CignaTTK ProHealth Cash: Types, Eligibility & Exclusions

Published: 28-01-2019 13:36:30 PM

Cigna TTK is a leading health insurance provider company in India. It offers several health insurance plans with options so that you can select a proper plan as per your need. Under CignaTTK Prohealth Cash Plus plan, Cigna TTK provides you cash benefit in case of hospitalization. The cash per day is calculated based on each completed period of 24 hours in the hospital. You can avail cash for maximum 450 days during lifetime under this policy. Within a policy year, you have an option to select maximum 60, 90 or 180 days of hospitalization compensation. Under this policy, you can avail a host of benefit like sickness hospital cash benefit, accident hospital cash benefit, ICU cash benefit, worldwide cover. If you opt for an enhanced plan, additional covers like convalescence benefit, companion benefit, and the compassionate benefit are provided.

Types of CignaTTK ProHealth Cash

CignaTTK ProHealth  Cash Insurance is of two types:

Type	Benefits
CignaTTK ProHealth Cash Basic Plan	· Sickness Hospital Cash Benefit · Accident Hospital Cash Benefit · ICU Cash Benefit · Worldwide Cover
CignaTTK ProHealth Cash Enhanced Plan	· Every Benefit of Basic Plan Plus Below enhanced benefits: · Convalescence Benefit · Companion Benefit · Compassionate Benefit

Eligibility Criteria

Parameters	Details
Minimum Entry Age	91 Days
Maximum Entry Age	65 Years
Renewal Age	Available for Lifetime
Policy Tenure	Can be renewed for One/Two/Three years in single premium
Family Meaning (Individual Health Plan)	Self, Spouse, Dependent children and parents, Siblings, Grand Parents, Grand Children, Parents in Law
Sum Insured	INR 500 (One Unit) to INR 5000(10 Units) per day.   INR 50000 to INR 25 Lacs in case of personal accident cover
Premium Criteria	Based on Age, Gender, Optional covers, Location, Sum Insured, Applicable discounts

Features of CignaTTK ProHealth Insurance

• Under sickness that needs hospitalization of an insured person, CignaTTK pays cash benefit for each completed days of hospitalization as per policy schedule.
• In the case of an accident that needs hospitalization treatment, above benefit is double than mentioned in the schedule.
• If the person needs the treatment in the Intensive Care Unit (ICU), the company pays the cash benefits equivalent to three times of benefit mentioned in the policy schedule. This benefit is payable for a maximum of 15 days.
• If the hospitalization occurs at an international location, then also the amount payable is three times the amount mentioned in the policy schedule.
• Under Convalescence Benefit cover, you can avail cash benefit equivalent to five times of benefits mentioned in policy schedule, in case hospitalization extends beyond 10 days.
• Under Companion Benefit, you can avail additional cash benefit equivalent to 50% of the amount mentioned in policy schedule to make good for the person who takes care the insured person in the hospital.
• In case of an accident, you can avail the amount equivalent to 10 times of benefit mentioned in the policy schedule, if you have opted for compassionate benefit while availing the plan.
• If you opt for daycare treatment, you can avail five times of daily cash benefit or Rs.25,000 whichever is lower. In such case, 24 hours of hospitalization is not necessary.
• You can also avail accidental death cover and permanent disability cover for enhanced benefit in case of unfortunate accident results in death or permanent disability.

Points to Consider before purchasing CignaTTK ProHealth Cash

1. Sufficient Sum Insured

Healthcare expenses are inflationary in nature. The cost which seems enough today may not be enough after five years. Hence, as far as your budget permits, consider taking a sufficient sum insured for yourself and family.

2. Avail early – when you don’t need it!

 The health insurance policy comes with a waiting period from 90 days to four years for the pre-existing disease. At a younger age, health-related issues are lesser, so you can easily complete waiting period. It is always recommended to act proactively to avail health insurance.

3. Avail optional cover of daycare treatment

Nowadays, with advancement in medical science, not every treatment need 24 hours hospitalization. However, the cost of treatment is very high. It is advisable to avail day care treatment cover so that you don’t have to bear the cost of treatment that does not require 24 hours of hospitalization.

Filing cliams with CignaTTK ProHealth Cash

• Contact CignaTTK health insurance through the call center, nearest office or advisor and intimate about your hospitalization.
• Your first intimation to CignaTTK should be within 48 hours of hospitalization but not after discharge.
• Your intimation should include the name of the insured, policy number, nature of treatment and complete details of hospitalization.
• Once discharged from the hospital, compile necessary documents and submit the same to the office of CignaTTK.
• Your claim shall be processed after due verification by CignaTTK.

Documents Required

• Claim Form Duly filled and Signed.
• Operation theatre notes( if applicable ).
• Pre-authorisation request letter and approval letter’s photocopy.
• Photo ID of the insured.
• Discharge Summary from the hospital.
• Death Certificate if applicable.
• Hospital’s main bill and detailed bill with payment receipt.
• Original medical test Reports, X-Ray, MRI, CT Films, HPE whichever applicable.
• Doctors’ prescription, consultation notes.
• Original Pharmacy Bills.

CignaTTK may ask other documents if required, based on actual case circumstances.

Exclusions

• Any illness claim within the first 30 days of availing policy is not admissible. However, the same is not applied in case of an accident.
• During the first 48 months, Pre-existing diseases are excluded from the claim.
• For specified diseases, 24 months of the waiting period is applied.
• There are permanent exclusions like dental surgery, mental illness and others listed in the policy documents.

How Long Does It Take to Payout a Claim?

Every claim made to CignaTTK is assessed based on claim-form filled and documents submitted. In case of insufficient information or documents, the payment gets delayed. After complete information and documentation, CignaTTK verifies the details and approves the payment as per terms and conditions of the policy. After approval, the payment is made directly in your bank account.

Advantages of CignaTTK ProHealth Cash Plan

1. Against your claim form and required documents, per day cash benefit is provided. Hence you don’t have to worry about uncovered/limited cover due to sub-limit or other reasons.
2. As per section 80-D of the Income Tax Act, the premium paid to CignaTTK Prohealth Cash plan is considered as a deduction from total income. Hence your actual cost of the premium is much lesser than your payment.
3. Avail free access to wellness program conducted by CignaTTK, that helps you to remain healthy.

FAQs

Q1. Is it mandatory to undergo a medical examination to avail CignaTTK health insurance policy?

It depends on your age and amount of sum insured. Above certain age and sum insured, it is mandatory. However, even if not required, you can undergo a medical examination and submit the reports to the insurance company. Such submission exempts you from pre-existing disease related matters.

Q2. What is the limit of claim in a year?

Your claim under CignaTTK HealthPro cash is limited by either 60, 90 or 180 days’ benefit. However, overall benefit during a lifetime is limited to 450 days’ benefit.

Q3. How can I avail discounts in premium of CignaTTK Prohealth Cash policy?

You can avail a 10% discount if you avail the insurance plan for the whole family. If you pay the premium for two or three years together, you can avail a discount of 7.5% and 10% respectively. If you buy the policy online or directly from the company or worksite marketing channel, you can avail another 10% discount.