{"uin":"IFFHLIP25040V022425","name":"Essential Health Protector + Add -Ons","url":"https://indiainsurances.com/policy/iffco-tokio-general-insurance/essential-health-protector-add-ons-iffhlip25040v022425","insurer":{"slug":"iffco-tokio-general-insurance","name":"IFFCO TOKIO General Insurance Company Limited","url":"https://indiainsurances.com/insurer/iffco-tokio-general-insurance"},"line":"health","category":"health-indemnity","category_name":"Health insurance (hospitalisation)","irdai_type":null,"kind":"product","status":"active","approved_on":null,"withdrawn_on":null,"summary":"Essential Health Protector is a health indemnity policy with individual or floater cover for hospitalisation, with policy terms of 1 year, 2 years or 3 years and sum insured options from Rs. 5 Lakhs to Rs. 30 Lakhs. It has 30 days initial waiting, 36 months pre-existing disease waiting, 12 or 24 months specific waiting, room rent sub-limits and optional OPD, dental, maternity and consumable covers.","analysis":{"state":"machine","analysed_at":"2026-10-19 20:00:27.765983+00","note":"First pass: one AI reading; every stated fact carries a verbatim quote found in the cited clause, but it has not been reviewed. Check the clause before relying on it."},"facts":[{"key":"plan_variants","label":"Plans and variants","section":"Overview","meaning":"The named plans inside this product (not cover types or payout options). Facts can differ between them.","status":"not-stated","value":null,"display":null,"note":null,"quote":null,"sources":[],"law":[]},{"key":"policy_term","label":"Policy term","section":"Eligibility","meaning":"How long one policy runs before it ends or must be renewed.","status":"quote-verified","value":"The policy period can be 1 year, 2 years or 3 years, up to a maximum of 3 years, as specified in the policy schedule.","display":"1 year / 2 years / 3 years","note":null,"quote":"Policy Period: The policy period shall be upto a maximum of 3 years (1 year/ 2 years/ 3 years) as specified in the policy schedule.","sources":[{"clause":"13","heading":"Policy Period","page":42,"url":"https://indiainsurances.com/policy/iffco-tokio-general-insurance/essential-health-protector-add-ons-iffhlip25040v022425/document/8686#c-13-3"}],"law":[]},{"key":"claim_intimation","label":"Claim intimation deadline","section":"Claims","meaning":"How soon you must tell the insurer about a claim or hospitalisation.","status":"quote-verified","value":"For cashless claims, contact the TPA or insurer at least 48 hours before planned hospitalisation, or within 24 hours of hospitalisation in an emergency. For reimbursement, report as soon as possible or within 24 hours of hospitalisation, and in any case 12 hours before discharge.","display":"Cashless: 48 hours before planned hospitalisation or within 24 hours in emergency; reimbursement: within 24 hours of hospitalisation and 12 hours before discharge","note":null,"quote":"The Insured Person must contact the Third Party Administrator/Us at least 48 hours before a planned Hospitalization. In an emergency situation We/ Third Party Administrator should be contacted within 24 hours of Hospitalization. | The Insured Person must report to us as soon as possible or within “a maximum of 24 hours of hospitalization, but in any case 12 hours prior to insured person(s)’s discharge from hospital/nursing home”.","sources":[{"clause":"15(a)","heading":null,"page":43,"url":"https://indiainsurances.com/policy/iffco-tokio-general-insurance/essential-health-protector-add-ons-iffhlip25040v022425/document/8686#c-15-a"}],"law":[{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, V.1","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, V.1","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part C, V.1","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Para 20, 21","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"}]},{"key":"claim_documents","label":"Claim documents","section":"Claims","meaning":"Documents the insurer asks for when you claim.","status":"quote-verified","value":["Claim Form duly filled in and signed","Photo Identity proof of the patient","Medical practitioner’s prescription advising admission","Original bills with itemized break-up","Original Payment receipts","Pharmacy Bills (Original Only) with supporting prescriptions","Discharge summary including complete medical history of the patient along with other details","Investigation/ Diagnostic test reports etc. supported by the prescription from attending medical practitioner","OT notes or Surgeon’s certificate giving details of the operation performed","Sticker/Invoice of the Implants, wherever applicable","All previous treatment papers related to Ailment of last 3 years","Copy/Copies of previous insurance policies if required","MLR (Medico Legal Report copy if carried out and FIR (First information report) if registered, where ever applicable","Registration Certificate of the Hospital under Clinical Establishment Act or similar state act for medical establishments","NEFT Details and cancelled cheque","CKYC number of the Policyholder","Identity Proof with Address Proof of the Insured Person","Legal heir/succession certificate, wherever applicable","Any other document if insured wants to furnish in support of the claim"],"display":"Claim form, ID proof, admission prescription, original bills and receipts, pharmacy bills, discharge summary, reports, OT notes, implant invoice, past papers, previous policies, MLR/FIR, hospital registration, NEFT and cancelled cheque, CKYC, address proof, legal heir certificate and any other supporting document","note":null,"quote":"Documents to be submitted:\nThe reimbursement claim is to be supported with the following documents and submitted within the prescribed time limit.\ni) Claim Form duly filled in and signed – As per prescribed format (Form B to be filled in and signed by the Hospital authorities under seal)\nii) Photo Identity proof of the patient\niii) Medical practitioner’s prescription advising admission\niv) Original bills with itemized break-up\nv) Original Payment receipts\nvi) Pharmacy Bills (Original Only) with supporting prescriptions\nvii) Discharge summary including complete medical history of the patient along with other details. (Photo Copy in case of claim for Pre/Post Hospitalization only)\nviii) Investigation/ Diagnostic test reports etc. supported by the prescription from attending medical practitioner\nix) OT notes or Surgeon’s certificate giving details of the operation performed (for surgical cases).\nx) Sticker/Invoice of the Implants, wherever applicable.\nxi) All previous treatment papers related to Ailment of last 3 years. (In some cases, we may ask for more than 3 years record if required)\nxii) Copy/Copies of previous insurance policies if required (in case not provided earlier)\nxiii) MLR (Medico Legal Report copy if carried out and FIR (First information report) if registered, where ever applicable.\nxiv) Registration Certificate of the Hospital under Clinical Establishment Act or similar state act for medical establishments. Please note registration under Shops and Establishment Act, Registration with CMO etc. are not sufficient to meet the requirements of policy.\nxv) NEFT Details (to enable direct credit of claim amount in bank account) and cancelled cheque\nxvi) CKYC number of the Policyholder (Pan Card and Identity Proof with Address) as per AML Guidelines\nxvii) Identity Proof with Address Proof of the Insured Person with respect to whom, claim is reported.\nxviii) Legal heir/succession certificate, wherever applicable\nxix) Any other document if insured wants to furnish in support of the claim","sources":[{"clause":"15(c)","heading":null,"page":43,"url":"https://indiainsurances.com/policy/iffco-tokio-general-insurance/essential-health-protector-add-ons-iffhlip25040v022425/document/8686#c-15-c"}],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 17","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 22","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 23","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, V.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, V.3(iii)","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part C, V.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"}]},{"key":"claim_settlement_time","label":"Claim settlement time promised","section":"Claims","meaning":"How quickly the policy says a claim is decided or paid, and from when that is counted (intimation or last document).","status":"quote-verified","value":"The insurer shall settle or reject a non-cashless claim within 15 days from submission of claim. If investigation is needed, it must be completed within 30 days from submission and the claim settled or rejected within 45 days from receipt of the last necessary document; delay attracts bank rate plus 2% interest from intimation to payment.","display":"15 days from submission; if investigated, 45 days from last necessary document, with bank rate plus 2% interest for delay","note":null,"quote":"We shall settle or reject a claim (other than cashless), as the case may be, within 15 days from the date of submission of claim. ... where the circumstances of a claim warrant an investigation during adjudication of the claim, We shall initiate and complete such investigation at the earliest, in any case not later than 30 days from the date of submission of claim. ln such cases, We shall settle or reject the claim within 45 days from the date of receipt of last necessary document. ... We shall be liable to pay interest to You at a rate bank rate** plus 2% from the date of receipt of intimation to the date of payment of claim.","sources":[{"clause":"34(i)","heading":null,"page":47,"url":"https://indiainsurances.com/policy/iffco-tokio-general-insurance/essential-health-protector-add-ons-iffhlip25040v022425/document/8686#c-34-i"},{"clause":"34(iii)","heading":null,"page":47,"url":"https://indiainsurances.com/policy/iffco-tokio-general-insurance/essential-health-protector-add-ons-iffhlip25040v022425/document/8686#c-34-iii"},{"clause":"34(iv)","heading":null,"page":47,"url":"https://indiainsurances.com/policy/iffco-tokio-general-insurance/essential-health-protector-add-ons-iffhlip25040v022425/document/8686#c-34-iv"}],"law":[{"title":"The Insurance Act, 1938","section":"Section 64UM(4) to (6)","url":"https://indiainsurances.com/law/insurance-act-1938"},{"title":"Master Circular on General Insurance Business, 2024","section":"Ch I, Para 10","url":"https://indiainsurances.com/law/irdai-general-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 15","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 16","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 22","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, V.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, V.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, V.3(i), V.3(ii)","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, V.3(iii)","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part C, V.3","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part C, V.4","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Para 23","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"The Motor Vehicles Act, 1988: Chapter XI, insurance of motor vehicles against third party risks","section":"Section 149","url":"https://indiainsurances.com/law/motor-vehicles-act-1988"}]},{"key":"exclusions_main","label":"Main exclusions","section":"Exclusions","meaning":"What the policy does not pay for, in the policy's own words.","status":"quote-verified","value":["Expenses related to the treatment of a pre-existing Disease (PED) and its direct complications shall be excluded until the expiry of 36 months","Expenses related to the treatment of any illness within 30 days from the first policy commencement date shall be excluded except claims arising due to an accident","Specific Waiting Period: expenses for listed conditions, surgeries/treatments excluded until 12/ 24 months","Any disease aggravated by Diabetes and/or Hypertension for a waiting period of 90 days","Cosmetic or plastic Surgery","Rest Cure, rehabilitation and respite care","Alcoholism, drug or substance abuse or any addictive condition and consequences thereof","Breach of law","Investigation & Evaluation","Maternity Expenses","Sterility and Infertility","Unproven Treatments","Hazardous or Adventure sports","Refractive Error","Procedures/treatments mainly done in outpatient department (OPD)"],"display":"PED 36 months, first 30 days illness waiting, specific 12/24 months waiting, diabetes/hypertension aggravation 90 days and standard exclusions including cosmetic surgery, rest cure, substance abuse, breach of law, investigation, maternity, infertility, unproven treatments, hazardous sports, refractive error and OPD procedures","note":null,"quote":"Expenses related to the treatment of a pre-existing Disease (PED) and its direct complications shall be excluded until the expiry of 36 months of continuous coverage after the date of inception of the first policy, with Us. ... Expenses related to the treatment of any illness within 30 days from the first policy commencement date shall be excluded except claims arising due to an accident, provided the same are covered. ... Expenses related to the treatment of the following listed conditions, surgeries/treatments shall be excluded until the expiry of 12/ 24 months of continuous coverage ... Any disease aggravated by Diabetes and/or Hypertension for a waiting period of 90 days. ... Expenses for cosmetic or plastic surgery or any treatment to change appearance ... Expenses related to any admission primarily for enforced bed rest and not for receiving treatment. ... Treatment for, Alcoholism, drug or substance abuse or any addictive condition and consequences thereof. ... Expenses for treatment directly arising from or consequent upon any Insured Person committing or attempting to commit a breach of law with criminal intent. ... Expenses related to any admission primarily for diagnostics and evaluation purposes. ... Medical treatment expenses traceable to childbirth ... Expenses related to sterility and infertility. ... Expenses related to any unproven treatment, services and supplies for or in connection with any treatment. ... Expenses related to any treatment necessitated due to participation as a professional in hazardous or adventure sports ... Expenses related to the treatment for correction of eye sight due to refractive error less than 7.5 dioptres. ... Procedures/treatments mainly done in outpatient department (OPD) even if these are converted to day care surgery or as in patient in hospital to make it hospitalization claim.","sources":[{"clause":"Excl01","heading":"Pre-Existing Diseases(Code- Excl01)","page":34,"url":"https://indiainsurances.com/policy/iffco-tokio-general-insurance/essential-health-protector-add-ons-iffhlip25040v022425/document/8686#c-excl01"},{"clause":"Excl03","heading":"First Thirty Days Waiting Period(Code- Excl03)","page":34,"url":"https://indiainsurances.com/policy/iffco-tokio-general-insurance/essential-health-protector-add-ons-iffhlip25040v022425/document/8686#c-excl03"},{"clause":"Excl02","heading":"Specific Waiting Period: (Code- Excl02)","page":34,"url":"https://indiainsurances.com/policy/iffco-tokio-general-insurance/essential-health-protector-add-ons-iffhlip25040v022425/document/8686#c-excl02"},{"clause":"17","heading":null,"page":37,"url":"https://indiainsurances.com/policy/iffco-tokio-general-insurance/essential-health-protector-add-ons-iffhlip25040v022425/document/8686#c-17-2"},{"clause":"Excl08","heading":"Cosmetic or plastic Surgery: Code- Excl08","page":35,"url":"https://indiainsurances.com/policy/iffco-tokio-general-insurance/essential-health-protector-add-ons-iffhlip25040v022425/document/8686#c-excl08"},{"clause":"Excl05","heading":"Rest Cure, rehabilitation and respite care- Code- Excl05","page":35,"url":"https://indiainsurances.com/policy/iffco-tokio-general-insurance/essential-health-protector-add-ons-iffhlip25040v022425/document/8686#c-excl05"},{"clause":"Excl10","heading":"Breach of law: Code- Excl10","page":36,"url":"https://indiainsurances.com/policy/iffco-tokio-general-insurance/essential-health-protector-add-ons-iffhlip25040v022425/document/8686#c-excl10"},{"clause":"Excl04","heading":"Investigation & Evaluation(Code- Excl04)","page":36,"url":"https://indiainsurances.com/policy/iffco-tokio-general-insurance/essential-health-protector-add-ons-iffhlip25040v022425/document/8686#c-excl04"},{"clause":"Excl18","heading":"Maternity Expenses (Code - Excl18)","page":36,"url":"https://indiainsurances.com/policy/iffco-tokio-general-insurance/essential-health-protector-add-ons-iffhlip25040v022425/document/8686#c-excl18"},{"clause":"Excl17","heading":"Sterility and Infertility: (Code- Excl17)","page":36,"url":"https://indiainsurances.com/policy/iffco-tokio-general-insurance/essential-health-protector-add-ons-iffhlip25040v022425/document/8686#c-excl17"},{"clause":"Excl16","heading":"Unproven Treatments: Code- Excl16","page":36,"url":"https://indiainsurances.com/policy/iffco-tokio-general-insurance/essential-health-protector-add-ons-iffhlip25040v022425/document/8686#c-excl16"},{"clause":"12","heading":"Hazardous or Adventure sports: Code- Excl09","page":36,"url":"https://indiainsurances.com/policy/iffco-tokio-general-insurance/essential-health-protector-add-ons-iffhlip25040v022425/document/8686#c-12-2"},{"clause":"15","heading":"Refractive Error: Code- Excl15","page":37,"url":"https://indiainsurances.com/policy/iffco-tokio-general-insurance/essential-health-protector-add-ons-iffhlip25040v022425/document/8686#c-15-2"}],"law":[{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 11","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Para 16","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"}]},{"key":"grievance","label":"Grievance route","section":"Claims","meaning":"Who to complain to first, as stated in the policy, before going to the Insurance Ombudsman.","status":"quote-verified","value":"First contact IFFCO-Tokio through its grievance redressal website, toll-free number, email, Chief Grievance Officer address or branch grievance cell. If not satisfied, the insured may contact the grievance officer and then approach the Insurance Ombudsman or lodge on IRDAI Bima Bharosa.","display":"First to IFFCO-Tokio grievance channels or Chief Grievance Officer; then Insurance Ombudsman or IRDAI Bima Bharosa","note":null,"quote":"In case of any grievance, the Insured Person may contact Us through:\nWebsite: https://www.iffcotokio.co.in/customer-services/grievance-redressal Grievance Registration: Follow the above-mentioned link and fil the details to register the grievance Toll Free: 1800-103-5499 Email: chiefgrievanceofficer@iffcotokio.co.in Address: Chief Grievance Officer IFFCO-Tokio General Insurance Co Ltd IFFCO Tower, Plot no. 3 Sector -29, Gurgaon – 122001 Insured Person may also approach the grievance cell at any of the our branches with the details of grievance. ... lf Insured Person is not satisfied with the redressal of grievance through above methods, the Insured Person may also approach the office of lnsurance Ombudsman","sources":[{"clause":"39","heading":"Redressal Of Grievance","page":48,"url":"https://indiainsurances.com/policy/iffco-tokio-general-insurance/essential-health-protector-add-ons-iffhlip25040v022425/document/8686#c-39-2"}],"law":[{"title":"Consumer Protection (Jurisdiction of the District Commission, the State Commission and the National Commission) Rules, 2021","section":"Rule 3","url":"https://indiainsurances.com/law/consumer-jurisdiction-rules-2021"},{"title":"Consumer Protection (Jurisdiction of the District Commission, the State Commission and the National Commission) Rules, 2021","section":"Rule 4","url":"https://indiainsurances.com/law/consumer-jurisdiction-rules-2021"},{"title":"Consumer Protection (Jurisdiction of the District Commission, the State Commission and the National Commission) Rules, 2021","section":"Rule 5","url":"https://indiainsurances.com/law/consumer-jurisdiction-rules-2021"},{"title":"The Consumer Protection Act, 2019","section":"Section 2(11)","url":"https://indiainsurances.com/law/consumer-protection-act-2019"},{"title":"The Consumer Protection Act, 2019","section":"Section 2(42)","url":"https://indiainsurances.com/law/consumer-protection-act-2019"},{"title":"The Consumer Protection Act, 2019","section":"Section 34","url":"https://indiainsurances.com/law/consumer-protection-act-2019"},{"title":"The Consumer Protection Act, 2019","section":"Section 69","url":"https://indiainsurances.com/law/consumer-protection-act-2019"},{"title":"The Insurance Act, 1938","section":"Section 38","url":"https://indiainsurances.com/law/insurance-act-1938"},{"title":"Master Circular on General Insurance Business, 2024","section":"Ch I, Para 12","url":"https://indiainsurances.com/law/irdai-general-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 19","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 20","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Life Insurance Products, 2024","section":"Chapter 1, Para 13","url":"https://indiainsurances.com/law/irdai-life-products-2024"},{"title":"Master Circular on Life Insurance Products, 2024","section":"Chapter 1, Para 2","url":"https://indiainsurances.com/law/irdai-life-products-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 5(5), 5(6)","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 5(9)","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 25","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, VI.1","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, VI.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, VI.3","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Para 26","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 11","url":"https://indiainsurances.com/law/irdai-products-regs-2024"},{"title":"Review of revision in premium rates under health insurance policies for senior citizens, 2025","section":"Para 3","url":"https://indiainsurances.com/law/irdai-senior-premium-2025"},{"title":"Insurance Ombudsman Rules, 2017","section":"Rule 13","url":"https://indiainsurances.com/law/ombudsman-rules-2017"},{"title":"Insurance Ombudsman Rules, 2017","section":"Rule 14","url":"https://indiainsurances.com/law/ombudsman-rules-2017"}]},{"key":"sum_insured_options","label":"Sum insured options","section":"Cover","meaning":"The cover amounts you can choose from.","status":"quote-verified","value":"The sum insured options are Rs. 5 Lakhs, Rs. 7.5 Lakhs, Rs. 10 Lakhs, Rs. 15 Lakhs, Rs. 20 Lakhs, Rs. 25 Lakhs and Rs. 30 Lakhs.","display":"Rs. 5 Lakhs, 7.5 Lakhs, 10 Lakhs, 15 Lakhs, 20 Lakhs, 25 Lakhs, 30 Lakhs","note":"From the prospectus.","quote":"Sum Insured Options– The following plans to offer you the widest possible\n• 5 Lakhs\n• 7.5 Lakhs\n• 10 Lakhs\n• 15 Lakhs\n• 20 Lakhs\n• 25 Lakhs\n• 30 Lakhs","sources":[{"clause":null,"heading":"How does the Health Product benefits you","page":1,"url":"https://indiainsurances.com/policy/iffco-tokio-general-insurance/essential-health-protector-add-ons-iffhlip25040v022425/document/8638#c-how-does-the-health-product-benefits-you"}],"law":[]},{"key":"initial_waiting","label":"Initial waiting period","section":"Waiting periods","meaning":"Days from the start of the first policy during which illness claims are not paid (accidents usually are).","status":"quote-verified","value":{"unit":"days","amount":30},"display":"30 days","note":"Does not apply to covered accident claims; does not apply after more than twelve months of continuous coverage.","quote":"Expenses related to the treatment of any illness within 30 days from the first policy commencement date shall be excluded except claims arising due to an accident, provided the same are covered.","sources":[{"clause":"Excl03","heading":"First Thirty Days Waiting Period(Code- Excl03)","page":34,"url":"https://indiainsurances.com/policy/iffco-tokio-general-insurance/essential-health-protector-add-ons-iffhlip25040v022425/document/8686#c-excl03"}],"law":[]},{"key":"ped_waiting","label":"Pre-existing disease waiting period","section":"Waiting periods","meaning":"How long you wait before conditions you already had when you bought the policy are covered. The law caps it at 36 months.","status":"quote-verified","value":{"unit":"months","amount":36},"display":"36 months","note":"For enhanced basic sum insured, the exclusion applies afresh to the increased amount; portability credit may reduce the waiting period.","quote":"Expenses related to the treatment of a pre-existing Disease (PED) and its direct complications shall be excluded until the expiry of 36 months of continuous coverage after the date of inception of the first policy, with Us.","sources":[{"clause":"Excl01","heading":"Pre-Existing Diseases(Code- Excl01)","page":34,"url":"https://indiainsurances.com/policy/iffco-tokio-general-insurance/essential-health-protector-add-ons-iffhlip25040v022425/document/8686#c-excl01"}],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 8","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 12","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 1.6","url":"https://indiainsurances.com/law/irdai-products-regs-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 7","url":"https://indiainsurances.com/law/irdai-products-regs-2024"}]},{"key":"specific_waiting","label":"Specific illness waiting period","section":"Waiting periods","meaning":"Waiting period for a list of named illnesses and procedures (cataract, hernia, joint replacement...). With several tiers (24 and 36 months), the shortest in the answer, the others in the note.","status":"quote-verified","value":{"unit":"months","amount":12},"display":"12 months and 24 months","note":"The listed conditions are divided into 12 months waiting period and 24 months waiting period; accident claims are excluded from this waiting period.","quote":"Expenses related to the treatment of the following listed conditions, surgeries/treatments shall be excluded until the expiry of 12/ 24 months of continuous coverage, as may be the case after the date of inception of the first policy with Us.","sources":[{"clause":"Excl02","heading":"Specific Waiting Period: (Code- Excl02)","page":34,"url":"https://indiainsurances.com/policy/iffco-tokio-general-insurance/essential-health-protector-add-ons-iffhlip25040v022425/document/8686#c-excl02"}],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 12","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 1.7","url":"https://indiainsurances.com/law/irdai-products-regs-2024"}]},{"key":"specific_waiting_list","label":"Illnesses with a specific waiting period","section":"Waiting periods","meaning":"The named illnesses and procedures that carry the specific waiting period.","status":"quote-verified","value":["Surgical treatment for Tonsillitis/ Adenoids","Tympanoplasty / Septoplasty","Fistula in anus, Anal Sinus, Piles","Any type of Carcinoma / Sarcoma/ Blood Cancer","Varicose Veins / Varicose Ulcers","All types of Ligament Meniscus Tears","Cataract, Benign Prostatic Hypertrophy, DUB","Uterine Fibroids, PV Bleeding, Hysterectomy, Myomectamy","Hernia, Hydrocele","Sinusitis","Gall Bladder, Billiary, Renal and Urinary Stones","Inter-vertebral Disc disorder like Spondylitis, Spondylosis and prolapse","Knee replacement/Joint Replacement/Hip replacement","Chronic Renal failure","Any type of benign growth/Cyst/Nodules/Polyps/Tumor/Lump"],"display":"Tonsillitis/adenoids, tympanoplasty/septoplasty, fistula/anal sinus/piles, carcinoma/sarcoma/blood cancer, varicose veins/ulcers, ligament meniscus tears, cataract/BPH/DUB, uterine fibroids/PV bleeding/hysterectomy/myomectomy, hernia/hydrocele, sinusitis, gall bladder/biliary/renal/urinary stones, inter-vertebral disc disorders, knee/joint/hip replacement, chronic renal failure and benign growths/cysts/nodules/polyps/tumours/lumps","note":null,"quote":"i) 12 Months waiting period\ni) Surgical treatment for Tonsillitis/ Adenoids\nii) Tympanoplasty / Septoplasty\niii) Fistula in anus, Anal Sinus, Piles\niv) Any type of Carcinoma / Sarcoma/ Blood Cancer\nv) Varicose Veins / Varicose Ulcers\nvi) All types of Ligament Meniscus Tears\nii. 24 Months waiting period\ni) Cataract, Benign Prostatic Hypertrophy, DUB\nii) Uterine Fibroids, PV Bleeding, Hysterectomy, Myomectamy\niii) Hernia, Hydrocele\niv) Sinusitis\nv) Gall Bladder, Billiary, Renal and Urinary Stones\nvi) Inter-vertebral Disc disorder like Spondylitis, Spondylosis and prolapse. (other than caused by an accident)\nvii) Knee replacement/Joint Replacement/Hip replacement (other than caused by an accident)\nviii) Chronic Renal failure\nix) Any type of benign growth/Cyst/Nodules/Polyps/Tumor/Lump","sources":[{"clause":"Excl02","heading":"Specific Waiting Period: (Code- Excl02)","page":34,"url":"https://indiainsurances.com/policy/iffco-tokio-general-insurance/essential-health-protector-add-ons-iffhlip25040v022425/document/8686#c-excl02"}],"law":[]},{"key":"moratorium","label":"Moratorium period","section":"Renewal and rights","meaning":"After this many months of continuous cover, the insurer cannot reject a claim for non-disclosure, except for proven fraud or permanent exclusions. The law sets 60 months.","status":"quote-verified","value":{"unit":"months","amount":60},"display":"sixty continuous months","note":"For enhanced sum insured, sixty continuous months applies from the enhancement date only on the enhanced limits.","quote":"After completion of sixty continuous months of coverage (including portability and migration) in health insurance policy, no policy and claim shall be contestable by Us on grounds of non-disclosure, misrepresentation, except on grounds of established fraud. This period of sixty continuous months is called as moratorium period.","sources":[{"clause":"9","heading":"Moratorium Period","page":41,"url":"https://indiainsurances.com/policy/iffco-tokio-general-insurance/essential-health-protector-add-ons-iffhlip25040v022425/document/8686#c-9-3"}],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 13","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, IV.8","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 8","url":"https://indiainsurances.com/law/irdai-products-regs-2024"}]},{"key":"portability","label":"Portability","section":"Renewal and rights","meaning":"Whether you can move this policy to another insurer and keep waiting-period credit.","status":"quote-verified","value":"The insured can port the policy to the same product of another insurer by applying at least 30 days before, but not earlier than 60 days from the renewal due date. Accrued continuity benefits include reductions in waiting periods and portability benefit to the extent of previous sum insured plus accrued bonus.","display":"Porting allowed to same product of other insurers with accrued continuity benefits","note":null,"quote":"You/the Insured Person will have the option to port the Policy to same product of other insurers by applying to such insurer to port the entire policy along with all the members of the family, if any, at least 30 days before, but not earlier than 60 days from due date for renewal. ... the proposed Insured Person will get all the accrued continuity benefits as under:\ni) The waiting periods specified in Section E,(I) Point No-1,2 and 3 shall be reduced by the number of continuous preceding years of coverage of the Insured Person under the previous health insurance Policy.\nii) Portability benefit will be offered to the extent of sum of previous sum insured and accrued bonus","sources":[{"clause":"8","heading":"Portability","page":41,"url":"https://indiainsurances.com/policy/iffco-tokio-general-insurance/essential-health-protector-add-ons-iffhlip25040v022425/document/8686#c-8-3"}],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 11","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 12","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, IV.6","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, VII.3","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Para 24","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 1.4 and 1.5","url":"https://indiainsurances.com/law/irdai-products-regs-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 10","url":"https://indiainsurances.com/law/irdai-products-regs-2024"}]},{"key":"lifelong_renewal","label":"Lifelong renewal","section":"Renewal and rights","meaning":"Whether the policy can be renewed for life without a maximum age.","status":"quote-verified","value":true,"display":"Yes, without any age restriction","note":"From the prospectus; the wording also says renewal shall not be denied because claims were made.","quote":"Renewable Age: Policy shall ordinarily be renewable without any age restriction, except on grounds of fraud, moral hazard or misrepresentation or non-cooperation by the insured, if it is renewed without any break.","sources":[{"clause":null,"heading":"WHO ARE ELIGIBLE TO TAKE THIS POLICY?","page":2,"url":"https://indiainsurances.com/policy/iffco-tokio-general-insurance/essential-health-protector-add-ons-iffhlip25040v022425/document/8638#c-who-are-eligible-to-take-this-policy"}],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 10","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch II D.II","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, IV.5","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 9","url":"https://indiainsurances.com/law/irdai-products-regs-2024"},{"title":"Review of revision in premium rates under health insurance policies for senior citizens, 2025","section":"Para 7","url":"https://indiainsurances.com/law/irdai-senior-premium-2025"}]},{"key":"claim_loading","label":"Premium loading after claims","section":"Renewal and rights","meaning":"Whether the premium can go up at renewal because you made a claim.","status":"quote-verified","value":"No loading applies on renewals based on individual claims experience.","display":"No loading based on individual claims experience","note":null,"quote":"vi) No loading shall apply on renewals based on individual claims experience.","sources":[{"clause":"17","heading":"Renewal of Policy","page":45,"url":"https://indiainsurances.com/policy/iffco-tokio-general-insurance/essential-health-protector-add-ons-iffhlip25040v022425/document/8686#c-17-3"}],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 10","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, IV.5","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 9","url":"https://indiainsurances.com/law/irdai-products-regs-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 4","url":"https://indiainsurances.com/law/irdai-products-regs-2024"},{"title":"Review of revision in premium rates under health insurance policies for senior citizens, 2025","section":"Para 7","url":"https://indiainsurances.com/law/irdai-senior-premium-2025"}]},{"key":"permanent_exclusions","label":"Permanent exclusions","section":"Exclusions","meaning":"Conditions or treatments that are never covered: the standard IRDAI exclusion codes Excl04 to Excl18 and the product's own permanent exclusions. Excl01 to Excl03 are waiting periods, not permanent exclusions.","status":"quote-verified","value":["Excl04 Investigation & Evaluation","Excl05 Rest Cure, rehabilitation and respite care","Excl06 Obesity/ Weight Control","Excl08 Cosmetic or plastic Surgery","Excl09 Hazardous or Adventure sports","Excl10 Breach of law","Excl11 Excluded Providers","Excl12 Alcoholism, drug or substance abuse or any addictive condition and consequences thereof","Excl13 Treatments received in health hydros, nature cure clinics, spas or similar establishments","Excl14 Dietary supplements and substances that can be purchased without prescription","Excl15 Refractive Error","Excl16 Unproven Treatments","Excl17 Sterility and Infertility","Excl18 Maternity Expenses","War and war like occurrence","Dental treatment or surgery of any kind, unless requiring Hospitalization","Procedures/treatments mainly done in outpatient department (OPD)","Cytotron Therapy, Rotational Field Quantum Magnetic Resonance (RFQMR), EECP, Chelation Therapy, Hyperberic Oxygen Therapy"],"display":"Permanent exclusions include Excl04 to Excl18 standard exclusions and product-specific exclusions such as war, non-hospital dental treatment, OPD procedures and certain therapies","note":null,"quote":"Excl04 Investigation & Evaluation(Code- Excl04) ... Excl05 Rest Cure, rehabilitation and respite care- Code- Excl05 ... Obesity/ Weight Control: Code- Excl06 ... Excl08 Cosmetic or plastic Surgery: Code- Excl08 ... Hazardous or Adventure sports: Code- Excl09 ... Excl10 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 health 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) ... Excl18 Maternity Expenses (Code - Excl18) ... War (whether declared or not) and war like occurrence ... Dental treatment or surgery of any kind, unless requiring Hospitalization. ... Procedures/treatments mainly done in outpatient department (OPD) even if these are converted to day care surgery or as in patient in hospital to make it hospitalization claim. ... Cytotron Therapy, Rotational Field Quantum Magnetic Resonance (RFQMR), EECP (Enhanced External Counter Pulsation) Therapy, Chelation Therapy, Hyperberic Oxygen Therapy.","sources":[{"clause":"Excl04","heading":"Investigation & Evaluation(Code- Excl04)","page":36,"url":"https://indiainsurances.com/policy/iffco-tokio-general-insurance/essential-health-protector-add-ons-iffhlip25040v022425/document/8686#c-excl04"},{"clause":"Excl05","heading":"Rest Cure, rehabilitation and respite care- Code- Excl05","page":35,"url":"https://indiainsurances.com/policy/iffco-tokio-general-insurance/essential-health-protector-add-ons-iffhlip25040v022425/document/8686#c-excl05"},{"clause":"13","heading":"Obesity/ Weight Control: Code- Excl06","page":36,"url":"https://indiainsurances.com/policy/iffco-tokio-general-insurance/essential-health-protector-add-ons-iffhlip25040v022425/document/8686#c-13-2"},{"clause":"Excl08","heading":"Cosmetic or plastic Surgery: Code- Excl08","page":35,"url":"https://indiainsurances.com/policy/iffco-tokio-general-insurance/essential-health-protector-add-ons-iffhlip25040v022425/document/8686#c-excl08"},{"clause":"12","heading":"Hazardous or Adventure sports: Code- Excl09","page":36,"url":"https://indiainsurances.com/policy/iffco-tokio-general-insurance/essential-health-protector-add-ons-iffhlip25040v022425/document/8686#c-12-2"},{"clause":"Excl10","heading":"Breach of law: Code- Excl10","page":36,"url":"https://indiainsurances.com/policy/iffco-tokio-general-insurance/essential-health-protector-add-ons-iffhlip25040v022425/document/8686#c-excl10"},{"clause":"14","heading":"Excluded Providers: Code- Excl11","page":37,"url":"https://indiainsurances.com/policy/iffco-tokio-general-insurance/essential-health-protector-add-ons-iffhlip25040v022425/document/8686#c-14-2"},{"clause":"Excl05(ii)","heading":null,"page":26,"url":"https://indiainsurances.com/policy/iffco-tokio-general-insurance/essential-health-protector-add-ons-iffhlip25040v022425/document/8638#c-excl05-ii"},{"clause":"16","heading":null,"page":37,"url":"https://indiainsurances.com/policy/iffco-tokio-general-insurance/essential-health-protector-add-ons-iffhlip25040v022425/document/8686#c-16-2"},{"clause":"17","heading":null,"page":37,"url":"https://indiainsurances.com/policy/iffco-tokio-general-insurance/essential-health-protector-add-ons-iffhlip25040v022425/document/8686#c-17-2"},{"clause":"15","heading":"Refractive Error: Code- Excl15","page":37,"url":"https://indiainsurances.com/policy/iffco-tokio-general-insurance/essential-health-protector-add-ons-iffhlip25040v022425/document/8686#c-15-2"},{"clause":"Excl16","heading":"Unproven Treatments: Code- Excl16","page":36,"url":"https://indiainsurances.com/policy/iffco-tokio-general-insurance/essential-health-protector-add-ons-iffhlip25040v022425/document/8686#c-excl16"},{"clause":"Excl17","heading":"Sterility and Infertility: (Code- Excl17)","page":36,"url":"https://indiainsurances.com/policy/iffco-tokio-general-insurance/essential-health-protector-add-ons-iffhlip25040v022425/document/8686#c-excl17"},{"clause":"Excl18","heading":"Maternity Expenses (Code - Excl18)","page":36,"url":"https://indiainsurances.com/policy/iffco-tokio-general-insurance/essential-health-protector-add-ons-iffhlip25040v022425/document/8686#c-excl18"}],"law":[{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Para 16","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"}]},{"key":"cancellation_refund","label":"Cancellation by you","section":"Renewal and rights","meaning":"What you get back if you cancel during the year.","status":"quote-verified","value":"You may cancel at any time by giving 7 days' written notice. For terms up to one year, the insurer refunds proportionate premium for the unexpired period if no claim was made; for terms over one year, it refunds premium for unexpired policy years where risk coverage has not commenced.","display":"7 days' written notice; proportionate unexpired premium if term up to 1 year and no claim, or unexpired years' premium for terms over 1 year before risk starts","note":null,"quote":"You may cancel this policy at any time during the term, by giving 7 days’ notice in writing. We shall\ni) refund proportionate premium for unexpired policy period, if the term of policy upto one year and there is no claim (s) made during the policy period.\nii) 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":"6","heading":"Cancellation","page":40,"url":"https://indiainsurances.com/policy/iffco-tokio-general-insurance/essential-health-protector-add-ons-iffhlip25040v022425/document/8686#c-6-3"}],"law":[{"title":"The Insurance Act, 1938","section":"Section 64VB","url":"https://indiainsurances.com/law/insurance-act-1938"},{"title":"Master Circular on General Insurance Business, 2024","section":"Ch I, Para 8","url":"https://indiainsurances.com/law/irdai-general-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 6","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Life Insurance Products, 2024","section":"Chapter 1, Para 5","url":"https://indiainsurances.com/law/irdai-life-products-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 17","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 20(3) to 20(5)","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, III.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, IV.4","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part C, IV.3","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"}]},{"key":"territory","label":"Where it covers","section":"Overview","meaning":"Geographic area of cover: India only, worldwide, or listed countries. 'As stated in the schedule' is not an answer.","status":"quote-verified","value":"All medical treatment must be taken in India only and claims are payable in Indian currency.","display":"India only","note":null,"quote":"All medical treatment for the purpose of this insurance will have to be taken in India only and all claims shall be payable in Indian currency.","sources":[{"clause":"22","heading":"Territorial Limit","page":45,"url":"https://indiainsurances.com/policy/iffco-tokio-general-insurance/essential-health-protector-add-ons-iffhlip25040v022425/document/8686#c-22-2"}],"law":[]},{"key":"free_look","label":"Free-look period","section":"Renewal and rights","meaning":"Days after you receive the policy in which you can return it for a refund if you do not agree with its terms.","status":"quote-verified","value":{"unit":"days","amount":30},"display":"thirty days","note":"Applies at inception of the policy and not on renewals or at the time of porting or migrating.","quote":"You/the Insured Person shall be allowed a period of thirty days from date of receipt of the Policy document to review the terms and conditions of the Policy, and to return the same if not acceptable.","sources":[{"clause":"11","heading":"Free look period","page":41,"url":"https://indiainsurances.com/policy/iffco-tokio-general-insurance/essential-health-protector-add-ons-iffhlip25040v022425/document/8686#c-11-3"}],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 5","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Life Insurance Products, 2024","section":"Chapter 1, Para 5","url":"https://indiainsurances.com/law/irdai-life-products-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 20(1), 20(2)","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 20(3) to 20(5)","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 20(6)","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, II.8","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, III.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, III.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"}]},{"key":"grace_period","label":"Grace period","section":"Renewal and rights","meaning":"Days you get after the due date to pay without losing cover or continuity.","status":"quote-verified","value":{"unit":"days","amount":30},"display":"15 days for monthly instalments; 30 days for other instalments and renewal","note":"Monthly instalment mode has a 15 days grace period; other instalment modes and renewal have 30 days.","quote":"The grace period for payment of the premium shall be:\na) fifteen days for monthly installment modes, (wherever applicable)\nb) thirty days for any other installment modes (wherever applicable)\nc) thirty days for renewal.","sources":[{"clause":"29","heading":"Grace Period","page":4,"url":"https://indiainsurances.com/policy/iffco-tokio-general-insurance/essential-health-protector-add-ons-iffhlip25040v022425/document/8686#c-29"}],"law":[{"title":"The Insurance Act, 1938","section":"Section 50","url":"https://indiainsurances.com/law/insurance-act-1938"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 8","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 9","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Life Insurance Products, 2024","section":"Chapter 1, Para 8","url":"https://indiainsurances.com/law/irdai-life-products-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, IV.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, IV.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Para 3","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule I, Para 1.2","url":"https://indiainsurances.com/law/irdai-products-regs-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 1.3","url":"https://indiainsurances.com/law/irdai-products-regs-2024"}]},{"key":"eligibility_entry_age","label":"Entry age","section":"Eligibility","meaning":"The youngest and oldest age at which you can buy this policy.","status":"quote-verified","value":"Entry age is 18 years with no upper limit. Dependent children can be covered from the 1st day onward when one or more adults are covered concurrently; there is no upper age limit for dependents.","display":"Adults: 18 Years-No Upper Limit; dependent child: 1st day onward","note":"From the prospectus.","quote":"Entry Age under the policy: 18 Years-No Upper Limit. The Insurance is available to dependent child from the age of 1st day onward. Dependents including children can be covered provided one or more adults are covered concurrently. There is no upper age limit for coverage of dependents.","sources":[{"clause":null,"heading":"WHO ARE ELIGIBLE TO TAKE THIS POLICY?","page":2,"url":"https://indiainsurances.com/policy/iffco-tokio-general-insurance/essential-health-protector-add-ons-iffhlip25040v022425/document/8638#c-who-are-eligible-to-take-this-policy"}],"law":[]},{"key":"premium_modes","label":"Premium payment options","section":"Premium","meaning":"How often you can pay: yearly, half-yearly, quarterly, monthly.","status":"quote-verified","value":["Monthly","Quarterly","Half-Yearly"],"display":"Monthly, Quarterly, Half-Yearly instalments for one-year policies","note":"The wording says instalment basis is applicable for policies with policy period 1 year.","quote":"Installment Options(For One Year Policies):Monthly/Quarterly/Half-Yearly","sources":[{"clause":null,"heading":"How does the Health Product benefits you","page":1,"url":"https://indiainsurances.com/policy/iffco-tokio-general-insurance/essential-health-protector-add-ons-iffhlip25040v022425/document/8638#c-how-does-the-health-product-benefits-you"}],"law":[]},{"key":"optional_covers","label":"Optional covers","section":"Cover","meaning":"Covers you can add for an extra premium. They change the answers above only if you buy them.","status":"quote-verified","value":["Consumable Protector","OPD Cover","Dental Cover","Maternity Cover"],"display":"Consumable Protector, OPD Cover, Dental Cover and Maternity Cover","note":null,"quote":"Extension Available (On Payment of Additional Premium)-Consumable Protector\nProspectus – Essential Health Protector ✓ Add-ons Available (On Payment of Additional Premium)-OPD Cover, Dental Cover, Maternity Cover","sources":[{"clause":null,"heading":"How does the Health Product benefits you","page":1,"url":"https://indiainsurances.com/policy/iffco-tokio-general-insurance/essential-health-protector-add-ons-iffhlip25040v022425/document/8638#c-how-does-the-health-product-benefits-you"}],"law":[]},{"key":"grace_cover","label":"Cover during the grace period","section":"Renewal and rights","meaning":"Whether a claim during the grace period is paid.","status":"quote-verified","value":"Coverage is available during the grace period where premium is paid in instalments. Coverage is not available during the period for which no premium is received after the expiry of the policy, and renewal grace has no coverage.","display":"Available during instalment grace period; not available after policy expiry during renewal grace","note":null,"quote":"a) the coverage shall be available during the grace period, wherever the premium payment is paid in installments. (wherever applicable)\nb) Coverage is not available during the period for which no premium is received after the expiry of the Policy. ... At the end of the policy period, the policy shall terminate and can be renewed within the Grace Period of 30 days to maintain continuity of benefits without break in policy. Coverage is not available during the grace period.","sources":[{"clause":"29","heading":"Grace Period","page":4,"url":"https://indiainsurances.com/policy/iffco-tokio-general-insurance/essential-health-protector-add-ons-iffhlip25040v022425/document/8686#c-29"},{"clause":"17","heading":"Renewal of Policy","page":45,"url":"https://indiainsurances.com/policy/iffco-tokio-general-insurance/essential-health-protector-add-ons-iffhlip25040v022425/document/8686#c-17-3"}],"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":"not-stated","value":null,"display":null,"note":null,"quote":null,"sources":[],"law":[]},{"key":"room_category","label":"Room category allowed","section":"Limits and co-pay","meaning":"Shared room, single private room or any room, by plan, when the limit is a room type rather than a rupee amount.","status":"not-stated","value":null,"display":null,"note":null,"quote":null,"sources":[],"law":[]},{"key":"icu_limit","label":"ICU limit","section":"Limits and co-pay","meaning":"The most the policy pays per day for intensive care.","status":"not-stated","value":null,"display":null,"note":null,"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":"quote-verified","value":"If an insured person chooses a room rent higher than the entitlement limit, associated medical expenses under items (2) and (3), except specified pharmacy, consumables, implants, medical devices and diagnostics, are restricted to the eligible room charges or the same proportion as entitled room rent bears to availed room rent. The proportionate payment will not be less than 40% for those items and does not apply to ICU charges or hospitals without differential billing.","display":"Yes; associated item (2) and (3) expenses are proportionately restricted if room rent exceeds entitlement, with minimum 40% payment and no ICU proportionate deduction","note":null,"quote":"In case Insured Person(s) opt(s) for a room with rent higher than the entitlement limit, the associated medical expenses payable under item (2) and (3) (except costs of pharmacy & covered consumables, implants & medical devices and cost of diagnostics above provided by the Hospital) above of ‘What is Covered’ shall be restricted to: - ... The same proportion as the entitled room rent bears to availed room rent (if hospital tariff is not available or no room available within the eligible room rent). This proportionate payment will not be less than 40% of the claim amount for item 2 & 3 of “What is covered”. The proportionate deduction will not be applied in respect of hospitals which do not follow differential billing or for those expenses in respect of which differential billing is not adopted based on the room category. The proportionate deduction shall also not apply for ICU charges.","sources":[{"clause":"9(i)","heading":null,"page":15,"url":"https://indiainsurances.com/policy/iffco-tokio-general-insurance/essential-health-protector-add-ons-iffhlip25040v022425/document/8686#c-9-i"},{"clause":"9(b)","heading":null,"page":15,"url":"https://indiainsurances.com/policy/iffco-tokio-general-insurance/essential-health-protector-add-ons-iffhlip25040v022425/document/8686#c-9-b"}],"law":[]},{"key":"copay","label":"Co-payment","section":"Limits and co-pay","meaning":"The share of every admissible claim you pay yourself, and when it applies (age, zone, choice of hospital).","status":"quote-verified","value":"There is no mandatory base co-payment stated. Optional voluntary co-payment of 10%, 20% or 25% may be chosen and, if opted, applies on each and every admissible claim as per the schedule.","display":"None unless opted; optional 10%, 20% or 25% on each admissible claim","note":"Optional cover or option; optional covers are not treated as the base answer.","quote":"D. Voluntary Co-Payment:\nThe following Co-pay options are available under the product: 10%, 20% or 25% . The Co-pay percentage, if opted shall be applied on each and every admissible claim as per the schedule.. Once the Co-Pay is opted under the policy, it cannot be opted out during the policy period","sources":[{"clause":null,"heading":"Case 2:Long Term Policies","page":21,"url":"https://indiainsurances.com/policy/iffco-tokio-general-insurance/essential-health-protector-add-ons-iffhlip25040v022425/document/8686#c-case-2-long-term-policies"}],"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":"not-stated","value":null,"display":null,"note":"The wording defines deductible generally but does not state a deductible amount or basis for this product.","quote":null,"sources":[],"law":[]},{"key":"disease_sublimits","label":"Disease or procedure sub-limits","section":"Limits and co-pay","meaning":"Caps on what is paid for named treatments (cataract, knee replacement...), even if the sum insured is higher.","status":"quote-verified","value":["Cataract: For Basic SI 5L- <10L- Rs.50 k per eye; For Basic SI10L-<15L- Rs.75 k per eye; For Basic SI 15L and above - Rs.1 L per eye","ENT Disorders: 10% of the Basic SI, up to Rs.1.5 L","Treatment of Hernia and its immediate complications, including cost of implant: 10% of the Basic SI, upto Rs 1.5 L per site","Hysterectomy: 10% of the Basic SI, upto Rs.2 L","Piles, Hamerrhoidectomy, Fissure, Fistula, Sphincterectomy: 10% of the Basic SI, upto Rs.1.5 L","Knee Ligament: 10% of the Basic SI, upto Rs.2 L","Joint Replacement (including Implant): 20% of the Basic SI, upto Rs.3 L per replacement","PIVD and all other spinal procedures: 20% of the Basic SI, upto Rs.3 L"],"display":"Cataract per-eye caps; ENT, hernia, hysterectomy, piles/fissure/fistula, knee ligament, joint replacement and PIVD/spinal procedure caps","note":null,"quote":"A | Cataract | a) For Basic SI 5L- <10L- Rs.50 k per eye b) For Basic SI10L-<15L- Rs.75 k per eye c) For Basic SI 15L and above - Rs.1 L per eye\nB | ENT Disorders | 10% of the Basic SI, up to Rs.1.5 L\nC | Treatment of Hernia and its immediate complications, including cost of implant | 10% of the Basic SI, upto Rs 1.5 L per site\nD | Hysterectomy | 10% of the Basic SI, upto Rs.2 L\nE | Piles, Hamerrhoidectomy, Fissure, Fistula, Sphincterectomy | 10% of the Basic SI, upto Rs.1.5 L\nF | Knee Ligament | 10% of the Basic SI, upto Rs.2 L\nG | Joint Replacement (including Implant) | 20% of the Basic SI, upto Rs.3 L per replacement\nH | PIVD and all other spinal procedures | 20% of the Basic SI, upto Rs.3 L","sources":[{"clause":"9","heading":null,"page":14,"url":"https://indiainsurances.com/policy/iffco-tokio-general-insurance/essential-health-protector-add-ons-iffhlip25040v022425/document/8686#c-9-2"}],"law":[]},{"key":"pre_hospitalisation","label":"Pre-hospitalisation cover","section":"Cover","meaning":"Medical costs in the days before admission that are paid if related to the hospitalisation.","status":"quote-verified","value":{"unit":"days","amount":60},"display":"60 days","note":null,"quote":"Pre-Hospitalization Medical Expenses incurred up to 60 days prior to Hospitalization for disease/illness/injury sustained, which will be part of Hospitalization expenses claim.","sources":[{"clause":"Row 2(a)","heading":null,"page":22,"url":"https://indiainsurances.com/policy/iffco-tokio-general-insurance/essential-health-protector-add-ons-iffhlip25040v022425/document/8686#c-row-2-a"}],"law":[]},{"key":"post_hospitalisation","label":"Post-hospitalisation cover","section":"Cover","meaning":"Medical costs in the days after discharge that are paid if related to the hospitalisation.","status":"quote-verified","value":{"unit":"days","amount":90},"display":"90 days","note":"For authorised hospitalisation of more than 12 hours but less than 24 hours, the wording separately limits post-hospitalisation to 15 days and allows no pre-hospitalisation expenses.","quote":"Post Hospitalization Medical Expenses incurred during a period up to 90 days after Hospitalization for disease/illness/injury sustained, which will be part of Hospitalization expenses claim.","sources":[{"clause":"Row 2(b)","heading":null,"page":22,"url":"https://indiainsurances.com/policy/iffco-tokio-general-insurance/essential-health-protector-add-ons-iffhlip25040v022425/document/8686#c-row-2-b"}],"law":[]},{"key":"day_care","label":"Day-care treatments","section":"Cover","meaning":"Treatments needing less than 24 hours in hospital (chemotherapy, dialysis, cataract) and whether all or only listed ones are covered.","status":"quote-verified","value":"Day care medical treatments listed in Annexure C are payable even if hospitalisation is less than 24 hours; the list is dynamic.","display":"Listed day-care treatments in Annexure C are covered even if less than 24 hours","note":null,"quote":"Day Care Treatment: Day care medical treatments listed in Annexure C – “List of Day Care Procedures” of the policy document, will be payable even if the duration of hospitalization is less than 24 hours. (Note: The list of such treatments is dynamic and hence may change from time to time.","sources":[{"clause":"Row 2(l)","heading":"Stem cell therapy","page":22,"url":"https://indiainsurances.com/policy/iffco-tokio-general-insurance/essential-health-protector-add-ons-iffhlip25040v022425/document/8686#c-row-2-l"}],"law":[]},{"key":"domiciliary","label":"Treatment at home","section":"Cover","meaning":"Whether treatment at home is covered when hospital admission is not possible or a doctor advises it.","status":"quote-verified","value":"Domiciliary hospitalisation expenses are covered for the relevant covered expenses, excluding road ambulance and daily allowance, if medically necessary and at reasonable and customary charges, up to the sum insured.","display":"Covered up to sum insured, except road ambulance and daily allowance","note":"The specific exclusions list several diseases for which domiciliary hospitalisation is not covered.","quote":"The above stated relevant expenses (except for clause 5 and 6), incurred for Domiciliary Hospitalisation, if Medically Necessary and at Reasonable and Customary Charges, up to the Sum Insured.","sources":[{"clause":"7","heading":null,"page":14,"url":"https://indiainsurances.com/policy/iffco-tokio-general-insurance/essential-health-protector-add-ons-iffhlip25040v022425/document/8686#c-7-2"}],"law":[]},{"key":"ayush","label":"AYUSH treatment","section":"Cover","meaning":"Ayurveda, Yoga, Unani, Siddha and Homeopathy treatment in a recognised hospital, and any limit.","status":"quote-verified","value":"AYUSH hospitalisation expenses incurred in AYUSH Hospitals or AYUSH Day Care Centres are covered, including pre-hospitalisation and post-hospitalisation expenses.","display":"AYUSH hospitalisation in AYUSH Hospitals or AYUSH Day Care Centres, including pre and post hospitalisation","note":null,"quote":"AYUSH hospitalization expenses Incurred in AYUSH Hospitals or AYUSH Day Care Centres. Coverage also includes pre- hospitalization and post hospitalization expenses.","sources":[{"clause":"4","heading":null,"page":14,"url":"https://indiainsurances.com/policy/iffco-tokio-general-insurance/essential-health-protector-add-ons-iffhlip25040v022425/document/8686#c-4-2"}],"law":[{"title":"Guidelines on providing AYUSH coverage in Health Insurance policies, 2024","section":"Para 1","url":"https://indiainsurances.com/law/irdai-ayush-2024"},{"title":"Guidelines on providing AYUSH coverage in Health Insurance policies, 2024","section":"Para 2","url":"https://indiainsurances.com/law/irdai-ayush-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 1","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch II A.I(1)","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 5","url":"https://indiainsurances.com/law/irdai-products-regs-2024"}]},{"key":"modern_treatments","label":"Modern treatments","section":"Cover","meaning":"Robotic surgery, immunotherapy, oral chemotherapy, stem cell therapy and the like, and any cap on them.","status":"quote-verified","value":"Specified modern treatment methods are covered where medically indicated as inpatient, domiciliary, home care or day care treatment in a hospital up to 50% of the sum insured during the policy period.","display":"Covered up to 50% of sum insured for listed modern treatments","note":"The listed procedures also include Balloon Sinuplasty, Deep Brain stimulation, Intra vitreal injections, Stereotactic radio surgeries, Bronchial Thermoplasty, Vaporisation of the prostrate and IONM.","quote":"The following procedures will be covered (wherever medically indicated) either as in patient or as part of Domiciliary Hospitalization or Home Care or as part of day care treatment in a hospital upto 50% of Sum Insured, during the policy period: ... a) Uterine Artery Embolization and HIFU (High intensity focused ultrasound) ... d) Oral chemotherapy ... e) Immunotherapy- Monoclonal Antibody to be given as injection ... g) Robotic surgeries ... l) Stem cell therapy: Hematopoietic stem cells for bone marrow transplant for haematological conditions to be covered.","sources":[{"clause":"Row 2(b)","heading":null,"page":22,"url":"https://indiainsurances.com/policy/iffco-tokio-general-insurance/essential-health-protector-add-ons-iffhlip25040v022425/document/8686#c-row-2-b"},{"clause":"Row 2(a)","heading":null,"page":22,"url":"https://indiainsurances.com/policy/iffco-tokio-general-insurance/essential-health-protector-add-ons-iffhlip25040v022425/document/8686#c-row-2-a-2"},{"clause":"Row 2(d)","heading":null,"page":22,"url":"https://indiainsurances.com/policy/iffco-tokio-general-insurance/essential-health-protector-add-ons-iffhlip25040v022425/document/8686#c-row-2-d"},{"clause":"Row 2(e)","heading":null,"page":22,"url":"https://indiainsurances.com/policy/iffco-tokio-general-insurance/essential-health-protector-add-ons-iffhlip25040v022425/document/8686#c-row-2-e"},{"clause":"Row 2(g)","heading":null,"page":22,"url":"https://indiainsurances.com/policy/iffco-tokio-general-insurance/essential-health-protector-add-ons-iffhlip25040v022425/document/8686#c-row-2-g"},{"clause":"Row 2(l)","heading":"Stem cell therapy","page":22,"url":"https://indiainsurances.com/policy/iffco-tokio-general-insurance/essential-health-protector-add-ons-iffhlip25040v022425/document/8686#c-row-2-l"}],"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":"quote-verified","value":"Hospitalisation expenses of the organ donor during organ transplant are covered within the insured person's applicable sub-limits and sum insured. For donor room rent, the payable amount is 50% of the insured person's room rent limit.","display":"Covered within sum insured and sub-limits; donor room rent limited to 50% of patient's room rent limit","note":"Ambulance charges, pre and post hospitalisation expenses and daily allowance for the donor are excluded.","quote":"Hospitalization expenses of person donating an organ during the course of organ transplant subject to the above sub-limits applicable to the Insured Person and within the sum insured. However, for Room Rent, the amount payable in respect of Donor will be 50% of Room Rent limit of Insured Person(patient) for whom the claim is lodged.","sources":[{"clause":"9(b)","heading":null,"page":15,"url":"https://indiainsurances.com/policy/iffco-tokio-general-insurance/essential-health-protector-add-ons-iffhlip25040v022425/document/8686#c-9-b"}],"law":[]},{"key":"ambulance","label":"Ambulance cover","section":"Cover","meaning":"Road (and air) ambulance cover and its limit.","status":"quote-verified","value":"Road ambulance charges are covered at actuals or Rs.10,000, whichever is less, for each hospitalisation, within the policy sum insured limit.","display":"Road ambulance: actuals or Rs.10,000 per hospitalisation, whichever is less","note":null,"quote":"Road Ambulance Charges: Actuals or Rs.10,000/- whichever is less, for each hospitalization. This benefit is within the Policy Sum Insured limit.","sources":[{"clause":"5","heading":"Road Ambulance Charges","page":14,"url":"https://indiainsurances.com/policy/iffco-tokio-general-insurance/essential-health-protector-add-ons-iffhlip25040v022425/document/8686#c-5-2"}],"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":"quote-verified","value":"After exhaustion of the sum insured, 100% of the basic sum insured is reinstated for the unexpired policy year without reinstatement premium, only once in a policy year. The reinstated sum insured is not available for the same claim, relapse within 45 days, domiciliary hospitalisation, home care or specified chronic diseases where the initial claim was lodged.","display":"100% of Basic Sum Insured reinstated once per policy year after exhaustion; not for same claim, 45-day relapse, domiciliary/home care or listed chronic diseases","note":null,"quote":"After the exhaustion of Sum Insured under the policy, 100% of the Basic Sum Insured shall be reinstated for the unexpired policy year(without any deduction of reinstatement premium), subject to the following: ... Reinstatement shall be made only once in a Policy Year. ... If the claimed amount is higher than the balance Sum Insured under the policy, then this reinstatement benefit will not be triggered for the same claim ... The reinstated Sum Insured would not be available: ... in cases of relapse within 45 days of first hospitalization ... for Domiciliary Hospitalization and Home Care. ... The reinstated basic sum insured will not be available for the following chronic diseases","sources":[{"clause":"9(b)","heading":null,"page":15,"url":"https://indiainsurances.com/policy/iffco-tokio-general-insurance/essential-health-protector-add-ons-iffhlip25040v022425/document/8686#c-9-b"},{"clause":"9(a)","heading":null,"page":16,"url":"https://indiainsurances.com/policy/iffco-tokio-general-insurance/essential-health-protector-add-ons-iffhlip25040v022425/document/8686#c-9-a-2"},{"clause":"9(d)","heading":null,"page":16,"url":"https://indiainsurances.com/policy/iffco-tokio-general-insurance/essential-health-protector-add-ons-iffhlip25040v022425/document/8686#c-9-d"},{"clause":"9(e)","heading":null,"page":16,"url":"https://indiainsurances.com/policy/iffco-tokio-general-insurance/essential-health-protector-add-ons-iffhlip25040v022425/document/8686#c-9-e"},{"clause":"9(e)(i)","heading":null,"page":17,"url":"https://indiainsurances.com/policy/iffco-tokio-general-insurance/essential-health-protector-add-ons-iffhlip25040v022425/document/8686#c-9-e-i"},{"clause":"9(e)(ii)","heading":null,"page":17,"url":"https://indiainsurances.com/policy/iffco-tokio-general-insurance/essential-health-protector-add-ons-iffhlip25040v022425/document/8686#c-9-e-ii"},{"clause":"9(f)","heading":null,"page":17,"url":"https://indiainsurances.com/policy/iffco-tokio-general-insurance/essential-health-protector-add-ons-iffhlip25040v022425/document/8686#c-9-f"}],"law":[]},{"key":"no_claim_bonus","label":"No-claim or cumulative bonus","section":"Cover","meaning":"How much the cover grows each year, the maximum, whether it depends on not claiming, and what happens after a claim.","status":"quote-verified","value":"At renewal, either cumulative bonus or no-claim discount applies based on the option chosen. Cumulative bonus increases by 25% of basic sum insured for the first claim-free policy year and 10% for each later claim-free policy year, up to 100%; in case of claim, existing cumulative bonus is reduced at the rate it accrued, while no-claim discount gives 5% on base premium at renewal until a claim is made.","display":"CB: 25% first claim-free year, 10% each subsequent claim-free year up to 100%; reduced on claim. Or 5% no-claim discount on renewal.","note":"Only one of cumulative bonus and no-claim discount is applicable on renewal.","quote":"The Cumulative Bonus shall be increased by 25% of the basic sum insured for the first claim-free Policy Year and by 10% at each subsequent claim free Policy Year for all Insured Person(s) either individually or on a collective basis, subject to a maximum of 100% ... In case of a claim under the policy in respect of any Insured Person(s), the existing cumulative bonus will be reduced at the rate it had accrued, subject to the stipulation that basic sum insured shall be maintained. ... No Claim Discount A discount of 5% on base premium would be allowed at the time of renewal, if no claim is made in the expiring policy.","sources":[{"clause":"9(a)","heading":null,"page":17,"url":"https://indiainsurances.com/policy/iffco-tokio-general-insurance/essential-health-protector-add-ons-iffhlip25040v022425/document/8686#c-9-a-3"},{"clause":null,"heading":"Grid-A","page":17,"url":"https://indiainsurances.com/policy/iffco-tokio-general-insurance/essential-health-protector-add-ons-iffhlip25040v022425/document/8686#c-grid-a"},{"clause":"Row 12(b)","heading":null,"page":20,"url":"https://indiainsurances.com/policy/iffco-tokio-general-insurance/essential-health-protector-add-ons-iffhlip25040v022425/document/8686#c-row-12-b-2"}],"law":[]},{"key":"consumables","label":"Consumables and non-medical items","section":"Cover","meaning":"Gloves, PPE, syringes and other items hospitals bill that standard policies exclude; whether this policy pays them.","status":"quote-verified","value":"Consumables are not generally covered in the base policy's List I of non-payable items. An optional consumable cover for additional premium pays listed medically necessary consumables when prescribed and when the related hospitalisation, daycare, homecare or domiciliary claim is accepted.","display":"Base excludes non-payable items; optional Consumable cover for additional premium covers listed medically necessary consumables","note":"The consumable cover is an extension available on payment of additional premium and, once opted, cannot be opted out in subsequent renewals.","quote":"List I – List of non-payable Items\nSl. No | Item\n1 | BABY FOOD ... 56 | GLOVES ... 60 | MASK ... 62 | OXYGEN MASK ... In Lieu of payment of additional premium, We shall pay the Reasonable and Customary charges incurred by the Insured Person, mentioned in List hereunder, subject to:\ni) The items payable are prescribed by the treating Medical Practitioner and are medically necessary for the treatment of the same illness/ injury for which Insured Person has taken In-Patient or Daycare Treatment.\nii) We have accepted Claim for Hospitalization/Daycare/Homecare/Domiciliary expenses under the Policy with which this extension is attached.","sources":[{"clause":"Annexure A","heading":null,"page":53,"url":"https://indiainsurances.com/policy/iffco-tokio-general-insurance/essential-health-protector-add-ons-iffhlip25040v022425/document/8686#c-annexure-a"},{"clause":null,"heading":"Consumable cover","page":32,"url":"https://indiainsurances.com/policy/iffco-tokio-general-insurance/essential-health-protector-add-ons-iffhlip25040v022425/document/8686#c-consumable-cover"}],"law":[]},{"key":"maternity","label":"Maternity cover","section":"Cover","meaning":"Whether childbirth costs are covered, the limit and the waiting period.","status":"quote-verified","value":"Base policy excludes maternity expenses except ectopic pregnancy. An optional maternity add-on for extra premium covers inpatient maternity expenses with limits of Rs. 50,000, Rs. 75,000 or Rs. 100,000 by base sum insured and a 24 months waiting period.","display":"Base excluded except ectopic pregnancy; optional add-on after 24 months, up to Rs. 50,000 / 75,000 / 100,000","note":"The optional add-on is not part of the base cover.","quote":"Medical treatment expenses traceable to childbirth (including complicated deliveries and caesarean sections incurred during hospitalization) except ectopic pregnancy; ... In lieu of payment of additional premium, We shall indemnify the Insured Person for Reasonable and Customary inpatient Maternity Expenses, up to the limit of liability mentioned against this Add-On. ... SI 5 L - <10 L | 50,000\nSI 10 L- 15 L | 75,000\nSI >15 L | 100,000 ... A waiting period of continuous 24 months shall be applicable from the time this Add-on is opted by/for the Insured Person under this policy.","sources":[{"clause":"Excl18","heading":"Maternity Expenses (Code - Excl18)","page":36,"url":"https://indiainsurances.com/policy/iffco-tokio-general-insurance/essential-health-protector-add-ons-iffhlip25040v022425/document/8686#c-excl18"},{"clause":null,"heading":"Coverage","page":24,"url":"https://indiainsurances.com/policy/iffco-tokio-general-insurance/essential-health-protector-add-ons-iffhlip25040v022425/document/8638#c-coverage-2"},{"clause":null,"heading":"Annual Sum Insured Limits","page":24,"url":"https://indiainsurances.com/policy/iffco-tokio-general-insurance/essential-health-protector-add-ons-iffhlip25040v022425/document/8638#c-annual-sum-insured-limits-3"},{"clause":null,"heading":"Conditions Applicable","page":24,"url":"https://indiainsurances.com/policy/iffco-tokio-general-insurance/essential-health-protector-add-ons-iffhlip25040v022425/document/8638#c-conditions-applicable-4"}],"law":[]},{"key":"newborn","label":"Newborn baby cover","section":"Cover","meaning":"Whether a newborn is covered from birth and for what.","status":"quote-verified","value":"A newborn baby is a baby born during the policy period and aged up to 90 days. No waiting period or sub-limits apply from the date the newborn baby has been added to the policy by endorsement on payment of additional premium.","display":"Covered from endorsement on payment of additional premium; no waiting period or sub-limits from that date","note":null,"quote":"Newborn baby means baby born during the policy period and is aged upto 90 days. ... No waiting period/ sub-limits are applicable from the date the Newborn baby (as defined) has been added in the policy through an endorsement upon payment of additional premium.","sources":[{"clause":"48","heading":"Newborn baby","page":7,"url":"https://indiainsurances.com/policy/iffco-tokio-general-insurance/essential-health-protector-add-ons-iffhlip25040v022425/document/8686#c-48"},{"clause":"9(b)","heading":null,"page":15,"url":"https://indiainsurances.com/policy/iffco-tokio-general-insurance/essential-health-protector-add-ons-iffhlip25040v022425/document/8686#c-9-b"}],"law":[]},{"key":"mental_illness","label":"Mental illness","section":"Cover","meaning":"Cover for in-patient treatment of mental illness.","status":"not-stated","value":null,"display":null,"note":"The documents mention a mental health helpline under wellness services and mental or nervous disorders under emergency assistance exclusions, but do not state inpatient mental illness cover for the base health indemnity benefit.","quote":null,"sources":[],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 3","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch III I","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"The Mental Healthcare Act, 2017","section":"Section 21(4)","url":"https://indiainsurances.com/law/mental-healthcare-act-2017"},{"title":"The Mental Healthcare Act, 2017","section":"Section 2(1)(s)","url":"https://indiainsurances.com/law/mental-healthcare-act-2017"},{"title":"The Mental Healthcare Act, 2017","section":"Section 21(1)","url":"https://indiainsurances.com/law/mental-healthcare-act-2017"}]},{"key":"health_checkup","label":"Health check-up","section":"Cover","meaning":"Free preventive check-ups and how often.","status":"quote-verified","value":"Periodic medical check-up is available upon renewal. For floater policies, Rs. 5 lacs to less than Rs. 10 lacs gets Gold Package after each claim-free policy year for any one member, Rs. 10 lacs up to Rs. 25 lacs gets Platinum Package after each policy year for any one member, and above Rs. 25 lacs gets Platinum Package after each policy year for any two members; individual policies have Gold after each claim-free year for Rs. 5 lacs to less than Rs. 10 lacs and Platinum after each policy year for Rs. 10 lacs and above.","display":"Health check-up on renewal; Gold or Platinum package based on sum insured and individual/floater basis","note":"The health check-up can be availed only through the insurer's empaneled service provider on cashless basis.","quote":"Health check-up: Insured Person(s) shall be entitled to undergo a periodic medical checkup upon renewal of the policy. This benefit is dependent on the Basic sum insured of the policy. ... 5 lacs to Less than 10 lacs | After each claim free Policy year | Any one member | Gold Package\n10 lacs upto 25 Lacs | After each Policy year, irrespective of claim | Any one member | Platinum Package\nAbove 25 lacs | After each Policy year, irrespective of claim | Any two members | Platinum Package ... 5 lacs to Less than 10 lacs | After each claim free Policy year | Gold Package\n10 lacs and above | After each Policy year, irrespective of claim | Platinum Package","sources":[{"clause":"Row 2(l)","heading":"Stem cell therapy","page":22,"url":"https://indiainsurances.com/policy/iffco-tokio-general-insurance/essential-health-protector-add-ons-iffhlip25040v022425/document/8686#c-row-2-l"},{"clause":"Row 2(a)","heading":null,"page":23,"url":"https://indiainsurances.com/policy/iffco-tokio-general-insurance/essential-health-protector-add-ons-iffhlip25040v022425/document/8686#c-row-2-a-3"},{"clause":"Row 2(b)","heading":null,"page":23,"url":"https://indiainsurances.com/policy/iffco-tokio-general-insurance/essential-health-protector-add-ons-iffhlip25040v022425/document/8686#c-row-2-b-3"}],"law":[]},{"key":"opd","label":"Out-patient (OPD) cover","section":"Cover","meaning":"Doctor consultations, tests and medicines without admission, and the limit.","status":"quote-verified","value":"The base policy excludes procedures or treatments mainly done in OPD even if converted to day care or inpatient to make a hospitalisation claim. An optional OPD add-on for extra premium covers OPD consultation and associated diagnostic services up to Rs. 10,000, Rs. 15,000 or Rs. 20,000 by base policy sum insured.","display":"Base OPD procedures excluded; optional OPD add-on up to Rs. 10,000 / 15,000 / 20,000","note":"The OPD add-on is not part of the base cover.","quote":"Procedures/treatments mainly done in outpatient department (OPD) even if these are converted to day care surgery or as in patient in hospital to make it hospitalization claim. ... In lieu of payment of additional premium, We shall indemnify the Reasonable and Customary Charges incurred within the Policy Period for OPD Consultation and/or associated Diagnostic Services pertaining to the Insured Person(s) up to the limit of liability mentioned against this Add-On for each policy year in the Policy Schedule. ... SI 5 L - <10 L | 10,000\nSI 10 L- 15 L | 15,000\nSI >15 L | 20,000","sources":[{"clause":"17","heading":null,"page":37,"url":"https://indiainsurances.com/policy/iffco-tokio-general-insurance/essential-health-protector-add-ons-iffhlip25040v022425/document/8686#c-17-2"},{"clause":null,"heading":"Coverage","page":21,"url":"https://indiainsurances.com/policy/iffco-tokio-general-insurance/essential-health-protector-add-ons-iffhlip25040v022425/document/8638#c-coverage"},{"clause":null,"heading":"Annual Sum Insured Limits","page":22,"url":"https://indiainsurances.com/policy/iffco-tokio-general-insurance/essential-health-protector-add-ons-iffhlip25040v022425/document/8638#c-annual-sum-insured-limits"}],"law":[]},{"key":"zone_pricing","label":"Zone or city-based premium","section":"Premium","meaning":"Whether premium or co-pay depends on the city you are treated in.","status":"not-stated","value":null,"display":null,"note":null,"quote":null,"sources":[],"law":[]},{"key":"cashless","label":"Cashless treatment","section":"Claims","meaning":"Whether and where the insurer pays the hospital directly instead of you paying and claiming back.","status":"quote-verified","value":"Cashless facility is available at network providers, where the insurer pays treatment costs directly to the network provider to the extent pre-authorisation is approved. Treatment may be taken in a network provider and is subject to pre-authorisation by the insurer or authorised TPA.","display":"Cashless at network providers, subject to pre-authorisation","note":null,"quote":"Cashless facility means a facility extended by Us to the Insured Person where the payments, of the costs of treatment undergone by the Insured Person in accordance with the policy terms and conditions, are directly made to the network provider by Us to the extent pre-authorization is approved. ... Treatment may be taken in a network provider and is subject to pre authorization by Us or Our authorized TPA.","sources":[{"clause":"12","heading":"Cashless facility","page":3,"url":"https://indiainsurances.com/policy/iffco-tokio-general-insurance/essential-health-protector-add-ons-iffhlip25040v022425/document/8686#c-12"},{"clause":"15(b)","heading":null,"page":43,"url":"https://indiainsurances.com/policy/iffco-tokio-general-insurance/essential-health-protector-add-ons-iffhlip25040v022425/document/8686#c-15-b"}],"law":[]},{"key":"claims_handled_by","label":"Claims handled by","section":"Claims","meaning":"The insurer itself or a third-party administrator (TPA).","status":"conflicting","value":"The wording refers to contacting the Third Party Administrator or the insurer and to pre-authorisation by the insurer or authorised TPA. The prospectus says the claim is directly serviced by IFFCO TOKIO without any third-party administrator.","display":"Conflicting: wording says Third Party Administrator/Us; prospectus says directly serviced by IFFCO TOKIO without TPA","note":"Prospectus says: 'Claim is directly serviced by IFFCO TOKIO without any Third party administrator.'","quote":"The Insured Person must contact the Third Party Administrator/Us at least 48 hours before a planned Hospitalization. ... Treatment may be taken in a network provider and is subject to pre authorization by Us or Our authorized TPA. ... Claim is directly serviced by IFFCO TOKIO without any Third party administrator.","sources":[{"clause":"15(a)","heading":null,"page":43,"url":"https://indiainsurances.com/policy/iffco-tokio-general-insurance/essential-health-protector-add-ons-iffhlip25040v022425/document/8686#c-15-a"},{"clause":"15(b)","heading":null,"page":43,"url":"https://indiainsurances.com/policy/iffco-tokio-general-insurance/essential-health-protector-add-ons-iffhlip25040v022425/document/8686#c-15-b"},{"clause":null,"heading":"How does the Health Product benefits you","page":1,"url":"https://indiainsurances.com/policy/iffco-tokio-general-insurance/essential-health-protector-add-ons-iffhlip25040v022425/document/8638#c-how-does-the-health-product-benefits-you"}],"law":[]},{"key":"family_floater","label":"Family floater available","section":"Cover","meaning":"Whether one sum insured can be shared by the whole family.","status":"quote-verified","value":true,"display":"Yes, floater sum insured basis is available","note":null,"quote":"It means the amount of Sum Insured mentioned in the Policy Schedule which is common to the whole family covered under the policy which will be the maximum amount payable under this policy for all the covered family members put together, during the policy period if opted to be a Floater policy.","sources":[{"clause":"28","heading":"Floater Benefit","page":4,"url":"https://indiainsurances.com/policy/iffco-tokio-general-insurance/essential-health-protector-add-ons-iffhlip25040v022425/document/8686#c-28"}],"law":[]}],"documents":[{"kind":"wording","label":"Essential Health Protector","pages":70,"fetched_at":"2026-10-17 19:46:26+00","source_url":"https://www.iffcotokio.co.in/content/dam/iffcotokio/iffco-pdf/wordings_EHP.pdf","url":"https://indiainsurances.com/policy/iffco-tokio-general-insurance/essential-health-protector-add-ons-iffhlip25040v022425/document/8686"},{"kind":"prospectus","label":"Essential Health Protector + Add -Ons","pages":44,"fetched_at":"2026-10-17 19:44:58+00","source_url":"https://www.iffcotokio.co.in/content/dam/iffcotokio/prospectus/health/prospectus-EHP.pdf","url":"https://indiainsurances.com/policy/iffco-tokio-general-insurance/essential-health-protector-add-ons-iffhlip25040v022425/document/8638"}],"versions":[],"where_to_buy":[{"purpose":"buy","kind":"insurer","name":"IFFCO TOKIO General Insurance official website","url":"https://www.iffcotokio.co.in/","note":"Buy directly from the insurer."},{"purpose":"buy","kind":"ours","name":"Get free help from IndiaInsurances","url":"/help","note":"Free. We do not sell insurance and earn no commission; your request is not passed to anyone."}],"claims_and_complaints":[{"purpose":"claim","kind":"insurer","name":"Claims","url":"https://www.iffcotokio.co.in/claims","note":null},{"purpose":"claim","kind":"insurer","name":"Register a claim","url":"https://www.iffcotokio.co.in/claims/register-a-claim","note":null},{"purpose":"claim","kind":"ours","name":"Get free help from IndiaInsurances","url":"/help","note":"Free. We do not sell insurance and earn no commission; your request is not passed to anyone."},{"purpose":"grievance","kind":"insurer","name":"Grievance redressal","url":"https://www.iffcotokio.co.in/contact-us/customer-services/grievance-redressal","note":null},{"purpose":"grievance","kind":"official","name":"Bima Bharosa (IRDAI grievance portal)","url":"https://bimabharosa.irdai.gov.in/","note":"Register and track a complaint against any insurer with IRDAI. Complain to the insurer first; escalate here if the reply is late or unsatisfactory."},{"purpose":"grievance","kind":"official","name":"e-Daakhil (consumer commission e-filing)","url":"https://edaakhil.nic.in/","note":"Not reachable from our crawler on 2026-10-19; use e-Jagriti if this link does not open."},{"purpose":"grievance","kind":"official","name":"e-Jagriti (consumer commission filing)","url":"https://e-jagriti.gov.in/","note":"Ministry of Consumer Affairs platform for consumer commission cases, a route for insurance disputes that the Ombudsman does not settle."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Ahmedabad","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Gujarat, Dadra & Nagar Haveli, Daman and Diu. Email: oio.ahmedabad@cioins.co.in. Phone: 079 - 25501201/02. Address: Office of the Insurance Ombudsman, Jeevan Prakash Building, 6th floor, Tilak Marg, Relief Road, AHMEDABAD – 380 001."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Bengaluru","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Karnataka. Email: oio.bengaluru@cioins.co.in. Phone: 080 - 26652048 / 26652049. Address: Office of the Insurance Ombudsman, Jeevan Soudha Building,PID No. 57-27-N-19 Ground Floor, 19/19, 24th Main Road, JP Nagar, Ist Phase, Bengaluru – 560 078."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Bhopal","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Madhya Pradesh, Chhattisgarh. Email: oio.bhopal@cioins.co.in. Phone: 0755 - 2769201 / 2769202 / 2769203. Address: Office of the Insurance Ombudsman, 1st floor,\"Jeevan Shikha\", 60-B,Hoshangabad Road, Opp. Gayatri Mandir,Arera Hills Bhopal – 462 011."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Bhubaneswar","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Odisha. Email: oio.bhubaneswar@cioins.co.in. Phone: 0674 - 2596461 /2596455/2596429/2596003. Address: Office of the Insurance Ombudsman, 62, Forest park, Bhubaneswar – 751 009."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Chandigarh","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Punjab, Haryana (excluding Gurugram, Faridabad, Sonepat and Bahadurgarh), Himachal Pradesh, Union Territories of Jammu & Kashmir,Ladakh & Chandigarh. Email: oio.chandigarh@cioins.co.in. Phone: 0172-2706468. Address: Office Of The Insurance Ombudsman, Jeevan Deep Building SCO 20-27, Ground Floor Sector- 17 A, Chandigarh – 160 017."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Chennai","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Tamil Nadu, PuducherryTown and Karaikal (which are part of Puducherry). Email: oio.chennai@cioins.co.in. Phone: 044 - 24333668 / 24333678. Address: Office of the Insurance Ombudsman, Fatima Akhtar Court, 4th Floor, 453, Anna Salai, Teynampet, CHENNAI – 600 018."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Delhi","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Delhi & following Districts of Haryana - Gurugram, Faridabad, Sonepat & Bahadurgarh. Email: oio.delhi@cioins.co.in. Phone: 011 - 46013992/23213504/23232481. Address: Office of the Insurance Ombudsman, 2/2 A, Universal Insurance Building, Asaf Ali Road, New Delhi – 110 002."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Guwahati","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Assam, Meghalaya, Manipur, Mizoram, Arunachal Pradesh, Nagaland and Tripura. Email: oio.guwahati@cioins.co.in. Phone: 0361 - 2632204 / 2602205 / 2631307. Address: Office of the Insurance Ombudsman, Jeevan Nivesh, 5th Floor, Near Pan Bazar , S.S. Road, Guwahati – 781001(ASSAM)."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Hyderabad","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Andhra Pradesh, Telangana, Yanam and part of Union Territory of Puducherry. Email: oio.hyderabad@cioins.co.in. Phone: 040 - 23312122 / 23376991 / 23376599 / 23328709 / 23325325. Address: Office of the Insurance Ombudsman, 6-2-46, 1st floor, \"Moin Court\", Lane Opp.Hyundai Showroom , A. C. Guards, Lakdi-Ka-Pool, Hyderabad - 500 004."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Jaipur","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Rajasthan. Email: oio.jaipur@cioins.co.in. Phone: 0141- 2740363. Address: Office of the Insurance Ombudsman, Jeevan Nidhi – II Bldg., Gr. Floor, Bhawani Singh Marg, Jaipur - 302 005."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Kochi","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Kerala, Lakshadweep, Mahe-a part of Union Territory of Puducherry. Email: oio.ernakulam@cioins.co.in. Phone: 0484 - 2358759. Address: Office of the Insurance Ombudsman, 10th Floor, Jeevan Prakash,LIC Building, Opp to Maharaja's College Ground,M.G.Road, Kochi - 682 011."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Kolkata","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: West Bengal, Sikkim, Andaman & Nicobar Islands. Email: oio.kolkata@cioins.co.in. Phone: 033 - 22124339 / 22124341. Address: Office of the Insurance Ombudsman, Hindustan Bldg. Annexe, 7th Floor, 4, C.R. Avenue, KOLKATA - 700 072."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Lucknow","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Districts of Uttar Pradesh : Lalitpur, Jhansi, Mahoba, Hamirpur, Banda, Chitrakoot, Allahabad, Mirzapur, Sonbhabdra, Fatehpur, Pratapgarh, Jaunpur,Varanasi, Gazipur, Jalaun, Kanpur, Lucknow, Unnao, Sitapur, Lakhimpur, Bahraich, Barabanki, Raebareli, Sravasti, Gonda, Faizabad, Amethi, Kaushambi, Balrampur, Basti, Ambedkarnagar, Sultanpur, Maharajgang, Santkabirnagar, Azamgarh, Kushinagar, Gorkhpur, Deoria, Mau, Ghazipur, Chandauli, Ballia, Sidharathnagar. Email: oio.lucknow@cioins.co.in. Phone: 0522 - 4002082 / 3500613. Address: Office of the Insurance Ombudsman, 6th Floor, Jeevan Bhawan, Phase-II, Nawal Kishore Road, Hazratganj, Lucknow - 226 001."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Mumbai","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: List of wards under Mumbai Metropolitan Region excluding wards in Mumbai – i.e M/E, M/W, N , S and T covered under Office of Insurance Ombudsman Thane and excluding areas of Navi Mumbai. Email: oio.mumbai@cioins.co.in. Phone: 022 - 69038800/27/29/31/32/33. Address: Office of the Insurance Ombudsman, 3rd Floor, Jeevan Seva Annexe, S. V. Road, Santacruz (W), Mumbai - 400 054."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Noida","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: State of Uttarakhand and the following Districts of Uttar Pradesh: Agra, Aligarh, Bagpat, Bareilly, Bijnor, Budaun, Bulandshehar, Etah, Kannauj, Mainpuri, Mathura, Meerut, Moradabad, Muzaffarnagar, Oraiyya, Pilibhit, Etawah, Farrukhabad, Firozbad, Gautam Buddh nagar, Ghaziabad, Hardoi, Shahjahanpur, Hapur, Shamli, Rampur, Kashganj, Sambhal, Amroha, Hathras, Kanshiramnagar, Saharanpur. Email: oio.noida@cioins.co.in. Phone: 0120-4027589. Address: Office of the Insurance Ombudsman, Bhagwan Sahai Palace 4th Floor, Main Road, Naya Bans, Sector 15, Distt: Gautam Buddh Nagar, U.P-201301."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman: offices and jurisdiction","url":"https://www.cioins.co.in/Ombudsman","note":"Addresses, phone numbers, e-mail and the states or districts each Ombudsman office covers."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Patna","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Bihar, Jharkhand. Email: oio.patna@cioins.co.in. Phone: 0612-2547068. Address: Office of the Insurance Ombudsman, 2nd Floor, Lalit Bhawan, Bailey Road, Patna 800 001."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Pune","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: State of Goa and State of Maharashtra excluding areas of Navi Mumbai, Thane district,Palghar District, Raigad district & Mumbai Metropolitan Region. Email: oio.pune@cioins.co.in. Phone: 020-24471175. Address: Office of the Insurance Ombudsman, Jeevan Darshan Bldg., 3rd Floor, C.T.S. No.s. 195 to 198, N.C. Kelkar Road, Narayan Peth, Pune – 411 030."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman: register a complaint online","url":"https://cioins.co.in/Complaint/Online","note":"Council for Insurance Ombudsmen. Free. For disputes with an insurer after its own grievance process; the office is chosen by where you live (see the offices list)."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Thane","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Area of Navi Mumbai, Thane District, Raigad District, Palghar District and wards of Mumbai , M/East, M/West, N, S and T. Email: oio.thane@cioins.co.in. Phone: 022-20812868/69. Address: Office of the Insurance Ombudsman, Jeevan Chintamani Building, 2nd Floor,Near New RTO Office, Louis Wadi,Vasantrao Naik Mahamarg, Thane (West)- 400604."},{"purpose":"grievance","kind":"official","name":"National Consumer Helpline","url":"https://consumerhelpline.gov.in/public/","note":"Government consumer helpline; can take up a complaint before you go to a consumer commission."},{"purpose":"port","kind":"ours","name":"Get free help from IndiaInsurances","url":"/help","note":"Free. We do not sell insurance and earn no commission; your request is not passed to anyone."},{"purpose":"renew","kind":"insurer","name":"Renew policy","url":"https://www.iffcotokio.co.in/renew-policy","note":null}],"notice":"Information, not advice. IndiaInsurances is not an insurer or an insurance intermediary, does not sell insurance and earns no commission. Policy terms change and your own policy schedule can differ: always confirm with the policy document and the insurer before you buy or claim.","cite_as":"Essential Health Protector + Add -Ons (UIN IFFHLIP25040V022425), IndiaInsurances, https://indiainsurances.com/policy/iffco-tokio-general-insurance/essential-health-protector-add-ons-iffhlip25040v022425"}