Cigna TTK Pro Health Plan

ProHealth Protect Policy
ProHealth Plus Policy
ProHealth Premiere Policy
ProHealth Preferred Policy
Cigna TTK Health Insurance Company Limited
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About Cigna TTK Health Insurance Company

Cigna TTK Health Insurance Company Limited is a joint venture between Cigna Corporation; a U.S based global healthcare provider and TTK Group, an Indian Conglomerate in February 2014. The company has a wide network spread across 15 cities of India which makes it one of its kinds leading health care provider. The company has its nerve centre in Mumbai.

Cigna Group is a fortune 500 company of U.S. operating in the health care sector. It made a combined step towards the health insurance services in Indian envisaging offering the customers with high quality and valuable Insurance plans and an acute grade of customer service experience.

The aim of the company is to offer trustworthy, high-grade insurance to the customers in health and accidental insurance sector. And with the health expertise of Cigna Group and trusted and efficient customer hold of the TTK Group the company seems to have efficiently worked towards its aim. The hassle-free, customized and widely supported policies of the company have already assisted many customers in their health concerns.

Cigna TTK Pro Health Plan

The Cigna TTK Pro Health Plan is a complete cover against all the expenses incurred in case of any medical emergency or accidental occurrence. The various policies under the Pro Health Plan take care of the costs incurred for hospitalization; pre and post, day care procedures (which doesnít require hospitalization) and any other accidental injury or disablement.

Sometime in our life we fall prey to the uncertainties and the health concern of us or our family needs a great investment to be made. There are many procedures that require huge financial support which might not be possible to be borne alone. The Cigna TTK Pro Health Plan promises to be at your side in case of health and accidental adversities.

The 5 Policies covered under Cigna TTK Pro Health Plan are:

  • Pro Health Protect
  • Pro Health Plus
  • Pro Health Preferred
  • Pro Health Premier
  • Pro Health Accumulate

You may choose the best plan as per your need and affordability. Here are the brief details of the policies:

ProHealth Protect:

Highlights:
  • 100% restoration of Sum Insured
  • Non-reducing cumulative Bonus.
  • Single, Private room and ICU costs included
  • Surgeonís fees, Nursing expenses, Oxygen, anesthetists charges, etc. are fully covered up to the sum insured.
  • All the emergency expenses are covered in Indian as well as in abroad (on a reimbursement basis) up to the sum insured.
  • 500 Rupees reimbursement per year to cover the out-patient expenses, medicine, tests, and medicine expenses
  • Healthy reward points of 1% of the premium paid per year.

Pro Health Plus:

Highlights:
  • The policy includes the cost of Inpatient hospitalization, Pre & Post Expenses and day care facilities.
  • Ambulance charges up to 3000 INR are covered under the policy.
  • In case of an emergency in Foreign Land, emergency cover offered on a reimbursement basis.
  • 2000 INR per year are allotted to cover the out-patient expenses such as Doctorís fees, Medicines, diagnostic tests and pharmacy expenses.
  • Maternity benefit after 48 months of coverage which ranges from Rs. 25000 for caesarean and Rs. 15,000 for normal delivery.
  • In the case of newborn hospitalization, the cost would be covered as per the sum insured.
  • First-year vaccination covered under the National Immunization Program.
  • For every unclaimed year, the sum insured gets increased 10% up to 100%.
  • Reward points of 1% of the sum insured which can be combined to avail other wellness programs offered by the company.
  • In the case of organ transplant, the expenses of the donorís hospitalization are covered under the scheme.

ProHealth Preferred:

Highlights:
  • Inpatient hospitalization including the cost of any room excluding suite, oxygen, medicines, operation theatre, blood, nursing, surgical appliances, surgeonís fees up to the sum insured.
  • Expenses incurred 60 days prior to the hospitalization and 180 days post discharge are covered under the policy.
  • 24 hours of day care including the cost of dialysis, cataract surgery, radiation therapy, etc. is covered.
  • Ambulance charges are redeemed as per the actual expenses incurred up to the sum insured. In abroad the same is covered on a reimbursement basis.
  • Rs. 15000 per year are reimbursed covering the out-patient expenses which include pharmacy charges, diagnostic costs, medicines and doctorís consultation fees.
  • After 48 months of successful coverage, the policyholder may avail Rs. 50000 for normal delivery and Rs. 100000 for a caesarean.
  • In need of any treatment for the newborn, the expenses would be covered up to limit under Maternity.
  • All the vaccines mentioned under the National Immunization Program are covered for the first year of newborn.
  • In the case of organ transplant, the expenses of the donorís hospitalization are covered under the scheme.

ProHealth Premier:

Highlights:
  • In-patient Hospitalization, pre and post hospitalization expense are covered under the policy.
  • The cost incurred in nursing, oxygen, blood, anesthesia, surgeonís fees, hospital room, Intensive care unit, drugs is covered during the hospitalization period.
  • Pre-hospitalization costs of 60 days and post hospitalization of up to 180 days is applicable.
  • Hospitalization for less than 24 hours is covered under the policy terms.
  • Emergency ambulance charges are insured up to the sum insured in India as well as in abroad (reimbursement basis).
  • Health maintenance benefits of Rs. 15000 are provided per year to cover outpatient costs.
  • Rs. 50000 and Rs. 100000 to be covered in case of normal and C-section delivery respectively.
  • The policy covers the expenses incurred in any treatment (if required) for the newborn and the vaccination (as per National Immunization Scheme) charges for the first year.
  • In the case of organ transplant, the expenses of the donorís hospitalization are covered under the scheme.

ProHealth Accumulate:

Highlights:
  • Current requirements covered as well as reserve built for future requirements.
  • Hospitalization, Pre and post hospitalization costs are covered under the policy.
  • The costs included are; Hospital room rent, Intensive Care Unit, Anaesthetists, surgeonís expenses, surgical appliances, blood, operation theatre charges, oxygen, medicines, nursing up to the sum insured.
  • The cost incurred in any procedure (dialysis, cataract surgery, radiation therapy) that requires hospitalization for less than 24 hours.
  • Expenses incurred in domiciliary treatment up to the sum insured.
  • Ambulance service in India and foreign country up to the sum insured.
  • In the case of organ transplant, the expenses of the donorís hospitalization are covered under the scheme.
Features/Policy ProHealth Accumulate ProHealth Premier ProHealth Preferred Pro Health Plus ProHealth Protect
Sum Insured 5.5 lakhs, 7.5 lakhs, 10 lakhs, 20 Lakhs and 25 lakhs 100 Lakhs 15 lakhs, 30 lakhs and 50 lakhs 4.5 lakhs, 5.5 lakhs, 7.5 lakhs and 10 lakhs 2.5 lakhs to 10 lakhs
Entry Age & Renewal 91 days for children and 18 years for adults 91 days for children and 18 years for adults 91 days for children and 18 years for adults 91 days for children and 18 years for adults 91 days for children and 18 years for adults
Medical Test Depends on the age and sum insured Mandatory Mandatory Depends on the age and sum insured Depends on the age and sum insured
Policy Period 1/2/3 years 1/2/3 years 1/2/3 years 1/2/3 years 1/2/3 years
Family Discount 10 % discount on premium (more than 2 family member under one policy) 10 % discount on premium (more than 2 family member under one policy) 10 % discount on premium (more than 2 family member under one policy) 10 % discount on premium (more than 2 family member under one policy) 10 % discount on premium (more than 2 family member under one policy)
Long Term Discount 7.5% for 2 years and 10 % for 3 years single premium policy 7.5% for 2 years and 10 % for 3 years single premium policy 7.5% for 2 years and 10 % for 3 years single premium policy 7.5% for 2 years and 10 % for 3 years single premium policy 7.5% for 2 years and 10 % for 3 years single premium policy

Exclusions

The policy does not cover the cost of:

  • HIV/AIDS and related complications.
  • Suicide/self-harm/drug abuse
  • Genetic disorders
  • Any loss incurred in childbirth or pregnancy
  • Mental disorders

Claims Process

The claims are entertained in two modes: Cashless and reimbursements

Cashless
  • Call at toll-free number 1-800-10-24462 3 days prior to the planned hospitalization or within 48 hours of emergency hospitalization.
  • Carry your ID Number and valid Photo ID Proof.
  • The cashless hospitalization requests sent by the network hospital through the pre-authorization form duly filled by you.
  • The request is ascertained on the basis of information provided and you are authorized for the admission.
  • The assistance of claim service associate is offered for smooth functioning.
  • Hospital bill and discharge summary along with any residual amount are sent to Cigna TTK by the network hospital.
  • Payment is done to the network hospital.
Reimbursement
  • Intimation to Cigna TTK at toll-free number 1-800-10-24462 within 48 hours of emergency hospitalization or 3 days prior to planned hospitalization.
  • Avail treatment and pay off the expenses. Ensure all the receipts, bills, discharge summary, investigation report, pharmacy bills, etc. are with you.
  • Submit the claim with all the supporting documents at nearest CIGNA TTK Branch.
  • CIGNA TTK assesses the form and if approved the same is reimbursed.

Documents Required

The claim form can be downloaded from www.cignattkinsurance.in . It is also available in the insurance kit provided to you. Below are the documents that you need to attach:

  • Claim form duly filled and signed.
  • Valid Photo Identity Proof approved by Government.
  • Hospitalization referring letter from the valid medical practitioner.
  • Lists of tests, medication, and consultations undergone approved by the hospital authority.
  • Original bill, receipts, discharge summary
  • Bills of pharmacies in the original copy.

FAQs

1
Is my claim payable in grace period?

No, during the grace period the company is not liable to pay any claim aroused due to Injury/accident/condition.

2
Who will receive the claim amount in case the policyholder dies during the course of treatment?

In the case of cashless claims the payment is rendered to the Network Hospital. In the case of reimbursement, the settlement amount is paid to the nominee mentioned in the policy.

3
What is the settlement period for the claims?

The claims are settled within 5 working days from the receipt of the last necessary document but not later than 30 days. This includes rejection as well.

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