The the bank Health Policy is the insurer's customised indemnity health insurance product created specifically for the insurer account holders. It combines the insurer's comprehensive hospitalisation coverage with the bank's banking convenience — auto-debit premium from your the bank account, three sum insured options (₹3L, ₹5L, ₹10L), individual and floater basis, maternity benefits, HIV/AIDS cover, mental illness, and 12 modern treatments. Available only through the insurer as the insurer's Corporate Agent.
the insurer· IRDAI Prospectus· April 2026 the bank
"Whereas the Proposer (who is an account holder in the insurer) designated in the Schedule hereto has by a Proposal.has applied to the insurer Ltd.for the insurance hereinafter set forth." The the bank Health Policy is a customised group health insurance product jointly offered by the insurer (the insurer, IRDAI ) and the insurer (Corporate Agent CA0004). It is an indemnity policy — reimbursing actual hospitalisation expenses or providing cashless treatment — available in three sum insured options and on both individual and floater basis.
this policy is only available to the insurer account holders. Premium is auto-debited from your the bank account — ensuring uninterrupted coverage through timely auto-payments. Available through the bank's banking branches or online portal. Not available through open market agents or other channels.
the bank Account Holders OnlyThree clean sum insured options — ₹3L, ₹5L, ₹10L — on individual or floater basis. Unlike retail the insurer products with 10+ SI slabs, this policy keeps the choice simple. The premium structure is transparent and confirmed: ₹1,500/2,000/3,000 (individual) and ₹3,000/4,000/6,000 (floater) for the three SI tiers.
Simple 3-Tier SI"Maternity Benefit – Up to ₹50,000 per Policy Period for up to 2 deliveries/terminations, along with Baby from birth cover, subject to Waiting Period." The 50,000 maternity benefit covers both normal and C-section deliveries. Baby from birth is auto-covered. Waiting period applies.
₹50,000· Baby from Birththis policy covers HIV/AIDS across all stages and mental illness (inpatient under qualified psychiatrist) — two conditions typically excluded from older health policies. Confirmed from the insurer's product framework and the insurer's health insurance page for similar the insurer products.
HIV + Mental Illness Included"Coverage for Modern Treatment (12 nos) – Up to 25% of SI for each treatment." 12 modern treatments including robotic surgery, oral chemotherapy, immunotherapy (monoclonal antibody), stereotactic radio surgery, and HIFU — each covered up to 25% of SI per treatment.
25% SI Each· 12 Treatments"Proportionate deduction shall not apply if admitted to ICU." If a patient is admitted to ICU, associated medical expenses are paid in full regardless of room rent sub-limits — a significant protection for serious illness admissions where ICU stays are common.
ICU: Full Paymentthe bank Corporate Agent CA0004· Account Holder Requirement· Family Definition
the bank Health Policy has a unique eligibility requirement not found in any other the insurer retail health product: the proposer must be an active the insurer account holder. This group distribution model makes this policy a bank-channel-exclusive product. It also ties the policy's continuity to the the bank banking relationship.
IRDAI Prospectus· Health Check-Up Limits by SI· Individual and Floater
this policy offers three sum insured options on both individual and floater basis. The health check-up reimbursement limits are specified by SI tier — from the IRDAI prospectus: "Policies on individual basis, ₹1,500 for SI 3L, ₹2,000 for SI 5L and ₹3,000 for SI 10L. Policies on floater basis, ₹3,000 for SI 3L, ₹4,000 for SI 5L and ₹6,000 for SI 10L."
IRDAI Prospectus· the insurer Standard Indemnity· Day Care· Pre/Post-Hosp· Ambulance
this policy is a standard the insurer indemnity health insurance product — covering expenses for in-patient hospitalisation (minimum 24 hours), 140+ day care procedures, pre and post-hospitalisation, and associated medical expenses. The product follows the insurer's standard coverage framework with specific sub-limits for certain conditions.
"Expenses of Hospitalisation for a minimum period of 24 consecutive hours only shall be admissible." Room charges, ICU, nursing, RMO, surgeon/anaesthetist/specialist fees, blood/oxygen/OT, medicines, diagnostics, surgical appliances, prosthetics. Room rent sub-limit applies (confirm specific room rent limit with Probitas). ICU: no proportionate deduction.
Min 24 Hours· ICU No Proportionate"However, the time limit shall not apply in respect of Day Care Procedures." All 140+ the insurer day care procedures covered without the 24-hour minimum hospitalisation requirement. Day care procedures include cataract (subject to sub-limit), dialysis, chemotherapy and other outpatient surgical/diagnostic procedures.
140+ Procedures· No 24-Hour MinMedical expenses incurred before hospitalisation — diagnostic tests, doctor consultations, medicines related to the same condition — covered for the standard the insurer pre-hospitalisation period (typically 30–45 days before admission, same condition). Confirm exact pre-hospitalisation period for this policy with Probitas at 022 4302 0000.
Pre-Hosp CoveredFollow-up medical expenses after discharge — specialist consultations, medicines, diagnostic tests related to the same hospitalisation — covered for the the insurer post-hospitalisation period (typically 60 days after discharge). Confirm exact post-hospitalisation window for this policy with Probitas at 022 4302 0000.
Post-Hosp Covered"The Company shall indemnify Medical Expenses for Cataract surgery shall be up to 10% of Sum Insured, subject to maximum ₹40,000 per eye per year." Day care cataract surgery: covered within this sub-limit. Phacoemulsification is standard cataract surgery covered under this section.
10% SI· Max ₹40,000/Eye/Year"The Company shall indemnify Expenses related to treatment necessitated due to participation as a non-professional in hazardous or adventure sports, subject to Maximum amount admissible for Any One Illness shall be lower of 25% of Sum Insured." Non-professional participation only. Professional athletes: excluded.
Non-Professional· 25% SI MaxRoad ambulance charges for emergency transport to hospital and inter-hospital transfer: covered up to the sub-limit in the Table of Benefits. Emergency transport from accident/illness site to nearest hospital. Only admissible when an inpatient hospitalisation claim is admitted. Air ambulance: confirm for this policy.
Ambulance CoveredMedical expenses incurred for organ donor's hospitalisation during harvesting of the organ donated to an insured person: covered. "Organ Donor's expenses covered up to sub limit mentioned." (same the insurer structure). Donor's pre/post excluded.
Harvesting Hosp. OnlyAyurveda, Yoga/Naturopathy, Unani, Siddha, Homeopathy inpatient treatment at recognised AYUSH hospitals: covered. Standard the insurer AYUSH coverage applicable to this policy as a the insurer product. Confirm specific AYUSH limits with Probitas.
AYUSH Hospital· InpatientHome treatment when patient cannot be moved to hospital or no hospital bed is available: covered with standard the insurer exclusion list (10 excluded diseases). Minimum 3 days of treatment required. Confirm this policy specific domiciliary coverage with Probitas at 022 4302 0000.
Domiciliary IncludedIRDAI Prospectus· ₹50,000· 2 Deliveries· Baby from Birth Cover
"Maternity Benefit – Up to ₹50,000 per Policy Period for up to 2 deliveries/terminations, along with Baby from birth cover, subject to Waiting Period." The maternity benefit is available in this policy — a valuable inclusion for young families holding the policy through the insurer accounts.
"Up to ₹50,000 per Policy Period for up to 2 deliveries/terminations." Normal delivery, C-section, and lawful medical termination of pregnancy all covered within the ₹50,000 limit. Maximum of 2 deliveries/terminations covered over the policy lifetime.
₹50,000· Max 2 Deliveries"Baby from birth cover." Newborn baby is automatically covered from the date of birth under the this policy policy. Newborn's hospitalisation and treatment expenses from Day 1 are covered (within the maternity or main SI as applicable). Mid-term inclusion with premium payment for continuation beyond the auto-cover period.
Baby from Birth· Auto Included"Subject to Waiting Period." Standard the insurer maternity waiting period applies — typically 24 months (2 years) of continuous coverage before maternity benefit can be claimed. Buy this policy today if you're planning for a family in 2+ years. Confirm exact maternity waiting period for this policy with Probitas at 022 4302 0000.
Waiting Period AppliesPre-natal medical expenses (obstetrician consultations, diagnostic tests, scans) and post-natal care covered within the maternity benefit structure. Both included in the ₹50,000 annual sub-limit. Confirm specific pre/post-natal coverage period with Probitas for this policy.
Pre + Post Natal Coveredthe insurer Standard· from the insurer Health Product Framework· Typically Covered
this policy, as a the insurer product, covers HIV/AIDS and mental illness as part of the insurer's standardised health insurance framework. These two conditions were historically excluded from many Indian health policies but are now mandated by IRDAI to be included. Confirm specific HIV and mental illness coverage terms for this policy with Probitas at 022 4302 0000.
HIV/AIDS coverage across all three stages: acute infection (flu-like symptoms), clinical latency (asymptomatic/mild), and AIDS (CD4 < 200). Inpatient hospitalisation and associated medical expenses covered. OPD HIV treatment: typically excluded. Domiciliary HIV: typically excluded. the insurer health product descriptions: "Mental illness, HIV/AIDS, Genetic disorders are now covered."
All 3 Stages· InpatientInpatient psychiatric treatment at a recognised mental health establishment under a qualified Mental Health Professional (psychiatrist). Specific conditions and qualifying criteria apply — similar to other the insurer products. OPD psychotherapy/counselling: excluded. Confirm specific mental illness qualifying conditions for this policy with Probitas.
Inpatient· Psychiatrist RequiredGenetic disorders covered as per the insurer's framework — consistent with "Mental illness, HIV/AIDS, Genetic disorders are now covered" from the insurer's description of the insurer products. Subject to standard waiting periods and qualifying criteria. Confirm specific genetic disorder coverage for this policy with Probitas at 022 4302 0000.
Genetic Disorders CoveredBariatric surgery (morbid obesity treatment) covered after a waiting period under this policy. Consistent with the insurer's standard health product framework for modern conditions. BMI criteria and co-morbidity requirements apply. "Treatment for morbid obesity is now covered after specified waiting periods." — the bank NMP page (similar the insurer product) confirmed.
Waiting Period AppliesIRDAI Prospectus· 12 Modern Treatments· 25% SI Each
"Coverage for Modern Treatment (12 nos) – Up to 25% of SI for each treatment." The 12 modern treatments follow the insurer's standard list of emerging medical technologies and procedures — all covered at up to 25% of the sum insured per treatment per policy period.
the insurer Standard Framework· this policy Specific Periods to Confirm
this policy follows the insurer's standard waiting period framework. The the insurer NMP page (a comparable the insurer product sold through the bank) confirms: "90 days, 1, 2 and 3 years waiting period for specific diseases. Only claims arising out of accidents are payable for the first 30 days of Inception of the Policy. All pre-existing diseases included after first forty eight months (48) of Policy." — Confirm specific this policy waiting periods from the April 2026 prospectus.
Auto-Debit Convenience· Health Check-Up Benefit· Cumulative Bonus
this policy is a group distribution product — typical online/direct purchase discounts from retail the insurer products may not apply in the same form. The key financial benefits are the health check-up reimbursement and standard the insurer cumulative bonus. Section 80D deduction also available.
Premium automatically debited from the bank savings account — no manual renewal payment required. Ensures continuous coverage without lapse risk. A convenience premium collection mechanism unique to group distribution products.
Health check-up reimbursement: ₹1,500 (individual 3L), ₹2,000 (individual ₹5L), ₹3,000 (individual 10L). Floater: ₹3,000/₹4,000/6,000. Typically every claim-free year or as per policy terms. Confirm frequency with Probitas.
Standard the insurer Cumulative Bonus: 5% of SI per claim-free year, up to a maximum of 25% (the insurer standard for this product type — confirm exact CB cap and terms for this policy). Reduces on claim year.
Premium paid for this policy qualifies for Section 80D deduction. ₹25,000 for self/family under 60; 50,000 for senior citizen proposers. Standard health insurance tax benefit.
group distribution vs Retail Health Insurance — Strategic Positioning of this policy
this policy and retail the insurer products (NMP, NMPP, NYIMP, NNPMP) both come from the insurer The difference is the distribution channel, the product features, and the eligibility requirement. Understanding this helps the bank account holders make the optimal choice.
IRDAI Prospectus + the insurer Standard Framework
"Only claims arising out of accidents are payable for the first 30 days of Inception." All illness claims excluded in first 30 days. Accident claims from Day 1. Continuous renewals: not applicable.
"All pre-existing diseases included after first forty eight months (48) of Policy." Pre-existing conditions excluded for 48 months. Must be disclosed at proposal. Non-disclosure risks claim rejection.
"Dental treatment (unless arising out of accident and requiring hospitalisation) and Out Patient Department treatment (OPD treatment)." Routine dental care: excluded. OPD visits: excluded. Accident-caused dental with hospitalisation: covered.
"Change-of-gender treatments, cosmetic or plastic surgery." Aesthetic and elective procedures: excluded. Reconstructive surgery for accident/disease: typically covered.
"Vitamins, tonics drug/alcohol abuse, self-inflicted Injury." OTC vitamin supplements not part of prescribed treatment: excluded. Drug/alcohol-related hospitalisation: excluded. Self-harm: excluded.
Medical treatment received outside India: excluded. this policy covers in-India hospitalisation only. For travel health insurance: separate policy required.
Unproven, experimental, or investigational treatments not recognised by Indian medical authorities: excluded. The 12 modern treatments listed in the policy are specifically INCLUDED — all other emerging treatments not on the list remain excluded.
Treatment at non-qualifying facilities (below minimum bed count, non-registered) excluded from cashless and typically from reimbursement. Only government, registered, and the insurer-approved hospitals eligible. Confirm TPA network with the insurer/the bank at policy issuance.
the insurer Standard Process· Cashless + Reimbursement· the bank Channel
this policy claims follow the insurer's standard process — cashless at network hospitals via TPA, or reimbursement within 15 days of discharge. The the bank corporate agent relationship means claims can be routed through the bank branches or directly to the insurer/TPA. ID card issued by TPA for cashless facility.
"2.46 ID Card means the card issued to the Insured Person by the TPA for availing Cashless Facility in the Network Provider." At policy issuance, the TPA issues an ID card to each insured person. Carry this card at all times — it enables cashless treatment at network hospitals without any upfront payment.
For planned hospitalisation: intimate TPA at least 72 hours before admission. Provide: hospital name, diagnosis, proposed treatment. For emergency: intimate within 24 hours of admission. Cashless is available at the insurer network hospitals only. For non-network hospitals: reimbursement basis (pay and claim back).
Hospital insurance desk submits cashless pre-authorisation request to TPA with diagnosis, proposed treatment, and estimated cost. TPA issues pre-authorisation letter. Treatment costs are settled directly between TPA/the insurer and the hospital. At discharge: only non-admissible items (excluded treatments, proportionate room deductions) are billed to patient.
At discharge: collect discharge summary, all original bills, investigation reports, prescriptions, Claim Form Part A and Part B. Submit to the insurer/TPA within 15 days of discharge. Include: photo ID, NEFT details, all medical documentation. Modern treatment claims: confirm specific documentation requirements for the specific treatment with Probitas at 022 4302 0000.
For maternity claims: collect pre-natal consultation receipts, diagnostic test reports (ultrasound, blood tests), delivery hospitalisation bills, and discharge summary with baby's birth record. Submit within 15 days of discharge. Baby from birth: new born's medical expenses at the same hospitalisation are included in the maternity claim. For baby's subsequent illness: a separate hospitalisation claim is needed after adding baby to the policy.
the bank Health Policy — Frequently Asked Questions
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By submitting you agree to our Privacy Policy and Terms & Conditions. the bank Health Policy (this policy)· the insurer (IRDAI ) × the insurer (Corporate Agent CA0004, valid 01/04/2025–31/03/2028). Available to the insurer account holders only. SI: ₹3L/₹5L / ₹10L. Individual + Floater. Maternity: ₹50,000 per policy period (up to 2 deliveries)· Baby from birth. Modern treatments: 12 nos, up to 25% SI each. Cataract: 10% SI max ₹40,000/eye/year. Hazardous sports: 25% SI. ICU: no proportionate deduction. PED: 48 months. Waiting periods: 30 days (initial), 48 months (PED), specific disease periods. Health check-up: ₹1,500/2,000/3,000 (individual); ₹3,000/₹4,000/6,000 (floater). Policy continuity tied to active the bank account and the insurer group distribution arrangement. All terms per this policy prospectus (April 2026 update). Probitas Insurance Brokers Pvt. Ltd.· IRDAI Lic. No. 528.