Shri Vector Care Insurance

What are Vector-Borne Diseases?

Introduction

Vector borne diseases account for a large chunk of infectious diseases. Mosquito being the most common carrier.

Shri Vector Care Insurance policy is the health insurance benefit product. It is designed to cater escalating medical cost arising of hospitalization due to covered vector borne diseases.

Sum insured available for

1. ₹10,000
2. ₹15,000
3. ₹25,000
4. ₹40,000
5. ₹50.000
6. ₹75,000

Maximum sum assured per life basis would be restricted to INR 75,000 considering all policies under this product.

 Age of Entry

• 91 days – 65 years
• Coverage for child (91 days – 18 years) is not allowed without any family member (more than 18 years) being the proposer or covered in the policy 

Policy Renewability

Lifelong renewability is applicable                                                                                         

Policy is available for Individual as well as for family floater

Family means comprising of:

• Self
• Spouse
• Children (including unmarried children, step children or legally adopted children, who are financially dependent and aged between 91 days and 18 years).
• Parents/parents-in-law

                                                                 

Policy available for period   - 1 Year, 2 Year and 3 Year

Scope of Coverage

If the Insured or the Insured Person(s), as the case may be diagnosed as suffering from any of covered Vector Borne disease during the Policy Period and Hospital admission longer than 24 continuous hours, the Company shall pay a lump sum payment of 100%, as specified under the Policy Schedule, subject to Sum Insured limits, terms, conditions, definitions and exclusions contained or otherwise expressed in the Policy Schedule.

Following are the vector borne disease covered under the policy.

1. Chikungunya,
2. Dengue,

• Japanese Encephalitis,

1. Kala-azar,
2. Lymphatic Filariasis,
3. Malaria,

• Zika Virus are the vector-borne diseases.

 

Coverage Option

Coverage without Restoration

1. Individual Cover

         Upon admission of any claim against one of the listed diseases, 100% sum assured will be paid and policy terminates subject to other terms and condition of policy.

2. Family Floater Cover

          Upon admission of a claim to any member against one of the listed diseases, 100% sum assured will be paidand policy terminates for the member for whom claim is admitted              while policy continues for the remaining members, if more than one claim is allowed under the floater policy. If only one claim is allowed, policy will terminate afteradmission of the first claim. (refer table below for the number of members and allowed numberof claims).

 

Scenario. No.	Covered Members	Max covered members per policy	Max number of claims per policy
1	Self	1	1
2	Self+ Spouse	2	1
3.	Self + Spouse+ 1or 2 Member (Child or Parent )	3 or 4	2
4	Self+ Spouse+3or 4 members (Child or/and parents)	5 or 6	2

           

Under option 3 and 4 above, irrespective of the number of parents / parents in laws covered, max number of members covered in family will not exceed the numbers mentioned above.

 

Coverage with Restoration

1. Individual Basis.

Upon admission of any claim against one of the listed diseases, sum assured will be restored to 100% and the policy continues until allowable number of claims is made under the policy or end of the policy term whichever is earlier subject to cooling off period.

2. Family floater

Upon admission of any claim against one of the listed diseases, sum assured will be restored to 100% and policy continues until allowable number of claims is made under the policy or end of the policy term whichever is earlier subject to cooling off period.

 

Scenario. No.	Covered Members	Max covered members per policy	Max number of claims per policy*
1	Self	1	2 claims including 1 restoration
2	Self+ Spouse	2	2 claims including 1 restoration
3.	Self + Spouse+ 1or 2 Member (Child or Parent/ Parent In law)	3 or 4	6 claims including 3 restorations
4	Self+ Spouse+ 3 or 4 members (Child or/and Parents/Parent in law)	5 or 6	6 claims including 3 restorations

*Per member max of 2 claims per policy year is allowed.

Under option 3 and 4 above, irrespective of the number of parents / parents in laws covered, max number of members covered in family will not exceed the numbers mentioned above.

 

Policy Termination

The policy will terminate on death of the life assured or on payment of all allowable claims under the policy or end of the policy term, whichever is earlier.

 

General Exclusion

1. Any condition other than Malaria, Lymphatic Filariasis, Dengue Fever, Japanese Encephalitis, and Kala Azar, Chikungunya or Zika virus as defined under this policy.
2. Admission to hospital for less than 24 hours.
3. Any of the covered vector borne disease diagnosedwithin the waiting period
4. Diagnosis and treatment outside India. However, this exclusion shall not be applicable in the following countries: Canada, Dubai, Hong Kong, Japan, Malaysia, New Zealand, Singapore, Switzerland, USA, and countries of the European Union. The Reinsurer may review theabove list of accepted foreign countries from time to time. Claims documents from outside India are only acceptable in English language unless specifically agreed otherwise, and duly authenticated.
5. Any claim during waiting period.

 

Specific Exclusion

1. Any of the listed vector borne disease diagnosed within the first 15 days of the date of commencement of the Policy is excluded. This exclusion shall not apply to an Insured/Insured Persons, as the case may be, for whom coverage has been renewed without a break, for subsequent years provided there are NIL claims in the previous Policies.
2. The initial waiting period of 15 days will be increased to 60 days, if the insured is suffering or has suffered within 60 days prior to the date of proposal, from any one of the listed vector borne disease except Lymphatic Filariasis at the time of taking the policy.
3. In case, if the insured is suffering or has suffered within 60 days prior to the date of proposal, from Lymphatic Filariasis at the time of taking the policy, Lymphatic Filariasis will be excluded from the policy and the other listed vector borne diseaseshall have an initial waiting period increased to 60 days.

 

Condition(s)

• Fraud

If the Insured and/ or Named Insured shall make or advance any claim knowing the same to be false or fraudulent as regards amount or otherwise, this Policy shall be void and all claims or payments hereunder shall be forfeited.

• Free Look Period

You have a period of 15 days from the date of receipt of the first policy document to review the terms and conditions of this Policy. If You have any objections to any of the terms and conditions, You have the option of cancelling the Policy stating the reasons for cancellation. If you have not made any claim during the Free look period, you shall be entitled to refund of premium subject to,

A deduction of the expenses incurred by Us on Your medical examination, stamp duty charges, if the risk has not commenced,

A deduction of the stamp duty charges, medical examination charges & proportionate risk premium for period on cover, If the risk has commenced

A deduction of such proportionate risk premium commensurating with the risk covered during such period,where only a part of risk has commenced

Free Look Period will not be applicable for renewal Policies.

• Cancellation

 

We may at any time cancel the Policy on grounds of misrepresentation, fraud, non-disclosure of material fact by sending notice in writing by Registered A/D to the insured at his/her last known address at least 15 days in advance in that case we shall refund pro-rata premium for the unexpired portion of the policy on the date of cancellation, provided no claim has occurred till the date of cancellation.

 

The Insured may also give 15 days’ notice in writing, to the Company, for the cancellation of this policy, in which case the Company shall retain the premium for the period this Policy has been in force at the Company’s shortperiod scales

 

Period on risk	% of Annual Premium refunded
	1 Year Policy	2 Year Policy	3 Year Policy
Upto 1 month	70%	75%	80%
Exceeding 1 month and upto 3 months	55%	70%	70%
Exceeding 3 months and upto 6 months	30%	55%	65%
Exceeding 6 months and upto 12 months	Nil	30%	45%
Exceeding 12 months and upto 18 months		10%	30%
Exceeding 18 months and upto 24 months		Nil	10%
Exceeding 24 months and upto 30 months			5%
Exceeding 30 months			Nil

 

Claims Procedure

1. We must be informed of any event or occurrence that may give rise to a claim under this Policy within 48 hours of hospitalization of the illness. You can intimate us through letter, email, fax or telephone.

1. You or someone claiming on Your behalf must promptly and in any event within 15 days of discharge from a Hospital give Us the necessary documents along with all original supporting documentation, including but not limited to the following, and other information We ask for, to investigate the claim for Our obligation to make payment for it

1. Our claim form duly completed (along with captioned documents) and signed by/ on behalf of the Insured Person.
2. Original Discharge Summary or copy duly attested by hospital

A precise diagnosis of the treatment for which a claim is made.

1. Treating doctor’s certificate regarding the duration of the illness & etiology.
2. KYC documents.
3. Laboratory reports.

Portability

Portability means transfer by an individual health insurance policyholder (including family cover) of the credit gained for pre-existing conditions and time bound exclusions if he/she chooses to switch from one Insurer to another.

If the Policyholder/ Insured Person renew with the Company, without break, any similar individual health insurance policy from any insurance company registered with IRDA, then the Waiting Periods as defined in exclusions shall be reduced by the number of years of continuous coverage under such health insurance policy with the previous insurer(s).

The Company's total liability for payment of all claims in aggregate, incurred during the Policy Period, on account of Portability shall not exceed Sum Insured Limit for Portability as defined in Policy Schedule.

The Waiting Periods as defined in policy exclusions shall be applicable individually for each Insured Person and Claims shall be assessed accordingly

 

Territorial Limits and Law

• We cover sickness sustained by the Insured Person during the Policy Period anywhere in India.
• All medical/ surgical treatments including investigations under this policy shall have to be taken in India, however if diagnosis and treatment is taken in following countries/ cities: Canada, Dubai, Hong Kong, Japan, Malaysia, New Zealand, Singapore, Switzerland, USA, and countries of the European Union, the same would be accepted, provided that the claims documents are only in English language unless specifically agreed otherwise, and duly authenticated. The admissible claims thereof shall be payable in Indian currency (Indian Rupees).
• The construction, interpretation and meaning of the provisions of this Policy shall be determined in accordance with Indian Law.
• The Policy constitutes the complete contract of insurance. No change or alteration shall be valid or effective unless approved in writing by Us, which approval shall be evidenced by an endorsement on the Schedule.

Examination of Records

        We may examine Your records relating to the insurance under this Policy at any time during the Policy Period and up to three years after the Policy expiration, or until final               adjustment (if any) and resolution of all claims under this Policy

Change of Sum Insured

Sum insured can be changed (increased/ decreased) only at the time of renewal, subject to underwriting by the Company.

 

Nomination:

The policyholder is required at the inception of the policy to make a nomination for the purpose of payment of  claims under the policy in the event of death of the policyholder. Any change of nomination shall be communicated to the company in writing and such change shall be effective only when an endorsement on the policy is made For Claim settlement under reimbursement, the Company will pay the policyholder, In the event of death of the policyholder, the Company will pay the nominee (as named in the Policy Schedule/Policy Certificate/Endorsement of any) and in case there is no subsisting nominee, to the legal heirs or legal representatives of the Policyholder whose discharge shall be treated full and final as of discharge its liability under Policy.

 

How to claim?

 

Inform our 24x7 Claim Help Desk about the loss on Toll Free Numbers & Mail id:-

 

Toll Free: 1800-103-3009, 1800-300-30000           

Mail ID: chd@shriramgi.com

 

Please refer the policy wording for more details.

FAQs (Frequently Asked Questions)

1. What is the Vector.

A vector is a living organism that transmits an infectious agent from an infected animal to a human or another animal. Vectors are frequently arthropods, such as mosquitoes, ticks, flies, fleas and lice.

2. What are the vector-borne diseases covered?

1. Chikungunya,
2. Dengue,

Japanese Encephalitis,

1. Kala-azar,
2. Lymphatic Filariasis,
3. Malaria,

Zika Virus are the vector-borne diseases.

3. Why vector- borne insurance required?

Dengue and malaria particularly will become more and more common as they are still unfortunately prevalent in various regions of India, and diagnosis and treatment can both be lengthy and expensive. prevention is the best cure - especially for your finances so having this policy you can assured best quality treatment.

4. What is a Vector-Borne Insurance?

Vector-Borne Insurance is a benefit policy that pays out a lump sum amount up to the Sum Insured upon diagnosis of a vector borne disease those covered under the policy.

5. What is a benefit policy?

Benefit policy is a kind of policy where the insurance company pays to policyholder a lump sum amount on happening of an insured event.

6. When the benefit payable?

If the Insured is diagnosed as suffering from any of covered Vector Borne disease during the Policy Period and Hospital admission longer than 24 continuous hours, the Company shall pay a lump sum payment of 100%, as specified under the Policy Schedule.

7. Does a Vector- Care insurance policy pay for the hospitalization benefit?

No, Vector- Care insurance is a benefit plan and only pays a lump sum compensation when the policyholder is diagnosed with any one of the listed specified diseases in the policy documents.

8. Do I need to undergo pre-insurance medical examination for buying Shri Vector Care Insurance?

No, For Shri Vector Care Insurance, there is no requirement for pre-insurance medical examination, irrespective of sum insured and age of the insured.

9. Is there loading on premium for adverse claim experiences under Shri Vector Care Insurance?

No, Shri Vector Care Insurance doesn’t feature loading on premium for adverse claim experiences.

10. Dose Shri Vector Care Insurance Offred any discount?

1. Yes, following are the discount available under Shri Vector Care Insurance policy

   • Long term discount - 2 Year Policy -5% and for 3 Year - 10%
   • Direct discount - 15%

11. Can I buy Shri Vector Care online?

Yes, If you willing to purchase Shri Vector Care, you can explore the official website of Shriram General Insurance Co. Ltd. www.shriramgi.com

12. Is there any age eligibility criteria for purchasing this policy?

• Entry age for this policy is 91 Days to 65 year
• Proposer age should be more than 18 plus.
• Coverage for child (91 days – 18 years) is not allowed without any family member (more than 18 years) being the proposer or covered in the policy.

13. What kind of documentation is required to purchase this policy?

The best part of this policy is that you do not require to submit any documentation. All you need to do is submit a duly signed and complete proposal form with relevant details. Choose the Sum Insured and pay vide a cheque or fill the credit card details in the form.

14. Ispolicy available for Family floater basis also

Yes, You can purchase policy individual as well as family floater basis.

15. What is the maximum policy renewability age?

Lifelong

16. What is the waiting period under this policy?

• The initial waiting period of 15 days
• It will be increased to 60 days, if the insured is suffering or has suffered within 60 days prior to the date of proposal, from any one of the listed vector borne disease except Lymphatic Filariasis at the time of taking the policy.

17. Is a Free- Look option available in this policy?

You have a period of 15 days from the date of receipt of the first policy document to review the terms and conditions of this Policy. If You have any objections to any of the terms and conditions, You have the option of cancelling the Policy stating the reasons for cancellation. If you have not made any claim during the Free look period, you shall be entitled to refund of premium subject to,

1. a deduction of the expenses incurred by Us on Your medical examination, stamp duty charges, if the risk has not commenced,
2. a deduction of the stamp duty charges, medical examination charges & proportionate risk premium for period on cover, If the risk has commenced

a deduction of such proportionate risk premium commensuration with the risk covered during such period, where only a part of risk has commenced

18. Is a Free- Look option available on renewal of this policy?

Free Look Period will not be applicable for renewal Policies.

19. Can I port any other policy into this policy?

Portability is applicable only within similar products. In this case, you can port your existing vector care policy into this policy.

20. What are the option available for sum insured under this policy?

You can choose below sum insured

₹10,000

₹15,000

₹25,000

₹40,000

₹50,000

₹75,000

21. Can sum insured change during the policy period

No, Sum insured can be changed (increased or decreased) at time of renewal only.

22. Whom to contact in case of Claim?

In case of a claim under the Policy, you should immediately intimate us on our helpline numbers mentioned at policy documents. On receipt of the intimation, we would register the claim and assign a unique claim reference number which may be used for all future correspondence.

23. What all documents are required at the time Claim?

Following are the necessary documents along with all original supporting documentation, including but not limited to the below mentioned, and other information We ask for, to investigate the claim for Our obligation to make payment for it.

1. Our claim form duly completed (along with captioned documents) and signed by/ on behalf of the
2. Insured Person.

Original Discharge Summary or copy duly attested by hospital

1. A precise diagnosis of the treatment for which a claim is made.
2. Treating doctor’s certificate regarding the duration of the illness & etiology.
3. KYC documents.

Laboratory reports.

24. Is there any deductible

No, deductible applicable in this policy.

25. What are the tax benefits that can be availed on this plan?

Deduction u/s 80 D of income tax act is available from taxable income for premium paid towards health insurance.

Family Member Age	Total Exemption Limit (₹)	Bifurcation of Limit (₹)
Individual & Parent both are below 60 year	50,000	i.                     25,000 for Individual ii.                   25,000 for Parent
Individual is below 60 & Parent above 60 year	75,000	i.                     25,000 for Individual ii.                   50,000 for Parent
Individual & Parent both are above 60 year	1,00,000	i.                     50,000 for Individual ii.                   50,000 for Parent