Private Vehicle Policy
This is motor insurance that needs to be taken for any private car owned by an individual and is mandated by the Government of India. It covers the vehicle for damages against accidents, fire, natural disasters, theft among others and also covers for any injury to the owner. It also covers any damages and injuries caused to the third party.
Car Insurance Add-On Covers :
Add-ons are those extra covers that you buy for better financial protection for your car during loss or damages. Add-on plans, as the name suggests, offer insurance for extra coverages in addition to own damage and third-party liability insurance that a regular motor policy offers. These affect your car insurance premium since you pay extra money for such coverages. The cost is dependent on the make-model and age of your car.
Types of Add-On Cover
Depreciation Re-imbursement
Zero dep insurance cover, also known as Zero Dep policy, is a type of insurance cover which offers complete coverage without factoring in depreciation value of the vehicle. This means that if your car gets damaged in an accident, you will receive the entire cost from the insurer.
Engine Secure
Insurer will pay you repair and replacement expenses for the loss or damage to -
-
Internal parts of the engine
-
Gear Box, Transmission or Differential Assembly Provided loss or damage is due to ingress of water in the engine or leakage of lubricating oil from engine/respective assembly. Insurance Company will also pay for the lubricating oils/consumables used in the respective assembly i.e. material, which is used up and needs continuous replenishment such as engine oil, gear box oil etc. but excluding fuel.
Consumable Expenses
Insurer will cover cost of consumables required to be replaced/replenished arising from an accident to the insured vehicle. Consumable for the purpose of this cover shall include engine oil, gear box oil, lubricants, nut & bolt, screw, distilled water, grease, oil filter, bearing, washers, clip, break oil, air conditioner gas and items of similar nature excluding fuel.
Tyre Cover
Insurance company will cover expenses for repair and/or replacement, as may be necessitated arising out of accidental loss or damage to tyres and tubes.
In any situation company’s liability would not exceed the following, basis the unused tread depth of respective tyre;
-
Unused tread depth < 3 mm- Considered as normal wear and tear and is not covered
-
Unused tread depth of - 3 to =5 to < 7 mm - 75% of cost of new tyre and/or tube
-
Unused tread depth of > = 7 mm - 100% of cost of new tyre and/or tube
Unused Tread depth will be measured at the centre of the tread. Minimum 4 measurements at 4 different places will be taken for the purpose of arriving at means tread depth which will be the basis of indemnity under the coverage
Whenever replacement of tyre will be allowed it will be of the same make and specification and if tyre of similar specification is not available and replaced tyre is superior to damaged tyre then Insurance Company will not be liable for betterment charges. Maximum of 4 (four) replacements will be allowed during the Period of Insurance. If damage to tyre and tube is due to the accidental damage to the insured vehicle covered under “Own Damage” section of the policy. Our liability under this cover will be restricted to the difference of depreciation percentage applied under “Own Damage” section and as mentioned above basis the unused tread depth.
Tyre which has been used for its full specified life as per manufacturer’s guideline or where unused tread depth is less than 3 mm.
Return to Invoice
Insurer will pay the financial shortfall between the amount You receive the purchase price of the Vehicle as confirmed in the invoice of sale OR current replacement price of new vehicle in case exactly same make/model is available, whichever is less, in the event of Your Vehicle being a Total Loss/CTL following an accident or stolen during the period of insurance and not recovered. We will also reimburse the first-time registration charges and road tax which You had incurred on the insured Vehicle.
Special conditions applicable to this benefit:
• You are the first registered owner of the motor vehicle
• The finance company/bank whose interest is endorsed on the policy must agree in writing.
No Claim Bonus Protection Cover:
Insurer will allow you the same No claim bonus, as shown on Your schedule at the time of renewal provided-
-
The rate of No claim bonus as shown in the schedule is an accumulation of 2 or more claim free years and their being no own damage claim in preceding 2 years.
-
Not more than 1 own damage claim is registered in the current period of insurance.
-
The renewal of policy is done with same Insurance Company within 90 days of expiry of the policy
-
The claim is not a Total LOSS (TL)/Constructive Total Loss (CTL) Special conditions applicable to this benefit in addition to the general conditions:
-
The claim made for damages only to the windscreen glass/rear glass/door glasses sun roof glass, will not be considered as a claim under this benefit.
-
The claim only partial theft of accessories/parts will not be considered as a claim under this benefit.
-
A claim for theft of entire motor vehicle will not be considered as a TL/CTL for this purpose provided a new motor vehicle is purchased and insured with us within 90 days of the theft.
Types of Add-On Cover
Loss of personal belongings
Insurer will pay for the loss or damage to you and your Family member’s personal belongings caused by perils of the policy while they are in the vehicle at the time of loss or damage to the vehicle.
Personal belongings for the purpose of this section means items such as clothes and other articles of personal nature likely to be worn, used or carried and includes audio/video tapes, CDs but excludes money, securities, cheques, bank drafts, credit or debit cards, jewellery, lens, glasses, travel tickets, watches, valuables, manuscripts, paintings and items of similar nature. Any goods or samples carried in connections with any trade or business is not covered.
A police report must be filed for claims due to burglary, house-breaking or theft. The maximum amount payable is limited to . Any claim under this section will be admissible only when there is a valid and admissible claim in respect of the vehicle arising out of the same accident.
Daily Allowances:
Insurer will pay You Daily Allowance as mentioned in the schedule to enable you to meet the cost of hired transport to reduce your inconvenience, if your Vehicle is damaged.
The allowance would be payable for a maximum period of 10 days during the period of insurance. In case of theft/total loss claim, we will pay for maximum 15 days during the period of insurance.
Reasonable time taken for repair in respect of damages not admissible of the policy (as agreed between you, surveyor & garage/workshop manager) would be excluded for the purpose of computation of Daily Allowance.
Your entitlement of Daily Allowance will start from the following calendar day of Your Vehicle reaching the garage for repair shall end on the day garage intimates you to take delivery of the Vehicle
Road side assistance
These services will be offered to you during the policy period as mentioned on your Policy Schedule or Certificate of Insurance.
-
Repair and Towing Assistance
-
Service for Flat Tyre
-
Flat Battery – Jump Start Service
-
Repair on the spot
-
Spare Key Retrieval / Service for Keys Locked Inside
-
Fuel Support (Emergency Fuel Delivery).
Emergency Towing Assistance
-
In case of Break-down
-
In case of an Accident
Key Replacement
-
Key Replacement – We will reimburse you for the cost of replacing your vehicle keys which are lost or stolen.
-
Break-in Protection – We will reimburse you for the cost of replacing your locks and keys if your vehicle is broken into. The covered costs include the labour cost for replacing the lock.
For break-in protection claims, you must provide an official police report that confirms the incident happened within the period of insurance.
Exclusions
Some of the situations that are permanently not covered by a standard car insurance are :
-
Damages incurred while using the car for illegal purposes.
-
Damages caused to the car due to its usage beyond limits.
-
Loss or damage as a result of war, terror attacks, hostilities or nuclear accidents.
-
Damages caused to the car while it was driven by a person under the influence of drugs or alcohol.
-
Accidents found to be fraudulent by the insurance company.
-
Damages caused to the car in an accident while the person driving could not produce a valid license.
-
Damages incurred by the car in an accident with an underage driver, or one who drove on the wrong side of the road.
-
Cost of car coolants, petrol, nuts, bolts, etc.
-
Willful damages caused to the vehicle by the owner.
-
Damages caused to the car during a time when the policy had expired and was not renewed. Car insurance policies are annual contracts that should ideally be renewed on time, without the occurrence of a gap between the expiry date and the renewal date.
-
Damages to the car and its engine due to oil leakage.
-
Consequential losses due to certain actions from the car owner or a third-party, and not due to an uncertain event. For instance, the engine damage of a car following hydrostatic loss during the monsoons is due to the negligence of the car-owner, as he had cranked it up in a flooded area. This will not be covered by the insurer.
-
Contractual liabilities that the policyholder has towards the car. For example, if the car-owner had pledged his car to another person for a certain duration, and the car is damaged while it was used by the person to whom it was pledged, the damages incurred by the car are not covered by the policy. However, if the pledged car was driven by the car-owner himself, the damages to the car will be covered by the insurance, as per the comprehensive coverage of the policy.
Mediclaim insurance premium tends to increase with age - more the age, higher the premium. You can be covered for medical conditions that may be diagnosed over the years provided there is no break in the policy. In addition, each 'no claim’ year would fetch you a discount on your premium or an increase in your sum insured amount at no extra cost. The treatment in case of ‘no-claim’ bonus varies from company to company. Lastly, the income tax benefit is available under Section 80 D of the Income Tax Act. While an internet connection is required to start the Point of Sale, it will stay operational even after a complete disconnection.
Mediclaim insurance is necessary owing to increasing medical costs these days and uncertain environment. Therefore, ensuring your family for health insurance is a must and should surely be a part of your regular financial planning. A family floater health insurance, as the name suggests is a plan that is made for families. Family floater health insurance plans usually cover the individual, spouse and children or parents. In general, the cost of buying floater coverage for the family is less than buying the Individual policies for each member. However, in a Floater Policy, the Sum Insured is shared by all members and in Individual policy each member has a separate Sum Insured.
This concept works on the same lines as the no-claim bonus on your car insurance. A Policyholder, who hasn’t made any claim in a year, can use the bonus to their benefit the following year.
Health Insurance companies use co-payment after insured member turns a certain age. Co-pay is that part of your claim amount, which you have to bear. Co-pay can be in % terms or an absolute amount. For example, in case of co-pay of 20% and claim of Rs. 10,000, the insurer will pay you Rs. 8,000 (80% of 10K) and you will bear 20% (Rs. 2,000).
Buying an individual cover or a floater cover is an individual’s perception. However, as a general rule, at younger if married its recommended to opt for floater cover. As you grow older you could go for an individual cover.
Yes, the waiting period is only for the amount by which the Sum Insured has been enhanced. For example, if the waiting period for heart attack cover is 3 years and the insured has to be treated for the same ailment within a year of the enhancement, any expenses over and above the old cover will not be covered if the expenses exceed the basic Sum Insured at the time of renewal.
The age after which the insured cannot take or renew the policy is the Exit Age. However, the new generation plans are covered for a lifetime.
Date of inception is the date from which the policy becomes valid.
Yes. For example, if you have a cover of Rs 100,000 and incur an expense of Rs 150,000 then you will have to pay Rs 50,000 by yourself.
While choosing a Mediclaim policy, you need to consider several factors that go into every Mediclaim policy. Make sure you go through the terms and conditions of the Mediclaim policy as to when the medical insurance premium needs to be paid. Also, what is the total medical cover which can be expected from the Mediclaim policy: whether the Mediclaim policy is a cashless one or not. The Mediclaim policy could also be a group or a family one and hence if you have a family to look after, you could opt for a family health insurance plan under which your spouse and your children get covered. In such a case you should be certain of who all fall under the family insurance plan. You can also go through the requirements of the policy like the number of days in which the medical bills of the medical expenses be submitted to the Insurance Company. After clearly going through the Mediclaim policy only then should you go for it.
Insurance is a contract of utmost good faith. It always pays to be honest. Declaring the correct and accurate health status at the time of buying health insurance ensures smooth processing of your application. This will also help us service you in a better manner.
For instance a person wants a Mediclaim insurance for himself, his spouse and their children, the Family Floater plan offers insurance coverage to the entire family under one premium payment. Let’s take an example wherein the person insures himself, his spouse and the dependent children with the individual insurance plans with a sum insured of Rs. 1 lakh each, he ends up paying premium ranging between Rs. 1000 - Rs. 2000 for each family member. On the other hand if the person would have opted for the family floater plan with the sum insured of Rs. 3 lakhs, the total premium would surely be less than the separate premium payments in individual health insurance plans. Moreover the separate Mediclaim plan holds the cover of only Rs. 1 lakh as against Rs. 3 lakh in case of the Floater plan thus helping the family in case the medical treatment costs go beyond that. This Rs. 3 Lac is available for each of the family members individually as well as collectively.
The disease under Permanent Exclusions will not be covered in the Health Insurance plan.
Immediate Relative would mean the insured's spouse, dependent children and dependent parents
No, the two are bundled, and in a new generation plan, both are covered within the limit of the policy. For Critical illness and special ailments there are special covers.
All the expenses including room rent, pre/post hospitalisation, etc. related to treatment are capped up to the amount mentioned in the sub limit bracket.
The age eligibility of the insured for taking the policy is the Entry Age
The Mediclaim premium refers to the amount that the Mediclaim policy holder pays to the insurance company or the Mediclaim Company. The Mediclaim premium may vary from company to company depending upon the number of items that get covered under the Mediclaim policy. The Mediclaim premium generally rises with an increase in the risk perception of the insurance company concerning the particular individual or group.
Thus, you might have the cost of the Mediclaim premium increasing for an aged person or for a person having a particular ailment or illness. A Mediclaim insurance premium rises for smokers as compared to non smokers. The Mediclaim insurance policy cover will give you an approximate figure of the Mediclaim premium amount that you would be charged by the company.
-
NO CLAIM-BASED LOADING: :
In this policy, there is a loading of your renewal premium because you availed a claim or fell ill during the policy period.
-
QUICK CLAIM PAYMENT: :
When it comes to claim settlement, SIB will help you get the claim in the shortest possible time for a genuine claim.
-
AMBULANCE COVER: :
Up to a certain limit subject to hospitalisation
-
TAX BENEFITS: :
You can get tax benefit for the premium amount under Section 80 D of the Income Tax Act.
-
PRE- AND POST-HOSPITALISATION EXPENSES: :
The old generation plans provide 30/60 days cover but in the new generation plans 60/180 days cover is provided.
-
DAYCARE PROCEDURES: :
All day-care treatments are covered.
-
RESTORE BENEFIT:
: A plan which restores your Sum Insured when you need it the most. Instant addition of 100% Basic Sum insured on complete utilisation of your existing policy Sum Insured including Cumulative Benefit if applicable during the policy year. This total amount (Basic Sum Insured, Cumulative Benefit and Restore Sum Insured) will be available to all Insured Persons for all claims under in-patient benefit during the current policy year.
-
HEALTH CHECK UP: :
To help you keep track of your health status, a preventive health check-up is offered at regular intervals opted by you irrespective of your claim status.
-
CUMULATIVE BONUS::
This is an amazing Restore Benefit that comes with a never-before renewal incentive. Normally, in most Mediclaim policies, if you have had claim-free years, the insurer will increase your Basic Sum Insured (SI) maximum by 50%. In a new generation plan the cumulative bonus can go beyond 100% in some of the cases.
-
LIFELONG COVER::
Renew your cover lifelong and stay insured forever.
-
NO SUB-LIMIT ON ROOM RENT: :
With this Mediclaim plan you can get the room you like and the treatment you deserve without a hassle within the sum assured limit. A new generation plan does not have such limits. You can avail the plan without the hassle of a sub-limit.
-
CASHLESS TRANSACTIONS: :
This policy enables you to get treated on a cashless basis across thousands of hospital and hundreds of cities.
-
NO GEOGRAPHY BASED SUB-LIMITS::
No matter where you buy your policy, you can get treated in any hospital or city of your choice with no additional co-pays or sub-limits.
-
DOMICILIARY TREATMENT::
Covered up to Sum Insured.
-
ORGAN DONOR: :
Covered up to Sum Insured.
- Claim Process for Mediclaim
:
Cashless Settlement- Most of the claims for IPD is settled cashless if the insurer opts for the network hospital. The process is seamless and hassle-free where one is entitled to cashless treatment for an amount within the eligible SA of the Policy. The Process for settlement of Mediclaims can be divided into two parts which are;·
·
-
Planned Hospitalisation:
·
·
·
·
·
-
Unplanned Hospitalisation:
·
·
·
·
·
-
Claim Process for Pre and Post hospitalisation Expenses:
• Get all the papers of the expenses incurred pre and post hospitalisation such as Bills of OPD prescription, Original Reports, bills of medication, Diagnostic bills etc 30/60 or 60/180 (as the terms offered in your policy)days prior and after the admission. Your claim in such category cannot exceed the Sum Assured limit of the Policy after the consuming during the Hospitalisation.
• The original Papers along with the claim form and cancelled cheque have to be submitted with the Insurance Company or TPA
• Insurance Company takes around 2-4 working days to respond in case of any queries
• Get the queries responded at the earliest.
• With the satisfaction of the TPA the claim is processed and paid in 7-10 working days.
• With satisfaction of the TPA, the approval is sent of the sanctioned amount and transfer of approved amount to the account is done in around 3-4 days.
• Claim Process for Reimbursement of claim incase of Non Network hospital
• Get all the papers like Bills of OPD prescription, Original Reports ,bills of Medication, Diagnostic bills, discharge summary, Final Bill with payment receipt of hospital, etc collected
• The original Papers alongwith the claim form and cancelled cheque have to be submitted with the Insurance Company or TPA
• Insurance Company takes around 2-4 working days to respond if there are queries
• Get the queries responded at the earliest with satisfaction of the TPA the approval is sent of the sanctioned amount and transfer of approved amount to the account is done in around 3-4 days
