GALAXY HEALTH INSURANCE COMPANY LIMITED

(Formerly known as “GALAXY HEALTH AND ALLIED INSURANCE COMPANY LIMITED”)

Reg. Office: Prestige Polygon – 12th Top Floor (P), No. 471, Anna Salai, Nandanam, Chennai – 600035.
T: 044 – 4001 7227 I Website: www.galaxyhealth.com I CIN: U65120TN2023PLC165765 IRDAI Reg. No.:167
Prospectus
Galaxy Guardian
UIN : GHIHLIP25037V012425

➢ Type of Cover: Individual

➢ Entry Age
o Adult : 18 years to any age
o Child: 5 months to 25 years.

➢ Policy Term : 1 /2 / 3 year/s

▪ Note: Where the policy is issued for more than 1 year, the Sum Insured including
sublimits, is for each of the year, without any carry over benefit thereof. The said
benefits / covers available for the 2nd year or 3rd year cannot be utilized in the 1st
year itself.

➢ Sum Insured Options: Rs.3,00,000/- or Rs.5,00,000/-

➢ Long Term Discount:

Two years policy: 10% discount on 2nd year premium
Three years policy: 12.5% discount on 2nd and 3rd year premium

➢ Instalment: Quarterly: 2%/Half-yearly: 1%

For Long-term: 4*: 2% loading /2*: 1% loading /Annual: No Instalment Loading and No Long Term
discount *Premium will be paid by the insured within the first year of policy. Further, first long-term
discount will be applied and then instalment loading will be applied.

Note:
a. For long term policies, in case if the insured is paying single premium at the inception of
the policy - long term discount will be applicable.
b. For long term policies, in case if the insured is paying quarterly/half yearly options for the
entire policy tenure, a loading of 2%/1% is applicable respectively. No long term discount
is applicable.
➢ Pre-acceptance medical screening: No pre-acceptance medical screening. For those who
declare adverse medical history, company may subject them to undergo pre-policy medical
check-up. 100% cost of such medical examination is borne by the company.

➢ Discounts offered:
S. No. Description Explanation
5% discount for online purchase first purchase and their renewals.
1 Online Purchase Discount (If the policy is first purchased online and the same is renewed
online, then 5% discount will be given for such renewals too)
Two-year policy: 10% discount on 2nd year premium. Three-year
2 Long Term Discount
policy: 12.5% discount on 2nd and 3rd year premium
No claim discount in lieu Sum Insured in Lakhs (Rs.) 3 5
3
of Cumulative Bonus Discount in Premium 3% 2%

➢ Medical Underwriting Loading:

Company may apply a risk loading on the premium payable (based upon the declarations
made in the proposal form and the health status of the persons proposed for insurance).

Galaxy Guardian Unique Identification No. GHIHLIP25037V012425 Page 1 of 18

 GALAXY HEALTH INSURANCE COMPANY LIMITED
(Formerly known as “GALAXY HEALTH AND ALLIED INSURANCE COMPANY LIMITED”)
Reg. Office: Prestige Polygon – 12th Top Floor (P), No. 471, Anna Salai, Nandanam, Chennai – 600035.
T: 044 – 4001 7227 I Website: www.galaxyhealth.com I CIN: U65120TN2023PLC165765 IRDAI Reg. No.:167
Prospectus
▪ The maximum risk loading for an individual will not exceed 125% per diagnosis/medical
condition, with an overall cap of 250% per insured person.
▪ This loading applies from the policy’s commencement date, including any subsequent
renewals with the company.
▪ The company will notify the insured of the applicable risk loading or exclusion, or both,
through a counter offer.
▪ The insured must respond to the company with their consent and any additional premium
(if required) within 7 days of receiving the counter offer.
▪ If the insured neither accepts the counter offer nor responds within 7 days, the company will
cancel the proposal and refund the premium.
▪ The company will issue the policy only after receiving the insured’s consent and any
additional premium (if required).

III. COVERAGE
1. Inpatient Treatment
a. Room rent inclusive of boarding, nursing charges, Residential/Duty Medical Officer charges during
Hospitalisation as charged by the Hospital where the Insured Person availed medical treatment as per
the table given below,
Sum Insured (Rs.) Per day limit
3,00,000 up to 1% of the Sum
5,00,000 Insured

Note: Associated Medical expenses which vary based on the room occupied by the insured person will
be considered in proportion to the room rent stated in the policy schedule or actuals whichever is less.
Proportionate deductions are not applied in respect of the hospitals which do not follow differential
billing or for those expenses in respect of which differential billing is not adopted based on the room
rent.
b. Surgeon, Anesthetist, Medical Practitioner, Consultants, Specialist Fees.
c. Anesthesia, Blood, Oxygen, Operation theatre charges, ICU charges, Surgical appliances, Medicines
and Drugs, Diagnostic materials and X-ray, Diagnostic imaging modalities, investigation test, dialysis,
chemotherapy, radiotherapy, cost of pacemaker, stent and similar expenses with regard to coronary
stenting, medicines, Implants and other similar items the Company will pay cost of stent as per the Drug
Price Control Order (DPCO) / National Pharmaceuticals Pricing Authority (NPPA) Capping.

2. Road Ambulance: Expenses incurred as per the table given below in respect of the following are
payable, provided that the hospitalisation claim is admissible.

i. for transportation of the insured person by private ambulance service to go to hospital when this is
needed for medical reasons or
ii. for transportation of the insured person by private ambulance service from one hospital to another
hospital for better medical treatment or
iii. for transportation of the insured person from the hospital where treatment is taken to their place of
residence (if it is in same city) provided the requirement of an ambulance to the residence is certified
by the medical practitioner.

Limit Per Hospitalisation (Rs) Covered up to Rs.1,500/-

Limit Per Policy Period (Rs) Covered up to Rs.3,000/-

3.Pre- Hospitalisation Expenses: Medical expenses incurred immediately before the insured person
is hospitalized is not exceeding 30 days.

Galaxy Guardian Unique Identification No. GHIHLIP25037V012425 Page 2 of 18

 GALAXY HEALTH INSURANCE COMPANY LIMITED
(Formerly known as “GALAXY HEALTH AND ALLIED INSURANCE COMPANY LIMITED”)
Reg. Office: Prestige Polygon – 12th Top Floor (P), No. 471, Anna Salai, Nandanam, Chennai – 600035.
T: 044 – 4001 7227 I Website: www.galaxyhealth.com I CIN: U65120TN2023PLC165765 IRDAI Reg. No.:167
Prospectus

4. Post Hospitalisation Expenses: Medical Expenses incurred in respect of the Insured Person
immediately following the Insured Person’s discharge from Hospital is not exceeding 60 days.

5. Day Care Procedures/Treatment: All day care Procedures/Treatment are covered upto sum insured.

6. Treatment of Cataract: Expenses incurred on treatment of Cataract is payable up to the limit as per
the table given below:
Sum Insured (Rs.) Limit per policy year (Rs.)
3,00,000 Up to 25,000 /-
5,00,000 Up to 35,000 /-
Note: The above limit is inclusive of pre and post hospitalisation expenses.

7. Health Check-up: Expenses incurred towards cost of health check-up is payable up to the limits
mentioned in the table given below:
Sum Insured (Rs.) Limit per policy year (Rs)
3,00,000 Up to 750/-
5,00,000 Up to 1,000/-
Available at network hospital for every claim free year
Note :
1. Any unutilized health check-up limit cannot be carried forward to the next Policy Year.
2. Payment under this cover will not have an impact on Cumulative Bonus / No Claim Discount.

8. Home Care Treatment

The Company will pay for expenses towards treatment availed by the Insured Person at home up to 10%
of Sum Insured in a policy year. It is available only for the specified conditions mentioned below, which
in normal course would require care and treatment at a hospital but is actually taken at home.
The below listed are covered
1. Fever and Infectious diseases which can be managed as Inpatient
2. Uncomplicated Urinary tract infections but needing Parenteral Antibiotics
3. Asthma and COPD -Mild Exacerbations needing Home Nebulization
4. Acute Gastritis/Gastroenteritis
5. I.V. Chemotherapy [Where advised by the doctor]
6. Palliative Cancer care requiring medical assistance
7. Acute Vertigo
8. Diabetic foot and Cellulitis
9. IVDP [Cervical and Lumbar disc diseases]
10. Major Surgeries/Arthroplasties needing IV Antibiotics Post Discharge
11. Care for Brain and Spinal Injury Cases Post Discharge
12. Post CVA Care at Home after Discharge
Note:
a. The Medical practitioner advises the Insured person to undergo treatment at home
b. There is a continuous active line of treatment with monitoring of health status by a medical
practitioner for each day through the duration of the home care treatment
c. Daily monitoring chart including records of treatment administered duly signed by the treating
doctor is maintained
d. Insured can avail ‘'Home Care Treatment'' service, if availed from the list of Network service provider
given in the Company website ''www.galaxyhealth.com''
e. Exclusion No.1: Pre-Existing disease (Code Excl 01), Exclusion No.2: Specified disease (Code Excl
02), Exclusion No.3: Initial waiting period (Code Excl 03) are applicable and the above mentioned

Galaxy Guardian Unique Identification No. GHIHLIP25037V012425 Page 3 of 18

 GALAXY HEALTH INSURANCE COMPANY LIMITED
(Formerly known as “GALAXY HEALTH AND ALLIED INSURANCE COMPANY LIMITED”)
Reg. Office: Prestige Polygon – 12th Top Floor (P), No. 471, Anna Salai, Nandanam, Chennai – 600035.
T: 044 – 4001 7227 I Website: www.galaxyhealth.com I CIN: U65120TN2023PLC165765 IRDAI Reg. No.:167
Prospectus
sub-limit will apply.
f. Insured claiming under this cover for Post CVA Care at Home after discharge, will not be eligible to
claim under Rehabilitation and Pain Management for Stroke.

9. Rehabilitation and Pain Management: The company will pay the medical expenses up to
Rs.25,000/- per policy year for Rehabilitation and Pain Management.

Rehabilitation: The company will pay the expenses for rehabilitation, if availed at authorized centres
as an In-patient/Out-patient, and if there is an admissible claim for In-patient hospitalisation for an
injury, disease or illness specified below.
1. Poly Trauma
2. Head injury
3. Diseases of the spine
4. Stroke
S. No. Name of the covered Pain Management Treatment
Lumbar and cervical medial branch block with RF ablation for lumbar and cervical facet joint
1 arthritis
2 Caudal epidural injection for Discogenic pain
3 Lumbar and cervical selective nerve root block for Lumbar and Cervical radicular pain
4 Caudal Neuroplasty for Failed back spine surgery
5 Stellate ganglion ablation for upper limb CRPS
6 Occipital nerve Pulsed RF lesioning for Migraines, Cluster headache and cervicogenic headaches
Lumbar sympathetic chain RF ablation for lower limb CRPS, diabetic periphery painful neuropathy
7 and Ischaemic limb pain
8 Gasserian ganglion ablation for Trigeminal neuralgia
9 Intercostal nerve Ablation for post thoracotomy pain and Thoracic malignancy pain
10 Coeliac plexus ablation for upper gastrointestinal malignancies pain
11 Superior hypogastric plexus ablation for lower Gastro intestinal malignancies pain
12 Ganglion impar ablation for perineal cancer pain and coccydynia
13 Cooled RF ablation of genicular nerve for grade 1 and 2 osteoarthritis knee and hip
14 Suprascapular nerve RF ablation for rotator cuff partial tear and peri arthritis shoulder pain
Physiotherapy maximum 10 session will be allowed per policy period not exceeding Rs.10,000/- per
15 policy period
Important Note:
1. Rehabilitation and/or Pain management treatment can be taken only at the Authorized centres
mentioned in the company website – www.galaxyhealth.com
2. Insured claiming under this cover for Stroke, will not be eligible to claim under Home Care Treatment
for Post CVA Care at Home after discharge.

10. Newborn Baby cover: Hospitalisation expenses for treatment of newborn is covered up to 10%
of the mother’s sum insured (including for twins/ triplets/ quadruplets) incurred in a hospital/
nursing home for any disease, illness or accidental injuries are payable as follows.
Waiting Period: Provided the mother is insured under the policy for a continuous period of 12
months without break in this policy

a) For one year policy term: The coverage for newborn baby starts from day-1 after its birth till the
expiry date of the policy year, as per the table given below subject to availability of the sum
insured.

Galaxy Guardian Unique Identification No. GHIHLIP25037V012425 Page 4 of 18

 GALAXY HEALTH INSURANCE COMPANY LIMITED
(Formerly known as “GALAXY HEALTH AND ALLIED INSURANCE COMPANY LIMITED”)
Reg. Office: Prestige Polygon – 12th Top Floor (P), No. 471, Anna Salai, Nandanam, Chennai – 600035.
T: 044 – 4001 7227 I Website: www.galaxyhealth.com I CIN: U65120TN2023PLC165765 IRDAI Reg. No.:167
Prospectus
b) For Long term policies (For 2 years policy term and 3 years policy term): The coverage for
Newborn Baby starts from day-1 after its birth till the expiry date of the policy year. Further,
newborn will be covered under this policy by paying additional premium for subsequent year/s.
Note:
1. Intimation about the birth of the Newborn Baby should be given to the company and policy must
be endorsed for this cover to commence.
2. Exclusion no. 3 initial waiting period (Code Excl 03) as stated under this policy shall not apply
for the Newborn Baby
3. All other terms, conditions and exclusions shall apply for the Newborn Baby.
4. The Exclusion No.1: Pre-Existing disease (Code Excl 01), Exclusion No.2: Specified disease
(Code Excl 02), and the above-mentioned sub-limit will not apply for treatment related to
Congenital Internal disease/defects for the newborn.

11. Bariatric Surgery: Expenses incurred on hospitalisation including pre-hospitalisation and post
hospitalisation for bariatric surgical procedure and its complications thereof are payable subject to
limits as per the table given below.

Sum Insured (Rs.) Limit Per Policy Year (Rs.)

3,00,000 Up to 90,000/-
5,00,000 Up to 1,50,000/-
Conditions:
a) This benefit is subject to a waiting period of 24 months from the date of first commencement of
this policy and continuous renewal thereof with the Company
b) The minimum age of the insured at the time of surgery should be above 18 years
c) This benefit shall not apply where the surgery is performed for
i. Reversible endocrine or other disorders that can cause obesity
ii. Current drug or alcohol abuse
iii. Uncontrolled, severe psychiatric illness
iv. Lack of comprehension of risks, benefits, expected outcome, alternatives and lifestyle
changes required with bariatric surgery
v. Bariatric surgery performed for Cosmetic reasons
d) The indication for the procedure should be found appropriate by two qualified surgeons and the
insured person should obtain prior approval for cashless treatment from the Company.
e) To make a claim, the insured person should satisfy the following criteria as devised by NIH
(National Institute of Health)
i. The BMI should be greater than 40 or greater than 35 with co-morbidities (like Diabetes,
High Blood Pressure etc.)
ii. The insured person is unable to lose weight through traditional methods like diet and
exercise

12. Modern Treatment: The following procedures will be covered (wherever medically indicated) either
as in patient or as part of day care treatment in a hospital as per the table given below (including Pre
and Post hospitalisation expenses) during the policy year.

Treatment type Limit per policy

year (Rs.)
I Robotic Surgeries Maximum up to
Total Knee Replacement & Total Hip Rs.4,00,000/- or
a
Replacement up to sum insured
whichever is less,

Galaxy Guardian Unique Identification No. GHIHLIP25037V012425 Page 5 of 18

 GALAXY HEALTH INSURANCE COMPANY LIMITED
(Formerly known as “GALAXY HEALTH AND ALLIED INSURANCE COMPANY LIMITED”)
Reg. Office: Prestige Polygon – 12th Top Floor (P), No. 471, Anna Salai, Nandanam, Chennai – 600035.
T: 044 – 4001 7227 I Website: www.galaxyhealth.com I CIN: U65120TN2023PLC165765 IRDAI Reg. No.:167
Prospectus
(Including the
Costs of Implants)
Radical Prostatectomy
Wipples Procedure
b For treatment of Thoracic & Abdominal Up to sum insured
Malignancies
Complex Intra-Abdominal Surgeries
For treatment of Laryngeal & Pharyngeal Cancers Up to sum insured
Staging Laparotomy (including the cost of
c
instruments)
Cyto-reduction Surgeries
For all other Robotic procedures Up to 30% sum
d
insured
II Immunotherapy – a For Cancer Treatment Up to sum insured
Monoclonal Antibody Other than treatment of Cancer Up to 30% sum
to be given as injection b insured
IIIStem Cell Therapy a For Cancer Treatment Up to sum insured
Hematopoietic stem Other than treatment of Cancer Up to 30% sum
cells for bone marrow insured
transplant for b
haematological
conditions
IV Intravitreal Injection Allowed Maximum 2 injections per eye (4 Up to 30% sum
a
injection both eyes) per policy period insured
V Deep Brain Stimulation a Upto sum insured
VI Other Modern a Balloon Sinuplasty
Treatments b Bronchial Thermoplasty
c IONM – (Intra Operative Neuro Monitoring)
d Stereotactic Radio Surgeries Up to 30% sum
e Vaporisation of Prostate insured
f Oral Chemotherapy
g Uterine Artery Embolization & High-Intensity
Focussed Ultrasound

13. AYUSH Treatment: Medical expenses for Inpatient Hospitalisation incurred on treatment under
Ayurveda, Yoga and Naturopathy, Unani, Sidha and Homeopathy systems of medicines in a AYUSH
Hospital is payable upto the sum insured.
Note: Claims under Yoga and Naturopathy system of treatment will be payable subject to prior approval
from the Company.

14. Organ Transplantation Expenses: Hospitalisation medical expenses incurred to the Insured
Person for inpatient organ transplantation treatment, including the harvesting of the donated organ will
be covered upto sum insured subject to a waiting period of 36 months from the date of first inception of
this policy with the Company.
Note: Organ transplant on the Insured Person shall satisfy the requirements of the Transplantation of
Human Organs Act of 1994 and any amendments thereto.

Galaxy Guardian Unique Identification No. GHIHLIP25037V012425 Page 6 of 18

 GALAXY HEALTH INSURANCE COMPANY LIMITED
(Formerly known as “GALAXY HEALTH AND ALLIED INSURANCE COMPANY LIMITED”)
Reg. Office: Prestige Polygon – 12th Top Floor (P), No. 471, Anna Salai, Nandanam, Chennai – 600035.
T: 044 – 4001 7227 I Website: www.galaxyhealth.com I CIN: U65120TN2023PLC165765 IRDAI Reg. No.:167
Prospectus

15.Domiciliary Hospitalisation: Coverage for medical treatment (Including AYUSH) for a period
exceeding three days, for an illness/disease/injury, which in the normal course, would require care and
treatment at a hospital but, on the advice of the attending Medical Practitioner, is taken whilst confined
at home under any of the following circumstances.
• The condition of the patient is such that he/she is not in a condition to be moved to a hospital,
or
• The patient takes treatment at home on account of non-availability of room/bed in a hospital.
However, this benefit shall not cover Asthma, Bronchitis, Chronic Nephritis and Nephritic Syndrome,
Diarrhoea and all types of Dysenteries including Gastroenteritis, Diabetes Mellitus and Insipidus,
Epilepsy, Hypertension, Influenza, Cough and Cold, all Psychiatric or Psychosomatic Disorders, Pyrexia
of unknown origin for less than 10 days, Tonsillitis and Upper Respiratory Tract infection including
Laryngitis and Pharyngitis, Arthritis, Gout and Rheumatism.

16. Outpatient Consultation: Expenses of Medical Consultations as an Outpatient incurred in a

Network Hospital up to the limits mentioned in the below table of benefits with a limit of Rs.750/- per
consultation. Payment under this section does not form part of Sum Insured, and payable while the
policy is in force.
Sum Insured (Rs.) Limit Per Policy Year (Rs.)
3,00,000 Up to 2,000/-
5,00,000 Up to 3,000/-
Note: Settling any claim under this section does not imply that the Company waives its right to deny
any claim due to non-disclosure of important information or pre-existing conditions, as per the
hospitalization terms of the policy contract.

17. A. Cumulative Bonus: The Company will provide a Cumulative Bonus at 10% of the Sum Insured at
the end of every claim free year subject to a maximum of 50 %, if the policy is continuously renewed
with the company.
Conditions
1. The Cumulative bonus will be calculated on the expiring Sum Insured.
2. If the insured opts to reduce the sum insured at the subsequent renewal, the limit of indemnity
by way of such Bonus shall not exceed such reduced sum insured.
3. In the event of a claim, such bonus so granted will be reduced at the same rate at which it has
accrued.

17. B. No Claim Discount (in lieu of Cumulative Bonus): Policy is eligible for no claim discount in lieu
of no claim bonus as per the table given below.
Sum Insured (Rs.) Discount in Premium
3,00,000 3%
5,00,000 2%
Note:
i. The customer should opt for either cumulative bonus or No claims discount during the first
purchase of this policy and the same will be maintained throughout the lifetime.
ii. This discount will be provided on renewal premium of each claim free year, and it is not
cumulative in nature.

Illustration: If the insured opts for higher sum insured at the time of renewal, the discount shall be
calculated on the previous year premium, and the same discounted amount shall be applied on the
renewed premium. Illustration is given below for better understanding.

Galaxy Guardian Unique Identification No. GHIHLIP25037V012425 Page 7 of 18

 GALAXY HEALTH INSURANCE COMPANY LIMITED
(Formerly known as “GALAXY HEALTH AND ALLIED INSURANCE COMPANY LIMITED”)
Reg. Office: Prestige Polygon – 12th Top Floor (P), No. 471, Anna Salai, Nandanam, Chennai – 600035.
T: 044 – 4001 7227 I Website: www.galaxyhealth.com I CIN: U65120TN2023PLC165765 IRDAI Reg. No.:167
Prospectus
Policy Type Fresh
Sum Insured (Rs.) 3,00,000
Self and Age 36
Base Premium (Rs.) 6,208 A
Add: GST at 18% (Rs.) 1,117 B = A * 18
Total Premium (Rs.) 7,325 C = A+B
During Renewal, Insured enhanced sum Insured to Rs.5,00,000/- and opted No
Claim discount
Policy Type Renewal
Sum Insured Enhanced to (Rs.) 5,00,000
Self and Age 37
Base Premium (Rs.) 7,431 D
Less: No Claims Discount at 4% (Rs.) 124 E = A*2%
Sub-total (Rs.) 7,307 F = D-E
Add: GST at 18% (Rs.) 1,315 G = F*18%
Total Premium (Rs.) 8,622 H = F+G

18. Co-payment: Each and every claim under the Policy shall be subject to a co-payment of 10%
applicable to claim amount admissible and payable as per the terms and conditions of the Policy. The
amount payable shall be after deduction of the co-payment.

➢ EXCLUSIONS
Standard Exclusions
1. Pre-Existing Diseases - Code- Excl 01:
A. Expenses related to the treatment of a pre-existing Disease (PED) and its direct complications
shall be excluded until the expiry of 36 months of continuous coverage after the date of
inception of the first policy with insurer
B. In case of enhancement of sum insured the exclusion shall apply afresh to the extent of sum
insured increase.
C. If the Insured Person is continuously covered without any break as defined under the
portability norms of the extant IRDAI (Health Insurance) Regulations, then waiting period for
the same would be reduced to the extent of prior coverage.
D. Coverage under the policy after the expiry of 36 months for any pre-existing disease is subject
to the same being declared at the time of application and accepted by Insurer, applicable for
1 year / 2 year / 3 year term plans.

2. Specified disease/procedure waiting period – Code Excl 02

Expenses related to the treatment of the listed conditions: surgeries/treatments shall be excluded
until the expiry of 24 months, provided continuous coverage after the date of inception of the first
policy with us. This exclusion shall not be applicable for claims arising due to an accident.
Applicable for 1 year / 2 year / 3 year term plans.
A. In case of enhancement of sum insured the exclusion shall apply afresh to the extent of sum
insured increase.
B. If any of the specified disease/procedure falls under the waiting period specified for pre-
Existing diseases, then the longer of the two waiting periods shall apply.
C. The waiting period for listed conditions shall apply even if contracted after the policy inception
or declared and accepted without a specific exclusion.
D. If the Insured Person is continuously covered without any break as defined under the
applicable norms on portability stipulated by IRDAI, then waiting period for the same would
be reduced to the extent of prior coverage.

Galaxy Guardian Unique Identification No. GHIHLIP25037V012425 Page 8 of 18

 GALAXY HEALTH INSURANCE COMPANY LIMITED
(Formerly known as “GALAXY HEALTH AND ALLIED INSURANCE COMPANY LIMITED”)
Reg. Office: Prestige Polygon – 12th Top Floor (P), No. 471, Anna Salai, Nandanam, Chennai – 600035.
T: 044 – 4001 7227 I Website: www.galaxyhealth.com I CIN: U65120TN2023PLC165765 IRDAI Reg. No.:167
Prospectus
E. List of specific diseases/procedures
1. Treatment of Cataract and diseases of the anterior and posterior chamber of the Eye,
Diseases of ENT, Diseases related to Thyroid, Benign diseases of the breast.
2. Subcutaneous Benign Lumps, Sebaceous cyst, Dermoid cyst, Mucous cyst lip / cheek,
Carpal Tunnel Syndrome, Trigger Finger, Lipoma, Neurofibroma, Fibroadenoma,
Ganglion and similar pathology.
3. All treatments (Conservative, Operative treatment) and all types of intervention for
Diseases related to Tendon, Ligament, Fascia, Bones and Joint Including Arthroscopy and
Arthroplasty / Joint Replacement [other than caused by accident].
4. All types of treatment for Degenerative disc and Vertebral diseases including
Replacement of bones and joints and Degenerative diseases of the Musculo-skeletal
system, Prolapse of Intervertebral Disc (other than caused by accident).
5. All treatments (conservative, interventional, laparoscopic and open) related to Hepato-
pancreato-biliary diseases including diseases of liver, Gall bladder and Pancreatic
calculi. All types of management for Kidney calculi and Genitourinary tract calculi.
6. All types of Hernia.
7. Desmoid Tumour, Umbilical Granuloma, Umbilical Sinus, Umbilical Fistula.
8. All treatments (conservative, interventional, laparoscopic and open) related to all
Diseases of Cervix, Uterus, Fallopian tubes, Ovaries, Uterine Bleeding, Pelvic
Inflammatory Diseases.
9. All Diseases of Prostate, Stricture Urethra, all Obstructive Uropathies.
10. Benign Tumours of Epididymis, Spermatocele, Varicocele, Hydrocele.
11. Fistula, Fissure in Ano, Haemorrhoids, Pilonidal Sinus and Fistula, Rectal Prolapse,
Stress Incontinence
12. Varicose veins and Varicose ulcers.
13. Congenital Internal disease / defect - [except for Newborn Coverage (10)].
Note: Waiting period for the following benefits are as follows
a. Organ Transplantation: A waiting period of 36 months from the date of first inception of
this policy with the Company for the insured person for all types of transplant and related
surgeries including Stem Cell transplant.
b. Bariatric Surgery: A waiting period of 24 months from the date of first inception of this
policy with the Company.
c. New born cover: A waiting period of 12 months from the date of first inception for the
mother in this policy with the Company
3. 30-day waiting period – Code Excl 03 (Not Applicable for Accidents)
a. Expenses related to the treatment of any illness within 30 days from the first policy
commencement date shall be excluded except claims arising due to an accident, provided the
same are covered.
b. This exclusion shall not, however, apply if the Insured Person has Continuous Coverage for more
than twelve months
c. The within referred waiting period is made applicable to the enhanced sum insured in the event
of granting higher sum insured subsequently
4. Investigation & Evaluation – Code Excl 04
a. Expenses related to any admission, primarily for diagnostics and evaluation purposes only are
excluded
b. Any diagnostic expenses which are not related or not incidental to the current diagnosis and
treatment are excluded
5. Rest Cure, rehabilitation (except to the extent covered under Coverage 9) and respite care –
Code Excl 05: Expenses related to any admission primarily for enforced bed rest and not for
receiving treatment. This also includes:

Galaxy Guardian Unique Identification No. GHIHLIP25037V012425 Page 9 of 18

 GALAXY HEALTH INSURANCE COMPANY LIMITED
(Formerly known as “GALAXY HEALTH AND ALLIED INSURANCE COMPANY LIMITED”)
Reg. Office: Prestige Polygon – 12th Top Floor (P), No. 471, Anna Salai, Nandanam, Chennai – 600035.
T: 044 – 4001 7227 I Website: www.galaxyhealth.com I CIN: U65120TN2023PLC165765 IRDAI Reg. No.:167
Prospectus
a. Custodial care either at home or in a nursing facility for personal care such as help with activities
of daily living such as bathing, dressing, moving around either by skilled nurses or assistant or
non-skilled persons
b. Any services for people who are terminally ill to address physical, social, emotional and spiritual
needs
6. Obesity/ Weight Control (except to the extent covered under Coverage 11)– Code Excl 06:
Expenses related to the surgical treatment of obesity that does not fulfil all the below conditions
i. Surgery to be conducted is upon the advice of the Doctor
ii. The surgery/Procedure conducted should be supported by clinical protocols
iii. The members must be 18 years of age or older and
iv. Body Mass Index (BMI)
1. greater than or equal to 40 or
2. greater than or equal to 35 in conjunction with any of the following severe co-morbidities
following failure of less invasive methods of weight loss:
a) Obesity-related cardiomyopathy
b) Coronary heart disease
c) Severe Sleep Apnea
d) Uncontrolled Type2 Diabetes

7. Change-of-Gender treatments – Code Excl 07: Expenses related to any treatment, including
surgical management, to change characteristics of the body to those of the opposite sex.
8. Cosmetic or plastic Surgery – Code Excl 08: Expenses for cosmetic or plastic surgery or any
treatment to change appearance unless for reconstruction following an Accident, Burn(s) or
Cancer or as part of medically necessary treatment to remove a direct and immediate health risk
to the insured. For this to be considered a medical necessity, it must be certified by the attending
Medical Practitioner.
9. Hazardous or Adventure sports – Code Excl 09: Expenses related to any treatment necessitated
due to participation as a professional in hazardous or adventure sports, including but not limited
to, para-jumping, rock climbing, mountaineering, rafting, motor racing, horse racing or scuba
diving, hand gliding, sky diving, deep-sea diving.
10. Breach of law – Code Excl 10: Expenses for treatment directly arising from or consequent upon
any Insured Person committing or attempting to commit a breach of law with criminal intent.
11. Excluded Providers– Code Excl 11: Expenses incurred towards treatment in any hospital or by
any Medical Practitioner or any other provider specifically excluded by the Insurer and disclosed
in its website / notified to the policyholders are not admissible. However, in case of life threatening
situations or following an accident, expenses up to the stage of stabilization are payable but not
the complete claim.
12. Treatment for Alcoholism, drug or substance abuse or any addictive condition and consequences
thereof – Code Excl 12
13. Treatments received in health hydros, nature cure clinics, spas or similar establishments or private
beds registered as a nursing home attached to such establishments or where admission is
arranged wholly or partly for domestic reasons – Code Excl 13
14. Dietary supplements and substances that can be purchased without prescription, including but
not limited to Vitamins, minerals and organic substances unless prescribed by a medical
practitioner as part of hospitalisation claim or day care procedure – Code Excl 14
15. Refractive Error – Code Excl 15 Expenses related to the treatment for correction of eyesight due
to refractive error less than 7.5 diopters.
16. Unproven Treatments – Code Excl 16: Expenses related to any unproven treatment, services and
supplies for or in connection with any treatment. Unproven treatments are treatments, procedures
or supplies that lack significant medical documentation to support their effectiveness.
17. Sterility and Infertility– Code Excl 17: Expenses related to sterility and infertility. This includes;

Galaxy Guardian Unique Identification No. GHIHLIP25037V012425 Page 10 of 18

 GALAXY HEALTH INSURANCE COMPANY LIMITED
(Formerly known as “GALAXY HEALTH AND ALLIED INSURANCE COMPANY LIMITED”)
Reg. Office: Prestige Polygon – 12th Top Floor (P), No. 471, Anna Salai, Nandanam, Chennai – 600035.
T: 044 – 4001 7227 I Website: www.galaxyhealth.com I CIN: U65120TN2023PLC165765 IRDAI Reg. No.:167
Prospectus
a) Any type of contraception, sterilization
b) Assisted Reproduction services including artificial insemination and advanced reproductive
technologies such as IVF, ZIFT, GIFT,ICSI
c) Gestational Surrogacy
d) Reversal of sterilization
18. Maternity – Code Excl 18
i. Medical treatment expenses traceable to childbirth (including complicated deliveries and
caesarean sections incurred during hospitalisation) except ectopic pregnancy.
ii. Expenses towards miscarriage (unless due to an accident) and lawful medical termination of
pregnancy during the policy period
Specific Exclusions
19. Circumcision (unless necessary for treatment of a disease not excluded under this policy or
necessitated due to an accident), Preputioplasty, Frenuloplasty, Preputial Dilatation and Removal
of SMEGMA -Code- Excl 19
20. Congenital External Condition / Defects / Anomalies -Code- Excl 20
21. Convalescence, general debility, run-down condition, Nutritional deficiency states -Code- Excl 21
22. Intentional self -injury-Code- Excl 22
23. Injury/disease caused by or arising from or attributable to war, invasion, act of foreign enemy,
warlike operations (whether war be declared or not) -Code- Excl 24
24. Injury or disease caused by or contributed to by nuclear weapons/ materials -Code- Excl 25
25. Expenses incurred on Enhanced External Counter Pulsation Therapy and related therapies,
Chelation therapy, Hyperbaric Oxygen Therapy, Rotational Field Quantum Magnetic Resonance
Therapy, VAX-D, Low level laser therapy, Photodynamic therapy and such other therapies similar
to those mentioned herein under this exclusion -Code- Excl 26.
26. Unconventional, Untested, Experimental therapies -Code- Excl 27
27. Autologous derived Stromal vascular fraction, Chondrocyte Implantation, Procedures using
Platelet Rich plasma and Intra articular injection therapy -Code- Excl 28
28. Biologicals, except when administered as an in-patient, when clinically indicated and
hospitalisation warranted. - Code- Excl 29
29. Inoculation or Vaccination (except for post–bite treatment and for medical treatment for
therapeutic reasons) -Code- Excl 31
30. Any payment in case of more than one claim under the policy during the period of insurance by
which the maximum liability of the Company in that period would exceed the amount specified in
the Schedule Excl 34
31. Cost of spectacles and contact lens, hearing aids, Cochlear implants and procedures, walkers
and crutches, wheel chairs, CPAP, BIPAP, Continuous Ambulatory Peritoneal Dialysis, infusion
pump and such other similar aids. -Code- Excl 35
32. Any hospitalisation which are not medically necessary / does not warrant hospitalisation-Code-
Excl 36
33. Other Excluded Expenses as detailed in the website www.galaxyhealth.com - Code Excl 37
34. Existing disease/s, disclosed by the insured and mentioned in the policy schedule under
permanent exclusion (based on insured's consent), for specified ICD codes -Code- Excl 38
35. All treatment/Interventions for Erectile Dysfunctions
36. Expenses for venereal disease or any sexually transmitted disease except HIV/AIDS
37. Dental Treatment, Diagnostics, Dental Procedures or Surgery of any kind unless requiring
Hospitalisation as a result of accidental Injury.

➢ Claim Settlement
A. Condition Precedent to Admission of Liability: The terms and conditions of the policy must be
fulfilled by the insured person for the Company to make any payment for claim(s) arising under the
policy.

Galaxy Guardian Unique Identification No. GHIHLIP25037V012425 Page 11 of 18

 GALAXY HEALTH INSURANCE COMPANY LIMITED
(Formerly known as “GALAXY HEALTH AND ALLIED INSURANCE COMPANY LIMITED”)
Reg. Office: Prestige Polygon – 12th Top Floor (P), No. 471, Anna Salai, Nandanam, Chennai – 600035.
T: 044 – 4001 7227 I Website: www.galaxyhealth.com I CIN: U65120TN2023PLC165765 IRDAI Reg. No.:167
Prospectus
B. For Cashless Treatment:
a. Call the 24 hour help-line for assistance – 18002030007.Senior Citizens may call at 18002030007
b. Inform the ID number for easy reference
c. On admission in the hospital, produce the ID Card issued by the Company at the Hospital Helpdesk
d. Obtain the Pre-authorisation Form from the Hospital Help Desk, complete the Patient Information
and resubmit to the Hospital Help Desk. (Insurers shall also provide pre-authorization to the
policyholder through Digital mode).
e. The Treating Doctor will complete the hospitalisation/ treatment information, and the hospital will
fill up expected cost of treatment. This form is submitted to the Company
f. The Company will process the request and call for additional documents / clarifications if the
information furnished is inadequate.
g. Once all the details are furnished, the Company will process the request as per the terms and
conditions as well as the exclusions therein and either approve or reject the request based on the
merits.
h. In case of emergency hospitalisation information to be given within 24 hours after hospitalisation
i. Cashless facility can be availed only in networked Hospitals. For details of Networked Hospitals, the
insured may visit www.galaxyhealth.com or contact the nearest branch or refer to the list of
Networked Hospitals provided with the policy document. KYC (Identity proof with Address) of the
proposer as per AML Guidelines.
In non-network hospitals payment must be made up-front and then reimbursement will be effected on
submission of documents.
Note: The Company reserves the right to call for additional documents wherever required.
Denial of a Pre-authorization request is in no way to be construed as denial of treatment or denial of
coverage. The Insured Person can go ahead with the treatment, settle the hospital bills and submit the
claim for a possible reimbursement.

C. For Reimbursement claims: Time limit for submission of necessary claim documents for
S. no. Type of Claim Prescribed time limit
1 Reimbursement of hospitalisation, day Claim must be filed within 15 days from the
care and pre-hospitalisation expenses date of discharge from the Hospital.
2 Reimbursement of Post hospitalisation within 15 days after completion of 60 days
from the date of discharge from hospital

D. Notification of Claim: Upon the happening of the event, notice with full particulars shall be sent
to the Company within 24 hours from the date of occurrence of the event irrespective of whether
the event is likely to give rise to a claim under the policy or not.
Note: Conditions C and D are precedent to admission of liability under the policy. The Company
will examine and relax the time limit mentioned in these conditions depending upon the merits of
the case.

E. Documents to be submitted for Reimbursement: The reimbursement claim is to be supported

with the following documents in original and submitted within the prescribed time limit.
i. Duly filled in claim forms with treating doctor signature.
ii. Pre/Post Hospitalisation investigations and treatment papers.
iii. All investigations reports including Radiological films (Xray, CT scan, MRI and USG) and Biopsy
during hospitalisation.
iv. Discharge Summary from the hospital
v. Cash receipts from hospital, chemists

Galaxy Guardian Unique Identification No. GHIHLIP25037V012425 Page 12 of 18

 GALAXY HEALTH INSURANCE COMPANY LIMITED
(Formerly known as “GALAXY HEALTH AND ALLIED INSURANCE COMPANY LIMITED”)
Reg. Office: Prestige Polygon – 12th Top Floor (P), No. 471, Anna Salai, Nandanam, Chennai – 600035.
T: 044 – 4001 7227 I Website: www.galaxyhealth.com I CIN: U65120TN2023PLC165765 IRDAI Reg. No.:167
Prospectus
vi. Cash receipts and reports for tests done
vii. Receipts from doctors, surgeons, anaesthetist
viii. Certificate from the attending doctor regarding the diagnosis.
ix. KYC (Identity proof with Address) of the proposer, as per AML Guidelines
x. Copy of PAN Card
xi. NEFT documents viz., Customer name, Bank Account No., Name of the Bank, IFSC code
xii. CKYC No. of the proposer (if available)
xiii. Legal heir/succession certificate, wherever applicable

For Outpatient Consultation:

i. Documents to be submitted for reimbursement: The reimbursement claim is to be
supported with the following documents in original and submitted within the prescribed
time limit;
ii. Duly completed claim form, and
iii. Certificate from the attending doctor regarding the diagnosis
iv. Prescription of the treating doctor
v. Receipt from the treating doctor / hospital / Physiotherapist
vi. KYC (Identity proof with Address) of the proposer, as per AML Guidelines
vii. NEFT documents viz., Customer name, Bank Account No., Name of the Bank, IFSC code
viii. CKYC No. of the proposer (if available)
Note:
i. Call the 24 hour help-line for assistance - 18002030007.Senior Citizens may call at
18002030007.
ii. The Company authorized doctor may examine the insured if required
iii. The Company reserves the right to call for additional documents wherever required.
iv. In case of Accidents and emergency treatments, insured person can claim for Outpatient
consultation expenses in non-network hospitals also.

➢ Renewal of Health Insurance policy:

a. A health insurance policy shall be renewable provided the product is not withdrawn, except in
case of established fraud or non-disclosure or misrepresentation by the Insured. If the product is
withdrawn, the policyholder shall be provided with suitable options to migrate.
b. An Insurer shall not deny the renewal on the ground that the policyholder had made a claim (s) in
the preceding policy years.
c. An Insurer shall not resort to fresh underwriting unless there is an increase in sum insured. In case
increase in sum insured is requested by the policyholder, the Insurer may underwrite only to the
extent of increased sum insured.
d. Request for renewal along with requisite premium shall be received by the Company before the
end of the policy period.
e. At the end of the policy period, the policy shall terminate and can be renewed within the Grace
Period of 30 days to maintain continuity of benefits without break in policy.
f. Coverage is not available during the grace period.
g. No loading shall apply on renewals based on individual claims experience.

➢ Possibility of Revision of Terms of the Policy including the Premium Rates: The Company may
revise or modify the terms of the policy including the premium rates with the extant guidelines. The
insured person shall be notified three months before the changes are effected.

➢ Withdrawal of policy
i. In the likelihood of this product being withdrawn in future, the Company will intimate the insured
person about the same 90 days prior to expiry of the policy.

Galaxy Guardian Unique Identification No. GHIHLIP25037V012425 Page 13 of 18

 GALAXY HEALTH INSURANCE COMPANY LIMITED
(Formerly known as “GALAXY HEALTH AND ALLIED INSURANCE COMPANY LIMITED”)
Reg. Office: Prestige Polygon – 12th Top Floor (P), No. 471, Anna Salai, Nandanam, Chennai – 600035.
T: 044 – 4001 7227 I Website: www.galaxyhealth.com I CIN: U65120TN2023PLC165765 IRDAI Reg. No.:167
Prospectus
ii. Insured Person will have the option to migrate to similar health insurance product available with
the Company at the time of renewal with all the accrued continuity benefits such as cumulative
bonus, waiver of waiting period as per IRDAI guidelines, provided the policy has been maintained
without a break.

➢ Premium Payment in Instalments: lf the insured person has opted for Payment of Premium on an
instalment basis i.e. Half Yearly or Quarterly as mentioned in the policy Schedule/Certificate of
Insurance, the following Conditions shall apply (notwithstanding any terms contrary elsewhere in
the policy)
i. 30 days (where premium is paid in quarterly/half yearly) is available on the premium due date, to
pay the premium. If the premium is paid in instalments during the policy period, coverage will be
available for the grace period also.
ii. If the policy is renewed during grace period, all the credits (sum insured, No Claim Bonus, Specific
Waiting periods, waiting periods for pre-existing diseases, Moratorium period etc.) accrued under
the policy shall be protected. The same is applicable for both Indemnity and Benefit products.
iii. No interest will be charged if the instalment premium is not paid on due date.
iv. ln case of instalment premium due not received within the grace period, the policy will get
cancelled.
v. ln the event of a claim, all subsequent premium instalments shall immediately become due and
payable.
vi. The company has the right to recover and deduct all the pending instalments from the claim
amount due under the policy.

➢ Free Look Period: The Free Look Period shall be applicable on new individual health insurance
policies and not on renewals or at the time of porting/migrating the policy.
The insured person shall be allowed free look period of 30 days from date of receipt of the policy
document whether electronically or otherwise to review the terms and conditions of the policy, and
to return the same if not acceptable.
lf the insured has not incurred any claim during the Free Look Period, the insured shall be entitled to
i. a refund of the premium paid less any expenses incurred by the Company on medical
examination of the insured person and the stamp duty charges or
ii. where the risk has already commenced and the option of return of the policy is exercised by the
insured person, a deduction towards the proportionate risk premium for period of cover or
iii. where only a part of the insurance coverage has commenced, such proportionate premium
commensurate with the insurance coverage during such period.

➢ Redressal of Grievance: In case of any grievance the insured person may contact the Company
through
Website : www.galaxyhealth.com
Toll free : 18002030007
Senior Citizens may call at 18002030007
E-mail : gro@galaxyhealth.com
Phone No.: 044 - 4001 7238
Courier : Prestige Polygon – 12th Top Floor (P), No. 471, Nandanam, Anna Salai, Chennai – 600035.
lnsured person may also approach the Grievance officer at any of the company's branches with the
details of grievance.
lf lnsured person is not satisfied with the redressal of grievance through one of the above methods,
insured person may contact the Grievance redressal officer (GRO) at corporate office - 044 - 4001
7238
For updated details of grievance officer, kindly refer the link
https://www.galaxyhealth.com/grievance-redressal

Galaxy Guardian Unique Identification No. GHIHLIP25037V012425 Page 14 of 18

 GALAXY HEALTH INSURANCE COMPANY LIMITED
(Formerly known as “GALAXY HEALTH AND ALLIED INSURANCE COMPANY LIMITED”)
Reg. Office: Prestige Polygon – 12th Top Floor (P), No. 471, Anna Salai, Nandanam, Chennai – 600035.
T: 044 – 4001 7227 I Website: www.galaxyhealth.com I CIN: U65120TN2023PLC165765 IRDAI Reg. No.:167
Prospectus
lf lnsured person is not satisfied with the redressal of grievance through above methods, the insured
person may also approach the office of Insurance Ombudsman of the respective area/region for
redressal of grievance as per insurance Ombudsman Rules 2017. For the details of Insurance
Ombudsman, please visit: https://cioins.co.in/Complaint/Online
Grievance may also be lodged at IRDAI integrated Grievance Management System -
https://bimabharosa.irdai.gov.in/

➢ Migration:
In case of migration of one policy to another with the same Insurer, the policyholder (including all
members under family cover and group insurance policies) can transfer the credits gained to the
extent of the Sum Insured, No Claim Bonus, Specific Waiting periods, waiting period for pre-existing
diseases, Moratorium period etc. in the previous policy to the migrated policy.

➢ Portability:
a. A policyholder desirous of porting his/her policy to another insurer shall apply to such insurer to
port the entire policy along with all the members of the family, if any, at least 30 days before, but
not earlier than 60 days from the due date for renewal. Insurers are free to consider proposal for
portability, but in all such cases acquiring insurer shall ensure that there is no break in policy.
b. The policyholder is entitled to transfer the credits gained to the extent of the Sum Insured, No
Claim Bonus, specific waiting periods, waiting period for pre-existing disease, Moratorium period
etc from the Existing Insurer to the Acquiring Insurer in the previous policy.

➢ Moratorium Period: After completion of sixty continuous months of coverage (including portability
and migration) in health insurance policy, no policy and claim shall be contestable by the insurer on
grounds of non-disclosure, misrepresentation, except on grounds of established fraud. This period
of sixty continuous months is called as moratorium period. The moratorium would be applicable for
the sums insured of the first policy. Wherever, the sum insured is enhanced, completion of sixty
continuous months would be applicable from the date of enhancement of sums insured only on the
enhanced limits. After the expiry of Moratorium Period no health insurance claim shall be
contestable except for proven fraud, nondisclosure, misrepresentation and exclusions specified in
the policy contract. The policies would however be subject to all limits, sub limits, co-payments and
deductibles as per the policy contract.

➢ Disclosure of Information: The policy shall be void and all premium paid thereon shall be forfeited
to the Company in the event of misrepresentation, misdescription or non-disclosure of any material
fact by the policy holder.

➢ Cancellation
i. The policyholder may cancel his/her policy at any time during the term, by giving 7 days notice in
writing. The Insurer shall
a. refund proportionate premium for unexpired policy period, if the term of policy up to one year
and there is no claim (s) made during the policy period.
b. refund premium for the unexpired policy period, in respect of policies with term more than 1
year and risk coverage for such policy years has not commenced.

Note: Notwithstanding anything contained herein or otherwise, no refunds of premium shall be made
in respect of Cancellation where, any claim has been admitted or has been lodged or any benefit has
been availed by the insured person under the policy.

Galaxy Guardian Unique Identification No. GHIHLIP25037V012425 Page 15 of 18

 GALAXY HEALTH INSURANCE COMPANY LIMITED
(Formerly known as “GALAXY HEALTH AND ALLIED INSURANCE COMPANY LIMITED”)
Reg. Office: Prestige Polygon – 12th Top Floor (P), No. 471, Anna Salai, Nandanam, Chennai – 600035.
T: 044 – 4001 7227 I Website: www.galaxyhealth.com I CIN: U65120TN2023PLC165765 IRDAI Reg. No.:167
Prospectus
ii. The Company may cancel the policy at any time on grounds of misrepresentation, non-disclosure
of material facts, fraud by the insured person by giving 15 days' written notice. There would be no
refund of premium on cancellation on grounds of misrepresentation, non-disclosure of material
facts or fraud.
iii. In case of long term policies the refund will be given after adjusting the long term
discount/instalment loading availed by the insured/ policyholder.

➢ Automatic Expiry: The insurance under this policy with respect to each relevant Insured Person
policy shall expire immediately on the earlier of the following events
• Upon the death of the Insured Person. This means that, the cover for the surviving members of
the family will continue, subject to other terms of the policy.
• Upon exhaustion of the Sum Insured and Limit of Coverage

➢ Revision of Sum Insured: Reduction or enhancement of Sum Insured is permissible only at the time
of renewal. The acceptance for enhancement and the amount of enhancement will be at the
discretion of the Company and subject to Exclusion Code Excl 01, Exclusion Code Excl 02 and
Exclusion Code Excl 03.

➢ Relief under Section 80-D: Insured Person is eligible for relief under Section 80-D of the IT Act in
respect of the premium paid by any mode other than cash

➢ Important Note: IRDAI or its officials do not involve in activities like selling insurance policies,
announcing bonus or investment of premiums. Public receiving such phone calls are requested to
lodge a police complaint.

➢ Prohibition of Rebates: Section 41 of Insurance Act 1938 (Prohibition of rebates): No person shall
allow or offer to allow, either directly or indirectly, as an inducement to any person to take out or
renew or continue an insurance in respect of any kind of risk relating to lives or property in India, any
rebate of the whole or part of the commission payable or any rebate of the premium shown on the
policy, nor shall any person taking out or renewing or continuing a policy accept any rebate, except
such rebate as may be allowed in accordance with the published prospectuses or tables of the
insurer. Any person making default in complying with the provisions of this section shall be liable for
a penalty which may extend to ten lakh rupee.

Galaxy Guardian Unique Identification No. GHIHLIP25037V012425 Page 16 of 18

 GALAXY HEALTH INSURANCE COMPANY LIMITED
(Formerly known as “GALAXY HEALTH AND ALLIED INSURANCE COMPANY LIMITED”)
Reg. Office: Prestige Polygon – 12th Top Floor (P), No. 471, Anna Salai, Nandanam, Chennai – 600035.
T: 044 – 4001 7227 I Website: www.galaxyhealth.com I CIN: U65120TN2023PLC165765 IRDAI Reg. No.:167
Prospectus
ILLUSTRATION
(Excluding Tax)
Benefit Illustration in respect of policies offered on individual and family floater basis
Age Coverage opted on Coverage opted on individual basis covering Coverage opted on family floater basis with overall Sum insured (Only
of the individual basis covering multiple members of the family under a single policy one sum insured is available for the entire family)
Members each member of the family (Sum insured is available for each member of the
insured separately (at a single point family)
(in yrs) of time)
Premium Sum Insured Premium Discount, Premium Sum Premium or Floater Premium Sum Insured (in lakhs)
(Rs.) (in lakhs) (Rs.) (if any) After Insured (in consolidated Discount*, After (Rs.)
(Rs.) Discount lakhs) premium for (if any) Discount
(Rs.) (Rs.) all members (Rs.)
of family (Rs.)
Illustration 1 (2A)
44 7,879 5 7,879 7,879 5
Nil Not Applicable
40 7,431 5 7,431 7,431 5
Total Premium for all members of the Total Premium for all members of the family is Rs.
Total Premium when policy is opted on floater basis is Rs.(Not
family is Rs.15,310/-, when each member 15,310/-, when they are covered under a single
Applicable)/-, Sum insured of Rs.5 lakhs is available for the entire
is covered separately. Sum insured policy. Sum insured available for each family
family (2A)
available for each individual is Rs.5 lakhs member is Rs.5 lakhs
Illustration 2 (2A+1C)
51 13,965 5 13,965 13,965 5
47 10,283 5 10,283 Nil 10,283 5 Not Applicable
21 5,441 5 5,441 5,441 5
Total Premium for all members of the Total Premium for all members of the family is Rs. Total Premium when policy is opted on floater basis is Rs.(Not
family is Rs.29,689/-, when each member 29,689/-, when they are covered under a single Applicable)/-, Sum insured of Rs.5 lakhs is available for the entire
is covered separately. Sum insured policy. Sum insured available for each family family (2A+1C)
available for each individual is Rs.5 lakhs member is Rs.5 lakhs
Note: Premium rates specified in the above illustration are standard premium rates without considering Medical Underwriting Loading.

Galaxy Guardian Unique Identification No. GHIHLIP25037V012425 Page 17 of 18

 GALAXY HEALTH INSURANCE COMPANY LIMITED
(Formerly known as “GALAXY HEALTH AND ALLIED INSURANCE COMPANY LIMITED”)
Reg. Office: Prestige Polygon – 12th Top Floor (P), No. 471, Anna Salai, Nandanam, Chennai – 600035.
T: 044 – 4001 7227 I Website: www.galaxyhealth.com I CIN: U65120TN2023PLC165765 IRDAI Reg. No.:167
Prospectus
Premium Chart - Excluding Tax (Rs.)

Family Size : 1A
Age Band/Sum Insured (Rs.) 3,00,000 5,00,000
5 months-17 years 4055 5037
18-25 4971 6147
26-30 5329 6540
31-35 5686 6995
36-40 6670 8114
41-45 7050 8531
46-50 8715 10563
51-55 12383 15066
56-60 16651 20137
61-65 20162 24316
66-70 26906 32301
71-75 32557 39043
>75 38930 46615

Galaxy Guardian Unique Identification No. GHIHLIP25037V012425 Page 18 of 18