Religare Health Insurance

Religare Joy Plan

  • Covers Maternity & Newborn Expenses
  • Upto 100% No Claim Bonus
  • 170-Daycare Treatments
  • Tax Benefits under IT Act
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Religare Joy

The Religare Joy was one of the health insurance which was instituted to provide financial assistance to the mother of newly born babies. The Religare prime objective to launch Religare Joy into the insurance market is to give coverage for maternity after and newborn baby expenses after a short period of waiting. Not only maternity it also covers day-to-day to treatments for the listed disease in the policy.

The Religare Joy is has segregated between two plans namely-

  1. Religare Joy Today
  2. Religare Joy Tomorrow

The plan gives coverage to both individuals and family for various hospitalization expenses in supplementary to multiple health benefits.

Eligibility Criteria

Religare Joy Plans Joy Today Joy Tomorrow
Minimum Age of Entry For adults-18 years For children- 1 day to 24 years For adults-18 years For children- 1 day to 24 years
Maximum Age of Entry 45 years 45 years
Sum Insured Amount 3 lakhs / 5 lakhs 3 lakhs / 5 lakhs
Period of the Policy 3 years 1/ 2/ 3 years
Pre-policy Medical Checkup Required for age above 45 years Required for age above 45 years
Who Can be Covered Under individual plan: spouse, parents, children, brother, sister, parents-in-law, Grandparents, Grandchildren, Niece, Nephew, uncle, aunt
Under Family Floater: self, spouse, parents, and children
Under individual plan: spouse, parents, children, brother, sister, parents-in-law, Grandparents, Grandchildren, Niece, Nephew, uncle, aunt
Under Family Floater: self, spouse, parents, and children
Number of Members Covered Individual Plan: maximum of 6 members
Family Floater: 2 adults/ 2 adults one child/ 2 adults 2 children
Individual: maximum of 6 members
Family Floater: 2 adults/ 2 adults one child/ 2 adults 2 children

Coverage Provided

Coverage Provided Joy Today Joy Tomorrow
In-Patient Treatment (charges of room, nursing, doctor, ICU, operation theatre) Covers medical expenses during hospitalization period of more than 24 hours. Covers medical expenses during hospitalization period of more than 24 hours.
Pre-Hospitalization Covers medical expenses for 30 days prior to entry of insured to the hospital Covers medical expenses for 30 days prior to entry of insured to the hospital
Post-Hospitalization Covers medical expenses occurred for 60 days after the discharge from the hospital Covers medical expenses occurred for 60 days after the discharge from the hospital
Day Care Procedures (for treatments requiring less than 24 hours) 170-day care treatments at network day care centers 170-day care treatments at network day care centers
Ambulance Cover (transportation to nearby hospitals in emergencies) Up to a limit of 1000 per claim Up to a limit of 1000 per claim
Room Rent Single room with AC Single room with AC
Pre-existing diseases After a waiting period of 48 months After a waiting period of 48 months
Maternity Expenses (delivery, pre, and postnatal expenses for up to 45 years of age) Sum insured of 3 lakhs: Rs 35,000 maximum
Sum insured of 5 lakhs: Rs 50,000 maximum
Sum insured of 3 lakhs: Rs 35,000 maximum
Sum insured of 5 lakhs: Rs 50,000 maximum
Newborn Baby Expenses (cover expenses for 90 days from the date of birth) Sum insured of 3 lakhs: Rs 30,000 maximum
Sum insured of 5 lakhs: Rs 50,000 maximum
Sum insured of 3 lakhs: Rs 30,000 maximum
Sum insured of 5 lakhs: Rs 50,000 maximum
New Born Baby Defects Not covered Lump Sum payment of Rs 50,000

Benefits of Religare Joy

1. No Claim Bonanza: The insurer will provide 100% no claim bonanza on the sum insured if the policyholder does not claim for continuous 3 years of the policy.

2. Tax Benefit: The individual who pays the premiums for health insurance can avail a benefit of tax deduction of some amount in the annual tax payment under Section 80D of Income Tax Act.

3. Lifelong Renewability: The policy can be renewed for a countless number of times regardless of age and the health condition of the policyholder.

4. Cashless Facility: The cashless facility can be taken at any of the network hospitals by simply displaying the health card issued by the Religare. All the expenses will be borne by the insurance provider.

5. Free Look Period: While purchasing Religare Joy, you will be assigned a limited period of 15 days to evaluate the terms and conditions of the policy. The policyholder has the right to cancel the policy if she/he is not contented with the any of the clauses and can get a refund after the reduction of stamp duty charges and medical tests if any.

6. Portability: Religare Joy comes with the advantage of portability where all the benefits in the shape of cumulative bonuses and reduction of waiting periods will be transferred to the new policy.

Exclusion of Religare Joy

  • HIV/AIDS that are sexually transmitted
  • Non-allopathic and OPD treatment
  • Injuries forming due to war like activities, weapons, chemicals release, capture, arrest, enemy attack, criminal activities, radioactivity etc
  • Treatment did outside the boundaries of India.
  • Congenital defects or anomalies, mental illness, psychological disorders etc
  • Cosmetic or plastic surgery, dental treatment, routine eye, and ear check-up.
  • Self-damaging activities like suicide, intake of alcohol and hallucinogenic substance, smoking etc.

Illustration - Religare Joy

Joy Today

Nidhi (34 years) has taken Religare Joy health insurance plan. The premium Nidhi had to pay annually is Rs 70,894 for a sum insured of Rs 5 lakhs. While she has to wait for 9 months to get coverage for maternity expenses.

Condition 1

  • If Nidhi wants to involve her husband, then she will have to pay a premium of Rs 78,525.

Condition 2

  • If Nidhi wants to include his husband and son into the same policy for the same amount, then she will have to pay a premium of Rs 82,055 for Rs 5 lakhs of sum insured.

NOTE: The maximum number of members in Religare Joy should not be more than 4 under family floater plan.

Joy Tomorrow

Shreya (36 years) and Shashank (38 years) are married a couple with a male child (6 years). They are planning to conceive in the next two-three years. So, Shashank suggested taking Religare Tomorrow which will give them financial aid at the time of delivery and will cover the expenses for the newly born infant.

They took a sum insured of Rs 5 lakhs for a period of one year against the annual premium payment of Rs 30,733. The couple has to wait for 24 months for maternity coverage which really suits their situation since they are planning admission of a newborn baby in two-three years.

Condition 1

  • If Shreya and Shashank have no child and buys the policy for two adults only, then their premium would be 27,743.

Review of Religare Joy

Overall the policy is best suited for individuals and family who want coverage for maternity and newborn baby expenses along with the coverage for specific ailments and pre-existing diseases.

FAQs

1. Does the policyholder need to go pre-policy medical check-up?

Age Limit Rs 3 lakh Rs 5 lakh
Till 45 years Not required Not required
46-above required required

2. Does Religare Joy include any co-payments?

A copayment is an agreed percentage of the claim amount which an insured have to pay or share with the insurance provider.

Type of coverage Entry age of the insured
Individual More than or equal to 61 years
Floater More than or equal to 61 years

3. What is the time period of notification of claim?

  • For planned hospitalization, inform within 48 hours before the actual treatment takes place.
  • For emergency hospitalization, inform within 24 hours of hospitalization.

4. What documents are required to support a claim?

  • Fully completed claim form with signature
  • Doctor’s reference letter for hospitalization
  • Original bills, discharge summaries, receipts and prescriptions
  • Original radiology/pathology reports/ diagnostic tests results.
  • Indoor case papers, ambulance receipts.

All the bills and reports should be in the name of the insured person who is admitted for hospitalization.

5. What is the process for a cashless claim?

  • In case of planned hospitalization, submit a pre-authorization form to your health insurance provider.
  • In case of emergency hospitalization, intimate the insurer on an immediate basis about the claim.

After notification of the claim, present health card at the network hospitals with KYC documents. On approval of authorization, the company will bear all the expenses incurred.

6. What is the process to claim reimbursement?

  • After notification of claim to the insurer, the insured must gather all the related documents of the hospitalization.
  • The documents must get submitted under 15 days after the discharge of the insured.
  • The insurer will settle the claim within a period of 30 days where insured will be issued claim settlement letter.
  • Payment will be made within 7 days from the receipt of the claim settlement letter

Any delay in the payment of the claim is subjected to receive an interest of 2% above the bank rate.

7. What information we have to provide at the time of intimation?

While informing the policyholder must disclose the following information-

  • Policy Number
  • Name of the policyholder and the insured for which claim has been made.
  • Nature of illness/injury
  • Name and address of the hospital and doctor who is ministering the patient/insured
  • Date of reception in the hospital

Additional information may be required on the demand of the insurer.

8. Do Religare Joy cover arthritis/cataract/kidney stones?

Yes, this plan covers all these after a waiting period of 24 months. Apart from these, there are other illnesses that are covered after the same duration such as-

  • Piles, Fistula in anus, gastric ulcers
  • Hernia (all types), hydrocele
  • Myomectomy for fibroids
  • Varicose veins and ulcers
  • Internal tumors, skin tumors, cysts, nodules, breast lumps etc

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