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Reliance Health Insurance

Reliance General Insurance Company has earned a popular name in the insurance industry since its inception. The company has a huge customer base including the individuals, corporates and SMEs. Reliance has 139 offices PAN India to provide you seamless insurance services as per your own convenience. Reliance health insurance also has its presence across India and abroad. And with online purchase and renewal services, they have become even more accessible to their customers.

Reliance Health Insurance Plan Overview:

Key Features Highlights
Incurred Claim Ratio 92.23%
Network Hospitals 4000+
No-claim-bonus Yes
Discount 7% for Daughters
Tax Benefits Yes
Waiting period for pre-existing illnesses 4 years

Features of Reliance Health Insurance

  • Cashless medical treatment in the registered hospitals PAN India
  • No-Claim-bonus for every claim free year
  • Reliance provides both family floater and individual health insurance plans
  • Independent women can avail a discount of 5 percent on the premium
  • Expenses incurred prior to the hospitalization and after the hospitalization are covered
  • Auto-reinstatement of the sum insured
  • Lifelong renewability of most of the plans
  • Hassle free documentation
  • All the plans do not have a co-payment policy

Reliance Health Insurance Plans Comparison Table

Plan Name Sum Assured (in Rs.) Age Criteria Coverage Type Waiting period for pre-existing diseases
Reliance HealthWise Plan 1 to 5 lacs 3 months to 65 years Individual/Family Floater 24 months
Reliance Health Gain Plan Plan A: 3 to 9 lacs.

Plan B: 12 to 18 Lacs.

5 to 65 years Individual/Family Floater 36 months
Reliance Health Gain Installment Plan 3 to 9 Lacs. Up to 61 years Individual/Family Floater 36 months
Reliance Critical Illness Plan 5, 7 & 10 Lacs. 18 to 65 years Individual 3 months for critical illnesses

36 months for other diseases

2 year for specific diseases

Reliance Personal Accident Plan  N/A Adults: 5 to 70 years

Children: 5 to 25 years

 

Individual/Family Floater N/A

Types of Reliance Health Insurance Plans

  1. Reliance HealthWise Plan– There is no room rent capping in this plan and it offers up to 20% of No-claim-discount on the premium. The plan also coverage against critical illnesses.
  2. Reliance Health Gain Plan– This is the Reliance senior citizen health insurance plan that offers coverage to both individuals and families. This plan offers benefits such as cashless medical treatment, day care procedures, and various other add-on coverages.
  3. Reliance Health Gain Installment Plan– It is a comprehensive health insurance plan that you can buy in 4-easy installments. You can choose the sum insured of Rs. 3, 6 & 9 lacs.
  4. Reliance Wellness Program-This program is for individuals and corporates where they have access to various online wellness programs and healthcare tips on the go.
  5. Reliance Critical Illness Plan– It covers 10 major critical illness and surgeries. And medical check-up is required only for applicants above the age of 45 years.
  6. Reliance Personal Accident Plan– The plan covers accidental death and disabilities and comes with a worldwide cover.

Reliance Health Insurance Claim Procedure

While lodging a claim with Reliance, make sure that you have the following details handy

  1. Reliance medical insurance policy number
  2. Contact details of the claimant/insured (contact no., email id, address etc.)
  3. Name of the person who is admitted into the hospital
  4. Relationship with the hospitalized person
  5. Hospital name
  6. In the case of health claims – Nature of the disease and the date of commencement of the symptoms
  7. In case of an accident- Nature of the  accident
  8. Time, date and location of the accident

Cashless Claim Procedure

The process to avail the cashless treatment is as follows-

  1. Take admission in any of the Reliance registered hospitals
  2. Present your Reliance health card at the third party administrator helpdesk
  3. Submit the duly filled claim form
  4. You also have to provide the authorization form, health card, and a photo ID
  5. The hospital department will share your authorization from with Reliance health team and based on the documents submitted you will get an approval
  6. Sign and verify all the bills
  7. The hospital will keep the discharge summary and investigation reports ( in original)
  8. Keep a photocopy of all the documents for your records

In case, your cashless claim is rejected you have to –

  1. Pay the bills from your own pocket
  2. While getting discharged collect all the reports, bills and documents ( original copies)
  3. File your claim with Reliance Health team or TPA to get reimbursement of your expenses

Cashless Claim procedure in case of an emergency hospitalization

  1. Take admission into a network hospital
  2. Collect the pre-authorization form, fill it and get it signed by the concerned doctor
  3. Email or fax the pre-authorization form to the insurance provider or TPA dept.
  4. Also, submit all the essential documents, reports and
  5. Keep a photocopy of the investigation reports and discharge summary

Reimbursement Claim process in case of an emergency hospitalization

  1. Select the hospital and start with the treatment
  2. Immediately intimate the insurance provider at their helpline number
  3. Pay all the hospital bills from your own pocket
  4. Collect all the documents, bills and reports before discharge ( original copies)
  5. Fill the claim form, provide all the documents and lodge your reimbursement claim request with Reliance health insurance provider.

Reimbursement Claim process in case of a planned hospitalization

  1. Inform the insurance company about the planned hospitalization
  2. Get admitted into the hospital
  3. Pay all the hospital bills
  4. Before discharge collect all the reports, bills and documents ( in original)
  5. File a claim to get reimbursement for your medical expense incurred during hospitalization

Reliance Health Insurance Renewal

Reliance mediclaim policies can be renewed online in a matter of few clicks. Check out the steps listed below:

  • Visit the company official site
  • Select the renewal option
  • Enter your mediclaim policy number
  • Select the plan type and coverage options
  • Review the policy
  • And calculate the premium online
  • If satisfied, you can pay the premium online using your debit or credit card or via net banking
  • Your policy will be renewed instantly
  • Download the policy documents for your future reference. However, a copy will be mailed on your registered id.

Before renewal it is suggested that you also have a quick glance at the Reliance health insurance reviews and select a plan that works just right for you.

Inclusions- What is covered in Reliance Health Insurance Plans?

Usually, Reliance health insurance recompenses the following expenses-

  • Pre & Post hospitalization expenses
  • In-patient treatment
  • Domestic road ambulance
  • Donor expenses
  • Domiciliary hospitalization
  • Daycare treatments
  • Critical Illness

Exclusions-What is not covered in Reliance Health Insurance Plans?

Reliance health insurance does not cover the expenses incurred on the following-

  • Health ailments resulting due to consumption of drugs and alcohol
  • Treatment for diseases such as HIV/AIDS
  • Intentional injuries/suicidal attempt
  • Any illness/injury resulting from a criminal activity
  • Congenital diseases
  • Dental surgeries or treatment
  • Treatment for mental disorders
  • Cosmetic and aesthetic treatments
  • Maternity complications or fertility treatment
  • Injuries resulting from war conditions/radio activities/ nuclear radiation/ biological injuries
  • Treatment has taken outside India
  • Stem cell treatment cost
  • Cost of hearing aids/contact lenses and spectacles

Benefits of Reliance Health Insurance Plans

Here is a quick rundown of the advantages of buying Reliance medical insurance plans-

  • Pre-existing illnesses are covered after a waiting period of 4 years
  • Health check-up expenses are reimbursed on completion of 4 claim-free years
  • The company offers the flexibility pay the premium online through your debit card, credit card, Netbanking, PayTm as per your convenience
  • Reliance health insurance offers restoration upon exhaustion of the base sum insured
  • Hassle-free and quick settlement of health insurance claims
  • Avail tax benefits against the annual premium

How to Calculate Reliance Health Insurance Premium?

Reliance medical insurance premium is calculated on the basis of the plan you opt for, type of coverage you opt for, policy term, add-on benefits, age and number of the members covered, geographical location etc. Your health insurance premium is calculated on the following parameters:

However, you can calculate the premium online by using Reliance health insurance premium calculator. To know the premium cost, the following specifications are required from your end-

  • Cover Opted (Individual/Family floater)
  • Sum Insured
  • Number of members
  • The DOB of the senior most member
  • Optional covers (add-ons opted by you)
  • Email address
  • Mobile Number
  • Pin code

You will get the quotation as soon as you provide the above details. Also, it is advisable that you read the Reliance health insurance reviews online before making the purchase.

Why Buy Reliance Health Insurance?

With the increasing cost of healthcare treatments, even a small treatment can burn a hole in your pocket. During this time, a mediclaim  policy comes as a savior.

Reliance mediclaim policy will recompense the hospitalization expenses, day care treatment costs, OPD charges, doctor consultation fees, diagnostic tests, and similar expenses which otherwise can put you in a financial shock.

You can buy a policy for yourself, your family and elderly parents. There are plans that offer worldwide coverage along with critical illness cover. Moreover, the insurer follows a hassle-free claim settlement process where minimum documentation is required.

Documents Required By Reliance Health Insurance

Here is a checklist of the documents that you need to submit while filing a claim for Reliance health insurance plans under the specific situations-

Daycare Treatment/Hospitalization

  • Claim form completely filled and duly signed by you
  • Doctor’s prescription stating the onset of the symptoms
  • Medical treatment papers
  • Doctors’ prescription papers
  • Diagnostic reports (like ECG, X-ray etc.)
  • Original receipts and medical bills
  • Ambulance bill/receipt
  • Discharge card from the hospital ( original)
  • In accidental cases, a copy of FIR is required
  • A cancelled cheque ( CTS 2010 format )
  • A copy of Reliance Health card
  • Xerox copy of PAN card/ID card

Domiciliary hospitalization

  • Reliance medical insurance claim form ( duly filled & signed)
  • The first prescription from the doctor (stating the date of the onset of the symptoms of the illness)
  • Doctor’s prescription and healthcare treatment papers
  • Medical Investigation Reports
  • Receipts and Original medical bills
  • FIR report (in case of an accident)
  • Certificate from the medical practitioner recommending the treatment at home
  • Documents as a proof showing lack of accommodation in the nursing home/hospital
  • PAN card
  • ID card
  • A cancelled cheque in CTS 2010 format

Critical Illness Claims

  • Claim Form
  • Doctor’s certificate with the diagnosis of the illness (stating the initial symptoms)
  • Radiology reports, pathology reports, and other investigation reports
  • Original receipts and hospital bills and receipts
  • Chemist bills
  • Hospital admission and discharge card/ certificate
  • Cancelled Cheque/1st page of passbook
  • PAN card
  • Identification card

Reliance Health Insurance FAQs

Q1. What all expenses are covered under basic hospitalization?

Check out the below list to know what all expenses are covered under basic hospitalization-

  • In-patient and daycare hospitalization expenses
  • Expenses incurred before and after the hospitalization
  • Organ donor expenses
  • Emergency road ambulance charges
  • Domiciliary hospitalization expenses
  • Cumulative bonus
  • Restoration of the sum insured
  • Accidental death is also covered

Q2. If the treatment required hospitalization for less than a day, will it still be covered?

To get reimbursement of your health care expenses, a minimum of 24-hours of hospitalization is required. However, there are certain day care treatments where hospitalization may be lesser than 24 hours.  Here is a listed of a few daycare medical procedures that are covered under Reliance health insurance plans –

  • Chemotherapy
  • Dialysis
  • Radiotherapy
  • Tonsillectomy
  • Lithotripsy ( removal of kidney stone)
  • Cardiac Catheterization
  • Dilatation & Curettage
  • Other surgeries that are conducted in less than 24 hours due to the technology advancement

Q3. What is the procedure to cancel my Reliance mediclaim policy?

Simply write a letter to the insurer requesting for cancellation of your Reliance health insurance plan. On receiving the letter, the insurer will initiate the refund of your premium amount on short-term basis, provided no claim was filed during that period. For more details, please refer to the policy wordings.

Q4. What happens to the premium if no claims are made against the policy?

If you have not made any claims against your policy during the year, Reliance General Insurance offers you a renewal discount of 5% of base premium on each claim-free renewal. The maximum overall discount is 20% overall claim free periods.

Q5. What are the factors than can affect your health insurance premium in India?

Your health insurance premium is calculated on the following parameters:

  • Cover opted( Individual/ floater)
  • Sum Insured Selected
  • Age of senior most member
  • Optional covers (add-ons opted for)

 Q6. How many claims can in make during a Reliance health insurance policy period?

You can as many claims during the policy term up to the sum assured limit.

Q7. Where can I contact Reliance for grievance redressal?

For grievance redressal, you can call at their toll-free number i.e. 1800 3009. Also, you can write them an email addressing your concerns at rgicl.services[at]relianceada.com.

Q8. What is covered under Reliance critical illness insurance plan?

For critical illness insurance, the payment is made in lump sum. You can choose the sum assured between Rs. 5 lakh, Rs. 7 lakh and Rs. 10 lakh as per your requirement. Following illnesses are covered in this plan-

  1. Life-Threatening Diseases (30 days survival period) –
  • Major Organ Transplant
  • Cancer
  • Third Degree Burns
  • Multiple Sclerosis
  • Aorta Graft Surgery
  1. Lifestyle Disabling (60 days of survival period)-
  • Total Blindness
  • Coma (specified severity)
  • Heart valve repair/replacement surgery
  • Coma Quadriplegia (showing no signs of recovery after 90 days of the diagnosis)
  • End Stage Renal Disease where regular dialysis is required