Renewals PROHLR010629

1 No - Plus
ProHealth
ZONE1OFFLINEYES
No No

Satish Kumar
54 C Diz Area Sec 4 Raja Bazar
Gole Market Bangla Sahib Road
Bangla Sahib Road
Delhi
Delhi - 110001
Mobile No : XXXXXX7161

PROHLR010629855

Dear Satish Kumar,

Thank you for choosing us as your trusted health insurance partner. We have highlighted some important points regarding your policy that
you should keep in mind, so please read it carefully.

KNOW YOUR POLICY HOW TO SUBMIT CLAIM?

Name of Your Plan ProHealth - Plus For hassle free claims experience, we have simplified our
claims process. Here's how it works,
Policy Number PROHLR010629855
Contact Number XXXXXX7161 Real-time claims Download Medibuddy app
status or visit www.medibuddy.in
E Mail ID XXXXXHDEV@LIVE.IN
Claims Helpline
Cover Start Date 06-SEP-2023 0406-817-8534
No.
Cover End Date 05-SEP-2024
Plan Type Family Floater Claims Email ID manipalcigna@mediassist.in
Policy Term 1 Year
Ported Policy Yes REACH US FOR ASSISTANCE:
Zone Zone I - Avail treatment all over India without any co-pay
PED Declared No Visit - www.manipalcigna.com

Call us - 1800-102-4462

Email us - customercare@manipalcigna.com

To locate the nearest branch office, visit -

https://www.manipalcigna.com/locate-us

WAITING PERIOD IN YOUR POLICY*

Particulars Details
Initial Waiting Period 30 days (Except accident and for renewal policies without break)
Pre Existing Disease (PED) Waiting period Covered after 36 months of continuous coverage
Specific Waiting Period 24 months since inception of first policy with us
Permanent Exclusions As mentioned in Policy Wording
* Note: For rollover / portability cases continuous coverage will be considered from first policy inception date with us or other insurer (as applicable)

Please read your policy schedule and policy wordings for detailed terms and conditions relating to the benefits. To download policy wordings, visit
https://www.manipalcigna.com/downloads/products
In case of any queries or clarifications, please feel free to contact your advisor or reach us at any of our touch points.

Thank you for choosing us as your partner in illness and wellness. Assuring you of our best services at all times.

Yours Sincerely,
ManipalCigna Health Insurance Company Limited

ManipalCigna ProHealth Insurance | UIN: MCIHLIP24011V072324 1/16

ManipalCigna ProHealth Insurance | UIN: MCIHLIP24011V072324 2/16
 PROHLR010629
Yes

Yes
Your Policy Kit Includes:

v The Policy Schedule: Presents the details of policy, such as level of protection, the premium payable for the cover, date of
Yes commencement, persons covered, specific conditions related to your plan and any special terms that apply to the policy.

v The Policy Contract: Details the terms and conditions, definitions and exclusions of the policy.

v The Personalized Health Card: Membership card that will help you access our services 24 hours a day, 7 days a week.

v Premium Receipt: Receipt issued for the premium paid by you.

This kit will help you understand your policy in detail and give you more information on how to access our services easily.

We request you to read the policy terms and conditions carefully so that you are fully aware of your policy benefits.

Your Health Card:

POLICY NUMBER : PROHLR010629855

INSURED NAME DOB

Satish Kumar 29-DEC-1988

Kavita . 03-MAR-1989

Ekaksh Dev 24-JUL-2016

Vamika Dev 13-JUN-2022

Claims 0406-817-8534
Claims manipalcigna@mediassist.in
Service 1800-102-4462 customercare@manipalcigna.com

ProHealth - Plus

ManipalCigna ProHealth Insurance | UIN: MCIHLIP24011V072324 3/16

 PR ManipalCigna ProHealth Insurance
NO

POLICY SCHEDULE
Fami
Policy Issuing Office: Policy Servicing Office:

ManipalCigna Health Insurance Company Limited (Formerly ManipalCigna Health Insurance Company Limited, 32-B, Pusa
known as Cigna TTK Health Insurance Company Limited), Road, Rajinder Nagar, Opp. Pillar no. 122 of Metro station,
Reg. Office: 401/ 402, 4th Floor, Raheja Titanium, Western Karol Bagh, New Delhi - 110005 Ph : 011 47554300
Express Highway Goregaon (East), Mumbai - 400 063 Ph :
022-61703600

Intermediary Name: Landmark Insurance Brokers Pvt Ltd

Code: 1603558-01 Contact Numbers: 18004194199
POLICYHOLDER DETAILS:
Name: Satish Kumar

Customer ID: 1000867371

Address: 54 C Diz Area Sec 4 Raja Bazar Gole Market Bangla Sahib Road Delhi Bangla Sahib Road 110001 Delhi
ProHealth - Plus

Telephone number(s): (R) - (O) - (M) - XXXXXX7161

Email
ID:
XXXXXHDEV@LIVE.IN

3
Subscribed to important alert on WhatsApp:

POLICY DETAILS:
Renewals

Plan: ProHealth - Plus

Policy Number: PROHLR010629855

Policy Period: Inception Date: From: 00:00 hrs on 06-SEP-2023 Expiry date: To: 24:00 hrs on 05-SEP-2024 Tenure (in years): 1

Policy Type: Family Floater Zone of Cover: ZONE1

Portable Case: Yes Migrated case: No Policy Category: Renewal_03

Premium Payment Mode: Single Pre- Existing Disease waiting period: Covered after 36 months of continuous coverage

For Roll over/Portability cases continuous coverage will be considered from first policy inception date with Us or other insurer (as applicable).

INSURED PERSON'S DETAILS:

Healthy
Pre- Rewards
Cumulative
Name Of Relationship Completed existing Points Points
Sr. Date of Date of Customer Sum Bonus
The Insured With Gender Age (In Disease/ Occupation Earned Earned
No. Inception Birth ID Insured Amount
Person(s) Policyholder years) Illness/ through through
Earned
Condition Premium Wellness
Paid Programs
SELF-
1000867371

23-JUL- 29-DEC- 10008673 Private

1 Satish Kumar PRIMARY Male 34 Nil
2018 1988 71 Service
MEMBER
23-JUL- 03-MAR- 10008673
2 Kavita . Wife Female 34 Nil Any Other
2018 1989 72 450000 225000 605.0
23-JUL- 24-JUL- 10008673
3 Ekaksh Dev SON Male 7 Nil Any Other
2018 2016 73
17-OCT- 13-JUN- 10023167
4 Vamika Dev
2023
Daughter Female
2022
1 Nil
52
-

ManipalCigna ProHealth Insurance | UIN: MCIHLIP24011V072324 4/16

 ADDRESS OF THE INSURED:
Insured ID Insured Address

1000867371 54 C DIZ AREA SEC 4 RAJA BAZAR GOLE MARKET BANGLA SAHIB ROAD Delhi Delhi 110001

NOMINEE DETAILS:
Nominee Name: Kavita . Relationship with proposer: Wife

CAREGIVER DETAILS:-
Caregiver name : Relationship with proposer :

1000867373
Mobile number : Email ID :

FAMILY PHYSICIAN DETAILS:-

Family Physician name : Address :

Mobile number : Email ID :

BENEFITS UNDER THE POLICY:

ProHealth - Plus

Base covers

In-patient Hospitalization Covered upto any Room Category except Suite or higher category

Pre - Hospitalization Medical Expenses Covered up to 60 days before date of hospitalisation

Post - Hospitalization Medical Expenses Covered up to 180 days post discharge from hospital

Day Care Treatment Covered up to the limit of Sum Insured opted

Domiciliary Treatment Covered up to the limit of Sum Insured opted

Ambulance Cover Up to Rs. 3000 per hospitalization event

Donor Expenses Covered upto full Sum Insured

Worldwide Emergency Cover Covered upto full Sum Insured once in a policy year

Restoration Of Sum Insured Multiple Restoration is available in a Policy Year for unrelated illnesses in addition to the Sum Insured opted

Ayush Covered up to full Sum Insured

Health Maintenance Benefit Covered up to 2000 per policy year

Covered upto Rs. 15,000 for normal delivery and Rs. 25,000 for C- Section per event ,after a Waiting Period of 48
Maternity Expenses
months

New Born Baby Expenses Covered for the inpatient hospitalisation expenses of a new born up to the limit provided under Maternity Expenses

First Year Vaccinations Covered as per national immunisation programme over and above Maternity Sum Insured

Value Added Covers

Health Check-Up Available each policy year (exluding the first year), to all insured persons who have completed 18 years of age

Expert Opinion on Critical illness Available once during the Policy Year

Cumulative Bonus A guaranteed 10% Increase in Sum Insured per policy year, maximum up to 200% of Sum Insured.

Reward Points equivalent to 1% of paid premium, to be earned each year. Rewards can also be earned for
enrolling and completing Our Array of Wellness Programs.These earned Reward Points can be used against
payable premium (including Taxes) from 1st Renewal of the Policy.OR they can be redeemed for equivalent value
Healthy Rewards
of Health Maintenance Benefits any time during the policy OR as equivalent value while availing services through
our Network
Providers as defined in the policy.

IN THE EVENT OF A CLAIM:

HealthLine No: Call (Toll Free): 0406-817-8534
Medi Assist Insurance TPA Pvt. Ltd. Tower D, 4th Floor, IBC Knowledge
Address for correspondence :- Park, 4/1 Bannerghatta Road, Bengaluru – 560029 OR Nearest Fax Number : 1800-425-9559
ManipalCigna Health Insurance Branch.
E-mail ID: manipalcigna@mediassist.in

ManipalCigna ProHealth Insurance | UIN: MCIHLIP24011V072324 5/16

 YOUR PREMIUM DETAILS:
Additional
Basic Add on Discounts Goods & Service GST Total
Loading
Premium (Rs.) Premium (Rs.) (if applicable) Tax (Rs.) Cess (Rs.) Premium (Rs.)
(if applicable)
21514.00 0.00 0.00 0.00 3872.52 0.0 25386.52

*Note: Only applicable Loadings and Discounts will be displayed as per policy.

PAN No.: AAECC7904J

The stamp duty of Rs. 1 paid vide receipt no, NO.LOA/CSD/133/05/10/2023 to 30/09/2028/4029 dated 05-OCT-2023 . Government Notification Revenue and
Forest Department No. Mudrank 2004/4125/CR/690/M-1, dated 31/12/2004

NOTE:

Basic premium is inclusive of opted Add on's and after adjustment of premium discounts, wherever applicable.

In the event of dishonor of cheque, this policy document automatically stands cancelled from inception, irrespective of whether a separate communication is sent or
not.

This Policy has been issued based on the information provided by you on the proposal form. Attached with this Policy Schedule are the Policy Terms & Conditions
and Annexures. Please ensure that these documents have been received, read and understood. If any of these documents have not been received, please contact
our Customer Service at the below mentioned details at the earliest. In case you find any discrepancy in the same, please contact us immediately.

You may write to us at customercare@manipalcigna.com Or call us at HealthLine No. (Toll Free): 1800-102-4462 or at +91 2261703600.
For any grievance related to the policy you may write to The Grievance Officer at the policy issuing office address mentioned above or email at
headcustomercare@manipalcigna.com or call at +91 2261703600.

In witness, where of this Policy has been signed at Mumbai on 17-OCT-2023

For and on behalf of ManipalCigna Health Insurance Company Limited

Authorised Signatory

ManipalCigna Health Insurance Company Limited

(Formerly known as Cigna TTK Health Insurance Company Limited)
‘This is a system generated communication and does not require signature’

ManipalCigna ProHealth Insurance | UIN: MCIHLIP24011V072324 6/16

 PROHLR010629855

Annexure to Policy Schedule

Insured Name Sum Insured Waiting Period Start Date

MISS VAMIKA DEV 450000.000 06-SEP-2023

Yours Sincerely,

PROHLR010629855
ManipalCigna Health Insurance Company Limited

PROHLR010629855

"This is a System generated communication and does not require signature.”

ManipalCigna ProHealth Insurance | UIN: MCIHLIP24011V072324 7/16

 Premium Certificate

For the purpose of deduction under section 80D of Income Tax Act, 1961 and any amendments made thereafter*.

This is to certify that MR. SATISH KUMAR has paid the premium of

₹25,386.52 (in words) Twenty Five Thousand Three Hundred and Eighty Six and Fifty Two paise only for the

period 06/09/2023 to 05/09/2024 towards Premium for Health Insurance policy for term of One Year policy.

Policy
Number PROHLR010629855

Receipt Receipt Payment

R002880440 Date 06/09/2023 25,387.00 CREDITCARD
Number Amount Mode

* Note:
1. For your eligibility and deductions please refer to provisions of Income Tax Act, 1961 as modified and/or consult your tax
consultant.
2. Any amount paid in cash towards premium will not qualify for tax benefits.
3. In case of dishonour of premium instrument, the policy will be deemed cancelled ab initio.
4. Deduction under section 80D shall not be allowed if the premium is paid by third party (other than proposed/insured) under
this policy.
5. This certificate must be surrendered to us in case of cancellation of Policy or for issuance of fresh certificate in case of any
alteration in the insurance affecting the premium.

Yours Sincerely,
ManipalCigna Health Insurance Company Limited

(Formerly known as CignaTTK Health Insurance Company Limited)

‘This is a system generated communication and does not require signature’.

Date: 17/10/2023
Location: Mumbai

ManipalCigna ProHealth Insurance MCIHLIP24011V072324 PROHLR010629855

Stamp Duty has been paid vide receipt no LOA No.CSD/111/2023/28/08/2023 to 28/08/2028/3581 dated 28th August 2023
ManipalCigna ProHealth Insurance | UIN: MCIHLIP24011V072324 8/16
 MANIPALCIGNA PROHEALTH INSURANCE
Customer Information Sheet
Description Refer to the
following
Title
Please refer to the Plan and Sum Insured you have opted to understand the available benefits Policy
under your plan in brief Section
number in
the Policy
Your Wording
Coverage Identify your Plan Protect Plus Preferred Premier Accumulate for more
Details: details on
each cover
` 2.5 Lacs `4.5 Lacs `15 Lacs, `100 Lacs `5.5 Lacs,
` 3.5 Lacs `5.5 Lacs, `30 Lacs, `7.5 Lacs,
` 4.5 Lacs, `7.5 Lacs, `50 Lacs `10 Lacs,
` 5.5 Lacs, `10 Lacs, `15 Lacs,
` 7.5 Lacs, `15 Lacs, `20 Lacs,
Identify your Opted `20 Lacs, `25 Lacs,
` 10 Lacs,
Sum Insured (SI) `25 Lacs, `30 Lacs,
` 15 Lacs,
` 20 Lacs, `30 Lacs, `50 Lacs
` 25 Lacs, `50 Lacs
` 30 Lacs,
` 50 Lacs

For Sum Insured Covered upto any Room Category except Suite or For Sum Insured
up to `5.5 Lacs - higher category `5.5 Lacs -
Covered up to Covered up to Single
Single Private Private Room
Room For Sum Insured `
Inpatient 7.5 Lacs and Above -
For Sum Insured
Hospitalisation Covered up to any
`7.5 Lacs and D.I.1
(When you are Room Category
Above -
hospitalised) except Suite or
Covered up
to any Room higher category
Category except
Suite or higher
category

Pre - hospitalisation Medical Expenses Covered up to 60 days before date of hospitalisation D.I.2

Medical Expenses Covered up to 90 days

Basic Cover: Covered up to post discharge from
This section Post - Medical Expenses Covered up to 180 days post hospital
90 days post D.I.3
lists the Basic hospitalisation discharge from hospital
discharge from
benefits hospital
available on

ManipalCigna ProHealth Insurance | Customer Information Sheet | UIN: MCIHLIP24011V072324 | April 2023
your plan
Day Care Treatment Covered up to the limit of Sum Insured opted D.I.4

Domiciliary
Treatment
Covered up to the limit of Sum Insured opted D.I.5
(Treatment at
Home)
Ambulance Cover Upto `2000 Upto `3000 Actual incurred expenses paid per Upto `2000 paid per D.I.6
(Reimbursement paid per paid per hospitalisation event hospitalisation event
of Ambulance hospitalisation hospitalisation
Expenses) event event

Donor Expenses
(Hospitalisation
Expenses of the Covered up to full Sum Insured D.I.7
donor providing the
organ)

Worldwide
Emergency Cover Covered up to full Sum Insured once in a Policy Year D.I.8
(Outside India)

Restoration of Sum
Insured (When
Multiple Restoration is available in a Policy Year for unrelated illnesses in addition to the Sum
opted Sum Insured D.I.9
Insured opted
is insufficient due to
claims)

ManipalCigna ProHealth Insurance | UIN: MCIHLIP24011V072324 9/16

 AYUSH Cover Covered up to full Sum Insured D.I.10

Option to choose
from - `5000,
`10,000, `15,000,
`20,000 per policy
Health Maintenance
year
Benefit
Can also be used
(Treatment that
Covered up to Covered up to to pay for Co-pay or
does not require Covered up to `15,000 per policy
`500 per policy `2000 per policy Deductible. D.I.11
hospitalisation and year.
year year Up to 50 % of the
can be carried out
accumulated Health
in an Out Patient
Maintenance Benefit
Department)
can be utilised for
payment against
premium from first
renewal of the policy
Covered upto
Covered upto Covered upto
`15,000 for
`50,000 for `100,000 for
normal delivery
normal delivery normal delivery
and `25,000 for
and `100,000 and `200,000
Maternity Expenses C- Section per D.I.12
for C-Section per for C-Section per
event,
event, after a event, after a
after a Waiting
waiting Period of waiting Period of
Period of 48
Not Available 48 months 48 months Not Available
months
Covered for the inpatient hospitalisation expenses of
New Born Baby
a new born up to the limit provided under Maternity D.I.13
Expenses
Expenses
Covered as per national immunisation programme over
First Year and above Maternity Sum Insured D.I.14
Vaccinations

Available once
every 3rd Policy Available once every
year to all 3rd Policy year to all
Available each policy year(excluding the first year), to
Health Check-up insured persons insured persons who D.II.1
Value Added all insured persons who have completed 18 years of Age
who have have completed 18
Covers completed 18 years of Age
years of Age
This section
lists the Expert Opinion on
additional Critical illness Available once during the Policy Year D.II.2
value added (By a Specialist)
benefits that
are available A guaranteed
A guaranteed 5%

ManipalCigna ProHealth Insurance | Customer Information Sheet | UIN: MCIHLIP24011V072324 | April 2023
along with your 5% Increase in
Increase in Sum
plan Sum Insured
A guaranteed 10% Increase in Sum Insured per policy Insured per policy
Cumulative Bonus per policy year, D.II.3
year, maximum up to 200% of Sum Insured. year, maximum up
maximum up to
to 200% of Sum
200% of Sum
Insured.
Insured.
Reward Points equivalent to 1% of paid premium, to be earned each year. Rewards can also be
earned for enrolling and completing Our Array of Wellness Programs. These earned Reward Points
can be used against payable premium (including Taxes) from 1st Renewal of the Policy.
Healthy Rewards OR they can be redeemed for equivalent value of Health Maintenance Benefits any time during the D.II.4
policy OR as equivalent value while availing services through our Network Providers as defined in
the policy.

ManipalCigna ProHealth Insurance | UIN: MCIHLIP24011V072324 10/16

 `1000 for each `2000 for each
continuous continuous `1000 for each
and completed and completed continuous and
`3000 for each continuous
24 Hours of 24 Hours of completed 24 Hours
and completed 24 Hours of
Hospital Daily Cash Hospitalisation Hospitalisation of Hospitalisation
Hospitalisation during the Policy Year D.III.1
Benefit during the Policy during the Policy during the Policy
up to a maximum of 30 days in a
Year up to a Year up to a Year up to a
policy year
maximum of 30 maximum of 30 maximum of 30 days
days in a policy days in a policy in a policy year
year year
Deductible
(Please select the
Sum Insured and
Deductible amount
as you have opted
`0.5/ 1/ 2/ 3/ 4/ 5/
on the Policy. `1/ 2/ 3/ 4/ 5/ 7.5 /10 Lacs Not Available D.III.2
7.5 / 10 Lacs
Deductible is the
amount beyond
which a claim will
Optional be payable in the
Covers Policy)

This section Waiver of

lists the Available Not available Available D.III.2
Deductible
available
optional covers
under your Reduction in Maternity waiting period Reduced from 48 months to 24
Not available Not available D.III.3
plan and the Maternity Waiting months
limits under
each of these Voluntary Co-pay
options (The cost sharing
percentage that
you have opted 10% or 20%
will apply on each voluntary co-
10% or 20% Voluntary Co-payment
claim.) Not Available payment for each D.III.4
for each and every claim as opted
If you have opted and every claim as
for a Deductible, opted on the Policy
Voluntary
Co-payment does
not apply
Waiver of
Mandatory Waiver of Mandatory co-payment of 20% for Insured Persons aged 65 years and above D.III.5
Co-pay
A guaranteed 25%
increase in Sum
Cumulative Bonus A guaranteed 25% increase in Sum Insured per policy Insured per policy
Not Available D.III.6

ManipalCigna ProHealth Insurance | Customer Information Sheet | UIN: MCIHLIP24011V072324 | April 2023
booster year, maximum up to 200% of Sum Insured year, maximum up
to 200% of Sum
Insured
Lump sum payment
Add on
Lump sum payment of an additional 100% of Sum of an additional
Critical Illness Not Available policy
Insured Opted 100% of Sum
wordings
Insured Opted
Add on ManipalCigna Health 360 - Shield:
cover(Rider) Coverage for listed Non-medical items up to base policy Sum Insured and Durable Medical Equipment up to maximum of Rs.1 Lac
This section
lists the Add ManipalCigna Health 360 - Advance:
on cover Coverage for ‘Any room’ category and unlimited restoration of Sum Insured within the base policy Sum Insured. It also provides Air
available Ambulance cover up to Sum Insured opted under the base policy subject to a maximum of Rs.10 Lacs, over and above the base policy
under your Sum Insured.
plan ManipalCigna Health 360 - OPD:
Package 1: Get cover for doctor consultations on cashless basis within the OPD Sum Insured
Package 2: Get coverage for doctor consultations and prescribed diagnostics on cashless basis within the OPD Sum Insured
Package 3: Get coverage for doctor consultations, prescribed diagnostics and pharmacy on cashless basis within the OPD Sum
Insured. Pharmacy limit is 20% of the OPD Sum Insured.

ManipalCigna ProHealth Insurance | UIN: MCIHLIP24011V072324 11/16

 Please note that this is an indicative list of exclusions; please refer the Policy wording and clauses for the
complete list of exclusions.
- Investigation & Evaluation- Code- Excl. 04
- Rest Cure, rehabilitation and respite care- Code- Excl. 05
- Obesity/ Weight Control: Code- Excl. 06
- Change-of-Gender treatments: Code- Excl. 07
- Cosmetic or plastic Surgery: Code- Excl. 08
- Hazardous or Adventure sports: Code- Excl. 09
- Breach of law: Code- Excl. 10
- Excluded Providers: Code- Excl. 11
- Treatment for, Alcoholism, drug or substance abuse or any addictive condition and consequences thereof
Code- Excl. 12
What are the - Treatments received in heath hydros, nature cure clinics, spas or similar establishments s. Code- Excl. 13
Major
exclusions in - Dietary supplements and substances that can be purchased without prescription. Code- Excl. 14
the Policy
- Refractive Error: Code- Excl. 15
This section - Unproven Treatments: Code- Excl. 16
provides a
- Sterility and Infertility: Code- Excl. 17 E.I and
brief list of the
E.II
major charges/
- Maternity: Code Excl. 18 (applicable to Protect and Accumulate plan)
treatments
which will not - External Congenital Anomaly or defects.
be covered
under the - Dental treatment.
Policy - Circumcision
permanently.
- Prostheses, corrective devices and/or medical appliances
- Treatment received outside India other than for coverage under World Wide Emergency Cover, Expert Opinion on
Critical Illnesses.
- All Illness/expenses caused by ionizing radiation or contamination by radioactivity.
- All expenses caused by or arising from war or war-like situation.
- Annexure IV list I of “Items for which Coverage is not available in the Policy”.
- Any form of Non-Allopathic treatment (except AYUSH In-patient Treatment),
- Any stay in Hospital without undertaking any treatment or any other purpose other than for receiving eligible
treatment
of a type that normally requires a stay in the hospital.
- Costs of donor screening or costs incurred in an organ transplant surgery involving organs not harvested

ManipalCigna ProHealth Insurance | Customer Information Sheet | UIN: MCIHLIP24011V072324 | April 2023
from a human body.
*Note: This list does not apply to coverage under Health Maintenance Benefit

a. First 30 days from the Policy start date, for all illnesses except accidents. E.I.3
Add on
Waiting
b. 90 days waiting period will be applicable for listed Critical Illness where Critical Illness Add on cover has been policy
Period
opted. wordings
This sections c. Specified disease/procedure waiting period: Two Year Waiting Period will be applicable for specific illnesses E.I.2
lists the
applicable d. A 48 months of waiting period will be applicable for Maternity, New Born and First year Vaccination expenses
period (days/ E.II.1
(Except where Reduction in Maternity Waiting is opted)
months)
before you can e. A Personal waiting period may apply to individuals depending upon declarations on the proposal form and existing
make a claim health conditions. Please refer to the “Special Conditions” Column on your Policy Schedule to identify if any E.II.2
for the listed personal waiting period is applied to your Policy.
diseases/
treatments f. Pre-existing disease waiting period: A 48 months waiting period will be applicable for any Pre-existing disease, for
Protect, a 36 months waiting period for any Pre-existing disease, for Plus and Accumulate plan and 24 months E.I.1
waiting period for Preferred & Premier Plan.
Pay-out a. For all covers (excluding Critical Illness Add On Benefit and Hospital Daily Cash Benefit) pay-out will be
Basis on reimbursement of actual expenses either by way of Cashless to the Hospital/ Network provider when a
G.I
cashless facility is availed or directly to you as a reimbursement against the bills when you have paid for the
This section expenses.
lists the Add on
manner in b. Critical Illness Add on pay-out will be on benefit payment basis as a lump sum fixed amount. policy
which the wordings
proceeds of
the Policy will c. Health Maintenance Benefit will be on reimbursement basis on submission of bills or payment towards
be paid to you G.I.12
Deductible or Co pay wherever opted.

ManipalCigna ProHealth Insurance | UIN: MCIHLIP24011V072324 12/16

 a. A mandatory co-payment will be applicable for insured’s aged 65 years and above F.II.6
Cost
Sharing b. A Voluntary co-payment of 10% or 20% on admissible claim amount (final payable claim amount after
D.III.4
assessment) will apply to each and every claim if opted under the plan.
This sections
c. A deductible option of `1 Lac, `2 Lacs, `3 Lacs, `4 Lacs, `5 Lacs, `7.5 Lacs, `10 Lacs as per plan selected
lists the
will apply on the Policy if opted. All payable claims up to this amount will be borne by you. Any claim over and
various
above this limit will become payable under the Policy. To know the applicable deductible on your Policy please G.I.16
circumstances
refer the Policy Schedule benefits. Co-pays under “b” above will not be applied for a Deductible Cover.
under which
Persons opting to take treatment outside of their Zone will bear a 10% or 20% co-pay as applicable.
you will bear
some portion d. A deductible of `50,000, `1Lac, `2 Lacs, `3 Lacs, `4 Lacs, `5 Lacs, `7.5 Lacs,`10 Lacs as opted will apply
of the claim on Accumulate Plan. All payable claims up to this amount will be borne by you. Any claim over and above this
out of your G.I.16
limit will become payable under the Policy. To know the applicable deductible on your Policy please refer the
pocket Policy Schedule benefits.
e. If a special sub-limit is applied at the time of Underwriting on a particular medical condition, the Policy will pay
F.II.12
only 75% of the payable claim amount arising out of the specified illness/medical condition.
a. This Policy is ordinarily renewable for lifetime on mutual consent, subject to application of Renewal and
realisation of Renewal premium.
Renewal b. Continuity will be provided if renewed within 30/15 days from the date of expiry of previous policy. If there is a
Conditions break in the policy, any claim occurring within the break in period will not be covered under the Policy.
This section
c. Renewals will not be denied except on grounds of misrepresentation, fraud, non-disclosure or non-co-operation F.II.8, F.I.9 &
lists the terms
from the Insured. F.II.9
of renewals
under the d. Alterations in the policy such as Increase/ decrease in Sum Insured or Change in Plan/Product, addition/ deletion
Policy of members, addition deletion of Medical Condition will be allowed at the time of Renewal of the Policy. We
reserve Our right to carry out underwriting in relation to any request for changes on the Policy. The terms and
conditions of existing policy will not be altered.
Renewal a. Cumulative Bonus- We will provide a 5% or 10% or 25% increase in Sum Insured for every policy year, subject
Benefits to a maximum of 200% accumulation, as per the Plan opted. The cumulative bonus will remain intact and not get D.II.3
This section reduced in case a claim is made during the policy.
lists the
various b. Health check-up – A health check-up is provided for persons aged 18 years and above, irrespective of the claim
benefits you status of the Policy.
D.II.1
can avail/ For Protect & Accumulate plan – Available once every 3rd Policy year
accumulate For Plus, Preferred and Premier Plan – Available once at each policy year (excluding first year)
every time you
renew a Policy c. Healthy Rewards – Reward Points are earned for each year of premium paid D.II.4
with us
a. Cancellations may be intimated to Us by giving 15 days’ notice wherein We shall refund the premium for the
Cancellation unexpired term on the short period scale as mentioned in the Policy wordings enclosed in the kit.
The section The Premium shall only be refunded only if no claim has been made under the Policy.
explains
the Policy b. This Policy can be cancelled on grounds of misrepresentation, fraud, non-disclosure of material fact, upon F.I.7
cancellation giving 15 days’ notice without refund of premium.
process in
brief c. Cover may end immediately for all Insured Persons, if there is non-cooperation by You/ Insured person, with
refund of premium on pro rata basis after deducting Our expenses, by giving 15 days’ notice in writing.

ManipalCigna ProHealth Insurance | Customer Information Sheet | UIN: MCIHLIP24011V072324 | April 2023
Legal disclaimer: The information mentioned above is illustrative and not exhaustive. Information must be read in conjunction with
the product brochures and Policy document. In case of any conflict between the Prospectus and the Policy document the terms and
conditions mentioned in the Policy document shall prevail.
For benefit illustration with indicative ages and Sum Insured, please refer Annexure to CIS - Benefit Illustration

ManipalCigna ProHealth Insurance | UIN: MCIHLIP24011V072324 13/16

 Annexure to Customer Information Sheet - Benefit Illustration
ProHealth Plus
Notes:
• All the premiums are excluding taxes
• All the premiums mentioned below are for illustration purpose only. The Premium charged on the Policy will depend
on the Plan, Sum Insured opted, Policy Tenure, Age, Policy Type, Gender, Zone of Cover, Optional Covers and Add
On Benefits opted. Additionally the health status of the individual will also be considered.
• Zone 1 rates are considered
• Premium rates are rounded off to the nearest integer value
• The premium rates are for the mandatory base covers in each variant
• The Gender considered for 1st and 3rd members in the tables below is Female and that for 2nd and 4th members it
is Male.

2A+2C
Age Coverage opted Coverage opted on Individual basis covering Coverage opted on family floater basis with
of the on Individual basis multiple member of the family under a single overall Sum Insured (Only one Sum Insured is
Insured covering each member policy (Sum insured is available for each available for the entire family)
Member of the family separately member of the family)
(at a single point in
time)
Premium Sum Insured Premium Discount, Premium Sum Insured Premium or Floater Premium Sum
(�) (�) (�) if any (�) after (�) consolidated discount, after Insured (�)
discount premium for if any discount
(�) all members (�)
of family (�)
18 a9,859 a5,50,000 a9,859 a2,465 a7,394 a5,50,000 a28,098 NA a28,098 `5,50,000
21 a8,762 a5,50,000 a8,762 a2,190 a6,572 a5,50,000 NA
39 a13,567 a5,50,000 a13,567 a3,392 a10,175 a5,50,000 NA
45 a14,880 a5,50,000 a14,880 a3,720 a11,160 a5,50,000 NA
Total Premium for all Total Premium for all members of the family is Total Premium when policy is opted on floater basis
members of the family a35,301, when they are covered under a single a28,098.
is a47,068, when each policy.
member is covered Sum insured of a5.5 Lacs is available for the entire
separately. Sum insured available for each individual is a5.5 family
Sum insured available Lacs.
for each individual is a5.5
Lacs.

2A
Age Coverage opted Coverage opted on Individual basis covering Coverage opted on family floater basis with
of the on Individual basis multiple member of the family under a single overall Sum Insured (Only one Sum Insured is
Insured covering each policy (Sum insured is available for each available for the entire family)
Member member of the family member of the family)
separately (at a single
point in time)
Premium Sum Premium Discount, Premium Sum Premium or Floater Premium Sum
(�) Insured (�) (�) if any (�) after Insured (�) consolidated discount, after Insured (�)
discount premium for if any discount
(�) all members (�)
of family (�)
55 a21,880 a5,50,000 a21,880 a5,470 a16,410 a5,50,000 a56,395 NA a56,395 a5,50,000
63 a39,404 a5,50,000 a39,404 a9,851 a29,553 a5,50,000 NA
Total Premium for all Total Premium for all members of the family is Total Premium when policy is opted on floater basis
members of the family a45,963, when they are covered under a single a56,395.
is a61,284, when each policy. Sum insured of a5.5 Lacs is available for the entire
member is covered Sum insured available for each individual is a5.5 family
separately. Lacs.
Sum insured available
for each individual is
a5.5 Lacs.

ManipalCigna ProHealth Insurance | UIN: MCIHLIP24011V072324 14/16

 Age Coverage opted Coverage opted on Individual basis covering Coverage opted on family floater basis with
of the on Individual basis multiple member of the family under a single overall Sum Insured (Only one Sum Insured is
Insured covering each policy (Sum insured is available for each available for the entire family)
Member member of the family member of the family)
separately (at a single
point in time)
Premium Sum Premium Discount, Premium Sum Premium or Floater Premium Sum
(�) Insured (�) (�) if any (�) after Insured (�) consolidated discount, after Insured (�)
discount premium for if any discount
(�) all members (�)
of family (�)
65 a34,117 a5,50,000 a34,117 a8,529 a25,588 a5,50,000 a73,969 NA a73,969 a5,50,000
70 a51,541 a5,50,000 a51,541 a12,885 a38,656 a5,50,000 NA
Total Premium for all Total Premium for all members of the family is Total Premium when policy is opted on floater basis
members of the family a64,244, when they are covered under a single a73,969.
is a85,658, when each policy. Sum insured of a5.5 Lacs is available for the entire
member is covered Sum insured available for each individual is a5.5 family
separately. Lacs.
Sum insured available
for each individual is
a5.5 Lacs.

ManipalCigna ProHealth Insurance UIN: MCIHLIP24011V072324

Note: Premium rates specified in the above illustration shall be standard premium rates without
considering any loading. Also, the premium rates shall be exclusive of
taxes applicable.

ManipalCigna ProHealth Insurance | UIN: MCIHLIP24011V072324 15/16