{"uin":"MCIHLIP24011V072324","name":"ManipalCigna ProHealth Insurance","url":"https://indiainsurances.com/policy/manipal-cigna-health-insurance/manipalcigna-prohealth-insurance-mcihlip24011v072324","insurer":{"slug":"manipal-cigna-health-insurance","name":"Manipal Cigna Health Insurance Company Limited","url":"https://indiainsurances.com/insurer/manipal-cigna-health-insurance"},"line":"health","category":"health-indemnity","category_name":"Health insurance (hospitalisation)","irdai_type":"Revision","kind":"product","status":"active","approved_on":"2022-02-11","withdrawn_on":null,"summary":"ManipalCigna ProHealth Insurance is a health indemnity policy with Protect, Plus, Preferred, Premier and Accumulate plans. It has a 30 days initial illness waiting period, plan-wise PED waiting of 24, 36 or 48 months, and 100% restoration for any number of times in a Policy Year for unrelated future claims.","analysis":{"state":"machine","analysed_at":"2026-10-19 21:46:24.264233+00","note":"First pass: one AI reading; every stated fact carries a verbatim quote found in the cited clause, but it has not been reviewed. Check the clause before relying on it."},"facts":[{"key":"plan_variants","label":"Plans and variants","section":"Overview","meaning":"The named plans inside this product (not cover types or payout options). Facts can differ between them.","status":"quote-verified","value":["Protect","Plus","Preferred","Premier","Accumulate"],"display":"Protect, Plus, Preferred, Premier and Accumulate","note":null,"quote":"24 months for Preferred, Premier plan/ 36 months for Plus, Accumulate plan/ 48 months for Protect plan","sources":[{"clause":null,"heading":"E.I. Standard Exclusions","page":14,"url":"https://indiainsurances.com/policy/manipal-cigna-health-insurance/manipalcigna-prohealth-insurance-mcihlip24011v072324/document/12779#c-e-i-standard-exclusions"}],"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":"One policy year is 12 consecutive months. The policy also refers to 2-year and 3-year policy periods.","display":"1, 2 or 3 years","note":null,"quote":"Policy Year means a period of 12 consecutive months within the Policy Period commencing from the Policy Anniversary Date. ... In case where the Policy Period for 2/3 years, the Sum Insured specified on the Policy is the limit for the first Policy Year.","sources":[{"clause":null,"heading":"C.II. Specific Definitions","page":4,"url":"https://indiainsurances.com/policy/manipal-cigna-health-insurance/manipalcigna-prohealth-insurance-mcihlip24011v072324/document/12779#c-c-ii-specific-definitions"}],"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 planned hospitalisation, intimate at least 3 days before the planned admission. For emergency hospitalisation, intimate within 48 hours of admission; worldwide emergency claims also require intimation within 48 hours of admission.","display":"Planned: at least 3 days before admission; emergency: within 48 hours of admission","note":"For Worldwide Emergency Cover, the policy also says intimation must be within 48 hours of admission.","quote":"Planned Hospitalization, You/the Insured Person will intimate such admission at least 3 days prior to the planned date of admission. ... Emergency Hospitalization, You /the Insured Person will intimate such admission within 48 hours of such admission.","sources":[{"clause":null,"heading":"G.I.3. Claim Intimation","page":20,"url":"https://indiainsurances.com/policy/manipal-cigna-health-insurance/manipalcigna-prohealth-insurance-mcihlip24011v072324/document/12779#c-g-i-3-claim-intimation"}],"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 signed","Copy of photo ID of patient","Hospital Discharge summary","Operation Theatre notes","Hospital Main Bill","Hospital Break up bill","Investigation reports","Original investigation reports, X Ray, MRI, CT films, HPE, ECG","Doctors reference slip for investigation","Pharmacy Bills","MLC/ FIR report, Post Mortem Report if applicable and conducted","KYC documents","Cancelled cheque for NEFT payment","Payment receipt"],"display":"Claim form, photo ID, discharge summary, OT notes, hospital bills, investigation reports, doctors reference slip, pharmacy bills, MLC/FIR/post mortem if applicable, KYC, cancelled cheque and payment receipt","note":null,"quote":"Claim form duly signed Copy of photo ID of patient Hospital Discharge summary Operation Theatre notes Hospital Main Bill Hospital Break up bill Investigation reports Original investigation reports, X Ray, MRI, CT films, HPE, ECG Doctors reference slip for investigation Pharmacy Bills MLC/ FIR report, Post Mortem Report if applicable and conducted\nKYC documents (Photo ID proof, address proof, recent passport size | ManipalCigna ProHealth Insurance | Terms & Conditions | UIN: MCIHLIP24011V072324 | April 2023\nphotograph) Cancelled cheque for NEFT payment Payment receipt.","sources":[{"clause":"Row 1(a)(ii)","heading":null,"page":21,"url":"https://indiainsurances.com/policy/manipal-cigna-health-insurance/manipalcigna-prohealth-insurance-mcihlip24011v072324/document/12779#c-row-1-a-ii-2"}],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 17","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 22","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 23","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, V.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, V.3(iii)","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part C, V.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"}]},{"key":"claim_settlement_time","label":"Claim settlement time promised","section":"Claims","meaning":"How quickly the policy says a claim is decided or paid, and from when that is counted (intimation or last document).","status":"quote-verified","value":"The company must settle or reject the claim within 30 days from receipt of the last necessary document. If investigation is warranted, it must be completed within 30 days from receipt of the last necessary document and the claim settled or rejected within 45 days from receipt of the last necessary document; delay attracts interest at 2% above bank rate.","display":"30 days from last necessary document; 45 days where investigation is needed","note":null,"quote":"The Company shall settle or reject the claim, as the case may be, within 30 days from the date of receipt of last necessary document. ... Company shall settle or reject the claim within 45 days from the date of receipt of last necessary document. ... to pay interest to the policyholder at a rate 2% above the bank rate","sources":[{"clause":null,"heading":"F.I.3. Claim Settlement (provision for Penal Interest)","page":16,"url":"https://indiainsurances.com/policy/manipal-cigna-health-insurance/manipalcigna-prohealth-insurance-mcihlip24011v072324/document/12779#c-f-i-3-claim-settlement-provision-for-penal-inter"},{"clause":null,"heading":"Refund Grid as % of Premium","page":16,"url":"https://indiainsurances.com/policy/manipal-cigna-health-insurance/manipalcigna-prohealth-insurance-mcihlip24011v072324/document/12779#c-refund-grid-as-of-premium"}],"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":["Pre-existing Disease - Code-Excl. 01","Specified disease/procedure Waiting Period - Code-E.I.2","30 days Waiting Period - Code-E.I.3","Investigation & Evaluation - Code-Excl 04","Rest Cure, rehabilitation and respite care - Code-Excl 05","Obesity/ Weight Control Code-Excl 06","Change-of-Gender treatments Code-Excl 07","Cosmetic or Plastic Surgery Code- Excl 08","Hazardous or Adventure sports Code-Excl 09","Breach of law Code-Excl 10","Excluded Providers Code-Excl 11","Treatment for Alcoholism, drug or substance abuse or any addictive condition and consequences thereof. Code-Excl 12","Refractive Error Code-Excl 15","Unproven Treatments Code-Excl 16","Sterility and Infertility Code-Excl 17"],"display":"PED, specified disease/procedure waiting period, 30 days waiting period, investigation and evaluation, rest cure, obesity surgery, change of gender, cosmetic surgery, hazardous sports, breach of law, excluded providers, alcoholism/drug abuse, refractive error, unproven treatments, sterility and infertility","note":null,"quote":"E.I.1. Pre-existing Disease - Code-Excl. 01 ... E.I.2. Specified disease/procedure Waiting Period - Code-E.I.2 ... E.I.3. 30 days Waiting Period - Code-E.I.3 ... E.I.4. Investigation & Evaluation - Code-Excl 04 ... E.I.5. Rest Cure, rehabilitation and respite care - Code-Excl 05 ... E.I.6. Obesity/ Weight Control Code-Excl 06 ... E.I.7. Change-of-Gender treatments Code-Excl 07 ... E.I.8. Cosmetic or Plastic Surgery Code- Excl 08 ... E.I.9. Hazardous or Adventure sports Code-Excl 09 ... E.I.10. Breach of law Code-Excl 10 ... E.I.11. Excluded Providers Code-Excl 11 ... Treatment for Alcoholism, drug or substance abuse or any addictive condition and consequences thereof. Code-Excl 12 ... E.I.15. Refractive Error Code-Excl 15 ... E.I.16. Unproven Treatments Code-Excl 16 ... E.I.17. Sterility and Infertility Code-Excl 17","sources":[{"clause":null,"heading":"E.I. Standard Exclusions","page":14,"url":"https://indiainsurances.com/policy/manipal-cigna-health-insurance/manipalcigna-prohealth-insurance-mcihlip24011v072324/document/12779#c-e-i-standard-exclusions"},{"clause":null,"heading":"E.I.2. Specified disease/procedure Waiting Period - Code-E.I.2","page":14,"url":"https://indiainsurances.com/policy/manipal-cigna-health-insurance/manipalcigna-prohealth-insurance-mcihlip24011v072324/document/12779#c-e-i-2-specified-disease-procedure-waiting-period"},{"clause":null,"heading":"E.I.4. Investigation & Evaluation - Code-Excl 04","page":14,"url":"https://indiainsurances.com/policy/manipal-cigna-health-insurance/manipalcigna-prohealth-insurance-mcihlip24011v072324/document/12779#c-e-i-4-investigation-evaluation-code-excl-04"},{"clause":null,"heading":"E.I.5. Rest Cure, rehabilitation and respite care - Code-Excl 05","page":14,"url":"https://indiainsurances.com/policy/manipal-cigna-health-insurance/manipalcigna-prohealth-insurance-mcihlip24011v072324/document/12779#c-e-i-5-rest-cure-rehabilitation-and-respite-care"},{"clause":null,"heading":"E.I.6. Obesity/ Weight Control Code-Excl 06","page":15,"url":"https://indiainsurances.com/policy/manipal-cigna-health-insurance/manipalcigna-prohealth-insurance-mcihlip24011v072324/document/12779#c-e-i-6-obesity-weight-control-code-excl-06"},{"clause":null,"heading":"E.I.7. Change-of-Gender treatments Code-Excl 07","page":15,"url":"https://indiainsurances.com/policy/manipal-cigna-health-insurance/manipalcigna-prohealth-insurance-mcihlip24011v072324/document/12779#c-e-i-7-change-of-gender-treatments-code-excl-07"},{"clause":null,"heading":"E.I.8. Cosmetic or Plastic Surgery Code- Excl 08","page":15,"url":"https://indiainsurances.com/policy/manipal-cigna-health-insurance/manipalcigna-prohealth-insurance-mcihlip24011v072324/document/12779#c-e-i-8-cosmetic-or-plastic-surgery-code-excl-08"},{"clause":null,"heading":"E.I.9. Hazardous or Adventure sports Code-Excl 09","page":15,"url":"https://indiainsurances.com/policy/manipal-cigna-health-insurance/manipalcigna-prohealth-insurance-mcihlip24011v072324/document/12779#c-e-i-9-hazardous-or-adventure-sports-code-excl-09"},{"clause":null,"heading":"E.I.10. Breach of law Code-Excl 10","page":15,"url":"https://indiainsurances.com/policy/manipal-cigna-health-insurance/manipalcigna-prohealth-insurance-mcihlip24011v072324/document/12779#c-e-i-10-breach-of-law-code-excl-10"},{"clause":null,"heading":"E.I.11. Excluded Providers Code-Excl 11","page":15,"url":"https://indiainsurances.com/policy/manipal-cigna-health-insurance/manipalcigna-prohealth-insurance-mcihlip24011v072324/document/12779#c-e-i-11-excluded-providers-code-excl-11"},{"clause":null,"heading":"E.I.15. Refractive Error Code-Excl 15","page":15,"url":"https://indiainsurances.com/policy/manipal-cigna-health-insurance/manipalcigna-prohealth-insurance-mcihlip24011v072324/document/12779#c-e-i-15-refractive-error-code-excl-15"},{"clause":null,"heading":"E.I.16. Unproven Treatments Code-Excl 16","page":15,"url":"https://indiainsurances.com/policy/manipal-cigna-health-insurance/manipalcigna-prohealth-insurance-mcihlip24011v072324/document/12779#c-e-i-16-unproven-treatments-code-excl-16"},{"clause":null,"heading":"E.I.17. Sterility and Infertility Code-Excl 17","page":15,"url":"https://indiainsurances.com/policy/manipal-cigna-health-insurance/manipalcigna-prohealth-insurance-mcihlip24011v072324/document/12779#c-e-i-17-sterility-and-infertility-code-excl-17"}],"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":"not-stated","value":null,"display":null,"note":null,"quote":null,"sources":[],"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":"not-stated","value":null,"display":null,"note":"The benefit chart contains OCR-garbled sum insured amounts, so the available cover amounts cannot be reliably extracted.","quote":null,"sources":[],"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 accident claims if otherwise covered; also does not apply after more than twelve months of continuous coverage.","quote":"Expenses related to the treatment of any illness within 30 days of continuous coverage from the first policy commencement date shall be excluded except claims arising due to an accident, provided the same are covered.","sources":[{"clause":null,"heading":"E.I.2. Specified disease/procedure Waiting Period - Code-E.I.2","page":14,"url":"https://indiainsurances.com/policy/manipal-cigna-health-insurance/manipalcigna-prohealth-insurance-mcihlip24011v072324/document/12779#c-e-i-2-specified-disease-procedure-waiting-period"}],"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":24},"display":"24 months for Preferred and Premier; 36 months for Plus and Accumulate; 48 months for Protect","note":"Shortest waiting period shown in value; longer plan-specific periods are in the display.","quote":"Expenses related to the treatment of a Pre-existing Disease (PED) and its direct complications shall be excluded until the expiry of applicable months (24 months for Preferred, Premier plan/ 36 months for Plus, Accumulate plan/ 48 months for Protect plan) of continuous coverage after the date of inception of the first policy with us.","sources":[{"clause":null,"heading":"E.I. Standard Exclusions","page":14,"url":"https://indiainsurances.com/policy/manipal-cigna-health-insurance/manipalcigna-prohealth-insurance-mcihlip24011v072324/document/12779#c-e-i-standard-exclusions"}],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 8","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 12","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 1.6","url":"https://indiainsurances.com/law/irdai-products-regs-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 7","url":"https://indiainsurances.com/law/irdai-products-regs-2024"}]},{"key":"specific_waiting","label":"Specific illness waiting period","section":"Waiting periods","meaning":"Waiting period for a list of named illnesses and procedures (cataract, hernia, joint replacement...). With several tiers (24 and 36 months), the shortest in the answer, the others in the note.","status":"quote-verified","value":{"unit":"months","amount":24},"display":"24 months","note":"If a listed condition is also pre-existing, the longer waiting period applies.","quote":"Expenses related to the treatment of the listed Conditions, surgeries/ treatments shall be excluded until the expiry of 24 months of continuous coverage after the date of inception of the first policy with us.","sources":[{"clause":null,"heading":"E.I.2. Specified disease/procedure Waiting Period - Code-E.I.2","page":14,"url":"https://indiainsurances.com/policy/manipal-cigna-health-insurance/manipalcigna-prohealth-insurance-mcihlip24011v072324/document/12779#c-e-i-2-specified-disease-procedure-waiting-period"}],"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":["Cataract","Hysterectomy for Menorrhagia or Fibromyoma or prolapse of Uterus unless necessitated by malignancy myomectomy for fibroids","Knee Replacement Surgery (other than caused by an Accident), Non-infectious Arthritis, Gout, Rheumatism, Oestoarthritis and Osteoposrosis, Joint Replacement Surgery (other than caused by Accident), Prolapse of Intervertibral discs (other than caused by Accident), all Vertibrae Disorders, including but not limited to Spondylitis, Spondylosis, Spondylolisthesis, Congenital Internal","Varicose Veins and Varicose Ulcers","Stones in the urinary uro-genital and biliary systems including calculus diseases","Benign Prostate Hypertrophy, all types of Hydrocele","Fissure, Fistula in anus, Piles, all types of Hernia, Pilonidal sinus, Hemorrhoids and any abscess related to the anal region","Chronic Suppurative Otitis Media (CSOM), Deviated Nasal Septum, Sinusitis and related disorders, Surgery on tonsils/ Adenoids, Tympanoplasty and any other benign ear, nose and throat disorder or surgery","gastric and duodenal ulcer, any type of Cysts/Nodules/Polyps/ internal tumors / skin tumors, and any type of Breast lumps (unless malignant), Polycystic Ovarian Diseases","Any surgery of the genito-urinary system unless necessitated by malignancy"],"display":"Cataract; hysterectomy and myomectomy for listed causes; knee/joint/vertebral disorders; varicose veins; urinary, uro-genital and biliary stones; BPH and hydrocele; anal fissure/fistula/piles/hernia; CSOM/DNS/sinusitis/tonsils/adenoids/tympanoplasty and benign ENT disorders; ulcers/cysts/nodules/polyps/tumours/breast lumps/PCOD; genito-urinary surgery unless malignancy","note":null,"quote":"f) List of specific diseases/procedures:\ni) Cataract,\nii) Hysterectomy for Menorrhagia or Fibromyoma or prolapse of Uterus unless necessitated by malignancy myomectomy for fibroids,\niii) Knee Replacement Surgery (other than caused by an Accident), Non-infectious Arthritis, Gout, Rheumatism, Oestoarthritis and Osteoposrosis, Joint Replacement Surgery (other than caused by Accident), Prolapse of Intervertibral discs (other than caused by Accident), all Vertibrae Disorders, including but not limited to Spondylitis, Spondylosis, Spondylolisthesis, Congenital Internal,\niv) Varicose Veins and Varicose Ulcers,\nv) Stones in the urinary uro-genital and biliary systems including calculus diseases,\nvi) Benign Prostate Hypertrophy, all types of Hydrocele,\nvii) Fissure, Fistula in anus, Piles, all types of Hernia, Pilonidal sinus, Hemorrhoids and any abscess related to the anal region.\nviii) Chronic Suppurative Otitis Media (CSOM), Deviated Nasal Septum, Sinusitis and related disorders, Surgery on tonsils/ Adenoids, Tympanoplasty and any other benign ear, nose and throat disorder or surgery.\nix) gastric and duodenal ulcer, any type of Cysts/Nodules/Polyps/ internal tumors / skin tumors, and any type of Breast lumps (unless malignant), Polycystic Ovarian Diseases,\nx) Any surgery of the genito-urinary system unless necessitated by malignancy.","sources":[{"clause":null,"heading":"E.I.2. Specified disease/procedure Waiting Period - Code-E.I.2","page":14,"url":"https://indiainsurances.com/policy/manipal-cigna-health-insurance/manipalcigna-prohealth-insurance-mcihlip24011v072324/document/12779#c-e-i-2-specified-disease-procedure-waiting-period"}],"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":"years","amount":8},"display":"8 continuous years","note":"For enhanced sums insured, completion of 8 continuous years applies from the date of enhancement only on the enhanced limits.","quote":"After completion of eight continuous years under the policy no look back to be applied. This period of eight years is called as moratorium period. ... After the expiry of Moratorium Period no health insurance claim shall be contestable except for proven fraud and permanent exclusions specified in the policy contract.","sources":[{"clause":"Row 1(b)(v)","heading":null,"page":17,"url":"https://indiainsurances.com/policy/manipal-cigna-health-insurance/manipalcigna-prohealth-insurance-mcihlip24011v072324/document/12779#c-row-1-b-v"}],"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":"You can port the policy to another insurer by applying at least 45 days before the renewal date, and accrued continuity benefits in waiting periods are available as per IRDAI portability guidelines.","display":"Allowed, with accrued continuity benefits in waiting periods as per IRDAI portability guidelines","note":"The OCR omits the number in “but not earlier than days”.","quote":"The insured person will have the option to port the policy to other insurers by applying to such insurer to port the entire policy along with all the members of the family, if any, at least 45 days before, but not earlier than days from the policy renewal date as per IRDAI guidelines related to portability. ... the proposed insured person will get the accrued continuity benefits in waiting periods as per IRDAI guidelines on portability.","sources":[{"clause":null,"heading":"F.I.9. Portability","page":17,"url":"https://indiainsurances.com/policy/manipal-cigna-health-insurance/manipalcigna-prohealth-insurance-mcihlip24011v072324/document/12779#c-f-i-9-portability"}],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 11","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 12","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, IV.6","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, VII.3","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Para 24","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 1.4 and 1.5","url":"https://indiainsurances.com/law/irdai-products-regs-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 10","url":"https://indiainsurances.com/law/irdai-products-regs-2024"}]},{"key":"lifelong_renewal","label":"Lifelong renewal","section":"Renewal and rights","meaning":"Whether the policy can be renewed for life without a maximum age.","status":"quote-verified","value":true,"display":"Renewable for life","note":null,"quote":"The Policy is ordinarily renewable on mutual consent for life, subject to application of Renewal and realization of Renewal premium.","sources":[{"clause":null,"heading":"F.II.9. Renewal Terms","page":18,"url":"https://indiainsurances.com/policy/manipal-cigna-health-insurance/manipalcigna-prohealth-insurance-mcihlip24011v072324/document/12779#c-f-ii-9-renewal-terms"}],"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 renewal loading applies based on individual claims experience, and renewal cannot be denied because claims were made in preceding policy years.","display":"No loading on renewals based on individual claims experience","note":null,"quote":"Renewal shall not be denied on the ground that the insured person had made a claim or claims in the preceding policy years. ... No loading shall apply on renewals based on individual claims ... Renewal premium will not alter based on individual claims experience.","sources":[{"clause":null,"heading":"F.I.10. Renewal of Policy","page":17,"url":"https://indiainsurances.com/policy/manipal-cigna-health-insurance/manipalcigna-prohealth-insurance-mcihlip24011v072324/document/12779#c-f-i-10-renewal-of-policy"},{"clause":"Row 1(b)(v)","heading":null,"page":17,"url":"https://indiainsurances.com/policy/manipal-cigna-health-insurance/manipalcigna-prohealth-insurance-mcihlip24011v072324/document/12779#c-row-1-b-v"},{"clause":null,"heading":"F.II.9. Renewal Terms","page":18,"url":"https://indiainsurances.com/policy/manipal-cigna-health-insurance/manipalcigna-prohealth-insurance-mcihlip24011v072324/document/12779#c-f-ii-9-renewal-terms"}],"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":"not-stated","value":null,"display":null,"note":null,"quote":null,"sources":[],"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 by giving 15 days written notice, and the company refunds premium for the unexpired policy period as per the policy grid. No refund is processed for half-yearly, quarterly or monthly premium payment modes, and no refund is made if any claim has been admitted or lodged or any benefit has been availed.","display":"15 days written notice; refund for unexpired policy period, subject to grid; no refund for instalment modes or if a claim/benefit exists","note":"The refund percentage grid is present but the OCR text does not preserve the percentages.","quote":"The policyholder may cancel this policy by giving 15 days written notice and in such an event, the Company shall refund premium for the unexpired policy period as detailed below. ... No refund will be processed for cancellation of policies with Premium Payment Mode as Half-yearly, Quarterly or Monthly. Notwithstanding anything contained herein or otherwise, no refunds of premium shall be made in respect of Cancellation where, any claim has been admitted or has been lodged or any benefit has been availed by the insured person under the policy.","sources":[{"clause":"Row 1(b)(i)","heading":null,"page":16,"url":"https://indiainsurances.com/policy/manipal-cigna-health-insurance/manipalcigna-prohealth-insurance-mcihlip24011v072324/document/12779#c-row-1-b-i"},{"clause":"Row 1(b)(ii)","heading":null,"page":17,"url":"https://indiainsurances.com/policy/manipal-cigna-health-insurance/manipalcigna-prohealth-insurance-mcihlip24011v072324/document/12779#c-row-1-b-ii"}],"law":[{"title":"The Insurance Act, 1938","section":"Section 64VB","url":"https://indiainsurances.com/law/insurance-act-1938"},{"title":"Master Circular on General Insurance Business, 2024","section":"Ch I, Para 8","url":"https://indiainsurances.com/law/irdai-general-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 6","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Life Insurance Products, 2024","section":"Chapter 1, Para 5","url":"https://indiainsurances.com/law/irdai-life-products-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 17","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 20(3) to 20(5)","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, III.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, IV.4","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part C, IV.3","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"}]},{"key":"territory","label":"Where it covers","section":"Overview","meaning":"Geographic area of cover: India only, worldwide, or listed countries. 'As stated in the schedule' is not an answer.","status":"quote-verified","value":"The policy covers events within India, except Worldwide Emergency Cover and other specifically covered schedule benefits; all admitted or payable claims are settled in India in Indian rupees.","display":"India, except Worldwide Emergency Cover","note":null,"quote":"The geographical scope of this policy applies to events within India other than for Worldwide Emergency Cover and which are specifically covered in the Schedule. However all admitted or payable claims shall be settled in India in Indian rupees.","sources":[{"clause":null,"heading":"F.II.5. Geography","page":18,"url":"https://indiainsurances.com/policy/manipal-cigna-health-insurance/manipalcigna-prohealth-insurance-mcihlip24011v072324/document/12779#c-f-ii-5-geography"}],"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":15},"display":"15 days","note":"Applicable to new individual health insurance policies, not renewals or porting/migration.","quote":"The insured person shall be allowed a free look period of fifteen days from date of receipt of the policy document to review the terms and conditions of the policy and to return the same if not acceptable.","sources":[{"clause":null,"heading":"F.I.15. Free Look period","page":17,"url":"https://indiainsurances.com/policy/manipal-cigna-health-insurance/manipalcigna-prohealth-insurance-mcihlip24011v072324/document/12779#c-f-i-15-free-look-period"}],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 5","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Life Insurance Products, 2024","section":"Chapter 1, Para 5","url":"https://indiainsurances.com/law/irdai-life-products-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 20(1), 20(2)","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 20(3) to 20(5)","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 20(6)","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, II.8","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, III.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, III.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"}]},{"key":"grace_period","label":"Grace period","section":"Renewal and rights","meaning":"Days you get after the due date to pay without losing cover or continuity.","status":"quote-verified","value":{"unit":"days","amount":30},"display":"30 days for renewal; 15 days for monthly instalment premium","note":"For half-yearly and quarterly instalments the OCR omits the number of days.","quote":"the policy shall terminate and can be renewed within the Grace Period of 30/15 days, to maintain continuity of benefits without break in policy. ... in no case later than the Grace Period of 30 days from the expiry of the Policy. ... grace period of 15 days for monthly mode of payment would be given to pay the instalment premium due for the Policy.","sources":[{"clause":"Row 1(b)(iv)","heading":null,"page":17,"url":"https://indiainsurances.com/policy/manipal-cigna-health-insurance/manipalcigna-prohealth-insurance-mcihlip24011v072324/document/12779#c-row-1-b-iv"},{"clause":null,"heading":"F.II.8. Grace Period","page":18,"url":"https://indiainsurances.com/policy/manipal-cigna-health-insurance/manipalcigna-prohealth-insurance-mcihlip24011v072324/document/12779#c-f-ii-8-grace-period"},{"clause":null,"heading":"F.I.13. Premium Payment in Instalments (Wherever applicable)","page":17,"url":"https://indiainsurances.com/policy/manipal-cigna-health-insurance/manipalcigna-prohealth-insurance-mcihlip24011v072324/document/12779#c-f-i-13-premium-payment-in-instalments-wherever-a"}],"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":"not-stated","value":null,"display":null,"note":null,"quote":null,"sources":[],"law":[]},{"key":"premium_modes","label":"Premium payment options","section":"Premium","meaning":"How often you can pay: yearly, half-yearly, quarterly, monthly.","status":"quote-verified","value":["Single","Yearly","Half yearly","Quarterly","Monthly"],"display":"Single, Yearly, Half yearly, Quarterly and Monthly","note":"A loading applies for premium payment modes other than Single and Yearly.","quote":"Premium can be paid on Single, Yearly, Half yearly, Quarterly and Monthly basis.","sources":[{"clause":null,"heading":"F.II.10. Premium calculation","page":19,"url":"https://indiainsurances.com/policy/manipal-cigna-health-insurance/manipalcigna-prohealth-insurance-mcihlip24011v072324/document/12779#c-f-ii-10-premium-calculation"}],"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":["Hospital Daily Cash Benefit","Deductible","Waiver of Deductible","Reduction in Maternity Waiting Period","Voluntary Co-Pay","Waiver of Mandatory Co-pay","Cumulative Bonus Booster","Critical Illness","ManipalCigna Health Shield","ManipalCigna Health 360"],"display":"Hospital Daily Cash Benefit, Deductible, Waiver of Deductible, Reduction in Maternity Waiting Period, Voluntary Co-Pay, Waiver of Mandatory Co-pay, Cumulative Bonus Booster, Critical Illness, ManipalCigna Health Shield and ManipalCigna Health 360","note":"These apply only if specifically mentioned in the schedule or chosen as add-on cover/rider.","quote":"The following optional covers shall apply under the Policy for an ... Insured Person if specifically mentioned on the Schedule ... D.III.1. Hospital Daily Cash Benefit ... D.III.2. Deductible ... Waiver of Deductible ... D.III.3. Reduction in Maternity Waiting Period ... D.III.4. Voluntary Co-Pay ... D.III.5. Waiver of Mandatory Co-pay ... D.III.6. Cumulative Bonus Booster ... $GGRQ FRYHU 5LGHU This section lists the Add on cover available under your plan | Critical Illness ... ManipalCigna +HDOWK | 6KLHOG ... Health 360","sources":[{"clause":null,"heading":"D.III. Optional covers","page":13,"url":"https://indiainsurances.com/policy/manipal-cigna-health-insurance/manipalcigna-prohealth-insurance-mcihlip24011v072324/document/12779#c-d-iii-optional-covers"},{"clause":null,"heading":"D.III. Optional covers","page":13,"url":"https://indiainsurances.com/policy/manipal-cigna-health-insurance/manipalcigna-prohealth-insurance-mcihlip24011v072324/document/12779#c-d-iii-optional-covers-2"},{"clause":null,"heading":"D.III.1. Hospital Daily Cash Benefit","page":13,"url":"https://indiainsurances.com/policy/manipal-cigna-health-insurance/manipalcigna-prohealth-insurance-mcihlip24011v072324/document/12779#c-d-iii-1-hospital-daily-cash-benefit"},{"clause":null,"heading":"D.III.2. Deductible","page":13,"url":"https://indiainsurances.com/policy/manipal-cigna-health-insurance/manipalcigna-prohealth-insurance-mcihlip24011v072324/document/12779#c-d-iii-2-deductible"},{"clause":null,"heading":"Waiver of Deductible","page":13,"url":"https://indiainsurances.com/policy/manipal-cigna-health-insurance/manipalcigna-prohealth-insurance-mcihlip24011v072324/document/12779#c-waiver-of-deductible"},{"clause":null,"heading":"D.III.3. Reduction in Maternity Waiting Period","page":14,"url":"https://indiainsurances.com/policy/manipal-cigna-health-insurance/manipalcigna-prohealth-insurance-mcihlip24011v072324/document/12779#c-d-iii-3-reduction-in-maternity-waiting-period"},{"clause":null,"heading":"D.III.4. Voluntary Co-Pay","page":14,"url":"https://indiainsurances.com/policy/manipal-cigna-health-insurance/manipalcigna-prohealth-insurance-mcihlip24011v072324/document/12779#c-d-iii-4-voluntary-co-pay"},{"clause":null,"heading":"D.III.5. Waiver of Mandatory Co-pay","page":14,"url":"https://indiainsurances.com/policy/manipal-cigna-health-insurance/manipalcigna-prohealth-insurance-mcihlip24011v072324/document/12779#c-d-iii-5-waiver-of-mandatory-co-pay"},{"clause":null,"heading":"D.III.6. Cumulative Bonus Booster","page":14,"url":"https://indiainsurances.com/policy/manipal-cigna-health-insurance/manipalcigna-prohealth-insurance-mcihlip24011v072324/document/12779#c-d-iii-6-cumulative-bonus-booster"},{"clause":"4","heading":null,"page":26,"url":"https://indiainsurances.com/policy/manipal-cigna-health-insurance/manipalcigna-prohealth-insurance-mcihlip24011v072324/document/12779#c-4"}],"law":[]},{"key":"grace_cover","label":"Cover during the grace period","section":"Renewal and rights","meaning":"Whether a claim during the grace period is paid.","status":"quote-verified","value":"Coverage is not available during the grace period, and the insurer will not pay claims arising out of an injury, accident or condition that occurred during the grace period. For Accumulate Plan only, unutilised Health Maintenance Benefit limit is available for a claim during the grace period.","display":"No coverage during grace period; Accumulate HMB exception","note":null,"quote":"Coverage is not available during the grace period. ... We will not be liable to pay for any claim arising out of an Injury/ Accident/ Condition that occurred during the Grace Period. ... In case of Accumulate Plan only the unutilised Health Maintenance Benefit limit (excluding any Cumulative Bonus) will be available for a claim during the grace period","sources":[{"clause":"Row 1(b)(iv)","heading":null,"page":17,"url":"https://indiainsurances.com/policy/manipal-cigna-health-insurance/manipalcigna-prohealth-insurance-mcihlip24011v072324/document/12779#c-row-1-b-iv"},{"clause":null,"heading":"F.II.8. Grace Period","page":18,"url":"https://indiainsurances.com/policy/manipal-cigna-health-insurance/manipalcigna-prohealth-insurance-mcihlip24011v072324/document/12779#c-f-ii-8-grace-period"},{"clause":null,"heading":"F.II.9. Renewal Terms","page":18,"url":"https://indiainsurances.com/policy/manipal-cigna-health-insurance/manipalcigna-prohealth-insurance-mcihlip24011v072324/document/12779#c-f-ii-9-renewal-terms"}],"law":[]},{"key":"room_rent","label":"Room rent limit","section":"Limits and co-pay","meaning":"The most the policy pays per day for the hospital room, or the room category allowed. If you take a costlier room, other bills can be cut in proportion.","status":"quote-verified","value":"Room rent is covered up to the room category for the plan opted and specified in the schedule. The benefit chart shows Single Private Room for some sum insured/plan combinations and any room category except suite or higher category for others.","display":"Up to plan room category; Single Private Room or any room except suite/higher depending on plan and sum insured","note":"The exact sum insured breakpoints in the benefit chart are OCR-garbled.","quote":"Reasonable and Customary Charges for Room Rent for accommodation in Hospital room up to Category as per Plan opted and specified in the Schedule to this Policy. ... For Sum Insured XSWRൠ/DFV - Covered up to Single Private Room For Sum Insured ൠ/DFVDQG Above - Covered up to any Room Category except Suite or higher category","sources":[{"clause":"1(II)(a)","heading":null,"page":4,"url":"https://indiainsurances.com/policy/manipal-cigna-health-insurance/manipalcigna-prohealth-insurance-mcihlip24011v072324/document/12779#c-1-ii-a-6"},{"clause":"4","heading":null,"page":26,"url":"https://indiainsurances.com/policy/manipal-cigna-health-insurance/manipalcigna-prohealth-insurance-mcihlip24011v072324/document/12779#c-4"}],"law":[]},{"key":"room_category","label":"Room category allowed","section":"Limits and co-pay","meaning":"Shared room, single private room or any room, by plan, when the limit is a room type rather than a rupee amount.","status":"quote-verified","value":"Allowed room category varies by plan and sum insured: the policy wording says the room is covered up to the category as per plan opted and specified in the schedule, and the benefit chart refers to Single Private Room or any room category except suite or higher category.","display":"Single Private Room or any room category except suite or higher category, depending on plan and sum insured","note":"The plan chart is OCR-garbled for the exact sum insured breakpoints.","quote":"Room Rent for accommodation in Hospital room up to Category as per Plan opted and specified in the Schedule to this Policy. ... Covered up to Single Private Room ... Covered up to any Room Category except Suite or higher category","sources":[{"clause":"1(II)(a)","heading":null,"page":4,"url":"https://indiainsurances.com/policy/manipal-cigna-health-insurance/manipalcigna-prohealth-insurance-mcihlip24011v072324/document/12779#c-1-ii-a-6"},{"clause":"4","heading":null,"page":26,"url":"https://indiainsurances.com/policy/manipal-cigna-health-insurance/manipalcigna-prohealth-insurance-mcihlip24011v072324/document/12779#c-4"}],"law":[]},{"key":"icu_limit","label":"ICU limit","section":"Limits and co-pay","meaning":"The most the policy pays per day for intensive care.","status":"quote-verified","value":"ICU accommodation charges are covered under inpatient hospitalisation. No separate ICU rupee or per-day sub-limit is stated in the extracted wording.","display":"ICU charges covered","note":"Subject to the policy sum insured and other applicable terms.","quote":"Intensive Care Unit charges for accommodation in ICU,","sources":[{"clause":"1(II)(b)","heading":null,"page":4,"url":"https://indiainsurances.com/policy/manipal-cigna-health-insurance/manipalcigna-prohealth-insurance-mcihlip24011v072324/document/12779#c-1-ii-b-6"}],"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 the insured person is admitted in a room category higher than specified in the schedule, the policyholder or insured person bears a ratable proportion of the total Associated Medical Expenses in the proportion of the difference between the entitled room rent and the room rent actually incurred.","display":"Yes, associated medical expenses are reduced proportionately if a higher room category is used","note":null,"quote":"If the Insured Person is admitted in a room category that is higher than the one that is specified in the Schedule to this Policy then the Policyholder/Insured Person shall bear a ratable proportion of the total Associated Medical Expenses (including surcharge or taxes thereon) in the proportion of the diႇerence between the room rent of the entitled room category to the room rent actually incurred.","sources":[{"clause":"1(II)(j)","heading":null,"page":5,"url":"https://indiainsurances.com/policy/manipal-cigna-health-insurance/manipalcigna-prohealth-insurance-mcihlip24011v072324/document/12779#c-1-ii-j"}],"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":"A mandatory 20% co-payment applies on all claims for insured persons aged 65 years and above unless Waiver of Mandatory Co-pay is opted. Zonal co-pay applies if a lower-zone premium payer takes treatment in a higher zone: Zone II to Zone I has 10%, Zone III to Zone II has 10%, and Zone III to Zone I has 20%; optional voluntary co-pay can be 10% or 20%.","display":"Mandatory 20% for age 65+; zonal 10% or 20% if treated outside zone; voluntary 10% or 20% if opted","note":"Zonal co-pay does not apply for hospitalisation due to accident. Voluntary co-pay is optional and applies only if chosen.","quote":"A compulsory Co-payment of 20% is applicable on all claims for Insured Persons Aged 65 years and above irrespective of Age of entry in to the Policy. ... Availing treatment in Zone I will have to bear 10% of each and every claim. ... Availing treatment in Zone II will have to bear 10% of each and every claim. ... Availing treatment in Zone I will have to bear 20% of each and every claim. ... We will only pay 90% or 80% of any amount that We assess (payable amount)","sources":[{"clause":null,"heading":"F.II.6. Mandatory Co-pay","page":18,"url":"https://indiainsurances.com/policy/manipal-cigna-health-insurance/manipalcigna-prohealth-insurance-mcihlip24011v072324/document/12779#c-f-ii-6-mandatory-co-pay"},{"clause":null,"heading":"F.II.10. Premium calculation","page":19,"url":"https://indiainsurances.com/policy/manipal-cigna-health-insurance/manipalcigna-prohealth-insurance-mcihlip24011v072324/document/12779#c-f-ii-10-premium-calculation"},{"clause":"Row 1(c)(ii)","heading":null,"page":19,"url":"https://indiainsurances.com/policy/manipal-cigna-health-insurance/manipalcigna-prohealth-insurance-mcihlip24011v072324/document/12779#c-row-1-c-ii"},{"clause":"Row 1(c)(iii)","heading":null,"page":19,"url":"https://indiainsurances.com/policy/manipal-cigna-health-insurance/manipalcigna-prohealth-insurance-mcihlip24011v072324/document/12779#c-row-1-c-iii"},{"clause":null,"heading":"D.III.4. Voluntary Co-Pay","page":14,"url":"https://indiainsurances.com/policy/manipal-cigna-health-insurance/manipalcigna-prohealth-insurance-mcihlip24011v072324/document/12779#c-d-iii-4-voluntary-co-pay"}],"law":[]},{"key":"deductible","label":"Deductible","section":"Limits and co-pay","meaning":"An amount of each claim or each year that you bear before the policy pays.","status":"quote-verified","value":"No deductible applies unless the optional deductible is selected. If selected, it applies each policy year on the aggregate of all claims in that policy year, except fixed benefit covers, Health Maintenance Benefit, Health Check Ups and add-on riders.","display":"None unless opted; optional aggregate deductible per policy year","note":"Voluntary co-pay shall not apply to plans with the deductible option.","quote":"We will provide for a Deductible on specific Sum Insured Options. Where ever a Deductible is selected such amounts will be applied for each Policy Year on the aggregate of all Claims in that Policy Year other than for claims under fixed Benefit Covers, Health Maintenance Benefit\n*Maximum reward that can be earned in a Policy Period is up to 20% and Health Check Ups. Deductible shall apply to all sections other than of the premium paid including taxes. In this case, the maximum limit of Hospital Daily Cash Benefit, Health Maintenance Benefit, Health Check 2000 (ൠ10000*20%) is achieved. Hence there shall not be any further Up benefits and Add On Riders if opted.","sources":[{"clause":null,"heading":"D.III.2. Deductible","page":13,"url":"https://indiainsurances.com/policy/manipal-cigna-health-insurance/manipalcigna-prohealth-insurance-mcihlip24011v072324/document/12779#c-d-iii-2-deductible"}],"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":"not-stated","value":null,"display":null,"note":"No fixed disease or procedure sub-limit amounts could be extracted from the wording. The policy says underwriting may apply condition-specific sub-limits, but no standard product sub-limit table is stated.","quote":null,"sources":[],"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":"not-stated","value":null,"display":null,"note":"The wording says pre-hospitalization is covered up to limits specified in the Schedule, but the number of days in the benefit chart is OCR-garbled.","quote":null,"sources":[],"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":"not-stated","value":null,"display":null,"note":"The wording says post-hospitalization is covered up to limits specified in the Schedule, but the number of days in the benefit chart is OCR-garbled.","quote":null,"sources":[],"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 treatment requiring less than 24 hours hospitalisation because of technological advancement is covered when undertaken in a hospital, nursing home or day care centre on a medical practitioner's recommendation. OPD treatment is not covered, and the policy refers to the Annexure II list of day care treatments.","display":"Covered for listed day care treatments requiring less than 24 hours; OPD excluded","note":null,"quote":"We will cover payment of Medical Expenses of an Insured Person in case of Medically Necessary Day Care Treatment or Surgery that requires less than 24 hours Hospitalization due to advancement in technology and which is undertaken in a Hospital / nursing home/Day Care Centre on the recommendation of a Medical Practitioner. Any treatment in an outpatient department/OPD is not covered. For list of Day Care Treatments refer Annexure II of the Policy.","sources":[{"clause":null,"heading":"D.I.4. Day Care Treatment","page":5,"url":"https://indiainsurances.com/policy/manipal-cigna-health-insurance/manipalcigna-prohealth-insurance-mcihlip24011v072324/document/12779#c-d-i-4-day-care-treatment"}],"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":"Treatment at home is covered if the illness or injury would otherwise have required hospitalisation but is taken at home on the attending medical practitioner's advice because the insured person cannot be transferred to a hospital or a hospital bed is unavailable, and treatment continues for at least 3 days.","display":"Covered when hospital transfer is not possible or no bed is available, if treatment continues at least 3 days","note":null,"quote":"We will cover Medical Expenses of an Insured Person which are towards a Disease/Illness or Injury which in the normal course would otherwise have been covered for Hospitalization under the policy but is taken at home on the advice of the attending Medical Practitioner, under the following circumstances:\ni) The condition of the Insured Person does not allow a Hospital transfer; or\nii) A Hospital bed was unavailable; Provided that, the treatment of the Insured Person continues for at least 3 days","sources":[{"clause":null,"heading":"D.I.5. Domiciliary Treatment","page":5,"url":"https://indiainsurances.com/policy/manipal-cigna-health-insurance/manipalcigna-prohealth-insurance-mcihlip24011v072324/document/12779#c-d-i-5-domiciliary-treatment"}],"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 inpatient treatment is covered up to the limits specified in the policy schedule when medically necessary treatment is taken in an AYUSH Hospital.","display":"Covered up to policy schedule limits in an AYUSH Hospital","note":"Facilities and services for pleasure, rejuvenation or preventive aid such as beauty treatments, Panchakarma, purification, detoxification and rejuvenation are excluded.","quote":"We will pay the Medical Expenses incurred during the Policy Year, up to the limits specified in the Policy Schedule of an Insured Person in case of Medically Necessary Treatment taken during In-patient Hospitalization for AYUSH Treatment for an Illness or Injury that occurs during the Policy Year, provided that:\nThe Insured Person has undergone treatment in an AYUSH Hospital","sources":[{"clause":null,"heading":"D.I.10. AYUSH Cover","page":6,"url":"https://indiainsurances.com/policy/manipal-cigna-health-insurance/manipalcigna-prohealth-insurance-mcihlip24011v072324/document/12779#c-d-i-10-ayush-cover"}],"law":[{"title":"Guidelines on providing AYUSH coverage in Health Insurance policies, 2024","section":"Para 1","url":"https://indiainsurances.com/law/irdai-ayush-2024"},{"title":"Guidelines on providing AYUSH coverage in Health Insurance policies, 2024","section":"Para 2","url":"https://indiainsurances.com/law/irdai-ayush-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 1","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch II A.I(1)","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 5","url":"https://indiainsurances.com/law/irdai-products-regs-2024"}]},{"key":"modern_treatments","label":"Modern treatments","section":"Cover","meaning":"Robotic surgery, immunotherapy, oral chemotherapy, stem cell therapy and the like, and any cap on them.","status":"quote-verified","value":"The policy covers listed modern treatments as inpatient or day care up to the sum insured specified in the policy schedule, including uterine artery embolization and HIFU, balloon sinuplasty, deep brain stimulation, oral chemotherapy, monoclonal antibody immunotherapy, intravitreal injections, robotic surgeries, stereotactic radiosurgeries, bronchial thermoplasty, prostate vaporisation, IONM and specified hematopoietic stem cell therapy.","display":"Covered up to Sum Insured for listed modern treatments","note":null,"quote":"The following procedures will be covered (wherever medically indicated) either as inpatient or as part of day care treatment in a hospital up to the Sum Insured specified in the policy schedule, during the policy period: ... Uterine Artery Embolization and HIFU (High intensity focused ultrasound) ... Balloon Sinuplasty ... Deep Brain stimulation ... Oral chemotherapy ... Immunotherapy - Monoclonal Antibody to be given as injection ... Intra vitreal injections ... Robotic surgeries ... Stereotactic radio surgeries ... Bronchical Thermoplasty ... Vaporisation of the prostrate (Green laser treatment or holmium laser treatment) ... IONM - (Intra Operative Neuro Monitoring) ... Stem cell therapy: Hematopoietic stem cells for bone marrow transplant for haematological conditions to be covered.","sources":[{"clause":"1(II)(j)","heading":null,"page":5,"url":"https://indiainsurances.com/policy/manipal-cigna-health-insurance/manipalcigna-prohealth-insurance-mcihlip24011v072324/document/12779#c-1-ii-j"},{"clause":"1(II)(a)","heading":null,"page":5,"url":"https://indiainsurances.com/policy/manipal-cigna-health-insurance/manipalcigna-prohealth-insurance-mcihlip24011v072324/document/12779#c-1-ii-a-7"},{"clause":"1(II)(b)","heading":null,"page":5,"url":"https://indiainsurances.com/policy/manipal-cigna-health-insurance/manipalcigna-prohealth-insurance-mcihlip24011v072324/document/12779#c-1-ii-b-7"},{"clause":"1(II)(c)","heading":null,"page":5,"url":"https://indiainsurances.com/policy/manipal-cigna-health-insurance/manipalcigna-prohealth-insurance-mcihlip24011v072324/document/12779#c-1-ii-c-3"},{"clause":"1(II)(d)","heading":null,"page":5,"url":"https://indiainsurances.com/policy/manipal-cigna-health-insurance/manipalcigna-prohealth-insurance-mcihlip24011v072324/document/12779#c-1-ii-d-3"},{"clause":"1(II)(e)","heading":null,"page":5,"url":"https://indiainsurances.com/policy/manipal-cigna-health-insurance/manipalcigna-prohealth-insurance-mcihlip24011v072324/document/12779#c-1-ii-e-2"},{"clause":"1(II)(f)","heading":null,"page":5,"url":"https://indiainsurances.com/policy/manipal-cigna-health-insurance/manipalcigna-prohealth-insurance-mcihlip24011v072324/document/12779#c-1-ii-f-2"},{"clause":"1(II)(g)","heading":null,"page":5,"url":"https://indiainsurances.com/policy/manipal-cigna-health-insurance/manipalcigna-prohealth-insurance-mcihlip24011v072324/document/12779#c-1-ii-g-2"},{"clause":"1(II)(h)","heading":null,"page":5,"url":"https://indiainsurances.com/policy/manipal-cigna-health-insurance/manipalcigna-prohealth-insurance-mcihlip24011v072324/document/12779#c-1-ii-h-2"},{"clause":"1(II)(i)","heading":null,"page":5,"url":"https://indiainsurances.com/policy/manipal-cigna-health-insurance/manipalcigna-prohealth-insurance-mcihlip24011v072324/document/12779#c-1-ii-i-2"},{"clause":"1(II)(j)","heading":null,"page":5,"url":"https://indiainsurances.com/policy/manipal-cigna-health-insurance/manipalcigna-prohealth-insurance-mcihlip24011v072324/document/12779#c-1-ii-j-2"},{"clause":"1(II)(k)","heading":null,"page":5,"url":"https://indiainsurances.com/policy/manipal-cigna-health-insurance/manipalcigna-prohealth-insurance-mcihlip24011v072324/document/12779#c-1-ii-k"},{"clause":"1(II)(l)","heading":"Stem cell therapy","page":5,"url":"https://indiainsurances.com/policy/manipal-cigna-health-insurance/manipalcigna-prohealth-insurance-mcihlip24011v072324/document/12779#c-1-ii-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":"The policy covers the donor's inpatient hospitalisation medical expenses for harvesting the organ up to the sum insured, when the organ is for the insured person and the insured person's inpatient claim has been admitted. It excludes the donor's pre/post-hospitalisation expenses, donor screening, organ acquisition costs and donor complications or other treatment.","display":"Covered up to Sum Insured for donor organ harvesting inpatient expenses","note":null,"quote":"We will cover In-patient Hospitalization Medical Expenses towards the donor for harvesting the organ up to the limits of the Sum Insured ... The organ donated is for the use of the Insured Person ... We have admitted a claim under Section D.I.1 - towards In-patient Hospitalization ... We will not cover expenses towards the Donor in respect of:\ni) Any Pre or Post-hospitalization Medical Expenses,\nii) Cost towards donor screening,\niii) Cost associated to the acquisition of the organ,\niv) Any other medical treatment or complication in respect of the donor, consequent to harvesting.","sources":[{"clause":"1(II)(a)","heading":null,"page":5,"url":"https://indiainsurances.com/policy/manipal-cigna-health-insurance/manipalcigna-prohealth-insurance-mcihlip24011v072324/document/12779#c-1-ii-a-10"},{"clause":"1(II)(b)","heading":null,"page":6,"url":"https://indiainsurances.com/policy/manipal-cigna-health-insurance/manipalcigna-prohealth-insurance-mcihlip24011v072324/document/12779#c-1-ii-b-10"},{"clause":"1(II)(c)","heading":null,"page":6,"url":"https://indiainsurances.com/policy/manipal-cigna-health-insurance/manipalcigna-prohealth-insurance-mcihlip24011v072324/document/12779#c-1-ii-c-4"},{"clause":"1(II)(d)","heading":null,"page":6,"url":"https://indiainsurances.com/policy/manipal-cigna-health-insurance/manipalcigna-prohealth-insurance-mcihlip24011v072324/document/12779#c-1-ii-d-4"}],"law":[]},{"key":"ambulance","label":"Ambulance cover","section":"Cover","meaning":"Road (and air) ambulance cover and its limit.","status":"quote-verified","value":"Road ambulance expenses by a registered healthcare or ambulance service provider are reimbursed up to the schedule limits for emergency transport to a hospital for covered illness or injury. The benefit also includes transfer from one hospital to another hospital or diagnostic centre for advanced diagnostics, or movement to a better hospital due to lack of super-speciality treatment.","display":"Road ambulance reimbursed up to Schedule limits","note":"The plan-wise rupee limits in the benefit chart are OCR-garbled.","quote":"We will provide for reimbursement of Reasonable and Customary expenses up to limits specified in the Schedule that are incurred towards transportation of an Insured Person by a registered healthcare or Ambulance service provider to a Hospital for treatment of an Illness or Injury covered under the Policy in case of an Emergency ... Costs towards transferring the Insured Person from one Hospital to another Hospital or diagnostic centre for advanced diagnostic treatment where such facility is not available at the existing Hospital; or ... When the Insured Person requires to be moved to a better Hospital facility due to lack of super speciality treatment in the existing Hospital.","sources":[{"clause":"1(II)(a)","heading":null,"page":5,"url":"https://indiainsurances.com/policy/manipal-cigna-health-insurance/manipalcigna-prohealth-insurance-mcihlip24011v072324/document/12779#c-1-ii-a-9"},{"clause":"1(II)(b)(i)","heading":null,"page":5,"url":"https://indiainsurances.com/policy/manipal-cigna-health-insurance/manipalcigna-prohealth-insurance-mcihlip24011v072324/document/12779#c-1-ii-b-i-3"},{"clause":"1(II)(b)(ii)","heading":null,"page":5,"url":"https://indiainsurances.com/policy/manipal-cigna-health-insurance/manipalcigna-prohealth-insurance-mcihlip24011v072324/document/12779#c-1-ii-b-ii-3"}],"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":"The policy provides 100% restoration of the sum insured any number of times in a policy year when the sum insured plus earned bonus is insufficient due to previous claims. The restored sum insured is not available for the same illness, disease or injury for which a claim has been paid in the current policy year for the same insured person, does not apply to the first claim, and is not carried forward.","display":"100% restoration, any number of times in a Policy Year, for future unrelated claims","note":"Not provided for Worldwide Emergency Cover, Maternity Expenses, New Born Baby Expenses and First Year Vaccinations.","quote":"We will provide for a 100% restoration of the Sum Insured for any number of times in a Policy Year ... The Sum Insured inclusive of earned Cumulative Bonus (if any) or Cumulative Bonus Booster (if opted & earned) is insuႈcient as a result of previous claims in that Policy Year. ... The Restored Sum Insured shall not be available for claims towards an Illness/ disease/ Injury (including its complications) for which a claim has been paid in the current Policy Year for the same Insured Person. ... The Restored Sum Insured will be available only for claims made by Insured Persons in respect of future claims ... If the Restored Sum Insured is not utilised in a Policy Year, it shall not be carried forward to subsequent Policy Year.","sources":[{"clause":null,"heading":"D.I.9. Restoration of Sum Insured","page":6,"url":"https://indiainsurances.com/policy/manipal-cigna-health-insurance/manipalcigna-prohealth-insurance-mcihlip24011v072324/document/12779#c-d-i-9-restoration-of-sum-insured"},{"clause":"1(II)(a)","heading":null,"page":6,"url":"https://indiainsurances.com/policy/manipal-cigna-health-insurance/manipalcigna-prohealth-insurance-mcihlip24011v072324/document/12779#c-1-ii-a-12"},{"clause":"1(II)(b)","heading":null,"page":6,"url":"https://indiainsurances.com/policy/manipal-cigna-health-insurance/manipalcigna-prohealth-insurance-mcihlip24011v072324/document/12779#c-1-ii-b-12"},{"clause":"1(II)(c)","heading":null,"page":6,"url":"https://indiainsurances.com/policy/manipal-cigna-health-insurance/manipalcigna-prohealth-insurance-mcihlip24011v072324/document/12779#c-1-ii-c-6"},{"clause":"1(II)(g)","heading":null,"page":6,"url":"https://indiainsurances.com/policy/manipal-cigna-health-insurance/manipalcigna-prohealth-insurance-mcihlip24011v072324/document/12779#c-1-ii-g-4"}],"law":[]},{"key":"no_claim_bonus","label":"No-claim or cumulative bonus","section":"Cover","meaning":"How much the cover grows each year, the maximum, whether it depends on not claiming, and what happens after a claim.","status":"quote-verified","value":"Cumulative Bonus increases the sum insured as specified under the plan opted at renewal, up to a maximum of 200% of the sum insured. The wording provided does not state the plan-wise annual percentage for the base cumulative bonus; an optional Cumulative Bonus Booster increases the sum insured by 25% each policy year up to 200%.","display":"Base Cumulative Bonus up to 200% of Sum Insured; optional booster 25% per policy year up to 200%","note":"The base plan-wise annual increase is referred to as specified under the plan opted, but the readable wording does not preserve the exact percentage.","quote":"We will increase Your Sum Insured as specified under the Plan opted at the end of the Policy Year if the Policy is renewed with Us: ... The Cumulative Bonus will not be accumulated in excess of 200% of the Sum Insured under the current Policy with Us under any circumstances. ... We will provide an option to increase the Sum Insured by 25% for each policy year up to a maximum of 200% of Sum Insured provided that the Policy is renewed with Us without a break.","sources":[{"clause":"1(II)(a)","heading":null,"page":9,"url":"https://indiainsurances.com/policy/manipal-cigna-health-insurance/manipalcigna-prohealth-insurance-mcihlip24011v072324/document/12779#c-1-ii-a-20"},{"clause":"1(II)(b)","heading":null,"page":9,"url":"https://indiainsurances.com/policy/manipal-cigna-health-insurance/manipalcigna-prohealth-insurance-mcihlip24011v072324/document/12779#c-1-ii-b-19"},{"clause":null,"heading":"D.III.6. Cumulative Bonus Booster","page":14,"url":"https://indiainsurances.com/policy/manipal-cigna-health-insurance/manipalcigna-prohealth-insurance-mcihlip24011v072324/document/12779#c-d-iii-6-cumulative-bonus-booster"}],"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":"Under inpatient hospitalisation, drugs and consumables used intra-operatively during a surgical procedure are covered. The policy excludes non-medical expenses listed in Annexure IV, while a separate ManipalCigna Health Shield add-on is described as covering listed non-medical items and durable medical equipment.","display":"Surgical consumables covered; listed non-medical items excluded unless Health Shield add-on is bought","note":"Health Shield is an add-on cover, not part of the base cover unless opted.","quote":"Drugs and consumables, blood, oxygen, surgical appliances and prosthetic devices recommended by the attending Medical Practitioner and that are used intra operatively during a Surgical Procedure. ... List I - Items for which Coverage is not available in the Policy ... ManipalCigna +HDOWK | 6KLHOG Coverage for listed Non-medical items and durable medical equipment","sources":[{"clause":"1(II)(j)","heading":null,"page":5,"url":"https://indiainsurances.com/policy/manipal-cigna-health-insurance/manipalcigna-prohealth-insurance-mcihlip24011v072324/document/12779#c-1-ii-j"},{"clause":null,"heading":"G.V. Annexure - IV","page":34,"url":"https://indiainsurances.com/policy/manipal-cigna-health-insurance/manipalcigna-prohealth-insurance-mcihlip24011v072324/document/12779#c-g-v-annexure-iv"},{"clause":"4","heading":null,"page":26,"url":"https://indiainsurances.com/policy/manipal-cigna-health-insurance/manipalcigna-prohealth-insurance-mcihlip24011v072324/document/12779#c-4"}],"law":[]},{"key":"maternity","label":"Maternity cover","section":"Cover","meaning":"Whether childbirth costs are covered, the limit and the waiting period.","status":"quote-verified","value":"Maternity expenses are available under applicable plans up to schedule limits, after 48 months of continuous cover, for delivery or lawful termination, up to maximum 2 deliveries or terminations during the lifetime of an insured person between ages 18 and 45. Maternity is not available under Protect and Accumulate plans; an optional cover can reduce the waiting period from 48 months to 24 months.","display":"Available under applicable plans after 48 months; maximum 2 deliveries/terminations; not available under Protect and Accumulate","note":"The plan-wise maternity rupee limits in the benefit chart are OCR-garbled.","quote":"We will cover Maternity Expenses up to limits for Maternity Sum insured specified in the Schedule for the delivery of a child and/ or Maternity\n+HSDWLWLV% ZHHN | 2\nExpenses incurred during the Policy Year, related to a Medically\n+LE ZHHN | 2\nNecessary and lawful termination of pregnancy up to maximum 2 deliveries or terminations during the lifetime of an Insured Person\n3 - 6 months | 239 ZHHN 25239,39 | 1 or 2\nbetween the ages of 18 years to 45 years. ... The Insured Person should have been continuously covered under this Policy for at least 48 months before availing this Benefit, ... E.I.18. Maternity Code-Excl 18 (applicable to Protect and Accumulate\nplan) ... We will provide for a waiver of waiting period for Maternity Expenses (Section D.I.12) from 48 months to 24 months","sources":[{"clause":"1(II)(c)","heading":null,"page":7,"url":"https://indiainsurances.com/policy/manipal-cigna-health-insurance/manipalcigna-prohealth-insurance-mcihlip24011v072324/document/12779#c-1-ii-c-8"},{"clause":"1(II)(b)","heading":null,"page":7,"url":"https://indiainsurances.com/policy/manipal-cigna-health-insurance/manipalcigna-prohealth-insurance-mcihlip24011v072324/document/12779#c-1-ii-b-15"},{"clause":null,"heading":"E.I.18. Maternity Code-Excl 18 (applicable to Protect and Accumulate","page":15,"url":"https://indiainsurances.com/policy/manipal-cigna-health-insurance/manipalcigna-prohealth-insurance-mcihlip24011v072324/document/12779#c-e-i-18-maternity-code-excl-18-applicable-to-prot"},{"clause":null,"heading":"D.III.3. Reduction in Maternity Waiting Period","page":14,"url":"https://indiainsurances.com/policy/manipal-cigna-health-insurance/manipalcigna-prohealth-insurance-mcihlip24011v072324/document/12779#c-d-iii-3-reduction-in-maternity-waiting-period"}],"law":[]},{"key":"newborn","label":"Newborn baby cover","section":"Cover","meaning":"Whether a newborn is covered from birth and for what.","status":"quote-verified","value":"Subject to an admitted maternity claim, the policy covers medical expenses for treatment of the newborn baby while the insured person is hospitalised for delivery, and reasonable and customary charges during and after birth up to 90 days from delivery within the maternity expense limits without additional premium. Beyond 90 days, the newborn can be covered on payment of the required premium by endorsement or at next renewal.","display":"Covered from birth up to 90 days within maternity limits, subject to admitted maternity claim","note":null,"quote":"Subject to a claim being admitted under Maternity Expenses Cover under Section D.I.12, We will cover. ... Medical Expenses towards treatment of the New Born Baby while the Insured Person is Hospitalised as an In-patient for delivery. ... The Reasonable and Customary Charges incurred on the New Born Baby during and post birth up to 90 days from the date of delivery, within the limits specified in the Schedule under Maternity Expenses without payment of any additional premium. ... We will cover the New Born Baby beyond 90 days on payment of requisite premium","sources":[{"clause":null,"heading":"D.I.13. New Born Baby Expenses","page":7,"url":"https://indiainsurances.com/policy/manipal-cigna-health-insurance/manipalcigna-prohealth-insurance-mcihlip24011v072324/document/12779#c-d-i-13-new-born-baby-expenses"},{"clause":"1(II)(a)","heading":null,"page":7,"url":"https://indiainsurances.com/policy/manipal-cigna-health-insurance/manipalcigna-prohealth-insurance-mcihlip24011v072324/document/12779#c-1-ii-a-14"},{"clause":"1(II)(b)","heading":null,"page":7,"url":"https://indiainsurances.com/policy/manipal-cigna-health-insurance/manipalcigna-prohealth-insurance-mcihlip24011v072324/document/12779#c-1-ii-b-14"},{"clause":"1(II)(c)","heading":null,"page":7,"url":"https://indiainsurances.com/policy/manipal-cigna-health-insurance/manipalcigna-prohealth-insurance-mcihlip24011v072324/document/12779#c-1-ii-c-8"}],"law":[]},{"key":"mental_illness","label":"Mental illness","section":"Cover","meaning":"Cover for in-patient treatment of mental illness.","status":"not-stated","value":null,"display":null,"note":null,"quote":null,"sources":[],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 3","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch III I","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"The Mental Healthcare Act, 2017","section":"Section 21(4)","url":"https://indiainsurances.com/law/mental-healthcare-act-2017"},{"title":"The Mental Healthcare Act, 2017","section":"Section 2(1)(s)","url":"https://indiainsurances.com/law/mental-healthcare-act-2017"},{"title":"The Mental Healthcare Act, 2017","section":"Section 21(1)","url":"https://indiainsurances.com/law/mental-healthcare-act-2017"}]},{"key":"health_checkup","label":"Health check-up","section":"Cover","meaning":"Free preventive check-ups and how often.","status":"quote-verified","value":"Health check-up is available for insured persons above age 18. For Protect and Accumulate plans it is available once every 3rd policy year; for Plus, Preferred and Premier plans it is available once each year excluding the first policy year.","display":"Protect and Accumulate: once every 3rd Policy year; Plus, Preferred and Premier: once each year excluding first policy year","note":"Not available on reimbursement basis.","quote":"All Insured members above the age of 18 years will be eligible for a Health Check Up. Health Check Ups will be and arranged by Us and conducted at Our Network Providers. For Protect & Accumulate Plan - Available once every 3rd Policy year For Plus, Preferred and Premier Plan - Available once each year excluding the first policy year.","sources":[{"clause":"1(II)(a)","heading":null,"page":8,"url":"https://indiainsurances.com/policy/manipal-cigna-health-insurance/manipalcigna-prohealth-insurance-mcihlip24011v072324/document/12779#c-1-ii-a-16"}],"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":"Health Maintenance Benefit covers OPD expenses up to schedule limits for Protect, Plus, Preferred and Premier plans, and OPD plus inpatient basis for Accumulate Plan. The benefit can include diagnostic tests, preventive tests, drugs, prosthetics, medical aids, dental treatment and AYUSH forms of medicines where prescribed; Health 360 add-on offers OPD packages for consultations, diagnostics and pharmacy.","display":"Health Maintenance Benefit covers OPD up to Schedule limits; Health 360 add-on has OPD packages","note":"The base OPD/HMB limits are specified in the Schedule; the OCR benefit chart does not preserve the rupee amounts reliably. Health 360 is an add-on.","quote":"We will cover, up to limits specific in the Schedule, by way of reimbursement of the Reasonable and Customary Charges incurred by the Insured Person for Medically Necessary charges incurred during the Policy Year on:\ni. an Out Patient basis for Protect, Plus, Preferred and Premier Plans ... an Out Patient and In-patient basis for Accumulate Plan. ... Diagnostic tests, preventive tests, drugs, prosthetics, medical aids ... Towards Dental Treatments and AYUSH Forms of Medicines wherever prescribed by a Medical Practitioner. ... Health 360 | OPD: Package 1: Coverage for doctor consultations on cashless basis within the OPD Sum Insured\nPackage 2: Coverage for doctor consultations and prescribed diagnostics on cashless basis within the OPD Sum Insured Package 3: Coverage for doctor consultations, prescribed diagnostics and pharmacy on cashless basis within the OPD Sum Insured.","sources":[{"clause":null,"heading":"D.I.11. Health Maintenance Benefit","page":6,"url":"https://indiainsurances.com/policy/manipal-cigna-health-insurance/manipalcigna-prohealth-insurance-mcihlip24011v072324/document/12779#c-d-i-11-health-maintenance-benefit"},{"clause":"1(II)(d)(ii)","heading":null,"page":6,"url":"https://indiainsurances.com/policy/manipal-cigna-health-insurance/manipalcigna-prohealth-insurance-mcihlip24011v072324/document/12779#c-1-ii-d-ii-2"},{"clause":"4","heading":null,"page":26,"url":"https://indiainsurances.com/policy/manipal-cigna-health-insurance/manipalcigna-prohealth-insurance-mcihlip24011v072324/document/12779#c-4"}],"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":"quote-verified","value":"Premium is calculated based on the zone of cover, with default zone based on the correspondence city-location. Zone I premium allows treatment all over India without co-pay; Zone II premium allows Zone II and III treatment without co-pay but Zone I treatment has 10% co-pay; Zone III premium allows Zone III treatment without co-pay, Zone II treatment has 10% co-pay and Zone I treatment has 20% co-pay.","display":"Yes. Zone I, II and III pricing; out-of-zone treatment can have 10% or 20% co-pay","note":"Out-of-zone co-payments do not apply in case of hospitalisation due to accident.","quote":"Premium will be calculated based on the Sum Insured opted, Age, gender, risk classification and Zone of Cover. Default Zone of Cover will be based on Your City-Location based on Your correspondence address. ... Zone Classification Zone I: Mumbai, Thane & Navi Mumbai, Gujarat and Delhi & NCR Zone II: Bangalore, Hyderabad, Chennai, Chandigarh, Ludhiana, Kolkata, Pune Zone III: Rest of India excluding the locations mentioned under Zone I & Zone II ... Persons paying Zone I premium can avail treatment all over India wit out any Co-pay. ... Availing treatment in Zone I will have to bear 10% of each and every claim. ... Availing treatment in Zone II will have to bear 10% of each and every claim. ... Availing treatment in Zone I will have to bear 20% of each and every claim.","sources":[{"clause":null,"heading":"F.II.10. Premium calculation","page":19,"url":"https://indiainsurances.com/policy/manipal-cigna-health-insurance/manipalcigna-prohealth-insurance-mcihlip24011v072324/document/12779#c-f-ii-10-premium-calculation"},{"clause":"Row 1(c)(ii)","heading":null,"page":19,"url":"https://indiainsurances.com/policy/manipal-cigna-health-insurance/manipalcigna-prohealth-insurance-mcihlip24011v072324/document/12779#c-row-1-c-ii"},{"clause":"Row 1(c)(iii)","heading":null,"page":19,"url":"https://indiainsurances.com/policy/manipal-cigna-health-insurance/manipalcigna-prohealth-insurance-mcihlip24011v072324/document/12779#c-row-1-c-iii"}],"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 only at network hospitals. The insurer pays the network provider directly to the extent of pre-authorisation approved, and cashless hospitalisation expenses are limited to covered medical expenses in a network hospital and are not available for Worldwide Emergency Cover.","display":"Available only at Network Hospital, subject to pre-authorisation","note":null,"quote":"Cashless Facility means a facility extended by the insurer to the insured where the payments, of the costs of treatment undergone by the insured in accordance with the Policy terms and conditions, are directly made to the network provider by the insurer to the extent pre-authorization approved. ... Cashless facility is available only at our Network Hospital. ... Cashless facility for Hospitalization Expenses shall be limited exclusively to Medical Expenses incurred for treatment undertaken in a Network Hospital for Illness or Injury which are covered under the Policy and shall not be available to the Insured Person for coverage under Worldwide Emergency Cover (Section D.I.8).","sources":[{"clause":null,"heading":"Cashless Facility","page":1,"url":"https://indiainsurances.com/policy/manipal-cigna-health-insurance/manipalcigna-prohealth-insurance-mcihlip24011v072324/document/12779#c-cashless-facility"},{"clause":null,"heading":"G.I.4. Cashless Facility","page":20,"url":"https://indiainsurances.com/policy/manipal-cigna-health-insurance/manipalcigna-prohealth-insurance-mcihlip24011v072324/document/12779#c-g-i-4-cashless-facility"},{"clause":"Row 1(b)(v)","heading":null,"page":21,"url":"https://indiainsurances.com/policy/manipal-cigna-health-insurance/manipalcigna-prohealth-insurance-mcihlip24011v072324/document/12779#c-row-1-b-v-2"}],"law":[]},{"key":"claims_handled_by","label":"Claims handled by","section":"Claims","meaning":"The insurer itself or a third-party administrator (TPA).","status":"quote-verified","value":"Cashless and reimbursement claim processing and network hospital access is through the insurer's service partner/TPA, but the TPA only facilitates claim processing and all customer contact points including claim intimation, submission, settlement and dispute resolution remain with the insurer.","display":"Through service partner/TPA for processing; customer contact and settlement with ManipalCigna","note":null,"quote":"Cashless and Reimbursement Claim processing and access to network hospitals is through our service partner/TPA, details of the same will be available on the Health Card issued by Us as well as on our website. ... Wherever a TPA is used, the TPA will only work to facilitate claim processing. All customer contact points will be with Us including claim intimation, submission, settlement and dispute resolutions.","sources":[{"clause":null,"heading":"G. Other terms and conditions","page":20,"url":"https://indiainsurances.com/policy/manipal-cigna-health-insurance/manipalcigna-prohealth-insurance-mcihlip24011v072324/document/12779#c-g-other-terms-and-conditions"}],"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":"Family floater available","note":null,"quote":"Family Floater means a Policy described as such in the Schedule where under You and Your Dependents named in the Schedule are insured under this Policy as at the Inception Date. The Sum Insured for a Family Floater means the sum shown in the Schedule which represents Our maximum liability for any and all claims made by You and/or all of Your Dependents during each Policy Period.","sources":[{"clause":null,"heading":"C.II. Specific Definitions","page":4,"url":"https://indiainsurances.com/policy/manipal-cigna-health-insurance/manipalcigna-prohealth-insurance-mcihlip24011v072324/document/12779#c-c-ii-specific-definitions"}],"law":[]}],"documents":[{"kind":"wording","label":"ManipalCigna ProHealth Insurance (MCIHLIP22211V062122)","pages":35,"fetched_at":"2026-10-17 19:51:14+00","source_url":"https://www.manipalcigna.com/documents/20124/10123363/20.+ProHealth+V6+TnC.pdf/3aecbfc9-b11d-3a62-5a49-e2dc1cdfa29b?t=1756470057638","url":"https://indiainsurances.com/policy/manipal-cigna-health-insurance/manipalcigna-prohealth-insurance-mcihlip24011v072324/document/12778"},{"kind":"wording","label":"ManipalCigna ProHealth Insurance (MCIHLIP24011V072324)","pages":35,"fetched_at":"2026-10-17 19:51:16+00","source_url":"https://www.manipalcigna.com/documents/20124/10123363/22.+ProHealth+V7+TnC.pdf/009a2881-b721-b79e-3d2a-b916eebe345d?t=1756470061397","url":"https://indiainsurances.com/policy/manipal-cigna-health-insurance/manipalcigna-prohealth-insurance-mcihlip24011v072324/document/12779"},{"kind":"wording","label":"ManipalCigna ProHealth Insurance (MCIHLIP25024V082425)","pages":60,"fetched_at":"2026-10-17 19:51:22+00","source_url":"https://www.manipalcigna.com/documents/20124/350424/ProHealth-V8-TnC-Withdrawn.pdf/30889a45-9b6a-aaea-47f3-e2a902150e31?t=1754062974288","url":"https://indiainsurances.com/policy/manipal-cigna-health-insurance/manipalcigna-prohealth-insurance-mcihlip24011v072324/document/12785"},{"kind":"wording","label":"ManipalCigna ProHealth Insurance (IRDAI copy)","pages":38,"fetched_at":"2026-10-20 02:29:19+00","source_url":"https://irdai.gov.in/documents/37343/931203/MCIHLIP22211V062122.pdf/b3a179da-4a2e-b4f2-27db-11779ec9a3cf?version=1.1&t=1668851771621&download=true","url":"https://indiainsurances.com/policy/manipal-cigna-health-insurance/manipalcigna-prohealth-insurance-mcihlip24011v072324/document/28520"},{"kind":"prospectus","label":"ManipalCigna ProHealth Insurance Prospectus (MCIHLIP25024V082425)","pages":33,"fetched_at":"2026-10-17 19:50:08+00","source_url":"https://www.manipalcigna.com/documents/d/guest/prohealth_v8_prospectus_25april22_01","url":"https://indiainsurances.com/policy/manipal-cigna-health-insurance/manipalcigna-prohealth-insurance-mcihlip24011v072324/document/12736"},{"kind":"premium","label":"ManipalCigna ProHealth Insurance Rate Chart (MCIHLIP25024V082425)","pages":null,"fetched_at":"2026-10-17 19:48:05+00","source_url":"https://www.manipalcigna.com/documents/d/guest/rate-chart-prohealth-v8","url":"https://indiainsurances.com/policy/manipal-cigna-health-insurance/manipalcigna-prohealth-insurance-mcihlip24011v072324/document/30351"}],"versions":[{"uin":"MCIHLIP22211V062122","version":null,"approved_on":null},{"uin":"MCIHLIP25024V082425","version":null,"approved_on":null},{"uin":"MCIHLIP24011V072324","version":null,"approved_on":null}],"where_to_buy":[{"purpose":"buy","kind":"insurer","name":"Manipal Cigna Health Insurance official website","url":"https://www.manipalcigna.com/","note":"Buy directly from the insurer."},{"purpose":"buy","kind":"ours","name":"Get free help from IndiaInsurances","url":"/help","note":"Free. We do not sell insurance and earn no commission; your request is not passed to anyone."}],"claims_and_complaints":[{"purpose":"claim","kind":"insurer","name":"Claims","url":"https://claim.manipalcigna.com/claims/","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.manipalcigna.com/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 online","url":"https://online.manipalcigna.com/erenewal/renew?source=NWEB","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":"ManipalCigna ProHealth Insurance (UIN MCIHLIP24011V072324), IndiaInsurances, https://indiainsurances.com/policy/manipal-cigna-health-insurance/manipalcigna-prohealth-insurance-mcihlip24011v072324"}