Cigna TTK Lifestyle Protection Group Policy- Types, Features & Exclusions

Updated: 05-09-2023 05:50:33 AM

While there is always a risk of accident or critical illness, you can ensure that your employees, club members, or associates are always protected, so that they always feel like they are part of a larger family. An association or organization unites its members through a common interest or goal, and will form an even tighter bond by getting protection against adversities such as accidents. Cigna TTK Lifestyle Protection Group Policy by Cigna TTK offers number of choices from protection against unfortunate accidents as well as risk of critical illness in one cover which is really helpful for organizations to provide cover for all members.

Types of Plan

There are two types of plan under Cigna TTK Lifestyle Protection Group Policy:

1. Group Personal Accident
2. Group Critical Illness policy

Group Personal Accident

Under his plan, protection is provided in the event of death or disability with different optional covers, support items, rehabilitation, accidental expenses, hospital cash and others. Policyholders are provided with comprehensive package to an ala-carte of benefits.

Eligibility Criteria

• Minimum sum that can be insured under the policy: INR 10,000
• Maximum sum that can be insured under the policy: INR 250,000,000
• The individual must be a group member or employee of the primary insured entity.
• Entry age of individual should range from 18 years to 75 years
• Entry age of dependent children should range from 5 years to 25 years

Features and Benefits

The defining feature of this product is that it offers many variants that can be bought in a customized manner to suit the needs of an organization that supports groups. These variants allow the choice of accident only, illness only, critical illness, personal accident, as well as different optional covers that can be upgraded with time. Essentially, the plan offers 4 core benefit types and 34 types of optional covers. The core benefit offered by Cigna TTK are:

• Death due to accident (AD)
• Permanent total disability (PTD)
• Permanent partial disability (PPD)
• Total Disability of Temporary Nature (TTD)

The optional covers include benefits such as:

• Breakage of bones
• Insured member going into coma
• Member suffering burns
• Injury due to animal attack
• Rehabilitation expenses
• Injury due to accident during working on equipment
• Coverage of funeral expenses
• Expenses of emergency ambulance
• Coverage of dependent children of member
• Extension of cover for spouse
• Extension of cover for dependent parents
• Heart conditions
• Final stage lung and liver failure
• Treatment of Alzheimer’s disease
• Bacterial meningitis
• Parkinson’s disease
• Loss of speech function
• Damage to or loss of hands and legs
• Brain surgery
• Terminal illness

Also Check: CignaTTK ProHealth Select : Eligibility, Type & Claim Process

Exclusions under Group Personal Accident

Every health cover has a specific set of conditions and instances which are not covered under the basic plan of the policy. While some exclusions are not covered under any optional cover, some can be included if additional covers are opted. The exclusions under this policy are:

• All pre-existing conditions or disabilities that arise as a result of such conditions
• Any injury caused by self-inflicted harm, regardless of the state of sanity of the individual/suicide.
• Psychiatric conditions and mental disorders, including physical convulsions arising as an effect of mental conditions are not covered.
• A medical certificate or treatment issued by a practitioner who belongs to the same family as the insured member.
• Death due to any act of foreign country such as invasion, war, riots, bombing or act of terrorism.
• Any form of disability or death arising due to STDs or venereal diseases.
• Harm caused by bacterial infections (other than the one caused by injury in an accident)
• Any operative procedures or treatments that are not critically required due to an accident.
• Death, disability, or illness caused by HIV Positive – AIDS.
• Change of profession or exit from the membership under which the policy is applied, unless accepted by the company.
• Death or injury due to crime committed by the injured member
• Any sort of harm caused by use of alcohol, drugs, and hallucinogen.
• Any sort of injury, condition, or death caused by pregnancy and the prolonged effects of pregnancy unless caused by accident.
• Injury caused by participation in flight, unless as a fare-paying consumer.
• Injury due to participation in activities such as para-gliding, scuba diving, rafting, rock-climbing, bungee jumping, etc.
• Death or injury due to release of chemical weapon or biological attack
• Any form of treatment under alternative medicine methods will not be covered under the policy

Group Critical Illness

When it comes specifically to the Group Critical Illness, there are 6 types which cover different ranges of critical illness. The freedom of choice is with the primary insured member. The extra benefits which can be added on to the Group Critical Illness Plan include:

• Use of emergency roam ambulance
• Availability of hospital cash
• Benefit of education fund for children
• Benefit of marriage expense for dependent children
• Medical repatriation
• Survival period waiver clause
• Coverage for loss of earning
• Expenses related to family counselling
• Expenses for family transportation
• Consultation from specialist for second opinion
• Wellness expenses

Exclusions under Group Critical Illness

• Any conditions illnesses except the ones stated in the company policy
• Any pre-existing conditions and illnesses evolving as a result of them
• Any illness or injury occurring as a result of consuming alcohol and intoxicating drugs
• HIV AIDS and any condition evolving from it
• Any form of sex-change procedures
• Any illness or injury as a result of foreign invasion, war, or terrorism
• Any injury occurred as a result of participation in adventure activities such as rafting, scuba diving, rock climbing, etc.
• Any critical illness or injury caused by self-inflicting harm
• Any injury occurred due to the member committing criminal activity
• Medical procedures conducted for birth control procedures any procedure related to pregnancy

Note: There is a 90-day waiting period during the initiation of the policy where any sort of claims related to both type of policies will not be covered under the policy.

How to Get Coverage?

• You can visit the online portal of Cigna TTK and click on “buy now” to initiate the process.
• The first step is to get a quick by entering your identification details, sum insured, and policy term.
• The next step is to choose the additional covers and to go through all the exclusions of the policy, and also the settlement ratio.
• You will also be required to submit your ID proof, address proof, and medical records if required according to the specific policy guidelines.

Additional Benefits

The additional benefits available for both the variants of the policy are:

• You can accurately track the progress of your claim process through the website.
• You can use several useful health tools on the website to calculate BMI, heart rate, etc.
• You also get access to the newsletter that posts health oriented articles on regular basis.

Filing claims with Cigna TTK Lifestyle Protection Group Policy

For filing claims with Cigna TTK Lifestyle Protection Group Policy, policyholders need to notify the company through call centre or in writing within 10 days from the date of occurrence of accidents/critical illness. The following details need to presented before filing the claim:

1. Policy Number
2. Name of the policyholder
3. Name of the insured person
4. Nature of Critical Illness/ Accident
5. Name and address of the medical practitioner and hospital
6. Date of admission

Documents Required

Below mentioned list of documents are required for all the claims:

1. Photo Identity Proof – Voter ID, Passport, PAN Card, Driving License, Ration Card, Aadhar, or any other proof accepted by the KYC norms as approved by Us and which is admissible in court of law
2. Duly completed and signed claim form in original as prescribed by Us.
3. Copy of FIR/ Panchnama /Police Inquest Report (if conducted) duly attested by the concerned Police Station;
4. Copy of Medico Legal Certificate(if conducted) duly attested by the concerned Hospitals

Renewal Process with Cigna TTK Lifestyle Protection Group Policy

Under this plan, policy can be renewed with the mutual consent to which the renewal premium should be paid to the company before the date of expiry of the policy or from the date of next instalment due date. Also, a grace period of 30 days is allowed before the expiry of the policy during which company is not liable to pay any of the claim arising out of any accidents or critical illnesses.

Surrender of the policy

Policyholders can raise request for cancellation of policy by giving at least 15 days written notice in which company shall refund the percentage of the premium on short term rates for the unexpired policy period.

Also Read: CignaTTK LifeStyle Protection Critical Care

FAQs

Q1. Who can be the buyer/policy holder for Group Protection Policy?

The policy is issued to the organization/institution/club and the owner of the establishment/organization is the policy holder who can make changes in the policy.

Q2. Can citizens of foreign countries working in/part of the organization be covered under the policy?

Yes, if the individual is a member and earning in Indian currency, then he/she can be covered under the policy.

Q3. Can claim-free years award any bonus to the policy holder?

No, there are no bonuses provided to the policy holder for claim-free years.

Q4. What is the minimum number of members which can qualify as a group to be eligible for the policy?

At least 7 members are required for a group to be recognized as per the policy guidelines.

Q5. Is any pre-assessment test required before the initiation of policy term?

According to the type of policy or age of the member, medical tests might be required.

Q6. Can the primary policy holder assign different levels of cover for different members of the organization?

Yes, different employee groups/job profiles/ ranking members can be put under different levels of protection under the policy.

Q7. Are the claims applied for during the grace period of policy remunerated under the policy?

No any claims made during the grace period are not entertained by the company.

Q8. What type of treatments are included under the term alternative medicine?

According to policy guidelines, alternative medicine includes Ayurveda, Sidha, Unani, Homeopathy, and any treatment other than Allopathy or Modern Medicine.

Q9. Is there a tax benefit available for premium payment for the policy?

Specifically, under the Group Critical Illness plans where members pay for their own premiums, income tax benefits are provided under Section 80D of the Income Tax Act.