Welcome to L&T Insurance

In todays age of hectic work and busy schedules, we rarely have the time to take proper care of ourselves. And more often than not, our health takes a backseat. Though the negligence may not be deliberate, the stress of everyday life has made us even more susceptible to health risks. With an increased cost of living and continuously growing expenses, treatment for even the most common illnesses can easily burn a hole in our pockets. At L&T Insurance, we put ourselves in your shoes and keep every detail in mind while designing your health plan. We understand that your familys health is the most precious to you. Which is why we offer you a thoughtful and holistic health insurance plan to reduce your concerns and let you enjoy absolute peace of mind.

my:health Medisure Classic Insurance

L&T Insurance presents my:health Medisure Classic Insurance, a meticulously designed insurance solution that understands your family's unique health needs and provides you with a step-by-step plan to ensure their complete well-being. Especially designed through a scientific process, my:health plans enables you to quickly bounce back from a medical emergency so that you can continue to spend and cherish your time with your loved ones.

What does my:health Medisure Classic Insurance Cover

At L&T Insurance, we make sure that most of your medical expenses are taken care of in case of a medical emergency. my: health Medisure Classic Insurance covers:

1. Basic Cover
Hospitalisation Expenses

For treatment of any disease, illness or injury in a Hospital as an in-patient which includesFees of Surgeon, Anesthetist, Nurses and Specialists; Cost of Operation Theatre, diagnostic tests, medicines, blood, oxygen and internal appliances like pacemaker as long as these are medically necessary;

Treatment should be for a continuous period and includes relapse within 45 days from the date of last consultation at the Hospital / Nursing Home. Occurrence of same illness after a lapse of 45 days will be considered as fresh illness.

Hospitalisation as In Patient for a minimum period of 24 hours subject to the limits set belowRoom Rent / Boarding & Nursing as per actuals limited to 1% of the Sum Insured (excluding cumulative bonus) per day subject to a maximum of `4,000/- per day ICU Rent / Boarding & Nursing as per actuals limited to 2% of the Sum Insured (excluding cumulative bonus) per day subject to a maximum of `6,000/- per day.

Expenses on account of Room Rent / ICU Boarding & Nursing if incurred higher than the limits above, shall be reduced in the same proportion as such actual costs bears to the eligible limits above. Such limits shall not apply where Optional Cover for Waiver of Room Rent Sub-limits has been opted;

Pre-hospitalisation expenses upto 30 days Post-hospitalisation expenses upto 60 days Day Care Procedures which requires less than 24 hours Hospitalisation due to advancement in technology. Any treatment in an out patient department or diagnostic procedures are not covered.

Domiciliary Hospitalisation: Coverage for medical treatment requiring hospitalisation, taken at home on advice of the attending medical practitioner, due to non-availability of a hospital bed, which continues for at least 3 days. Coverage is extended for pre-hospitalisation expenses incurred upto 30 days. However, the post-hospitalisation expenses are not covered.

Hospitalisation due to Accident: If, during the term of your policy, the entire Sum Insured gets used up or is not enough to cover your second hospitalisation due to accident, the Sum Insured of your policy is reinstated or replenished to the extent of the claim amount (but not exceeding the Sum Insured) to cover this hospitalisation. This additional amount will be available only ONCE during the 12-month Policy Year.

Maternity and New-born baby Cover

Coverage towards maternity expenses and new-born baby cover upto the limit of Sum Insured below:

Maximum of 10% of Sum Insured or `20,000/- for a normal delivery and 20% of Sum

Insured or `40,000/- for a caesarean section or actual cost, whichever is lower. Coverage is applicable only for the first two children and / or termination(s). Coverage is limited to the female member who has been covered under any Policy issued by us for a continuous period of 48 months. New-born baby covered for a period of 90 days from date of birth within the maternity limits. Ayurvedic Treatment: Coverage for cost of (non cosmetic) Ayurvedic treatment upto `25,000 per Policy Year, with prior approval from the Company requiring 24 hours hospitalisation / residential inpatient with government registered hospital for the specified treatments (For details refer the Prospectus). Coverage for Ayurvedic treatments is applicable subject to terms, conditions, definitions, waiting periods and exclusions under the Policy. Pre-existing Diseases: After 36 months of continuous renewals, from the 4th year you can claim the payment of relevant medical expenses incurred on your pre-existing diseases.

2. Optional Covers
You can also avail of our Optional covers on payment of additional premium. Double Sum Insured for Critical Illness Provides for an additional cover equivalent to the Sum Insured excluding the cumulative bonus (which essentially doubles the sum insured) for treatment of - Cancer, Kidney Failure, Multiple Sclerosis, Primary Pulmonary Hypertension, Major Organ Transplant, Aorta Graft Surgery, Coronary Artery Bypass Graft, First Heart Attack and Stroke. Additional Sum Insured (excluding cumulative bonus) is exclusively available only for the treatment of the first occurrence of the above Critical Illnesses. Coverage will not be extended for the same Critical Illness for any subsequent Policy Year, however, the remaining critical illnesses will continue to be covered. This coverage is in addition to the Hospitalisation cover and the cumulative Sum Insured under both could be used for any Critical Illness event. The option can be availed only up to the age of 65 years (age last birthday) and for Sum Insured of `2 Lacs and above. For customers who avail of such option at or before that age, the cover shall continue to be available in the case of continuous renewals. Waiver of Room Rent Sub-limits The limits under the Basic Cover of Hospitalisation Expenses for Room Rent may be waived subject to the overall limit of Sum Insured on payment of an additional premium. This Option can be availed during inception of the Policy or at the time of renewal, thereafter.

Other Features of my:health Medisure Classic Insurance

It is our constant endeavour to give you the plan best suited to your requirements. Equipped with various innovative features, L&T Insurances my:health Medisure Classic Insurance offers you the following additional features: Hospital Cash: `500 per day from 4th to 10th day when hospitalisation exceeds 3 continuous days. Ambulance Charges: Maximum upto `1,500/- per hospitalisation. Recovery Benefit: `5,000/- when hospitalisation exceeds 10 continuous days or more. Health Check-Up: For all Insured Persons at the end of four continuous claim free Policy Years, limited to 1% of average Sum Insured excluding cumulative bonus, per person in case of Individual Policy and for all members put together in case of a floater. Family Floater: You can cover upto 4 members of your family your lawful spouse and 2 dependent children upto the age of 23 years - under a single policy and single sum insured. Family Discount: If you opt for Individual Sum Insured for each of your family members under a single policy instead of a Family Floater option, we give you a Family Discount of 10% on the total premium payable for covering more than 2 family members. This will include you, your lawful spouse, dependent children and dependant parents only. The Family discount will be available for a maximum of 6 persons only. Cumulative Bonus: The Sum Insured of your policy progressively increases by 5% on every renewal, for every claim-free year, subject to a maximum accumulation of 50% of your sum insured (if a claim is made, the Cumulative Benefit that has accrued will be reduced by 20% however, the basic Sum Insured will be maintained at all times).

Two year policy Option: A discount of 5% is available on the combined premium for both the years. Life time renewal of policy Income Tax Benefit: You can get tax exemption on the premium paid under section 80D of the Income Tax Act.

Free-look Period: If you are not satisfied with our coverage or terms, you have the option of cancelling the policy within 15 days, provided there has been no claim.

How to Cancel your Policy

In case you are not content with our policy and wish to cancel it, you may intimate us by giving 15 days notice in writing and we will refund the premium for the unexpired term as per the short period scales given below: Period of Cover up to 1 Month 3 Months 6 Months Exceeding Six Months up to 365 days Company. For two year policies, we will retain 15% of the premium for the balance period. Eg. A 2 Year policy is issued for 730 days. Refund of Annual Premium rate (%) 75% 50% 25% NIL

A minimum premium of `250 per policy will be retained towards administration charges by the

Cancellation request is received on day 395 (1 year and 1 month) The amount refunded will be calculated as follows: The amount to be refunded will be 15% less than the pro-rata premium for the balance period. If 2 year premium is `1000. Utilised period is 395 days, unutilised period is 335. Pro-rata premium for unutilised premium will be `458.9. Refund amount shall be `458.9 15% i.e. (`458.9 `68.83) = `390 No refund will be given if you have lodged a claim under the policy.

Get the L&T Advantage

For over 7 decades, across industries, the L&T Group has practised and perfected incisive solutions and its precise delivery. We are a state-of-the-art, technologically-driven company that has the calibre and expertise to provide world-class customer service. Claims Service Assurance* We make cashless decision within 6 business hours (where the request is received between 9 am to 9 pm on Monday to Saturday) giving you the advantage of time and convenience. During non-working hours and on any other holiday/s, the decision will be in a maximum of 8 hours. Reimbursement claim settlements are made within 6 working days on receipt of complete set of documents. In case we fail in meeting this assurance, a fixed compensation of `1,000/- shall be payable for a single claim. Assurance is applicable only to the first response on a single claim and no subsequent correspondence.

The above compensation shall be paid notwithstanding the Companys obligation to pay interest in cases of delay in settlement of claims, as per Reg. 9(6) of IRDA (PPH) Regulations. *Service features are inbuilt in to the policy and will be available to all Insured Persons without any additional cost. We combine innovative and unique product benefits coupled with seamless customer support to make sure our approach to your life is a thoughtful one. At L&T Insurance, your health is our priority.

FAQs
Q. Can my:health Medisure Classic Insurance cover my entire family? Are there any age limits? The Proposer, Spouse, Dependent Children, Dependant Parents and blood relatives can be covered under the Individual Policy. For a floater, Self, Spouse and Dependent Children upto 23 years can be covered under a Single Policy. The following criteria are applicable if you wish to cover you family under a policy: Minimum age at entry will be 3 months for children and 18 years for adults. Entry and renewals are available for Lifetime. Children between the age of 3 months (91 days) and 18 years will be covered only if either of the parent is covered. Optional Cover of Double Sum Insured for Critical Illness only up to the age of 65 years (age last birthday) and for Sum Insured of `2 Lacs and above. For customers who avail of such option at or before that age, the cover shall continue to be available in the case of continuous renewals.

The availability of Optional Cover of Waiver of Room Rent Sub-limits under hospitalisation is for lifetime.

Q. What will be my Sum Insured? With my:health Medisure Classic Insurance, the amount will differ depending on the type of policy you have opted for. 1 Lac to 5 Lacs in multiples of 1 Lac for Individual Policies 2 Lacs to 5 Lacs in multiples of 1 Lac for Floater Policies

Q. What is not covered in my policy? The following ailments are not covered During the first 2 years of the policy - Cataract, benign prostatic hypertrophy, congenital internal diseases, and fistula in anus, piles, and hysterectomy for Menorrhagia or Fibromyoma, hernia, sinusitis and related disorders. Pre-existing disease / illness / injury / condition will not be covered for first 3 years of the policy. Any disease contracted during the first 30 days from start of policy. Suicide, self-inflicted injury or illness, treatment for mental disorder, anxiety, stress or depression, use of alcohol or drugs. Diseases such as AIDSs or HIV and its complications.

Note: For detailed list of exclusions please refer to the prospectus, visit our website www.ltinsurance.com or contact our Insurance Partner.

Q. What is the premium payable for my:health Medisure Classic Insurance? The Premium will be based on the age, total number of persons you wish to cover, the policy tenure and Sum Insured you opt for. For complete details on the premium structure, please visit us at www.ltinsurance.com or call us at 1800-209-5846 or visit our nearest office or contact our insurance partner. Q. How do I get my:health Medisure Classic Insurance Policy? 1.1 All Individuals upto 50 years (age last birthday) - The Company will rely on the declarations made on the Proposal Form. In case the declaration reveals any medical adversity, the Company may require the individual to undergo appropriate medical tests. 1.2 For age group 51 - 65 years (age last birthday) - The Individuals would be required to undergo pre-acceptance medical tests - Medical Examination Report, Treadmill Test, Lipid Profile, HbA1C, Serum Creatinine, Complete Blood Count, Urinalysis. 1.3 For the following category: Medical Tests Requirement Medical Examination Report, Treadmill Test, Complete Blood Count, Lipid Profile, HBA1C, Serum Creatinine, Urinalysis, SGOT, SGPT and GGT

Scenarios Age group 66 yrs and above Age group 51 - 65 years with Optional Cover for Double Sum Insured for Critical Illness Optional Cover for Double Sum Insured for Critical Illness at Renewal with or without Claim irrespective of age Age last birthday to be considered

The Company reserves its right to require any individual to undergo such medical tests or where required any further additional tests, at the sole discretion of the Company to determine the acceptance of a Proposal. Some of the objective criteria defined as under Individual cover without family members. Minor lives without parents cover. Residential risk, eg. Screening for H1N1 in Maharashtra belt, LFTs for residents of Kubernagar and Charanagar etc. Family History , eg. Double Family History of Diabetes etc. Disproportionately high Sum Insured in relation to declared income. No adverse medical history declared but BMI beyond average levels. Renewals of policies where claims were repudiated for non disclosure / PED.

All Medical reports need to be within 30 days from date of Proposal Form and can be conducted at the Companys list of Network Hospitals / Clinics. In case of accepted proposals, the Company shall reimburse 50% of the pre-acceptance medical test costs.

Q. How do I lodge a claim under my:health Medisure Classic Insurance? There are various methods to lodge a claim under my:health Medisure Classic Insurance. For cashless* hospitalisation: (*cashless facility is available only at our network hospitals) All you have to do is contact us at the numbers provided on your health card immediately. Just submit a Cashless Request form to us, along with all information and documents pertaining to the illness as required. Our representative will be happy to guide you further and help you process the request. Based on the coverage under your policy, the cashless request will be approved. For a reimbursement of expenses: (at other hospitals outside of our network) or at network hospitals where cashless is not availed: You will need to collate the original bills along with other documents as required and submit it to the address mentioned in your policy schedule. In case of planned hospitalisation, please inform us 72 hours in advance and in case of emergency within 24 hours of admission. (For detailed information on our network of hospitals as well as documentation for cashless claims please visit www.ltinsurance.com) Q. What is the claims settlement procedure? Our Claims settlement procedure is quick and transparent. For any kind of support or information, please call our helpline 1800 102 3243 or write to us at [email protected]. Undue delay in intimation of claim or submission of documents may prejudice a claim.

To understand the claims process in detail, and to get a checklist of the documentation, please visit www.ltinsurance.com and view the claims process section. Q. How do I avail of continuity benefits on renewal of my policy? You can renew your policy within 15 days after its expiry. By doing so, you will be eligible to continuity benefits like the cumulative benefit and others. If you do not renew your policy within 15 days, it will be treated as a new / fresh policy. Change in Sum Insured may be allowed on renewals. Waiting periods will apply for the enhanced amount. The Company reserves its rights to vary the premium from time to time subject to approval of IRDA. Q. Does my policy have the option of portability? Portability will be provided on your policy in accordance to IRDA guidelines issued on Portability. Disclaimers:L&T Insurance is the brand of L&T General Insurance Company Ltd. Registered Office: L&T House, Ballard Estate, N.M. Marg, Mumbai - 400 001. Corporate Office: 6th Floor, City 2, Plot no. 177, CST Road, Near Bandra-Kurla Telephone Exchange, Kalina, Santacruz East, Mumbai - 400 098, INDIA. Insurance is subject matter of the solicitation. IRDA Reg. No. 146

Reach us at the touch points below

Toll - free No.: 1800-209-5846 (1800-209-LTIN) SMS: LTI to 5607058 (56070LT). We will call you back. Email: [email protected] Write to us: L&T General Insurance Company Limited 6th Floor, City 2, Plot no. 177, CST Road, Near Bandra-Kurla Telephone Exchange, Kalina, Santacruz East, Mumbai 400098, INDIA Website: www.Ltinsurance.com

The product literature gives the salient features of the Policy only. Actual benefits and coverage are described in the Policy and will be subject to Policy terms, conditions and exclusions. For further details on all the conditions and for complete information please visit our website www.Ltinsurance.com
LTGICL/HL-10

Registered Office: L&T General Insurance Company Limited, L&T House, N.M. Marg, Ballard Estate, Mumbai - 400001. IRDA Registration No. 146. Insurance is the subject matter of solicitation.