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FAQs on Revised Diabetes Safe
 
Product features
 
1.What is different about the new Diabetes Safe policy?
Ans:It is a policy exclusively meant for persons who are diabetic. No insurer prefers to cover persons who have some existing illnesses. If cover is given, it is given with a lot of limits and exclusions.
 
2.Does it cover the declared medical condition of Diabetes and it complications?
Ans: Yes. The policy covers all complications of diabetes. Over and above, the policy provides regular medical cover for other illnesses too.
 
3.Every policy covers the PEDs after 4 years of continuous renewals. So, what is different about Diabetes Safe policy?
Ans: This policy covers the PED and its complications from Day One of the policy. You need not wait for 48 months for getting coverage of complications of Diabetes.
 
4.Is a medical screening mandatory for getting Diabetes Safe policy?
Ans: A medical examination is required if you wish to have coverage from Day One for diabetic complications. But a diabetic person can also take the cover without a medical examination.
 
5.What is different about the cover without a medical screening?
Ans:The only difference is that coverage for diabetic complications shall start only after a waiting period of fifteen months, in case the cover is taken without a medical screening.
 
6.Is there a cost for the medical screening?
Ans:No, the cost for medical screening is absorbed 100% by the company, if the policy is accepted. If the policy is rejected, 50% of the medical screening will be chargeable to you.
 
Eligibility :
 
1.Who can apply for the cover? (Who can take the cover?)
Ans: Anybody diabetic within the age 18 to 65 can opt for the policy.
 
2.What will happen once I touch age 65?
Ans: No fresh cover will be given after the age of 65. That's the only restriction. If you have taken the policy before 65 years of age, you can continue the policy for life time.
 
3.My wife and I both are diabetic. Should I take two different policies if both of us want the cover?
Ans: No, we have a Family floating option, which means both of you can take a single policy for joint coverage under a single sum insured.
 
4.My child has juvenile diabetes. Can I cover him under the policy?
Ans: Unfortunately, no. The cover is possible only for persons above 18.
 
5.You say that there are two Plans, Plan A and Plan B. Which do I choose?
Ans: This is your choice. If you wish to have day 1 coverage, it is Plan A. But, you have to undergo medical screening and wait for the medical decision for the acceptance. Once you get cleared, you are admitted into coverage as per Plan A. But if you do not want the hassle of medical screening, then you can join Plan B, but the coverage for diabetic complications start from 15th month.
 
6.Can I take the cover without a medical, join Plan B and next year shift to Plan A after a medical check?
Ans :No change of plan is allowed. Please choose carefully.
 
Coverage:
 
7.Along with Diabetes, I have the PED of Asthma and wheezing also. I intend to declare them. Will I get cover from 'day one' of the policy for the same and any complications?
Ans: The policy covers both diabetic complications and other types of ailments in two different sections. Diabetic complications are covered in Section 1 which has no waiting period, if the cover is taken after a medical screening. Without a medical screening you have to wait 15 months for the coverage. All other diseases are covered in Section 2, as per the usual health insurance terms. So, any PEDs other than diabetes shall be covered under Section2. Here, the PED waiting period is 48 months of continuous coverage..
 
8.Is a Cataract claim admitted on Day1 of the coverage?
Ans: No, cataract is coming under Section 2. It is covered with a waiting period of 24 months, if it is not a PED.
 
9.Are day-care procedures covered?
Ans: Yes, day care procedures are covered. The numbers of day-care procedures covered and listed are expanded to 423 in the policy.
 
10.What do I do, if the sum insured is exhausted?
Ans: Your concerns are well taken care of in this policy. There is an Auto-Restore facility which restores the SI to the original level (100% of SI) once in the policy period.
 
11.Can I use up the sum insured for repeat claims of chronic types I claimed earlier?
Ans: The Restored SI will be available for only illnesses new. It cannot be used for diseases which have been claimed under the policy earlier by the same person.
 
12.The Auto-restore facility is available for the Family Floater option too?
Ans: No, the Auto-restore will be available for only individual covers. This facility is not extended for Family floating option.
 
Limits :
 
13.What are the sum insured options available?
Ans: Four options are available: Rs3/4/5/10 Lakhs, depending on your choice.
 
14.What are the room rent limits in the policy?
Ans: For section 1 (Diabetic complications), the room rent limit is that the cost equivalent to a single standard AC, and it is 1.5% of sum insured (subject to a max of Rs8,500) in hospitalizations under Section 2 for treatment of diseases other than diabetic complications.
 
15.What is the limit set for cataract removal surgery?
Ans: For all SI options up to Rs 5 lakhs, Rs20,000 per hospitalization with a max of Rs30,000 during the policy term. It is Rs 30,000 (Max of Rs.40,000 for the policy term) for Rs 10 Lakh.
 
16.Are there any other sub limits?
Ans: No, there are no sub-limits for claims under Plan A which is policy taken after a medical screening. For Plan B, which is taken without a medical screening, for claims there is a sub-limit ranging from 2Lakhs for 3 lakh SI to 4Lakhs for 10 Lakh SI for claims in treatment of Cardiovascular diseases.
 
Premium :
 
17.Isn't the premium higher than the regular medical policies?
Ans: Naturally. The persons taken for cover are high-risk individuals. You have to expect some increase in premium. But the benefits offered should also be kept in view.
 
18.Is the cost for Plan A and Plan B same or different?
Ans: Plan A is given after a medical screening. We know what the health status of the insured is. How good or bad is the medical control on diabetes, which is not available for Plan B entrants. The actual control or extent can be varying from what is actually stated in the proposal form. So, to take care of the margin of error, the premium is slightly higher. For a person aged 38, opting for Rs4lakhs, the premium is Rs16490, or in monthly terms, Rs1374/-.

This is not too high when compared to Plan A premium.