Rs. 10,000 up to Unlimited Sum Insured (more than Rs. 3 crore without any limitation). Individual or floater sum insured.","display":"Rs. 10,000 to Unlimited (above Rs. 3 crore)","note":"Other sections have their own limits, for example Maternity Rs. 10,000 to 5,00,000, OPD Rs. 2,500 to 50,000, critical illness and cancer covers up to Rs. 3,50,00,000. Unlimited premium = 1.15 x premium for Rs. 3 crore.","quote":"A. Accidental & Illness Hospitalization Cover | 10,000 | Unlimited Sum Insured ... Note: For this policy Unlimited Sum Insured means Sum Insured more than INR 3 crore without any limitation.","sources":[{"clause":"Section 1","heading":"HOSPITALIZATION COVER","page":47,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-care-plus-policy-godhlip27048v052627/document/52#c-section-1-3"},{"clause":"Section 30","heading":"WELLNESS BENEFIT PROGRAM | NA | NA","page":47,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-care-plus-policy-godhlip27048v052627/document/52#c-section-30-2"}],"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 (can be reduced to none, 2, 7 or 15 days as opted)","note":"Accidents are covered from day one. Not applicable if continuously covered for more than twelve months. Critical illness and cancer benefit covers have their own initial waiting period options (none, 30, 60 or 90 days).","quote":"Expenses related to the treatment of any illness within 30 days from the first policy commencement date shall be excluded except claims arising due to an accident ... such waiting Period can be reduced to number of days as opted by you ... Initial Waiting Period Option | No Initial Waiting Period, 2 days, 7 days, 15 days, 30 days","sources":[{"clause":null,"heading":"3. 30-day waiting period/ Initial Waiting Period- Code- Excl03","page":49,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-care-plus-policy-godhlip27048v052627/document/51#c-3-30-day-waiting-period-initial-waiting-period-c"},{"clause":null,"heading":"What are the waiting period and survival periods under this Policy?","page":48,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-care-plus-policy-godhlip27048v052627/document/52#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":"As opted: none, 3 months, 6 months, 1, 2 or 3 years","note":"Value is the longest option (3 years). Section 27 Fastrack, if bought, covers listed declared conditions (asthma, diabetes, hypertension and others) after 30 days.","quote":"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 opted by You and specified in the Policy Schedule ... Pre-existing Disease Waiting Period Options | No Pre-existing Disease Waiting Period,3 months,6 months, 1 Year, 2 Years, 3 Years,","sources":[{"clause":"1","heading":"Pre-Existing Diseases - Code- Excl01","page":48,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-care-plus-policy-godhlip27048v052627/document/51#c-1-7"},{"clause":null,"heading":"What are the waiting period and survival periods under this Policy?","page":48,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-care-plus-policy-godhlip27048v052627/document/52#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":"As opted: none, 3 months, 6 months, 1 or 2 years","note":"Value is the longest option (2 years); the shortest is none. Not applicable to accidents. Where a listed condition is also a pre-existing disease, the longer waiting period applies.","quote":"Expenses related to the treatment of the listed Conditions, surgeries/treatments shall be excluded until the expiry of number of months, as opted by You and specified in the Policy Schedule ... Specific Waiting period | No Specific Waiting Period, 3 months,6 months,1 Year, 2 years","sources":[{"clause":"2","heading":"Specified disease/procedure waiting period- Code- Excl02","page":48,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-care-plus-policy-godhlip27048v052627/document/51#c-2-7"},{"clause":null,"heading":"What are the waiting period and survival periods under this Policy?","page":48,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-care-plus-policy-godhlip27048v052627/document/52#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), Systemic Connective Tissue disorders, Dorsopathies, Spondylopathies, Inflammatory Polyarthropathies, Arthrosis and Intervertebral disorders","Pancreatitis, calculus disease of gall bladder/biliary tract and urogenital system, Gastric & Duodenal erosions/ulcers, Varices of GI tract, Cirrhosis of Liver, Rectal prolapse","Cataract, Glaucoma and Disorder of retina","Hyperplasia of Prostate, Urethral strictures, Hydrocele/Varicocele and spermatocele","All 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","Disease of middle ear and mastoid, Sinusitis, Tonsillitis, Adenoid hypertrophy, Nasal septum deviation, Turbinate hypertrophy, Nasal polyp and others","All internal and external benign or In Situ Neoplasms/Tumours, Cyst, Sinus, Polyp, Nodules, Swelling, Mass or Lump including breast lumps","Internal Congenital Anomaly","Psychiatric illness and Disorders (ICD F20-F29, F30-F39, F40-F48, F99)","Neurodegenerative disorders including Alzheimer's disease and Parkinson's disease","Joint Replacement, Bariatric Surgery and Organ Transplant"],"display":"Joint, digestive, eye, prostate, gynaecological, ENT, hernia, varicose veins, benign growths, psychiatric, neurodegenerative conditions and joint replacement, bariatric surgery, organ transplant","note":"The internal congenital anomaly waiting period does not apply to new born babies.","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. ... xii) Psychiatric illness and Disorders listed below: ... F20-F29 | Schizophrenia, schizotypal and delusional disorders F30-F39 | Mood [affective] disorders F40-F48 | Neurotic, stress-related and somatoform disorders F99-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":48,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-care-plus-policy-godhlip27048v052627/document/51#c-2-7"}],"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 60 months run from the date of enhancement, on the enhanced part only.","quote":"After completion of sixty continuous months of coverage (including portability and migration) in health insurance policy, no policy and claim shall be contestable by the insurer on grounds of non-disclosure, misrepresentation, except on grounds of established fraud.","sources":[{"clause":"7","heading":"Moratorium Period","page":55,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-care-plus-policy-godhlip27048v052627/document/51#c-7-6"}],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 13","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, IV.8","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 8","url":"https://indiainsurances.com/law/irdai-products-regs-2024"}]},{"key":"portability","label":"Portability","section":"Renewal and rights","meaning":"Whether you can move this policy to another insurer and keep waiting-period credit.","status":"cross-checked","value":"Yes. The policyholder can port to another insurer and transfer credits for sum insured, No Claim Bonus, specific waiting periods, pre-existing disease waiting period and moratorium.","display":"Yes, with credit for waiting periods","note":"Applies to indemnity based sections. Migration to another Digit policy also carries the credits.","quote":"A Policyholder has the choice to port his/ her policies from one Insurer to another. ... 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":57,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-care-plus-policy-godhlip27048v052627/document/51#c-15-a"},{"clause":"15(d)","heading":null,"page":57,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-care-plus-policy-godhlip27048v052627/document/51#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 policy 'shall ordinarily be renewable' and renewal cannot be denied for claims, and the prospectus shows no maximum entry age, but no document says renewal is lifelong or states 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.","display":"No loading for claims","note":"Renewal shall not be denied on the ground of claims made in earlier years.","quote":"No loading shall apply on renewals based on individual claims experience.","sources":[{"clause":"14(iii)","heading":null,"page":57,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-care-plus-policy-godhlip27048v052627/document/51#c-14-iii"}],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 10","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, IV.5","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 9","url":"https://indiainsurances.com/law/irdai-products-regs-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 4","url":"https://indiainsurances.com/law/irdai-products-regs-2024"},{"title":"Review of revision in premium rates under health insurance policies for senior citizens, 2025","section":"Para 7","url":"https://indiainsurances.com/law/irdai-senior-premium-2025"}]},{"key":"permanent_exclusions","label":"Permanent exclusions","section":"Exclusions","meaning":"Conditions or treatments that are never covered: the standard IRDAI exclusion codes Excl04 to Excl18 and the product's own permanent exclusions. Excl01 to Excl03 are waiting periods, not permanent exclusions.","status":"cross-checked","value":["Investigation & Evaluation (Excl04)","Rest Cure, rehabilitation and respite care (Excl05)","Obesity/ Weight Control (Excl06)","Change-of-Gender treatments (Excl07)","Cosmetic or plastic Surgery (Excl08)","Hazardous or Adventure sports (Excl09)","Breach of law (Excl10)","Excluded Providers (Excl11)","Alcoholism, drug or substance abuse or any addictive condition (Excl12)","Treatments received in heath hydros, nature cure clinics, spas or similar establishments (Excl13)","Dietary supplements and substances that can be purchased without prescription (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","Stem Cell Transplant other than for Bone Marrow Transplant","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 NOT implanted internally by surgery","Predictive Genome testing"],"display":"IRDAI exclusions Excl04 to Excl18 plus the policy's own specific exclusions","note":"Excl17, Excl18, non-medical expenses, dental treatment, organ donor and weight loss surgery exclusions are lifted to the extent the matching optional sections are bought. Cover is India only unless the geographical extension is bought.","quote":"Investigation & Evaluation- Code- Excl04 ... Rest Cure, rehabilitation and respite care- Code- Excl05 ... Obesity/ Weight Control: Code- Excl06 ... Change-of-Gender treatments: Code- Excl07 ... Cosmetic or plastic Surgery: Code- Excl08 ... Hazardous or Adventure sports: Code- Excl09 ... Breach of law: Code- Excl10 ... Excluded Providers: Code- Excl11 ... Treatment for, Alcoholism, drug or substance abuse or any addictive condition and consequences thereof. Code- ... Excl12 ... Treatments received in heath hydros, nature cure clinics, spas or similar establishments ... Code- Excl13 ... Dietary supplements and substances that can be purchased without prescription ... Code- Excl14 ... 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 ... 27. Preventive Treatment ... 28. Spectacles, Hearing aids & other Expenses ... 29. Stem Cell Transplant: Any stem cell transplant other than for Bone Marrow Transplant ... 30. Unjustified or Unwarranted Hospitalization ... 31. War and hazardous substances ... 32. Legal Liability ... 33. Substance abuse and Addictions by the Insured ... 34. Ear, Eyesight & Optical Services ... Prosthetics and other devices NOT implanted internally by surgery. ... Predictive Genome testing","sources":[{"clause":"4","heading":"Investigation & Evaluation- Code- Excl04","page":49,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-care-plus-policy-godhlip27048v052627/document/51#c-4-6"},{"clause":"5","heading":"Rest Cure, rehabilitation and respite care- Code- Excl05","page":49,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-care-plus-policy-godhlip27048v052627/document/51#c-5-6"},{"clause":"6","heading":"Obesity/ Weight Control: Code- Excl06","page":49,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-care-plus-policy-godhlip27048v052627/document/51#c-6-5"},{"clause":"7","heading":"Change-of-Gender treatments: Code- Excl07","page":49,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-care-plus-policy-godhlip27048v052627/document/51#c-7-5"},{"clause":"8","heading":"Cosmetic or plastic Surgery: Code- Excl08","page":50,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-care-plus-policy-godhlip27048v052627/document/51#c-8-5"},{"clause":"9","heading":"Hazardous or Adventure sports: Code- Excl09","page":50,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-care-plus-policy-godhlip27048v052627/document/51#c-9-5"},{"clause":"10","heading":"Breach of law: Code- Excl10","page":50,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-care-plus-policy-godhlip27048v052627/document/51#c-10-5"},{"clause":"11","heading":"Excluded Providers: Code- Excl11","page":50,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-care-plus-policy-godhlip27048v052627/document/51#c-11-4"},{"clause":"12","heading":null,"page":50,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-care-plus-policy-godhlip27048v052627/document/51#c-12-4"},{"clause":"Excl12","heading":null,"page":50,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-care-plus-policy-godhlip27048v052627/document/51#c-excl12"},{"clause":"13","heading":null,"page":50,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-care-plus-policy-godhlip27048v052627/document/51#c-13-4"},{"clause":"14","heading":null,"page":50,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-care-plus-policy-godhlip27048v052627/document/51#c-14-4"},{"clause":"15","heading":"Refractive Error: Code- Excl15","page":50,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-care-plus-policy-godhlip27048v052627/document/51#c-15-4"},{"clause":"16","heading":"Unproven Treatments: Code- Excl16","page":50,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-care-plus-policy-godhlip27048v052627/document/51#c-16-4"},{"clause":"17","heading":"Sterility and Infertility: Code- Excl17","page":50,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-care-plus-policy-godhlip27048v052627/document/51#c-17-4"},{"clause":"18","heading":"Maternity: Code Excl18","page":50,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-care-plus-policy-godhlip27048v052627/document/51#c-18-3"},{"clause":null,"heading":"19. Artificial Life Maintenance","page":51,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-care-plus-policy-godhlip27048v052627/document/51#c-19-artificial-life-maintenance"},{"clause":null,"heading":"20. Suicide and Self-Injury","page":51,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-care-plus-policy-godhlip27048v052627/document/51#c-20-suicide-and-self-injury"},{"clause":null,"heading":"21.Circumcision, Aesthetic reasons","page":51,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-care-plus-policy-godhlip27048v052627/document/51#c-21-circumcision-aesthetic-reasons"},{"clause":null,"heading":"22. External Congenital Anomaly","page":51,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-care-plus-policy-godhlip27048v052627/document/51#c-22-external-congenital-anomaly"},{"clause":null,"heading":"24. Defence Operation","page":51,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-care-plus-policy-godhlip27048v052627/document/51#c-24-defence-operation"},{"clause":null,"heading":"25. Non-Medical Expenses","page":51,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-care-plus-policy-godhlip27048v052627/document/51#c-25-non-medical-expenses"},{"clause":null,"heading":"27. Preventive Treatment","page":52,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-care-plus-policy-godhlip27048v052627/document/51#c-27-preventive-treatment"},{"clause":null,"heading":"28. Spectacles, Hearing aids & other Expenses","page":52,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-care-plus-policy-godhlip27048v052627/document/51#c-28-spectacles-hearing-aids-other-expenses"},{"clause":null,"heading":"30. Unjustified or Unwarranted Hospitalization","page":52,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-care-plus-policy-godhlip27048v052627/document/51#c-30-unjustified-or-unwarranted-hospitalization"},{"clause":null,"heading":"31. War and hazardous substances","page":52,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-care-plus-policy-godhlip27048v052627/document/51#c-31-war-and-hazardous-substances"},{"clause":null,"heading":"32. Legal Liability","page":52,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-care-plus-policy-godhlip27048v052627/document/51#c-32-legal-liability"},{"clause":null,"heading":"33. Substance abuse and Addictions by the Insured","page":52,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-care-plus-policy-godhlip27048v052627/document/51#c-33-substance-abuse-and-addictions-by-the-insured"},{"clause":null,"heading":"34. Ear, Eyesight & Optical Services","page":52,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-care-plus-policy-godhlip27048v052627/document/51#c-34-ear-eyesight-optical-services"},{"clause":null,"heading":"35. Prosthetics and other devices","page":52,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-care-plus-policy-godhlip27048v052627/document/51#c-35-prosthetics-and-other-devices"},{"clause":"1(a)","heading":null,"page":53,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-care-plus-policy-godhlip27048v052627/document/51#c-1-a-2"}],"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":"Cancel any time with 7 days' written notice. For a policy of up to one year with no claim, proportionate premium for the unexpired period is refunded; for terms over 1 year, premium for policy years whose cover has not started is refunded.","display":"Proportionate refund if no claim (7 days' notice)","note":"The wording gives no refund rule for a policy of up to one year where a claim has been made.","quote":"You may cancel your policy at any time during the term, by giving 7 days notice to us in writing. We shall a) 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. b) 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 A. Cancellation by You","page":55,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-care-plus-policy-godhlip27048v052627/document/51#c-8-6"}],"law":[{"title":"The Insurance Act, 1938","section":"Section 64VB","url":"https://indiainsurances.com/law/insurance-act-1938"},{"title":"Master Circular on General Insurance Business, 2024","section":"Ch I, Para 8","url":"https://indiainsurances.com/law/irdai-general-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 6","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Life Insurance Products, 2024","section":"Chapter 1, Para 5","url":"https://indiainsurances.com/law/irdai-life-products-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 17","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 20(3) to 20(5)","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, III.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, IV.4","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part C, IV.3","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"}]},{"key":"territory","label":"Where it covers","section":"Overview","meaning":"Geographic area of cover: India only, worldwide, or listed countries. 'As stated in the schedule' is not an answer.","status":"cross-checked","value":"India only. On payment of additional premium cover can be extended to Asia, Worldwide excluding USA & Canada, or Worldwide including USA & Canada.","display":"India (worldwide extension for extra premium)","note":"Treatment abroad needs prior approval and carries an additional co-payment as opted. Air ambulance is within India only.","quote":"This Policy covers all treatments received within India and Our liability will be to make Payment Indian Rupees Only. However, on payment of additional premium, the Geographical Limits can be extended to Asia / Worldwide Excluding USA & Canada / Worldwide Including USA & Canada","sources":[{"clause":null,"heading":"23. Geographical Limits","page":51,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-care-plus-policy-godhlip27048v052627/document/51#c-23-geographical-limits"}],"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 proportionate risk premium if cover has started). CIS says '30 days from the beginning of the policy'.","quote":"The insured person shall be allowed free look period of thirty (30) from date of receipt of the policy document, whether received electronically or otherwise, to review the terms and conditions of the policy, and to return the same if not acceptable.","sources":[{"clause":"9","heading":"Free Look Period","page":55,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-care-plus-policy-godhlip27048v052627/document/51#c-9-6"}],"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 instalments)","note":null,"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. ... can be renewed within the Grace Period of 30 days to maintain continuity of benefits without break in policy.","sources":[{"clause":"4","heading":"Special Conditions Applicable for Policies issued with premium Payment on Instalment basis","page":54,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-care-plus-policy-godhlip27048v052627/document/51#c-4-7"},{"clause":"14(iii)","heading":null,"page":57,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-care-plus-policy-godhlip27048v052627/document/51#c-14-iii"}],"law":[{"title":"The Insurance Act, 1938","section":"Section 50","url":"https://indiainsurances.com/law/insurance-act-1938"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 8","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 9","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Life Insurance Products, 2024","section":"Chapter 1, Para 8","url":"https://indiainsurances.com/law/irdai-life-products-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, IV.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, IV.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Para 3","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule I, Para 1.2","url":"https://indiainsurances.com/law/irdai-products-regs-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 1.3","url":"https://indiainsurances.com/law/irdai-products-regs-2024"}]},{"key":"eligibility_entry_age","label":"Entry age","section":"Eligibility","meaning":"The youngest and oldest age at which you can buy this policy.","status":"cross-checked","value":"Adults (proposer and insured) from 18 years; children from 91 days. No maximum entry age.","display":"18 years (child 91 days) to no limit","note":"For critical illness cover the child minimum is 181 days.","quote":"Hospitalization Cover & Daily Hospital Cash Cover | Proposer | 18yrs | No Limit Child | 91days | No Limit Adult Insured | 18yrs | No Limit","sources":[{"clause":null,"heading":"What are the Minimum & Maximum Entry age for Adults & Children?","page":46,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-care-plus-policy-godhlip27048v052627/document/52#c-what-are-the-minimum-maximum-entry-age-for-adult"}],"law":[]},{"key":"premium_modes","label":"Premium payment options","section":"Premium","meaning":"How often you can pay: yearly, half-yearly, quarterly, monthly.","status":"cross-checked","value":["Half Yearly","Quarterly","Monthly"],"display":"Half-yearly, quarterly or monthly instalments","note":"Otherwise the premium is paid for the policy period (1 to 5 years); 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","sources":[{"clause":"4","heading":"Special Conditions Applicable for Policies issued with premium Payment on Instalment basis","page":54,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-care-plus-policy-godhlip27048v052627/document/51#c-4-7"}],"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":["Post Hospitalization Lumpsum Benefit","Organ Donor","Emergency Air Ambulance","Home (Domiciliary) Hospitalization","Maternity Benefit & New Born Baby Cover","Infertility Treatment Cover","Out-Patient (OPD) Benefit","Second Medical Opinion","Consumable Cover","Unused Sum Insured Benefit","Sum Insured Refill Benefit","Daily Hospital Cash Cover","Daily Cash for Accompanying an Insured Child","Long Hospitalization Cash Benefit","Loss of Income Cover","Critical Illness Benefit Cover","Critical Illness Hospitalization Cover","Cancer Benefit Cover","Cancer Hospitalization Cover","Woman Cancer Benefit","Health Checkup Cover from Day One","Advance Heart Ambulance","Advance Care","SI Multiplier","Support Plus","Fastrack","Cumulative Bonus Protection Cover","Smart Save","Wellness Benefit Program","Geographical extension to Asia / Worldwide"],"display":"Sections chosen by the buyer, from post-hospitalisation lump sum to wellness programme, plus cover abroad","note":"Section 1 Hospitalization Cover is bought as A (accident and illness) or B (accident only). Other options include a voluntary deductible, voluntary co-payment, Preferred Care (network-only) and the choice of waiting periods.","quote":"You can choose any one or more sections from the sections available under the product: ... SECTION 2. POST HOSPITALIZATION LUMPSUM BENEFIT ... SECTION 3. ORGAN DONOR ... SECTION 4. EMERGENCY AIR AMBULANCE ... SECTION 5. HOME (DOMICILIARY) HOSPITALIZATION ... SECTION 6. MATERNITY BENEFIT & NEW BORN BABY COVER ... SECTION 7. INFERTILITY TREATMENT COVER ... SECTION 8. OUT-PATIENT (OPD) BENEFIT ... SECTION 9. SECOND MEDICAL OPINION ... SECTION 10. CONSUMABLE COVER ... SECTION 11. UNUSED SUM INSURED BENEFIT ... SECTION 12. SUM INSURED REFILL BENEFIT ... SECTION 13. DAILY HOSPITAL CASH COVER ... SECTION 14. DAILY CASH FOR ACCOMPANYING AN INSURED CHILD ... SECTION 15. LONG HOSPITALIZATION CASH BENEFIT ... SECTION 16. LOSS OF INCOME COVER ... SECTION 17. CRITICAL ILLNESS BENEFIT COVER ... SECTION 18. CRITICAL ILLNESS HOSPITALIZATION COVER ... SECTION 19. CANCER BENEFIT COVER ... SECTION 20. CANCER HOSPITALIZATION COVER ... SECTION 21. WOMAN CANCER BENEFIT ... SECTION 22. HEALTH CHECKUP COVER FROM DAY ONE ... SECTION 23. ADVANCE HEART AMBULANCE ... SECTION 24. ADVANCE CARE ... SECTION 25. SI MULTIPLIER ... SECTION 26. SUPPORT PLUS ... SECTION 27. FASTRACK ... SECTION 28. CUMULATIVE BONUS PROTECTION COVER ... SECTION 29. SMART SAVE ... SECTION 30. WELLNESS BENEFIT PROGRAM ... on payment of additional premium, the Geographical Limits can be extended to Asia / Worldwide Excluding USA & Canada / Worldwide Including USA & Canada","sources":[{"clause":null,"heading":"What is covered under Digit Health Care Plus Policy?","page":1,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-care-plus-policy-godhlip27048v052627/document/52#c-what-is-covered-under-digit-health-care-plus-pol"},{"clause":null,"heading":"Table of Contents","page":1,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-care-plus-policy-godhlip27048v052627/document/51#c-table-of-contents"},{"clause":null,"heading":"23. Geographical Limits","page":51,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-care-plus-policy-godhlip27048v052627/document/51#c-23-geographical-limits"}],"law":[]},{"key":"grace_cover","label":"Cover during the grace period","section":"Renewal and rights","meaning":"Whether a claim during the grace period is paid.","status":"cross-checked","value":"No. Coverage is not available during the grace period.","display":"Not covered during grace period","note":"The Grace Period definition in the same wording says insurers shall offer coverage during the grace period if premium is paid in instalments, which contradicts the instalment condition.","quote":"Coverage is not available during the grace period. ... During such Grace Period, Coverage will not be available from the instalment premium payment due date till the date of receipt of premium by company.","sources":[{"clause":"14(iii)","heading":null,"page":57,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-care-plus-policy-godhlip27048v052627/document/51#c-14-iii"},{"clause":"4","heading":"Special Conditions Applicable for Policies issued with premium Payment on Instalment basis","page":54,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-care-plus-policy-godhlip27048v052627/document/51#c-4-7"}],"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":"As opted: a room rent limit of 1%, 1.5% or 2% of the Section 1 sum insured per day, or no limit (or a room type restriction).","display":"1%, 1.5% or 2% of sum insured per day, or no limit, as opted","note":"Same options for Sections 1B, 18 and 20. A daily cash is paid for choosing shared accommodation.","quote":"Hospital accommodation in a ward, shared, twin sharing room or private room subject to a Limit Per Day as opted by You and mentioned in Your Policy Schedule against this Cover. ... Accommodation/Room Rent: 1%, 1.5% or 2% or No Limit (as a % of Section 1.A Sum Insured)","sources":[{"clause":null,"heading":"A. Accidental & Illness Hospitalization Cover","page":8,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-care-plus-policy-godhlip27048v052627/document/51#c-a-accidental-illness-hospitalization-cover"},{"clause":"Section 1","heading":"HOSPITALIZATION COVER","page":48,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-care-plus-policy-godhlip27048v052627/document/52#c-section-1-4"}],"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":"As opted: ward, shared, twin sharing or private room (room type restriction), or a per-day limit instead.","display":"Ward, shared, twin sharing or private room, as opted","note":null,"quote":"Hospital accommodation in a ward, shared, twin sharing room or private room base on the room type opted by you or subject to a Limit Per Day as opted by You and mentioned in Your Policy Schedule against this Cover.","sources":[{"clause":null,"heading":"B. Accidental Hospitalization Cover","page":12,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-care-plus-policy-godhlip27048v052627/document/51#c-b-accidental-hospitalization-cover"}],"law":[]},{"key":"icu_limit","label":"ICU limit","section":"Limits and co-pay","meaning":"The most the policy pays per day for intensive care.","status":"not-stated","value":null,"display":null,"note":"ICU charges are listed as covered under Section 1; no per-day ICU limit is printed in the sub-limit table.","quote":null,"sources":[],"law":[]},{"key":"proportionate_deduction","label":"Proportionate deduction","section":"Limits and co-pay","meaning":"If you choose a room above your limit, whether the insurer reduces associated charges (doctor fees, tests, procedures) by the same proportion.","status":"cross-checked","value":"Yes. If the room exceeds the opted rent limit or room type, the claim is reduced in the same proportion, except for medicines and consumables, unless waived in the schedule.","display":"Yes, except medicines and consumables","note":null,"quote":"our liability will be restricted to the same proportion as the Admissible Rate Per Day Limit Opted bears to the Actual Rate Per Day of Room Rent Charges except for the cost of medicines and consumables, unless this condition is specifically waived off and mentioned in Your Policy Schedule.","sources":[{"clause":null,"heading":"A. Accidental & Illness Hospitalization Cover","page":8,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-care-plus-policy-godhlip27048v052627/document/51#c-a-accidental-illness-hospitalization-cover"}],"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":"Zone-based co-pay only: 10% or 20% of the admissible claim when treated in a hospital in a higher-cost zone than the one chosen (not for accidental injury). Any other co-pay applies only if opted.","display":"10% or 20% if treated in a higher-cost zone than chosen (not for accidents); otherwise none unless opted","note":"An optional co-pay of 0% to 50% can be chosen for Section 1 (prospectus table). Preferred Care option: 20% on a non-accidental claim at a non-network hospital. OPD Basis 1: 25% in the first year, 10% on first renewal. Treatment abroad carries an additional co-pay as opted.","quote":"If You have availed choice of Zone B at the time of Policy Inception and availing treatment in a Hospital which is situated in Zone A, 10% Co-pay would be applicable on admissible claim amount. ... If You have availed choice of Zone C at the time of Policy Inception and availing treatment in a Hospital which is situated in Zone A, 20% Co-pay would be applicable on admissible claim amount. ... Zone based Co-pay as mentioned above will not be applicable in case of accidental injury. ... A. Accidental & Illness Hospitalization Cover | Yes | 50,000 | 25 Lakhs | Yes | 0% | 50%","sources":[{"clause":"1","heading":"Zone wise Classification","page":58,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-care-plus-policy-godhlip27048v052627/document/51#c-1-11"},{"clause":"Section 1","heading":"HOSPITALIZATION COVER | Yes","page":50,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-care-plus-policy-godhlip27048v052627/document/52#c-section-1-5"}],"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 the optional deductible is chosen: Rs. 50,000 to 25 lakhs, aggregate or per claim (smart deduct).","display":"None unless opted (Rs. 50,000 to 25 lakhs)","note":null,"quote":"A. Accidental & Illness Hospitalization Cover | Yes | 50,000 | 25 Lakhs | Yes | 0% | 50% ... Deductible specific to Section 1A. Accidental & Illness Hospitalization Cover and Section 1B. Accidental Hospitalization will be applicable in aggregate or smart deduct (per claim deductible) as opted","sources":[{"clause":"Section 1","heading":"HOSPITALIZATION COVER | Yes","page":50,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-care-plus-policy-godhlip27048v052627/document/52#c-section-1-5"},{"clause":"13","heading":"Deductible","page":4,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-care-plus-policy-godhlip27048v052627/document/51#c-13"}],"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":["Listed modern treatments (robotic surgery, oral chemotherapy, immunotherapy and others): up to 50% of sum insured","Cochlear Implant: 50% of sum insured","Hyaluronic acid, Remicade or similar, intra-articular/intra thecal or cortico-steroid injections: 5% of sum insured","Bariatric surgery: 5%/10%/20%/100% of sum insured as opted"],"display":"Modern treatments 50%, cochlear implant 50%, certain injections 5% of sum insured; bariatric surgery as opted","note":"Advance Care (Section 24) raises the modern-treatment cap to 100%. Smart Save (Section 29), if chosen for a discount, caps cataract, knee and hip replacement, angiography, angioplasty, hernia, CABG, hysterectomy, kidney stone and oral chemotherapy as per schedule. The prospectus sub-limit note also puts 'Immunotherapy/hormonal therapy' under the 5% cap, while its own exclusion 37 and the policy wording put immunotherapy under the 50% cap.","quote":"37.Our Maximum Liability in respect of the following procedures will be covered (wherever medically indicated) either as in patient or as part of day care treatment in a hospital up to 50% of Sum Insured ... D. Oral chemotherapy E. Immunotherapy - Monoclonal Antibody to be given as injection ... G. Robotic surgeries ... Our Maximum Liability in respect of Cochlear Implant Procedure will be restricted to 50% of the Sum Insured ... We will not pay for expenses related to administration of below medications or procedures in excess of 5% of Sum Insured ... a) Hyaluronic acid, Remicade or similar medications ... b) Intra-articular/intra thecal or cortico-steroid injections. ... A6. Bariatric Surgery Cover | 5%/10%/20% / 100% of Section 1.A Sum Insured","sources":[{"clause":"1(a)","heading":null,"page":53,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-care-plus-policy-godhlip27048v052627/document/51#c-1-a-2"},{"clause":"1","heading":null,"page":52,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-care-plus-policy-godhlip27048v052627/document/51#c-1-9"},{"clause":null,"heading":"36. Specific Treatments","page":52,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-care-plus-policy-godhlip27048v052627/document/51#c-36-specific-treatments"},{"clause":"1(a)","heading":null,"page":53,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-care-plus-policy-godhlip27048v052627/document/51#c-1-a"},{"clause":"1(b)","heading":null,"page":53,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-care-plus-policy-godhlip27048v052627/document/51#c-1-b"},{"clause":"Section 1","heading":"HOSPITALIZATION COVER","page":48,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-care-plus-policy-godhlip27048v052627/document/52#c-section-1-4"}],"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, 60 or 90 days, as opted","note":"Value is the shortest option. The policy wording refers to the number of days opted and shown in the schedule.","quote":"A2. Pre-Hospitalization Expenses - <<30/60/90>> days before hospitalization, as per the plan opted","sources":[{"clause":"5","heading":null,"page":1,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-care-plus-policy-godhlip27048v052627/document/53#c-5"}],"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, 90, 120 or 180 days, as opted","note":"Value is the shortest option. Section 2 offers a one-time lump sum of 1% to 5% of the approved claim instead of reimbursement.","quote":"A3. Post-Hospitalization Expenses - <<60/90/120/180>> days post hospitalization, as per the plan opted","sources":[{"clause":"5","heading":null,"page":1,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-care-plus-policy-godhlip27048v052627/document/53#c-5"}],"law":[]},{"key":"day_care","label":"Day-care treatments","section":"Cover","meaning":"Treatments needing less than 24 hours in hospital (chemotherapy, dialysis, cataract) and whether all or only listed ones are covered.","status":"cross-checked","value":"Covered: any medical treatment or surgical procedure under general or local anaesthesia taking less than 24 hours because of technological advancement; out-patient treatment is not included.","display":"All day care procedures covered","note":"Under Section 1B (accident only) day care is covered only for accidental injury.","quote":"If You suffer an Accidental Injury or Illness during the Policy Period, 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 Procedure. Treatment normally taken on an out-patient basis is not included in the scope of this Cover.","sources":[{"clause":null,"heading":"A1. Day Care Procedures","page":8,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-care-plus-policy-godhlip27048v052627/document/51#c-a1-day-care-procedures"}],"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":"Not part of the base cover: home treatment is paid only if the optional Section 5 Home (Domiciliary) Hospitalization is bought.","display":"Only with optional Section 5 (Home Hospitalization)","note":"With Section 5: paid when the patient cannot be moved to hospital or no hospital room is available, and the condition lasts at least 3 days; within the Section 1 sum insured. Asthma, bronchitis, diabetes, hypertension and other listed conditions are excluded.","quote":"If You have opted for this Cover, 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 ... The condition of the patient is such that s/he is not in a condition to be moved to a Hospital ... The patient takes treatment at home on account of non-availability of room in a Hospital ... The condition for which the medical treatment is required continues for at least 3 days ... Subject to availability of the sum insured under Section 1.A. Accidental & Illness Hospitalization Cover and/or Section 1.B. Accidental Hospitalization Cover. ... No Payment will be made if the condition for which You require medical treatment is due to: Asthma, Bronchitis ... Diabetes Mellitus and Insipidus, Epilepsy, Hypertension","sources":[{"clause":"Section 5","heading":"HOME (DOMICILIARY) HOSPITALIZATION","page":15,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-care-plus-policy-godhlip27048v052627/document/51#c-section-5"},{"clause":"Section 5(a)","heading":null,"page":16,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-care-plus-policy-godhlip27048v052627/document/51#c-section-5-a"},{"clause":"Section 5(b)","heading":null,"page":16,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-care-plus-policy-godhlip27048v052627/document/51#c-section-5-b"},{"clause":"Section 5(c)","heading":null,"page":16,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-care-plus-policy-godhlip27048v052627/document/51#c-section-5-c"},{"clause":"Section 5(e)","heading":null,"page":16,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-care-plus-policy-godhlip27048v052627/document/51#c-section-5-e"},{"clause":"Section 5(d)","heading":null,"page":16,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-care-plus-policy-godhlip27048v052627/document/51#c-section-5-d"}],"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 paid up to the Section 1A sum insured; out-patient and preventive/rejuvenation treatments are excluded.","display":"Covered up to sum insured (in-patient, AYUSH Hospital)","note":"The hospital must hold NABH pre-entry level or NQAS state level certification. The wording says 'If You have opted for this Cover'.","quote":"If You have opted for this Cover, we will pay the Medical Expenses for Your In-patient Treatment, taken under Ayurveda, Unani, Siddha or Homeopathy. This is up to the Sum Insured mentioned in Your Policy Schedule against Section 1. A. Accidental & Illness Hospitalization Cover. This is paid provided that the AYUSH treatment has been undergone in an Ayush Hospital. ... a) Outpatient Medical Expenses. b) All Preventive and Rejuvenation Treatments","sources":[{"clause":null,"heading":"A9. AYUSH COVER","page":11,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-care-plus-policy-godhlip27048v052627/document/51#c-a9-ayush-cover"}],"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 Section 1 sum insured for listed procedures (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 100% with the Advance Care option.","display":"Up to 50% of sum insured (100% with Advance Care)","note":null,"quote":"37.Our Maximum Liability in respect of the following procedures will be covered (wherever medically indicated) either as in patient or as part of day care treatment in a hospital up to 50% of Sum Insured opted under Section 1.A. Accidental & Illness Hospitalization Cover and/or Section 1.B. Accidental Hospitalization Cover: A. 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 ... 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 cover, our maximum liability in respect of the following procedures or new age treatments will be up to 100% of the sum insured","sources":[{"clause":"1(a)","heading":null,"page":53,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-care-plus-policy-godhlip27048v052627/document/51#c-1-a-2"},{"clause":"1(I)","heading":null,"page":53,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-care-plus-policy-godhlip27048v052627/document/51#c-1-i"},{"clause":"Section 24","heading":"ADVANCE CARE","page":38,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-care-plus-policy-godhlip27048v052627/document/51#c-section-24"}],"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":"Organ donation expenses are excluded unless the optional Section 3 Organ Donor is bought.","display":"Only with optional Section 3","note":"With Section 3: harvesting costs within the Section 1A sum insured, and the donor's pre and post hospitalisation expenses up to 5% of the approved harvesting claim; no other treatment of the donor. The specific waiting period applies.","quote":"If You have opted for this Cover, We will pay You for the following incurred Medical Expenses in respect of organ transplantation: ... a) For the harvesting of the donated organ subject to availability of the Sum Insured under Section 1. A. Accidental & Illness Hospitalization Cover. ... 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. ... d) We will not pay any other medical treatment for the donor consequent on the harvesting. ... The Expenses incurred by You on organ donation, except for those covered under Section 3. Organ Donor, if opted by You.","sources":[{"clause":"Section 3","heading":"ORGAN DONOR","page":14,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-care-plus-policy-godhlip27048v052627/document/51#c-section-3"},{"clause":"Section 3(a)","heading":null,"page":14,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-care-plus-policy-godhlip27048v052627/document/51#c-section-3-a"},{"clause":"Section 3(c)","heading":null,"page":14,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-care-plus-policy-godhlip27048v052627/document/51#c-section-3-c"},{"clause":"Section 3(d)","heading":null,"page":14,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-care-plus-policy-godhlip27048v052627/document/51#c-section-3-d"},{"clause":null,"heading":"39. Organ Donor","page":53,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-care-plus-policy-godhlip27048v052627/document/51#c-39-organ-donor"}],"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 up to 1% of the Section 1 sum insured, maximum INR 5000 per hospitalisation. Air ambulance (within India) and advanced heart ambulance (2% of sum insured) are optional sections.","display":"Road: 1% of sum insured, max INR 5000; air ambulance optional","note":"Planned hospitalisations and the trip home after discharge are not covered.","quote":"We will pay for the expenses incurred on Your road transportation by a Healthcare or an Ambulance Service Provider to a Hospital for treatment following an Emergency ... The maximum liability per Hospitalization is restricted to the amount as mentioned in Your Policy Schedule against this Cover. ... A5. Road Ambulance | 1% of Section 1.A Sum Insured Max up to the INR 5000 ... The Air ambulance services will be limited within India only ... SECTION 23. ADVANCE HEART AMBULANCE | (2% of Section 1A/1B. Sum Insured)","sources":[{"clause":null,"heading":"A5. Road Ambulance","page":9,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-care-plus-policy-godhlip27048v052627/document/51#c-a5-road-ambulance"},{"clause":"Section 1","heading":"HOSPITALIZATION COVER","page":48,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-care-plus-policy-godhlip27048v052627/document/52#c-section-1-4"},{"clause":null,"heading":"Specific Conditions applicable to Emergency Air Ambulance","page":15,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-care-plus-policy-godhlip27048v052627/document/51#c-specific-conditions-applicable-to-emergency-air"},{"clause":"Section 21","heading":"WOMAN CANCER BENEFIT | 10,000 | 3,50,00,000","page":47,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-care-plus-policy-godhlip27048v052627/document/52#c-section-21-2"}],"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":"Not part of the base cover: the optional Section 12 Sum Insured Refill Benefit refills 100% of the used Section 1 sum insured.","display":"Only with optional Section 12 (100% refill)","note":"With Section 12: refill for related or unrelated illness as opted (45-day gap between related hospitalisations); not for the same hospitalisation; number of refills as per schedule; a single claim after refill cannot exceed the Section 1 sum insured. Unused Sum Insured Benefit (Section 11) and SI Multiplier (Section 25) are other options.","quote":"Section 12 SUM INSURED REFILL BENEFIT ... If you have opted for this Cover, We will refill 100% of the Sum Insured specified and utilized under Section 1.A. Accidental & Illness Hospitalization Cover and/or Section 1.B. Accidental Hospitalization Cover for that particular Policy Period ... The refiled Sum Insured would be utilized if the cause of the Hospitalization is related or not related (as opted by you) ... In case of related Hospitalization cooling off period of 45 days will be applicable. ... the refilled Sum Insured will not be applicable for the same hospitalisation. ... The number of times this benefit may be availed shall be as per the limit mentioned in Your Policy Schedule","sources":[{"clause":"Section 12","heading":"SUM INSURED REFILL BENEFIT","page":19,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-care-plus-policy-godhlip27048v052627/document/51#c-section-12"},{"clause":"Section 12(a)","heading":null,"page":20,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-care-plus-policy-godhlip27048v052627/document/51#c-section-12-a"},{"clause":"Section 12(b)","heading":null,"page":20,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-care-plus-policy-godhlip27048v052627/document/51#c-section-12-b"},{"clause":"Section 12(c)","heading":null,"page":20,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-care-plus-policy-godhlip27048v052627/document/51#c-section-12-c"},{"clause":"Section 12(e)","heading":null,"page":20,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-care-plus-policy-godhlip27048v052627/document/51#c-section-12-e"}],"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":"Choose Cumulative Bonus or No Claim Discount. Cumulative Bonus options: 5%, 10%, 20%, 50% or 100% a claim-free year up to 25%, 50%, 100%, 150% or 200%, or 50% a year up to 100%; after a claim it reduces by the same percentage. Or no bonus.","display":"5% to 100% a year up to 25% to 200%, as opted; reduces after a claim","note":"No Claim Discount instead gives a renewal premium discount per claim-free year (example: 1% a year up to 5%). Cumulative Bonus Protection (Section 28) stops the reduction. No cumulative bonus if Unused Sum Insured Benefit is opted. The bonus is lost if not renewed within the 30-day grace period.","quote":"No Claim Bonus – You can opt for either of Cumulative Bonus or No Claim Discount ... No Cumulative Bonus of 5%, 10%, 20%, 50% and 100% Cumulative Bonus each year. Cumulative Bonus can be accrued up to a maximum of 25%, 50%, 100%,150% and 200% respectively. - There is one more option for Cumulative Bonus to be accrued up to 100% for 50% increase each year. - In case a person enjoying Cumulative Bonus, makes a claim in a year, his cumulative Bonus will decrease by the same percentage, it increases each year.","sources":[{"clause":null,"heading":"What are benefits if I renew this Policy?","page":52,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-care-plus-policy-godhlip27048v052627/document/52#c-what-are-benefits-if-i-renew-this-policy"}],"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 by default: non-medical expenses (Annexure A) are excluded. Optional Consumable Cover (Section 10) pays them, from 1% up to 100% of the approved Section 1 claim as opted.","display":"Excluded unless Consumable Cover is opted","note":null,"quote":"25. Non-Medical Expenses ... If you have opted for this cover and if Your claim is approved under Section 1.A. Accidental & Illness Hospitalization Cover and/or Section 1.B. Accidental Hospitalization Cover, we will compensate for non-medical expenses incurred by You ... SECTION 10. CONSUMABLE COVER | Inbuilt Sum Insured under Section 1 (1%/2%/5%/10%/15%/100% of approved claim amount)","sources":[{"clause":null,"heading":"25. Non-Medical Expenses","page":51,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-care-plus-policy-godhlip27048v052627/document/51#c-25-non-medical-expenses"},{"clause":"Section 10","heading":"CONSUMABLE COVER","page":19,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-care-plus-policy-godhlip27048v052627/document/51#c-section-10"},{"clause":"Section 9","heading":"SECOND MEDICAL OPINION | NA","page":49,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-care-plus-policy-godhlip27048v052627/document/52#c-section-9-3"}],"law":[]},{"key":"maternity","label":"Maternity cover","section":"Cover","meaning":"Whether childbirth costs are covered, the limit and the waiting period.","status":"cross-checked","value":"Excluded (Excl18) unless the optional Section 6 Maternity Benefit & New Born Baby Cover is bought.","display":"Only with optional Section 6","note":"With Section 6: delivery, pregnancy complications and lawful termination; sum insured Rs. 10,000 to 5,00,000; up to two childbirths; waiting period as opted (none, 6 months, 9 months, 1, 2, 3 or 4 years). The female insured's spouse must also be insured unless waived. Ectopic pregnancy is paid under Section 1.","quote":"If You have opted for this Cover, 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 termination. ... MATERNITY BENEFIT & NEW BORN BABY COVER | 10,000 | 5,00,000 ... The maternity benefit in this policy is limited to cover up to two childbirth events. ... Section 6. Maternity and New Born Baby Cover | No Waiting Period,6 Months, 9 Months, 1 Year, 2 Years, 3 Years, 4 Years ... Maternity: Code Excl18 ... This exclusion stands deleted to the extent of the coverage provided Under SECTION 6. MATERNITY BENEFIT & NEWBORN BABY COVER if opted by You.","sources":[{"clause":"Section 6","heading":"MATERNITY BENEFIT & NEW BORN BABY COVER A. Maternity Benefit","page":16,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-care-plus-policy-godhlip27048v052627/document/51#c-section-6"},{"clause":"Section 6","heading":"MATERNITY BENEFIT & NEW BORN BABY COVER | 10,000 | 5,00,000","page":47,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-care-plus-policy-godhlip27048v052627/document/52#c-section-6-2"},{"clause":"Section 6(b)","heading":null,"page":16,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-care-plus-policy-godhlip27048v052627/document/51#c-section-6-b"},{"clause":null,"heading":"What are the waiting period and survival periods under this Policy?","page":48,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-care-plus-policy-godhlip27048v052627/document/52#c-what-are-the-waiting-period-and-survival-periods"},{"clause":"18","heading":"Maternity: Code Excl18","page":50,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-care-plus-policy-godhlip27048v052627/document/51#c-18-3"}],"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 under the optional Section 6, once a maternity claim is accepted: the newborn's treatment during the mother's delivery stay, hospitalisation for complications up to 90 days from delivery and vaccinations up to 90 days, within the maternity sum insured. After that the baby must be added to the policy.","display":"Only with optional Section 6 (up to 90 days)","note":"Once added as an insured, vaccinations are paid until age 5 on continuous renewal with Section 6.","quote":"provided that We have accepted a claim under Section 6. A. Maternity Benefit ... we will also pay the Medical Expenses, within the limit of the Sum Insured available under the Section 6. A Maternity Benefit Section of the Policy ... a) The medical treatment of the Insured Person’s New Born Baby while the Insured Person is hospitalised as an inpatient for delivery. ... b) The New Born Baby’s hospitalisation charges as a result of any medical complications, up to 90 Days from the date of delivery. ... c) 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. ... 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.","sources":[{"clause":null,"heading":"B. New Born Baby Benefit","page":17,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-care-plus-policy-godhlip27048v052627/document/51#c-b-new-born-baby-benefit"},{"clause":"Section 6(a)","heading":null,"page":17,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-care-plus-policy-godhlip27048v052627/document/51#c-section-6-a-3"},{"clause":"Section 6(b)","heading":null,"page":17,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-care-plus-policy-godhlip27048v052627/document/51#c-section-6-b-3"},{"clause":"Section 6(c)","heading":null,"page":17,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-care-plus-policy-godhlip27048v052627/document/51#c-section-6-c-3"},{"clause":"Section 6(e)","heading":null,"page":17,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-care-plus-policy-godhlip27048v052627/document/51#c-section-6-e"}],"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 (ICD F20-F29, F30-F39, F40-F48, F99) is paid up to the sum insured, if first diagnosed and hospitalised during the policy period; prior approval needed except emergencies; specific waiting period applies.","display":"Covered up to sum insured, after specific waiting period","note":"OPD (Section 8) also covers psychiatric consultations if opted.","quote":"We will pay upto the Sum Insured as mentioned in your policy schedule 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) This also has a waiting period. Waiting period shall be as per the “Specific Waiting Period” Section ... F20-F29 | Schizophrenia, schizotypal and delusional disorders F30-F39 | Mood [affective] disorders F40-F48 | Neurotic, stress-related and somatoform disorders F99-F99 | Unspecified mental disorder ... c) Hospitalization under this benefit shall be subject to prior approval from Us, except in cases of emergencies.","sources":[{"clause":null,"heading":"A7. Psychiatric illness Cover","page":10,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-care-plus-policy-godhlip27048v052627/document/51#c-a7-psychiatric-illness-cover"}],"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":"At every renewal without break, a health check-up for insured persons above 18, up to 0.25% or 0.5% of the sum insured, maximum INR 5,000 per policy. The optional Health Checkup Cover from Day One gives a check-up once a year from day one.","display":"At each renewal, up to 0.25%/0.5% of sum insured, max INR 5,000","note":"Paid in addition to the sum insured. Section 22 packages 1 to 6, booked through the Digit App.","quote":"If You Renew Your Policy with Us without a break, then at every Policy Renewal We will pay the expenses incurred towards cost of health check-up up to the Limits Per Policy (excluding any cumulative bonus) mentioned in Your Policy Schedule. ... You are above 18 Years of age at the time of Health Check Up. ... A8. Complimentary Health Check Up | Up to 0.25%/0.5% of the Sum Insured (excluding any cumulative bonus) Subject to maximum of INR 5,000 Per Policy ... If You have opted for this cover, we will pay for the expenses incurred towards cost of health check-up which will be available from Day 1 of the Policy ... The benefit provided under this cover will be applied only once during each Policy Year","sources":[{"clause":null,"heading":"A8. Complimentary Health Check Up","page":11,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-care-plus-policy-godhlip27048v052627/document/51#c-a8-complimentary-health-check-up"},{"clause":"Section 1","heading":"HOSPITALIZATION COVER","page":48,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-care-plus-policy-godhlip27048v052627/document/52#c-section-1-4"},{"clause":"Section 22","heading":"HEALTH CHECKUP COVER FROM DAY ONE","page":37,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-care-plus-policy-godhlip27048v052627/document/51#c-section-22"}],"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 part of the base cover: out-patient treatment is paid only if the optional Section 8 Out-Patient (OPD) Benefit is bought.","display":"Only with optional Section 8","note":"With Section 8: allopathic consultations, diagnostics, minor procedures, medicines, dental, hearing aids and psychiatric consultation from network practitioners; sum insured Rs. 2,500 to 50,000. Co-pay Basis 1: 25% in the first year, 10% on first renewal, nil after; Basis 2: nil. Hearing aids need 36 months continuous OPD cover. Spectacles, physiotherapy, cosmetic procedures and others are excluded. Section 30 Wellness can also include OPD services.","quote":"If You have opted for this 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 ... Basis 1: Co-payment of 25% in the First Year of this Section being Opted, 10% on First Renewal. From the Second Renewal, there will be no Co-payment ... Basis 2: Nil Co-payment ... Professional Fees | Fees for Medically Necessary Consultation ... Diagnostic | Medically Necessary Out-patient diagnostic Procedures ... Surgical Treatment | Minor Surgical Procedure ... Medication | Drugs & Medicines prescribed by a Medical Practitioner ... Out-Patient Dental Treatment ... Hearing Aids ... Psychiatric Illness | Specialist Consultation ... OUT-PATIENT (OPD) BENEFIT | 2,500 | 50,000","sources":[{"clause":null,"heading":"You are not hospitalized are covered under this!","page":17,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-care-plus-policy-godhlip27048v052627/document/51#c-you-are-not-hospitalized-are-covered-under-this"},{"clause":"Section 8","heading":"OUT-PATIENT (OPD) BENEFIT | 2,500 | 50,000","page":47,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-care-plus-policy-godhlip27048v052627/document/52#c-section-8-2"}],"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. Insured persons are placed in Zone A, B or C by city of residence; treatment in a higher zone than chosen carries a 10% or 20% co-pay (not for accidents).","display":"Yes, three zones; 10% or 20% co-pay in a higher zone","note":"Zone A: Delhi & NCR, Greater Hyderabad, Mumbai region, Gujarat. Zone B: Chennai, Bengaluru, Kolkata, Pune. Zone C: rest of India. The documents do not say whether the premium itself differs by zone.","quote":"Based on your city of residence, we have classified you within Three Zones. ... If You have availed choice of Zone B at the time of Policy Inception and availing treatment in a Hospital which is situated in Zone A, 10% Co-pay would be applicable on admissible claim amount. ... If You have availed choice of Zone C at the time of Policy Inception and availing treatment in a Hospital which is situated in Zone A, 20% Co-pay would be applicable on admissible claim amount. ... Zone based Co-pay as mentioned above will not be applicable in case of accidental injury.","sources":[{"clause":"1","heading":"Zone wise Classification","page":58,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-care-plus-policy-godhlip27048v052627/document/51#c-1-11"}],"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 Service Provider / TPA, after pre-authorisation. Reimbursement at any hospital in India.","display":"Yes, at network hospitals","note":"CIS: pre-authorisation within 1 hour, final bill authorisation within 3 hours.","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 of Your Choice","sources":[{"clause":"7","heading":"Claims Notification and Procedure","page":59,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-care-plus-policy-godhlip27048v052627/document/51#c-7-7"},{"clause":"7(g)","heading":null,"page":59,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-care-plus-policy-godhlip27048v052627/document/51#c-7-g"}],"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":"A Service Provider / Third Party Administrator (TPA) for both cashless and reimbursement claims.","display":"Service Provider / TPA","note":null,"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","sources":[{"clause":"7","heading":"Claims Notification and Procedure","page":59,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-care-plus-policy-godhlip27048v052627/document/51#c-7-7"},{"clause":"7(g)","heading":null,"page":59,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-care-plus-policy-godhlip27048v052627/document/51#c-7-g"}],"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":"Individual sum insured is also available.","quote":"Family Floater means policy as mentioned in Your Policy Schedule where You and Your family members are covered in the same Policy. The Sum Insured would be shared among all the family members in the Policy.","sources":[{"clause":"II","heading":"SPECIFIC DEFINITIONS","page":6,"url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-care-plus-policy-godhlip27048v052627/document/51#c-ii"}],"law":[]}],"documents":[{"kind":"wording","label":"Policy Wordings - Digit Health Care Plus Policy - GODHLIP27048V052627","pages":71,"fetched_at":"2026-10-16 06:29:32.252994+00","source_url":"https://www.godigit.com/content/dam/godigit/directportal/en/downloads/health/policy-wordings-digit-health-care-plus-policy.pdf","url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-care-plus-policy-godhlip27048v052627/document/51"},{"kind":"prospectus","label":"Prospectus - Digit Health Care Plus Policy - GODHLIP27048V052627","pages":65,"fetched_at":"2026-10-16 06:29:32.252994+00","source_url":"https://www.godigit.com/content/dam/godigit/directportal/en/downloads/health/prospectus-digit-health-care-plus-policy.pdf","url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-care-plus-policy-godhlip27048v052627/document/52"},{"kind":"cis","label":"CIS - Digit Health Care Plus Policy - GODHLIP27048V052627","pages":5,"fetched_at":"2026-10-16 06:29:32.252994+00","source_url":"https://www.godigit.com/content/dam/godigit/directportal/en/downloads/health/cis-digit-health-care-plus-policy.pdf","url":"https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-care-plus-policy-godhlip27048v052627/document/53"}],"versions":[{"uin":"GODHLGP19013V011819","version":null,"approved_on":null},{"uin":"GODHLIP27048V052627","version":null,"approved_on":null}],"where_to_buy":[],"claims_and_complaints":[],"notice":"Information, not advice. IndiaInsurances is not an insurer or an insurance intermediary, does not sell insurance and earns no commission. Policy terms change and your own policy schedule can differ: always confirm with the policy document and the insurer before you buy or claim.","cite_as":"Digit Health Care Plus Policy (UIN GODHLIP27048V052627), IndiaInsurances, https://indiainsurances.com/policy/go-digit-general-insurance/digit-health-care-plus-policy-godhlip27048v052627"}