Family Health Optima Insurance Plan Unique Identification No.: SHAHLIP22030V062122 PROS / FHO / V.8 / 2021 1 of 11 The product provides for regular hospitalization benefits on floater basis ò Who can take this insurance?

Any person aged between 18 years and 65 years can take this insurance for his/her family consisting of Self, Spouse and dependent children not exceeding three in number, dependent Parents and dependent Parents-in-law. Beyond 65 years, only renewals are allowed. Dependent children are covered from 16 th day of its birth till expiry of the policy subject to the limits mentioned above. If, at the commencement of the policy, the new born child is less than 16 days of age, the proposer can opt to cover such new born child also in the same policy by paying the applicable premium in full. However, the cover for such new born child will commence only from the 16th day of its birth and will continue till the expiry date of the policy. Maximum age limit for coverage of dependent children is 25 years.

ò Policy term: 1 year

ò Type of Policy: Floater

ò Sum Insured Options: Rs.3,00,000/-, Rs.4,00,000/-, Rs.5,00,000/-, Rs.10,00,000/-, Rs.15,00,000/-, Rs.20,00,000/- and Rs.25,00,000/-

Note: Sum Insured options of Rs.1,00,000/- and Rs.2,00,000/- are available only for renewals

ò Pre-acceptance medical screening: All persons above 50 years of age and those who declare adverse medical history in the proposal form are required to undergo pre-acceptance medical screening at the Company designated Centers. At present 100% of cost of medical screening is borne by the Company. The age for Health screening may be scaled downwards or upwards. Due advance information will be given to the customer.

ò Instalment Facility available: Premium can be paid Quarterly and Half-yearly. Premium can also be paid Annually.

For instalment mode of payment, there will be loading as given below:

Quarterly: 3%

Half Yearly: 2%

ò What are the benefits available under the insurance? A. Room, Boarding, Nursing Expenses all inclusive as provided by the Hospital / Nursing Home as per the limits given below;

Note: Expenses relating to hospitalization will be considered in proportion to the eligible room rent/room category 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 category. 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, dialysis, chemotherapy, radiotherapy, cost of pacemaker, stent and similar expenses. With regard to coronary stenting, medicines, Implants and such other similar items the Company will pay cost of stent as per the Drug Price Control Order (DPCO) / National Pharmaceuticals Pricing Authority (NPPA) Capping.

D. All day care procedures are covered.

Expenses on Hospitalization for a minimum period of 24 hours only are admissible. However this time limit will not apply for the day care treatments / procedures, where treatment is taken in the Hospital / Nursing Home and the Insured is discharged on the same day.

E. Expenses incurred on treatment of Cataract is subject to the limit as per the following table;

F. Emergency Road ambulance charges up-to a sum of Rs. 750/- per hospitalization and overall limit of Rs. 1,500/- per policy period for transportation of the insured person by private ambulance service when this is needed for medical reasons to go to hospital for treatment provided there is an admissible claim for hospitalization under the policy.

G. Air Ambulance charges up to 10% of the Sum Insured during the entire policy period, provided that

1. It is for life threatening emergency health condition/s of the insured person which requires immediate and rapid ambulance transportation to the hospital/medical centre that ground transportation cannot provide. 2. Necessary medical treatment not being available at the location where the Insured Person is situated at the time of Emergency 3. It is prescribed by a Medical Practitioner and is Medically Necessary; 4. The insured person is in India and the treatment is in India only 5. Such Air ambulance should have been duly licensed to operate as such by Competent Authorities of the Government/s

Note: This benefit is available for sum insured options of Rs.5,00,000/- and above only.

H. Relevant Pre-Hospitalization medical expenses incurred for a period not exceeding 60 days prior to the date of hospitalization, for the disease/illness, injury sustained following an admissible claim for hospitalization under the policy. I. Post Hospitalization medical expenses incurred for a period of 90 days from the date of discharge from the hospital towards Consultant fees, Diagnostic charges, Medicines and Drugs wherever recommended by the Hospital / Medical Practitioner, where the treatment was taken, following an admissible claim for hospitalization provided however such expenses so incurred are in respect of ailment for which the insured person was hospitalized. J. Domiciliary Hospitalization: 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

1. The condition of the patient is such that he/she is not in a condition to be removed to a Hospital, or

2. The patient takes treatment at home on account of non-availability of room in a hospital.

However, this benefit shall not cover Asthma, Bronchitis, Chronic Nephritis and Nephritic Syndrome, Diarrhoea and all types of Dysenteries including Gastro- enteritis, 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. K. Organ Donor Expenses for organ transplantation where the insured person is the recipient are payable provided the claim for transplantation is payable and subject to the availability of the sum insured. Donor screening expenses and post-donation complications of the donor are not payable. This cover is subject to a limit of 10% of the Sum Insured or Rupees One lakh, whichever is less. L. Cost of Health Checkup: Expenses incurred towards cost of health check-up up to the limits mentioned in the table given below for every claim free year provided the health checkup is done at network hospitals and the policy is in force. If a claim is made by any of the insured persons, the health check up benefits will not be available under the policy.

Note:

1. This benefit is payable on renewal and when the renewed policy is in force 2. Payment under this benefit does not form part of the sum insured and will not impact the Bonus

Note: Payment of any claim under this benefit shall not be construed as a waiver of Company's right to repudiate any claim on grounds of non disclosure of material fact or pre-existing disease, for hospitalization expenses under hospitalization provisions of the policy contract

Sum Insured (Rs.) Room Rent Limit (Rs.)

1,00,000/- and 2,00,000/- Up to 2,000/- per day

3,00,000/- and 4,00,000/- Up to 5,000/- per day

5,00,000/-, 10,00,000/-, 15,00,000/-,

20,00,000/- 25,00,000/-

Single Standard

A/C Room

Sum Insured (Rs.) Limit per eye (Rs.) Limit per policy period (Rs.) 1,00,000/- and 2,00,000/- Up to 12,000/- per eye, per policy period 3,00,000/- Up to 25,000/- Up to 35,000/-

4,00,000/- Up to 30,000/- Up to 45,000/-

5,00,000/- Up to 40,000/- Up to 60,000/-

10,00,000/-, 15,00,000/-

20,00,000/- 25,00,000/- Up to 50,000/- Up to 75,000/- FAMILY HEALTH OPTIMA INSURANCE PLAN

Unique Identification No. : IRDAI/HLT/SHAI/P-H/V.III/129/2017-18 PROSPECTUS - FAMILY HEALTH OPTIMA INSURANCE PLAN

Unique Identification No.: SHAHLIP22030V062122

STAR HEALTH AND ALLIED INSURANCE COMPANY LIMITED

Regd. & Corporate Office: 1, New Tank Street, Valluvar Kottam High Road, Nungambakkam, Chennai - 600 034. « Phone : 044 - 28288800 « Email : adpkp2@r.postjobfree.com Website : www.starhealth.in « CIN : U66010TN2005PLC056649 « IRDAI Regn. No. : 129 Sum Insured (Rs.) Limit Per Policy Period (Rs.)

1,00,000/- and 2,00,000/- Not Available

3,00,000/- Up to 750/-

4,00,000/- Up to 1,000/-

5,00,000/- Up to 1,500/-

10,00,000/- Up to 2,000/-

15,00,000/- Up to 2,500/-

20,00,000/- Up to 3,000/-

25,00,000/- Up to 3,500/-

Family Health Optima Insurance Plan Unique Identification No.: SHAHLIP22030V062122 PROS / FHO / V.8 / 2021 2 of 11 M. Hospitalization expenses for treatment of New Born Baby: The coverage for New Born Baby starts from the 16th day after its birth till the expiry date of the policy and is subject to a limit of 10% of the Sum Insured or Rupees Fifty thousand, whichever is less, subject to the availability of the sum insured, provided the mother is insured under the policy for a continuous period of 12 months without break.

Note:

1. Intimation about the birth of the New Born Baby should be given to the company and policy has to be endorsed for this cover to commence. 2. Exclusion no. 3 (Code Excl 03) as stated under this policy shall not apply for the New Born Baby

3. All other terms, conditions and exclusions shall apply for the New Born Baby N. Emergency Domestic Medical Evacuation: Subject to limits mentioned in the table given below, the Company will reimburse reasonable and necessary expenses incurred towards transportation of the insured person from the hospital where the insured person is currently undergoing treatment to another hospital for further treatment provided :

a. The medical condition of the Insured Person is a life threatening emergency, b. Further treatment facilities are not available in the current hospital c. The Medical Evacuation is recommended by the treating Medical Practitioner.

d. Claim for Hospitalization is admissible under the policy. Note : Payment under this benefit does not form part of the sum insured but will impact the Bonus

O. Compassionate travel: In the event of the insured person being hospitalized for a life threatening emergency at a place away from his usual place of residence as recorded in the policy, the Company will reimburse the transportation expenses by air incurred upto Rs.5,000/- for one immediate family member (other than the travel companion) for travel towards the place where hospital is located, provided the claim for hospitalization is admissible under the policy. Note: This benefit is available for sum insured options of Rs.10,00,000/- and above only. Payment under this benefit does not form part of the sum insured but will impact the Bonus

P. Repatriation of Mortal Remains Following an admissible claim for hospitalization under the policy, the Company shall reimburse up to Rs.5,000/- per policy period towards the cost of repatriation of mortal remains of the insured person (including the cost of embalming and coffin charges) to the residence of the Insured as recorded in the policy. Payment under this benefit does not form part of the sum insured but will impact the Bonus

Q. Treatment in Valuable Service Providers: In the event of a medical contingency requiring hospitalization, if the insured seeks advice from the Company, the Company may suggest an appropriate hospital from the network for treatment. Where the insured accepts the same and undergoes treatment in the suggested hospital, an amount calculated at 1% of Sum Insured subject to a maximum of Rs.5,000/- per policy period is payable as lump sum. Note:

1. This benefit is applicable for Sum Insured of Rs.3, 00,000/- and above only. 2. This benefit is payable only if there is an admissible claim for hospitalization under the policy.

3. This benefit shall be paid if a hospital is a part of the list as on date of admission

4. Payment under this benefit does not form part of the sum insured but will impact the Bonus

5. The Company shall not be responsible for the quality of the treatment in the Valuable Service Providers.

6. FOR LIST OF VALUABLE SERVICE PROVIDERS PLEASE VISIT WEBSITE : www.starhealth.in.

R. Shared accommodation: If the Insured person occupies, a shared accommodation during in-patient hospitalization, then amount as per table given below will be payable for each continuous and completed period of 24 hours of stay in such shared accommodation.

Note:

i) This benefit is applicable for Sum Insured of Rs.3, 00,000/- and above only. ii) This benefit is payable only if there is an admissible claim for hospitalization under the policy

iii) This benefit will not be applicable where the sanction is on package rates iv) Insured stay in Intensive Care Unit or High Dependency Units / wards will not be counted for this purpose

v) Payment under this benefit does not form part of the sum insured but will impact the Bonus

S. AYUSH Treatment: Inpatient Hospitalizations Expenses incurred on treatment under Ayurveda, Unani, Sidha and Homeopathy systems of medicines in a AYUSH Hospital is payable up to the limits given below: Note:

i. Payment under this benefit forms part of the sum insured and will impact the Bonus

ii. Yoga and Naturopathy systems of treatments are excluded from the scope of coverage under AYUSH treatment.

T. Second Medical Opinion: The Insured Person can obtain a Second Medical Opinion from a Doctor in the Company's network of Medical Practitioners. All the medical records provided by the Insured Person will be submitted to the Doctor chosen by him/her online and the medical opinion will be made available directly to the Insured by the Doctor. To utilize this benefit, all medical records should be forwarded to the mail-id “adpkp2@r.postjobfree.com.” or through post/courier.

Special Conditions:-

● This should be specifically requested for by the Insured Person

● This opinion is given based only on the medical records submitted without examining the patient,

● The second opinion should be only for medical reasons and not for medico- legal purposes.

● Any liability due to any errors or omission or consequences of any action taken in reliance of the second opinion provided by the Medical Practitioner is outside the scope of this policy.

● Utilizing this facility alone will not be considered as a claim Note: Medical Records / Documents submitted for utilizing this facility will not prejudice the Company's right to reject a claim in terms of policy. U. Assisted Reproduction Treatment: The Company will reimburse medical expenses incurred on Assisted Reproduction Treatment, where indicated, for sub-fertility subject to:

1. A waiting period of 36 months from the date of first inception of this policy with the Company for the insured person.

The maximum liability of the Company for such treatment shall be limited to Rs.1,00,000/- for Sum Insured of Rs.5,00,000/- and Rs.2,00,000/- for Sum Insured of Rs.10,00,000/- and above for every block of 36 months and payable on renewal

2. For the purpose of claiming under this benefit, in- patient treatment is not mandatory.

3. Automatic Restoration of Sum Insured, Recharge Benefit shall not be applicable for this benefit.

Note: To be eligible for this benefit both husband and spouse should stay insured continuously without break under this policy for every block. This coverage is available only for sum insured options of Rs.5,00,000/- and above

Special Exclusions:-

The Company shall not be liable to make any payments under this policy in respect of any expenses what so ever incurred by the insured person in connection with or in respect of:

1. Pre and Post treatment expenses

2. Sub-fertility services that are deemed to be unproven, experimental or investigational

3. Services not in accordance with standards of good medical practice and not uniformly recognized and professionally endorsed by the general medical community at the time it is to be provided.

4. Reversal of voluntary sterilization

5. Treatment undergone for second or subsequent pregnancies except where the child from the first delivery/ previous deliveries is/are not alive at the time of treatment

6. Payment for services rendered to a surrogate

7. Costs associated with cryopreservation and storage of sperm, eggs and embryos

8. Selective termination of an embryo.

9. Services done at unrecognized centre

10. Surgery / procedures that enhances fertility like Tubal Occlusion, Bariatric Surgery, Diagnostic Laparoscopy with Ovarian Drilling and such other similar surgery / procedures

V. Automatic Restoration of Sum Insured (Applicable for A to K, M, S Only): There shall be automatic restoration of the Sum Insured immediately upon exhaustion of the limit of coverage, during the policy period. Such Automatic Restoration is available 3 times at 100% each time, during the policy period. Each restoration will operate only after the exhaustion of the earlier one.

Sum Insured (Rs.) Limit per hospitalization (Rs.)

Up to 4,00,000/- Up to 5,000/-

5,00,000/- to 15,00,000/- Up to 7,500/-

20,00,000/- and 25,00,000/- Up to 10,000/-

Sum Insured (Rs.) Limit per day (Rs.)

1,00,000/- and 2,00,000/- Not Available

3,00,000/-, 4,00,000/-, 5,00,000/- 10,00,000/-,

15,00,000/- 800/- per day

20,00,000/- and 25,00,000/- 1,000/- per day

Sum Insured (Rs.) Limit per policy period (Rs.)

1,00,000/-, 2,00,000/-,

3,00,000/- and 4,00,000/- Up to 10,000/-

5,00,000/- to 15,00,000/- Up to 15,000/-

20,00,000/- and 25,00,000/- Up to 20,000/-

Family Health Optima Insurance Plan Unique Identification No.: SHAHLIP22030V062122 PROS / FHO / V.8 / 2021 3 of 11 It is made clear that such restored Sum Insured can be utilized only for illness / disease unrelated to the illness / diseases for which claim/s was / were made. The unutilized restored sum insured cannot be carried forward. This Benefit is not available for Modern Treatment.

Note: Automatic Restoration of Sum Insured is available only for sum insured options of Rs.3,00,000/- and above

Illustration

W. Recharge Benefit (Applicable for A to K, M, S): If the limit of coverage under the policy is exhausted/ exceeded during the policy period, additional indemnity up to the limits stated in the table given below would be provided once for the remaining policy period. Such additional indemnity can be utilized even for the same hospitalization or for the treatment of diseases / illness / injury / for which claim was paid / payable under the policy. The unutilized Recharge amount cannot be carried forward. This Benefit is not available for Modern Treatment. X. Additional Sum Insured for Road Traffic Accident (RTA): If the insured person meets with a Road Traffic Accident resulting in in-patient hospitalization, then the sum insured shall be increased by 25% subject to a maximum of Rs.5,00,000/- and subject to the following;

1. It is evidenced that the insured person was wearing helmet and was either riding or travelling as pillion rider in a two wheeler at the time of accident as evidenced by Police record and Hospital record.

2. The additional sum insured shall be available only once during the policy period. 3. The additional sum insured shall be available after exhaustion of the limit of coverage.

4. The additional sum insured can be utilized only for the particular hospitalization following the Road Traffic Accident 5. Automatic Restoration of Sum Insured and Recharge Benefit shall not apply for this benefit

6. This benefit shall not be applicable for day care treatment 7. The unutilized balance cannot be carried forward for the remaining policy period or for renewal

8. Claim under this benefit will impact the Bonus

Y. Coverage for Modern Treatments: The following expenses are payable during the policy period for the treatment/procedure (either as a day care or as an in-patient) is limited to the amount mentioned in table below. This benefit forms part of sum insured.

*Sublimit all inclusive with or without hospitalization where ever hospitalization includes pre and post hospitalization.

Sum Insured (Rs.) Limit (Rs.)

1,00,000/- and 2,00,000/- Not Available

3,00,000/- 75,000/-

4,00,000/- 1,00,000/-

5,00,000/-, 10,00,000/-, 15,00,000/-,

20,00,000/- and 25,00,000/- 1,50,000/-

Scenario 1

(New Policy)

Scenario 2

(Renewal)

Sum Insured (SI) Rs.10,00,000/- Rs.10,00,000/-

No Claim Bonus (NCB) 0 Rs.2,50,000/-

Recharge Rs.1,50,000/- Rs.1,50,000/-

Total Cover Available Rs.11,50,000/- Rs.14,00,000/- 1st

Claim

1st Claimed settled Rs.5,00,000/- Rs.5,00,000/-

Total Coverage available

for next claim

Rs.6,50,000/-

(Balance SI

Rs.5,00,000/-

+ Recharge

Rs.1,50,000/-)

Rs.9,00,000/-

(Balance SI

Rs.5,00,000/-

+ Bonus Rs.2,50,000/-

+ Recharge

Rs.1,50,000/-)

2nd

Claim

2nd Hospital Bill Amount Rs.10,00,000/- Rs.10,00,000/- Claim Settled

Rs.6,50,000/-

(Balance SI

Rs.5,00,000/-

+ Recharge

Rs.1,50,000/-)

Rs.9,00,000/-

(Balance SI

Rs.5,00,000/-

+ Bonus Rs.2,50,000/-

+ Recharge

Rs.1,50,000/-)

Will the restoration kick in ?

If yes How Much?

Yes, Why - Since there is full

utilization of Sum Insured.

Rs.10,00,000/- Rs.10,00,000/-

Total Coverage available

for next claim (Available

for different illness)

Rs.10,00,000/- Rs.10,00,000/-

3rd

Claim

Hospital Bill Amount (For

different illness) Rs.5,00,000/- Rs.5,00,000/-

Claim Settled Rs.5,00,000/- Rs.5,00,000/-

Will the restoration kick in ?

If yes How Much?

No, Why - Since the sum

insured is not utilized in full

0 0

Total Coverage available

for next claim (Available

for different illness)

Rs.5,00,000/- Rs.5,00,000 /-

4th

Claim

Hospital Bill Amount (For

Same Illness) Rs.8,00,000/- Rs.8,00,000/-

Claim Settled

0

(Automatic Restoration

is not available for

Same illness)

0

(Automatic Restoration

is not available for

Same illness)

Total Coverage available

for next claim (Available

for different illness)

Rs.5,00,000/- Rs.5,00,000/-

5th

Claim

Hospital Bill Amount (For

Different Illness) Rs.10,00,000/- Rs.11,00,000/-

Claim Settled

Rs.5,00,000/-

(Since the balance

cover available after

settlement of previous

claim is Rs.5,00,000/-)

Rs.5,00,000/-

(Since the balance

cover available after

settlement of previous

claim is Rs.5,00,000/-)

Will the restoration kick in ?

If yes How Much?

Yes, Why - Since there is full

utilization of Sum Insured.

Rs.10,00,000/- Rs.10,00,000/-

Total Coverage available

for next claim (Available

for different illness)

Rs.10,00,000/- Rs.10,00,000/-

Limit per policy period

for each treatment / procedure (Rs.)

1,00,000/- 12,500/- 5,000/- 25,000/- 12,500/- 25,000/- 5,000/- 2,00,000/- 25,000/- 10,000/- 50,000/- 25,000/- 50,000/- 10,000/- 3,00,000/- 37,500/- 15,000/- 75,000/- 37,500/- 75,000/- 15,000/- 4,00,000/- 1,00,000/- 40,000/- 2,00,000/- 1,00,000/- 2,00,000/- 40,000/- 5,00,000/- 1,25,000/- 50,000/- 2,50,000/- 1,25,000/- 2,50,000/- 50,000/- 10,00,000/- 1,50,000/- 1,00,000/- 3,00,000/- 2,00,000/- 4,00,000/- 75,000/- 15,00,000/- 1,75,000/- 1,25,000/- 4,00,000/- 2,50,000/- 5,00,000/- 1,00,000/- 20,00,000/- 2,00,000/- 1,50,000/- 4,50,000/- 2,75,000/- 5,50,000/- 1,25,000/- 25,00,000/- 2,00,000/- 1,50,000/- 5,00,000/- 3,00,000/- 6,00,000/- 1,50,000/- Balloon

Sinuplasty,

Deep Brain Stimulation

Oral Chemotherapy*

(Sublimits including Pre

and Post Hospitalisation)

Intra Vitreal injections

Sum Insured in (Rs.)

Immunotherapy-

Monoclonal Antibody

to be given as injection

Uterine artery

Embolization and HIFU,

Limit per policy period

for each treatment / procedure (Rs.)

1,00,000/- 25,000/- 25,000/-

Up to Sum Insured

25,000/-

2,00,000/- 50,000/- 50,000/- 50,000/-

3,00,000/- 75,000/- 75,000/- 75,000/-

4,00,000/- 2,00,000/- 1,75,000/- 2,00,000/-

5,00,000/- 2,50,000/- 2,00,000/- 2,50,000/-

10,00,000/- 3,00,000/- 2,25,000/- 3,00,000/-

15,00,000/- 4,00,000/- 2,50,000/- 4,00,000/-

20,00,000/- 4,50,000/- 2,75,000/- 4,50,000/-

25,00,000/- 5,00,000/- 3,00,000/- 5,00,000/-

Sum Insured in (Rs.)

Stereotactic

radio surgeries

Bronchical

Thermoplasty

Vaporisation of the

prostate (Green laser

treatment or holmium

laser treatment)

IONM-(Intra Operative

Neuro Monitoring)

Stem cell therapy:

Hematopoietic stem cells

for bone marrow

transplant for

haematological conditions

Robotic surgeries

Family Health Optima Insurance Plan Unique Identification No.: SHAHLIP22030V062122 PROS / FHO / V.8 / 2021 4 of 11 Z. Cumulative Bonus (Applicable for [A to K], [M to S], U, and X ): In respect of a claim free year of Insurance, for the Sum Insured options Rs.3,00,000/- and above, the insured would be entitled to benefit of bonus of 25% of the expiring Sum Insured in the second year and additional 10% of the expiring sum Insured for the subsequent years. The maximum allowable bonus shall not exceed 100%. The Bonus will be calculated on the expiring sum insured or on the renewed sum insured whichever is less. Bonus will be given on that part of sum insured which is continuously renewed. 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.

Bonus shall be available only upon timely renewal without break or upon renewal within the grace period allowed.

In the event of a claim, such bonus so granted will be reduced at the same rate at which it has accrued. However the sum insured, will not be reduced. AA. Co-payment(Applicable for A to K and S): This policy is subject to co-payment of 20% of each and every claim amount for fresh as well as renewal policies for insured persons whose age at the time of entry is 61 years and above. ò Exclusions: The Company shall not be liable to make any payments under this policy in respect of any expenses what so ever incurred by the insured person in connection with or in respect of:-

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 48 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 for the same would be reduced to the extent of prior coverage

d. Coverage under the policy after the expiry of 48 months for any pre-existing disease is subject to the same being declared at the time of application and accepted by Insurer

2. Specified disease / procedure waiting period - Code Excl 02 a. Expenses related to the treatment of the following listed Conditions, surgeries/treatments shall be excluded until the expiry of 24 months of 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 b. In case of enhancement of sum insured the exclusion shall apply afresh to the extent of sum insured increase

c. 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

d. The waiting period for listed conditions shall apply even if contracted after the policy or declared and accepted without a specific exclusion e. 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 f. 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 Gall bladder and Pancreatic calculi. All types of management for Kidney calculi and Genitourinary tract calculi.

6. All types of Hernia,

7. Desmoid Tumor, Umbilical Granuloma, Umbilical Sinus, Umbilical Fistula,

8. All treatments (conservative, interventional, laparoscopic and open) related to all Diseases of Cervix, Uterus, Fallopian tubes, Ovaries

(other than due to Cancer), 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, Hemorrhoids, Pilonidal Sinus and Fistula, Rectal Prolapse, Stress Incontinence

12. Varicose veins and Varicose ulcers

13. All types of transplant and related surgeries. 14. Congenital Internal disease / defect

3. 30-day waiting period - Code Excl 03

a. Expenses related to the treatment of any illness within 30 days from the first policy commencement date shall be excluded except

Contact this candidate