Frequently Asked Questions

Insured can opt for a reduction in maternity waiting period by paying one-time additional premium.
On availing this benefit, the mandatory waiting period for maternity cover will be reduced from 36 to
24 months. New born cover and First Year Vaccination will follow reduction in waiting period.

Maternity benefits include expenses for the delivery of child or expenses related to medically necessary and lawful termination of pregnancy.

Maximum 2 deliveries / terminations are covered during the lifetime of an insured between the age group of 18-45 years (both age included) after a waiting period of 36 months

Coverage will be restricted to the sum insured as per policy.

ManipalCigna offers comprehensive coverage of medical expenses for Inpatient hospitalization including Daycare, Pre and Post hospitalization expenses. It offers Ayush inpatient hospitalization/day care procedures, Restoration benefit and Smart non- reducing guaranteed Cumulative bonus as inbuilt features.

Policy also offers Optional Cumulative Bonus Booster which works on non-reducing basis and adds more to the policy every  year irrespective of claims. It also covers Worldwide Emergency, Domiciliary treatment and Donor expenses upto Sum Insured

Outpatient treatment, AYUSH, Doctor consultation, diagnostics and pharmacy bills are covered under Health Maintenance benefit. We offer Healthy Rewards as value added benefit associated with our ProActiv Living Program.

All above features are also offered for policies where Optional Deductible or Voluntary co-pay has been opted**

*Voluntary Co-pay and Deductible cannot be taken under a single plan.

 Note - Above is the list of covers under the product and are applicable as per availability in the plan chosen.

Please find the detail process flow step by step as attached link https://www.manipalcigna.com/claims

The Insured may cancel this Policy by giving 15 days' written notice, and in such an event, the Company shall refund premium on short term rates for the unexpired Policy Period as per policy terms and conditions.

Request for cancellation shall be notified to Us by giving 15 days' written notice in which case We shall refund the premium for the unexpired term as per the short period scale

 All claims for Saral Suraksha Bima to be informed within 30 days of occurrence of the event at a ManipalCigna branch   call center or head office. Submit the dully filled and signed claim form along with the documents mentioned in the  claim form within 30 days of occurrence of the event at any of our branches or head office.

If any treatment for which a claim may be made is to be taken and that treatment requires  Hospitalisation in an Emergency, the company shall be informed within 24 hours of the admission of the Insured Person in Hospital.

For any claims related query, information or assistance you can contact our Health line 1800-102-4462 or visit our website https://www.manipalcigna.com/ or email us at customercare@manipalcigna.com .

All Payments under the Policy will be made in Indian currency only.

In case you are not satisfied with the policy, you can request for a cancellation of the policy by giving 15 days' notice in writing.Refund will be processed as per policy terms and conditions

Step -1 The product brochure, policy benefits, exclusions and premium details must be thoroughly understood and discussed with Our advisor/ Company representative, before buying the policy

Step 2: Once the benefits of the policy are understood, the Proposal Form must be filled, wherein details of the prospective Insured Persons including medical information must be provided as accurately as possible.

Step 3: The proposal form with the required documents have to be submitted.

 Step 4: If You are required to undergo medicals tests as per the chosen Sum Insured and Age band, we would arrange the medical check-up’s at Our network of diagnostic centres.

Step 5: Based on the above information we will process Your proposal for Insurance and a policy kit containing the Policy Schedule, Policy Terms & Conditions and associated documents will be sent to you.

In case we are unable to underwrite i.e. if the Proposal is rejected We will intimate the same to You through a rejection letter

Upon assessment if the premium is loaded then We will inform You about any revised terms through a counter offer letter. We will issue the Policy only once you accept the counter offer. Where You do not agree to the counter offer we will cancel your proposal.

Step 1: The product brochure, policy benefits, exclusions and premium details must be thoroughly understood and discussed with Our advisor/ Company representative, before buying the policy.

Step 2: Once the benefits of the policy are understood, the Proposal Form must be filled, wherein details of the prospective Insured Persons including medical information must be provided as accurately as possible.

Step 3: The proposal form with the required documents have to be submitted.

Step 4: If You are required to undergo medicals tests as per the chosen Sum Insured and Age band, we would arrange the medical check-up's at Our network of diagnostic centres.

Step 5: Based on the above information we will process Your proposal for Insurance and a policy kit containing the Policy Schedule, Policy Terms & Conditions and associated documents will be sent to you

upon assessment if the premium is loaded then We will inform You about any revised terms through a counter offer letter. We will issue the Policy only once you accept the counter offer. Where You do not agree to the counter offer we will cancel your proposal.

ManipalCigna ProHealth Prime offers high Sum Insured to cover Hospitalisation expenses, Pre & Post Hospitalisation expenses & day care treatments. It also provides cover for Individuals with existing conditions such as Asthma, Hypertension, Diabetes, Obesity, Dyslipidaemia etc.

It is a comprehensive product with very innovative and beneficial covers such as coverage for Non-Medical Expenses, Option to choose ‘Any Room’ category, Switch off, Premium waiver benefit, Unlimited restoration of Sum Insured, Guaranteed Cumulative Bonus, Discount on Network Providers and much more.

There are optional packages and optional covers which makes the product highly customizable and making it suitable for all the customer segments.

The insured will be allowed a period of at least 30 days from the date of receipt of the policy to review the terms and conditions of the policy and to return the same if not acceptable. Free look cancellation & refund will be made within 7 days from the date of receipt of request.

We will increase the sum insured by 5% for every year up to a maximum of 50%. For example, if you have coverage of Rs. 5 Lacs, an additional Sum Insured of Rs. 25,000 will be allowed as Cumulative Bonus every year, maximum up to 50%.

Pre-existing diseases/illness/injury/conditions will be covered post 36 months of continuous cover depending upon the plan opted.

*Such waiting period shall reduce if the insured has been covered under a similar policy before opting for this policy, subject however to portability/migration regulations.

It means an increase in the Sum Insured granted by the insurer for policy period without an increase in the premium. The percentage of increase in sum insured is 5% each year. The maximum accumulation is up to 100%

We may apply a risk loading on the premium payable (excluding Statutory Levies and Taxes) or Special Conditions on the policy based upon the health status of the persons proposed for insurance and declarations made in the Proposal Form. These loadings will be applied from inception date of the first Policy including subsequent Renewal(s) with Us. Additional waiting periods may be applied upto a maximum of 36 months from the date of inception of first policy. 

We shall inform you about the applicable risk loading or special condition through a counter offer letter and you would need to revert with consent and Premium, within 7 working days of the issuance of such counter offer letter.

Your existing Mediclaim policy will continue to cover pre-existing diseases however fresh waiting period of 36 months will be applied with ManipalCigna Super Top up policy.

An option is available to reduce your waiting period from 36 to 24 months on payment of additional premium at time of first purchase.

There is a 15% annual cumulative bonus available under the product

After completion of 60 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 60 continuous months is called as moratorium period. The moratorium would be applicable for the Sums Insured of the first Policy and subsequently completion of 60 continuous months would be applicable from date of enhancement of Sums Insured only on the enhanced limits. The policies would however be subject to all limits, sub limits, co-payments, deductibles as per the policy contract

AYUSH treatment refers to the medical and / or hospitalization treatments given under Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homeopathy systems