Reliance HealthGain Health Insurance Plan

Brief Overview

Reliance General Insurance Company is a part of one of India’s leading business groups, Reliance Anil Dhirubhai Ambani Group. Established in the year 2000, the company has made its mark in the Indian insurance industry with its innovative insurance solutions. One of the most popular insurance products by Reliance has been health insurance plans.  These plans do not just offer comprehensive coverage but are available at an affordable price. Along with in-patient hospitalisation cover, the plans also offer various wellness benefits that motivate you to stay fit and healthy.  

Best Features of  Reliance HealthGain

1. This health insurance policy is available on monthly EMI
2. You can opt for a higher sum insured by paying small instalment as premiums
3. Log of sum insured options from INR 3 lakhs to INR 18 lakhs
4. Opt a policy for 1 year/ 2 years/ 3 years
5. The policy comes with zero paperwork and is available online
6. Option of voluntary co-payment
7. In case you exhaust the sum insured, there would be an auto-refill
8. You can avail the facility of cashless treatments in a network hospital
9. You can avail up to 15% discount on the premiums
10. Enhance the coverage with optional add-ons

Benefits of Reliance HealthGain

1. Hospitalisation Expenses
   In case you need to be hospitalised for over 24 hours due to an illness or an injury, your Reliance HealthGain plan would cover the expenses.
2. Reinstatement of Sum Insured
   In case the entire sum insured amount and cumulative bonus are exhausted, and you still require treatment in the hospital, the sum insured would be reinstated.
3. Call Option
   If a claim is not made for a period of 4 years, then at the end of the fourth year your cumulative bonus would be equal to the sum insured. In the fifth year, you would have the option to double your sum insured.
4. Pre and Post-Hospitalisation 
   Medical expenses start much before the hospitalisation and continue thereafter too. With Reliance HealthGain your expenses related to the same treatment will be covered for a period of 30 days before and 60 days after hospitalisation.
5. Day-Care Procedures
   Sometimes you need a treatment that requires less than 24 hours of hospitalisation, such procedures, called day-care procedures will be covered under the HealthGain plan.
6. Domiciliary Treatment
   If you/ the insured member could not get treatment in a hospital due to ill health or unavailable accommodation, medical expenses for the treatment at home would be covered.
7. Discounts
   With Reliance HealthGain, you have the option of availing great discounts on the premium such as:
   1. 5% discount for single women/ girl child
   2. 5% discount if all members of the family opt for an individual cover
   3. 7.5% discount for a 2 year policy
   4. 5% discount for policyholders of the Reliance Private Car Package Policy
8. Ambulance Charges
   If in a life-threatening emergency, you make use of a road ambulance to the nearest hospital, the ambulance charges would be covered up to INR 1,500 under plan A and up to INR 3,000 under plan B.
9. Organ Donor Expenses
   Up to 50% of the sum insured, the maximum of INR 5 lakhs, will be covered as donor expenses.
10. Wellness Solutions
    With Reliance HealthGain, you also get the option to get discounts, value-added services such as wellness programmes.
11. Cumulative Bonus
    At the end of each claim-free year, you would be eligible for a cumulative bonus which is 33.33% of the base sum insured.
12. Accidental Death Cover
    An accidental death cover of INR 1 lakh is provided under Plan B, at the end of every claim-free policy year.
13. Health Insurance Renewal 
    Under Plan B, you have the option to renew your medical insurance policy free of charge in case you are diagnosed with a listed critical illness.

Plan Details of  Reliance HealthGain

Waiting Period

• Pre-existing diseases are covered only after a period of 36 months
• Listed conditions and treatments have a waiting period of 24 months
• Treatment of an illness/ sickness is not covered for the initial 30 days
• Claims arising from accidental injuries are covered from day 1
   

Free Look Period
When you purchase the Reliance HealthGain plan, the company gives you a period of 15 days to review the terms and conditions of the plan. If in case you do not feel completely satisfied with the plan, you have the option to return it, provided no claim has been made so far. The premium that you have paid will be refunded after deducting the stamp duty charges and the proportionate risk premium. 

What is not Covered in Reliance HealthGain?

The Reliance HealthGain plan offers a wide scope of cover, however, the following situations are not covered:

1. Expenditure that is related to diagnostic and evaluation purposes
2. Services to people who are terminally ill
3. Obesity and weight control treatments
4. Change of gender treatments
5. Sexually transmitted diseases
6. Artificial life support equipment

For a more detailed list, refer to the policy document.

Renewal Process of Reliance HealthGain

If you wish to renew your health insurance policy, you can visit the company website and click “renew” or just click https://www.reliancegeneral.co.in/Insurance/Health-Insurance/Health-Infinity-Renewal/Renewal-Health-Online-Premium-Calculation.aspx. You need to enter your policy number or your mobile number. You will then be taken to a page with your policy details, check all the credentials and then proceed to payment. Make the payment via any of the available electronic mediums. 

If you want, you can also renew the policy by visiting a branch office and filling in the paperwork. Once you make the payment, your policy will be renewed. Due to the COVID-19 situation, it is suggested that you renew the policy online. 

Keep in mind:

1. Make sure that your renewal request reaches the company, before the expiry date of the policy
2. After the policy expires, you have a grace period of 30-days to get it renewed
3. After these 30 days, your policy will be terminated
4. A claim made during the 30-day grace period is not accepted

Reliance HealthGain- Claim Process

In case you have advised hospitalisation, you must at the earliest notify the company about the same, preferably 48 hours before hospitalisation in case of planned treatment and within 24 hours in case of an emergency. To be intimate, the company sends an email to rgicl.rcarehealth@relianceada.com or contact 022-48903009. Following all the given instructions carefully will make the process of claim settlement easy and smooth.
Due to the COVID-19 situation, the company is asking for a scanned copy of original documents, however, it reserves the right to seek the original documents within 1 year from claim submission. 

Cashless Claim 

Step 1
Once the doctor advises hospitalisation, intimate the company about the claim

Step 2
Visit the nearest network hospital for your treatment. To locate a network hospital near you, go to the company website

Step 3
The TPA from the hospital Help Desk would get in touch with the company to arrange the cashless treatment

Step 4
The company would settle the hospital bill directly with the hospital 

Reimbursement Claim 
In case a cashless facility is not availed, the policyholder or someone on his behalf would have to notify the company about the hospitalisation once the same is advised by a doctor.  

Step 1
Intimate the company about the claim

Step 2
Undergo the prescribed treatment at the hospital and make the payment 

Step 3
Submit the original scanned documents of all treatment-related documents and other listed documents with 7 days of discharge

Step 4
The company would settle the hospital bill once all documents are authenticated

Required Documents for claim settlement

The following documents are required while making the claim:

1. Valid Photo Identification Card
2. Claim Form - duly filled and signed
3. Treatment-related bills and receipts
4. Discharge Summary
5. Doctor’s prescription letter that advises hospitalisation
6. All investigations, tests, medicines, consultations etc
7. Ambulance Charges, if used
8. A Medico-Legal Certificate or FIR in case of an accidental injury

Reliance Health Insurance - Policy Network Hospitals

With Reliance on health insurance, you get a collaboration with over 7,300 hospitals all over the country. These hospitals/ healthcare centres offer you a cashless treatment which acts as a big advantage in the time of medical urgency. The company/TPA executives are present at the hospital and will help you with the claim procedure. They would also ensure that the claim is settled at the earliest without causing you any trouble.

Review of Reliance HealthGain Plan

Today, when healthcare treatments have become rather unaffordable, having health insurance is soon becoming a basic necessity. Though you would want the best insurance plan for your loved ones and want the highest sum insured for them, you may have felt the premium would be out of your budget. Reliance HealthGain Plan lets you choose a plan with a high sum insured, that you can pay for in monthly instalments. This is a big advantage of this unique health insurance plan that offers a lot of other advantages and benefits. Reliance HealthGain has the feature of re-instatement of the sum insured that makes it a great health insurance option for the entire family.

Reliance Health Insurance - Customer Care Details