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(New Car or Renew from other Insurer)
Health Total is a Comprehensive Retail Health Product with wider and long term coverage.
There are 3 different plans: Vital, Superior and Premiere. All plans are available with individual and floater option and with Lifelong renewal facility.
Family definition:
Vital Plan - Self, spouse, dependent children (unmarried and up to the age of 25 years) and dependent parents
Superior Plan & Premiere Plan - Self, spouse, dependent (unmarried and up to the age of 25 years) or non – dependent children, dependent or non – dependent parents, dependent siblings, daughter in law, son in law, parents in law, grandparents and grandchildren (maximum up to 15 members).
Sum Insured available in the product are as below:
Policy Term:
Day One up to any age
up to Rs 1 Crore
Age upto 50 years in Vital plan: Medical tests not required
Age above 50 years in Vital plan: Medical tests required
Age From 18 years onwards in Superior plan: Medical tests required
Age From 18 years onwards in Premiere plan: Medical tests required
No tests required for children below 18 years for any plan.
** Age in completed yeasured is eligible for 100% of reimbursement of pre-acceptance medical tests charges subject to policy issuance & 64 VB compliance.re policy tests need to be done in the empanelled diagnostic center’s only. test would be valid for a period of one month from the date the tests have been conducted
Hospitalization Medical Expenses, Day Care Treatment expenses, Pre-hospitalization Medical Expenses, Post-hospitalization Medical Expenses, Organ Donor Expenses, Domiciliary Hospitalisation Expenses.
If the Sum Insured and Cumulative Bonus (if any) is exhausted due to claims payable, Restore Sum Insured (equal to 100% of the Sum Insured) will be automatically available for the particular Policy Year subject to T & C.
Maternity benefit with only two years of waiting period when both husband and wife are covered together
Our Health Total now covers Mental Illness treatment at par with physical illness.
It covers Mental illness as per terms & conditions of the policy.
Covered as inpatient hospitalization
Covered as an OPD benefit under Superior & Premiere plan
Patient Care, Accompanying Person, Road Ambulance Charges, Wellness Care, E-Opinion in respect of an Illness or Injury and Alternative Treatment
Increase in the Sum Insured by 25% of the available balance Sum Insured subject to maximum 10 lakhs in case of Accidental Hospitalisation.
We will reimburse expenses under this Benefit incurred for medical evacuation from the place of local Hospitalisation /Accident to any other Hospital within India.
We shall reimburse expenses towards consultation, diagnostic tests and medications prescribed as per plan opted.
We will cover charges for vaccinations for child less than 12 years of age.
(applicable for Superior Plan and Premiere Plan)
(applicable for Premiere Plan)
Patient care, Accompanying Person, Road Ambulance Charges, E-Opinion in respect of an Illness or Injury, Alternative Treatment, Wellness Care
50% for every claims free year to a maximum of 100% * Product coverage’s applicable would be as per plan opted
Covers Mental Illness as well as Physical Illness.
** Outpatient medical expenses. (Applicable for Superior and Premier Plan)
In case of bills for any prescribed drugs/medicines, our liability will be restricted to 80% of admissible bills.
In case of dental consultations and diagnostics, our liability will be restricted to 70% of admissible bills.
Family discount of 10% is available in case more than one person is covered in the same policy in case of Individual Sum Insured option.
Premium applicable for the primary insured will be the standard individual premiums. For remaining dependant members, floater discounts will be applicable on their respective premium as per their age.
Discount of 10% to 25% on premium as per the voluntary deductible and plan opted.
Long-term discount upto 10% applicable in case of upfront premium payment for long term policy.
In case of policies which are on long term basis, facility of instalment payment is available monthly, quarterly and half yearly. Loadings maximum of 5% will be applicable on standard premiums as per the instalment frequency opted.
There will be no loading on premium for adverse claims experience.
Premium paid by any mode other than cash is eligible for tax relief as provided under Section 80-D of the Income Tax Act.
In case an insured enters the policy at age of 60 years and above , copayments will be applicable on each and every admissible claim
Waiting Periods
Buy your Health Insurance Plan Online
Buying your health insurance plan online for you and your Family in simple steps.
Here are the steps to buying online:
Get an Online Quote It takes just a few minutes to generate your quote online. a.Select your policy type.If you are looking for an individual health insurance plan,each individual of a family is entitled to a sum insured you opt.In a family floater,the sum insured is shared by all members of the family in the plan. Get your Health Insurance quote
Fill in Your Proposal Form You need to fill in the proposal form and answer from basic questions about your medical history before you can buy the policy.
Review Your Proposal Review your quote and verify you have provided correct information including your nominee name and the premium you need to pay.
Complete Your Purchase After your confirm your premium and agree to the terms&conditions,select a payment method(Credit Card/Debit Card or Net Banking)and pay securely&conveniently in easy steps and you’re done.
Download Your Policy You can download your policy schedule and print it out.A copy of the policy is also sent to the email address you have provided during the time of registration.
Good health adds years to your life.Secure your family today by buying Future Generali Health Insurance Plan.
When you become a Future Generali Health Customer, you will receive a membership pack containing the following:
Health card to utilise cashless facility at Network hospitals. You can avail discounts offered by our Allied Partners. Check out our FGH Privilege section for more details.
Policy Schedule
Premium Receipt
80D certificate for tax deduction if the premium is paid via Credit Card/Debit Card, Net Banking, or Cheque except cash payment.
Policy coverage and Terms & Conditions
You can intimate your claim online or submit the form to your branch office or alternatively email
Should you have any complaints/feedback, you can fill in the form and submit it to the nearest branch or email us.
Procedure along with list of ombudsman addresses. In case you are not satisfied with the resolution to the complaint as provided by us, you may approach the Insurance Ombudsman for review.
You can expect to receive this pack within 12-15 working days of purchasing our health insurance.
Making a Claim
At Future Generali, we will do everything to make your claim as simple and convenient. And here are few reasons why:
We have an in-house claim settlement team that processes your Cashless claims within 90 minutes from the time we receive your Cashless Request and Reimbursement claims within 10 working days from the time we receive your complete claim documents.
In order to get the periodic update on your claim, please ensure to mention your Mobile Number and e-mail Id on the claim form.
Find out more about how to make a claim or check out our claim process.
In-house team of professionals who can give specialised advice.
Contact our Helpline
In case you wish to speak to our experts about your policy, you can call us on:
1800-220-233
Comprehensive cover Hospitalization Medical Expenses,Day Care Treatment expenses,Pre-hospitalization Medical Expenses,Post-hospitalization Medical Expenses,Restoration of the Sum Insured,Maternity Expenses,Organ Donor Expenses,Road Ambulance Charges,Domiciliary Hospitalisation Expenses,New Born Baby (applicable for Superior Plan and Premiere Plan),Alternative Treatment,Wellness Care,Cumulative Bonus,100% Reimbursement of cost of pre insurance medical examination upon acceptance of proposal,Cover up to 15 family members under Superior and Premiere plan,Patient Care,Accidental Hospitalization (Increase in sum insured),Accompanying Person,Emergency medical Evacuation (applicable for Superior Plan and Premiere Plan),Out Patient Medical Expenses (applicable for Superior Plan and Premiere Plan),Child Vaccination Benefits (applicable for Premiere Plan),E-Opinion in respect of an Illness or Injury,Medical Treatment Abroad (applicable for Premiere Plan)
Optional Covers You get Long term discount if you pay premium for more than one year.,You get discounts in premium if you choose to opt voluntary deductible are chosen.
You can choose from 3 plan types ( Vital, Superior and Premier).
Plan - Sum insured (in Rs ) Vital - 3, 5, 10 lakhs Superior - 15, 20, 25 lakhs Premiere - 50 lakhs, 1 Crore.
The age eligibility of the insured for taking the policy is the Entry age. Age will mean completed age as on last birthday.
The minimum age required for entry is 1 day. There is no limit of Maximum age for entry. Children will be covered as dependents up to 25 years of age.
No, there is no exit age in this policy.
A nominee can be spouse, children or parents.
Vital Plan: Self, spouse, dependent children and dependent parents.Children will be covered as dependents up to 25 years of age.
Superior and Premiere Plan: Self, spouse, dependant or non-dependent children, dependent or non-dependent parents, Dependent Siblings, daughter in law, son in law, parents in law, grandparents and grandchildren.
Yes Senior citizens can apply for the cover as there is no limit on entry age.
Yes. Premium paid by any mode other than Cash / DD under the Policy shall be eligible for income tax benefit under Sec 80 D of the Income Tax Act and any amendments thereon.
When an insured is hospitalized and stays in hospital for more than 24 hours solely for receiving treatment it is termed as inpatient treatment.
Out-patient treatment is when insured visits a clinic/hospital or a consultation room for diagnosis and treatment based on the advice of medical practitioner. In out-patient hospitalizationpatient is not admitted under a day care or as an in-patient.
Day care Procedure means the course of medical treatment or a surgical procedure listed in the Policy wordings which requires less than 24 hours admission. This excludes all procedures or treatment taken in out- patient departments.
Hospitalization under Ayurveda, Unani, Siddha, or Homeopathy (AYUSH ) are covered provided that the treatment has been undergone in a government hospital or in any institute recognized by government and / or accrediated by Quality Council of India / National Accreditation Board on Health for that Alternative treatment.
Future Generali under this policy will pay the Reasonable and Customary Charges incurred for an organ donor’s treatment for the harvesting of the organ donated provided that:
The organ donor is any person whose organ has been made available in accordance and in compliance with the Transplantation of Human Organs Act, 1994 and the organ donated is for the use of the Insured Person;
We will not pay the donor’s screening expenses or pre and post hospitalisation expenses or for any other medical treatment for the donor consequent on the harvesting;
We have accepted claim under Hospitalisation medical expenses for the Insured Person and the Insured Person has been Medically Advised to undergo an organ transplant;
Costs directly or indirectly associated with the acquisition of the donor’s organ will not be covered.
If an Insured Person suffers an Illness or Injury during the Policy Period in respect of which a claim has been admitted under Hospitalisation medical expenses then at the Insured Person’s request We will arrange a maximum of two e-opinions (in a Policy Year) from a Medical Practitioner selected by the Insured Person from Our panel. The e-opinion will be based only on the information and documentation provided to the Medical Practitioner by or on behalf of the Insured Person.
If the Sum Insured and Cumulative Bonus (if any) is exhausted due to claims incurred and paid during the Policy Year or incurred during the Policy Year and accepted as payable, then it is agreed that a Restore Sum Insured (equal to 100% of the Sum Insured) will be automatically available for the particular Policy Year, provided that:
The Restore Sum Insured will be enforceable only after the Sum Insured and the Cumulative Bonus have been completely exhausted in that Policy Year;
The Restore Sum Insured can only be used for claims made by the Insured Person in respect of Benefits 1-4 (refer policy wordings).
The Restore Sum Insured cannot be used for claims based on Maternity Expenses/Treatment;
The Restore Sum Insured can be used for only future claims made by the Insured Person and not against any claim for an Illness (including its complications) for which a claim has been paid in the current Policy Year under Benefits 1-4(refer policy wordings).
Only the Sum Insured (excluding Cumulative Bonus) will be considered as Restore Sum Insured;
The Restore Sum Insured will only be applied once for the Insured Person during a Policy Year;
If the Restore Sum Insured is not utilised in a Policy Year, it shall not be carried forward to any subsequent Policy Year.
If the Policy is opted by You on a ‘Family Floater’ basis as specified in the Schedule, then the Restore Sum Insured will only be available in respect of claims made by those Insured Persons who were Insured Persons under the Policy before the Sum Insured and Cumulative Bonus was exhausted.
This is a health insurance policy which covers inpatient hospitalization expenses. In this cover, single sum insured floats/is shared by all family members.
The customer has to first pay the tests charges for his pre policy tests directly to the diagnostic centre. Upon acceptance of the proposal by Future Generali and issuance of policy for that member, customer can claim for 100% reimbursement by submitting the original payment receipt.
Yes 10 % Family discount will be given under Individual Health Total in case insured members are more than one under a policy. No family discount is applicable for floater policy.
Change in Sum Insured /Plan can be done at renewals only. No increase/decrease in Sum Insured/Plan is allowed during the currency of the policy. Increase in Sum Insured can be allowed up to two slabs higher, whereas increase in Plan can be allowed up to one plan higher.
For age group above 60 years, increase in Plan would not be allowed.For age group up to 50 years increase in sum insured up to Rs 10Lacs (within Vital Plan) can be allowed without medical examination (in case of no claim / no health declaration). For Superior/Premiere Plan (Sum Insured above 10 lakhs), medical examination is required irrespective of age.
For age group above 50 years increase in sum insured can be allowed with medical examination.Decrease in Sum Insured allowed up to one slab lower only, in case of no claim in any preceding Health Total policies.
The Dependent Sum insured criteria will apply for enhancement of sum insured for dependent.Sum insured enhancement would be allowed for age group lower than 50 years in case of portable policies.
In case of individual Sum Insured option, dependents sum insured can be upto two Sums Insured lower than Self /Proposer’s sum insured
In case of our renewal a grace period of 30 days is permissible and the Policy will be considered as continuous for the purpose of all waiting periods and health check-up benefits. However, We shall not provide coverage under the Policy to the Insured Persons for any Illness or Injury that occurs during the break period or for any claim which arises during the break period.
Cumulative Bonus means any increase in the sum insured granted by the insurer without an associated increase in premium.
If no claim has been made in respect of any Benefits with the exception of any claim under Benefit 13 (OPD Treatment) and the Policy is Renewed with Us without any break, We will apply a bonus to the next Policy Year by automatically increasing the Sum Insured for the next Policy Year by 50% of the Sum Insured for this Policy Year. The maximum bonus for any Policy Year will not exceed 100% of the Sum Insured of the first Policy Year.
If a Cumulative Bonus has been applied and a claim is made, then in the subsequent Policy Year We will automatically decrease the Cumulative Bonus by 50% of the Sum Insured in the following Policy Year. However this reduction will not reduce the Sum Insured below the base Sum Insured of the Policy.
Our obligation to make payment in respect of Surgery for cataracts (after the expiry of the two years waiting period), shall be restricted to 10% of the Sum Insured for each eye, and a maximum of Rs.1,00,000/- per eye.
24 months waiting period for: Pre existing conditions, Internal Congenital Anomalies, Cataracts, Benign Prostatic Hypertrophy Hernia of all types, Deviated Nasal Septum, Hypertrophied Turbinate, Hydrocele, All types of sinuses Fistulae, haemorrhoids, fissure in ano, Dysfunctional uterine bleeding, Fibromyoma, Endometriosis, Hysterectomy, All internal or external tumors/cysts/nodules/polyps of any kind including breast lumps with exception of malignant tumor or growth. Surgery for prolapsed inter vertebral disc unless arising from Accident, Surgery of varicose veins and varicose ulcers, any types of gastric or duodenal ulcers, stones in the urinary and biliary systems, Surgery on ears and tonsils.
48 months waiting period for Organ transplant, Rheumatoid Arthritis, Gout, Joint replacement due to degenerative condition age related osteoarthritis, Osteoporosis , unless such joint replacement surgery is medically necessary due to injury.
First 30 days waiting period for For medical expenses incurred for any illness diagnosed or diagnosable except those incurred as a result of Injury.
The treatment of obesity (including morbid obesity) and other weight control programs, services and supplies. External Congenital Anomaly and related Illness/ defect.
Vitamins, tonics, nutritional supplements unless forming part of the treatment for Injury or Illness as certified by the attending Medical Practitioner. Genetic disorders and stem cell implantation/Surgery/storage. Treatment for any mental illness or psychiatric illness.
Expenses incurred towards treatment of Illness or Injury arising out of alcohol use/misuse or abuse of alcohol, narcotic substance or drugs (whether prescribed or not).
Any treatment received in convalescent home, rehabilitation centre, convalescent hospital, health hydro, nature care clinic or similar establishments.
Non-prescribed drugs and medical supplies, hormone replacement therapy, sex change or treatment which results from or is in any way related to sex change.
Any treatment required arising from Insured Person’s participation in any hazardous activity including but not limited to scuba diving, motor racing, parachuting, hang gliding, rock or mountain climbing unless specifically agreed by Us.
Any expenses in excess of the maximum amount payable under the outpatient medical expenses limit specified in the Schedule of Benefits.
Any expenses for OPD Treatment including dental expenses in case of Vital Plan.
Any expenses for prescribed medications in case of Superior Plan.
Any expenses for consultation, diagnostics, medications which are not duly supported with medical documents from the Medical Practitioner mentioning:
-Diagnosis;
-Referral for diagnostic test;
-Prescription for medications.
Costs incurred on all methods of treatment except Allopathic.
Network Provider means hospitals or health care providers enlisted by Future Generali to provide medical services to an insured on payment by a Cashless Facility.
(Please note: The Hospitals which have been empanelled by Us as Network Providers are as per the latest version of the schedule of Hospitals maintained by Us, which is available to You on request.)
Non-Network Provider means any hospital, day care centre or other provider that is not part of the network.
You may call on our 24 hours call center on 1800 103 8889 or Fax on 1800 103 9998.
Or mail us on fgh@futuregenerali.in
Call Centre will assist you with emergencies, your eligibility and status, documentation support and general information on the health policy. Call center will not impart any medical advice on the telephone.
The cashless facility can be availed in case of admission in network hospitals. If the policy holder presents the heath card or cashless card at the network hospital, the hospital authorities contact us and provide the details of the hospitalization. If the illness is covered as per the policy terms and conditions Authorization letter is issued to the hospital. The hospital sends all the bills and documents to us for settlement. The insured has to pay the non-admissible expenses to the hospital.
Claim-Reimbursement If the admission is in Non-network hospital then you need to settle the hospitals bills & submit the hospitalization documents along with the claim form for reimbursement of hospitalization expenses.
In case of Emergency hospitalization You need to notify us at the earliest and not later than 48 hours from the time of hospitalization or prior to discharge whichever is earlier. In case of planned admission you need to notify atleat 48 hours in advance prior to admission in the hospital.
You can submit your claim documents at our nearest branch office or you may even send documents at the following address.
Claims Department Future Generali Health (FGH) Future Generali India Insurance Co. Ltd. Office No. 3, 3rd Floor, “A” Building , G - O – Square S. No. 249 & 250, Aundh Hinjewadi Link Road, Wakad, Pune - 411 057. Toll Free Number: 1800 103 8889 Toll Free Fax: 1800 103 9998 Email: fgh@futuregenerali.in
In case of Individual policy it is as per the age band and the sum insured selected by the customer.
In case of family floater the premium for the primary insured remains at actuals from the individual table. For remaining dependent members discounts applicable on their respective premium is as table below.
Proposals with health declarations may also be advised Pre policy medical examinations irrespective of age.
Pre policy tests need to be done in the empanelled diagnostic centers only.
The test would be valid for a period of one month from the date the tests have been conducted.
With Health Total, we can give you a comprehensive cover, a near –perfect answer to all your medical needs.
Specialist claims service and claims settlement within 14 working days***
Port your existing policy with us to opt for our benefits and services. Portability can be offered as per the Portability guidelines of IRDAI.
You can renew your Policy within 30 days from the date of expiry of your policy .
Not satisfied with the coverage, and terms and conditions of the policy, opt for cancellation of the policy within 15 days from the date of receipt of the policy documents, provided there has been no claim and you shall be entitled to a refund as per the Policy terms and conditions.
*Refer our brochure for Pre-acceptance Medical Tests.
DOWNLOADS
DOWNLOADS Brochure Proposal Form / Prospectus Claim Form
Disclaimer For complete details of Policy coverage, terms, conditions and exclusions, please refer the policy wordings. Click here to view Policy Wordings.
*Subject to Terms & Conditions and Waiting Periods given in Policy Wordings
Product Name:-Health Total UIN NO:-FGIHLIP21163V022021 Launch Date:-1st October 2020
Sanket Shah
Ganpat R Mali
N. Yogeshwaran
Vijay Vagdoda
Kaizad Mistry
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