Future Generali Health Insurance
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FUTURE GENERALI HEALTH INSURANCE

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Future Generali Health Insurance

Overview
Future Generali India Insurance Co. Ltd. is headquartered in Mumbai and is a joint venture between the Future Group and Generali Group. The Future group is well known for its presence in retail and supermarket industry with flagships like Food Bazaar, Big Bazaar, Central, Home Town and E-Zone. The Generali group is a renowned insurance company in Italy and one of the top private sector insurance companies in Europe. It has over 125 branches across India with Rs. 2,484 crores worth of asset under management.

Future Generali Health Insurance at a Glance
  • Cashless access to over 4300 network hospitals
  • 31001policies issues till date
  • Offers lifetime renewability
  • Approximately 99.98% grievances resolved.
  • The brand has an incurred claims ratio of 81.53%%.
  • Claim settlement ratio of 79% for FY 2015-16.

Awards & Recognitions
  • Impresa Awards 2017
  • BW HR Excellence Awards 2017 - Best Emerging HR Strategy
  • Companies with Great Managers - People Business
  • EE Achievers Awards 2017 - HR

Documents needed to apply for Future Generali Health Insurance
  • Age proof - (Any One)
    Driving License, Passport, Voter ID Card, Birth Certificate, etc
  • Identity proof – (Any One)
    Driving License, Passport, Voter ID card, PAN Card, Aadhar Card, or any document which proves citizenship
  • Income proof
  • Address proof – (Any One)
    Driving License, Passport and Utility Bill should clearly mention the permanent address
  • Income proof – (Any One)
    Salary Slip, Form 16, ITR
  • Recent passport size photograph

Why Future Generali Health Insurance?
Here are some reasons why Future Generali is the right insurance provider for you:

Features Description
Sum Insured Sum insured ranging from Rs. 1 lac toRs. 1 crore available.
Cashless hospitalisation Future Generali provides access to over 4300 network hospitals across India where you can avail cashless facility.
Claim process Cashless access to over 4300 hospitals. Future Generali has a claim settlement ratio of 79%.
In-patient hospitalization/treatment Expenses incurred during hospitalisation for 24hours or more is covered by all Future Generali Health Insurance plans.
Pre-hospitalization Expenses Expenses incurred during 60 days prior to hospitalisation are also covered.
Post-hospitalization Expenses Expenses incurred during 90 days post hospitalisation are covered.
Floater Basis Family is covered in all policies, where family is specified as the policy holder, spouse and dependent children (upto 25 years of age) and dependent parents.
Free Health Check up Free health check-up after every 4 claim free years.
Portability A prospective customer can port their cover from a third-party insurance provider to Future Generali.

Types of Future Generali Health Insurance Plans
Future Generali offers insurance coverage in two variations: Individual Plans and Family Health Insurance Plans.

1: Future Generali Health Total Plan- This is Future Generali’s most popular insurance plan. It provides comprehensive coverage with the highest range of sum insured and covers available for both individual and family.

2: Future Generali Future Health Suraksha(Individual Plan)– This policy is specifically geared towards the needs of an individual to provide financial protection against sudden hospitalisation expenses.

3: Future Generali Future Health Suraksha (Family Plan) –This is a family floater plan for the policy holder, spouse and 2 dependent children. It has four plans – basic, gold, silver and platinum divided by specific geographical zones to account for the cost.

4: Future Generali Accident Suraksha(Personal Accident) – This is an individual policy intended to provide financial coverage in case of an accident.

5: Future Generali Future Criticare(Critical Illness) Policy –This is a critical illness policy which provides coverage in case of diagnosis of any of the 12 critical illness or medical events.

6: Future Generali Future Hospicash(Hospital Cash) Policy –This plan provides fixed daily benefit as a method to provide financial protection against lost income during hospitalisation.

7: Future Generali Future Health Surplus (Top-Up)Policy – This is a top-up policy aimed at providing reasonable coverage at low premium. This is available on individual and floater basis.

Future Generali Health Insurance Plans in detail
1: Future Generali Health Total Plan
There are three variations to this plan – Vital, superior and Premier

Features Description
Entry age 1 day
Type of Plan Individual / Floater
Sum Insured 3-100 lacs
Coverage for Spouse, dependent children (upto 25 years of age) and dependent parents
Policy term 1-3year

Inclusions, Benefits and Features
  • In-patient hospitalisation – Expenses for hospitalisation like rent, boarding, medical supplies will be covered upto sum insured.
  • Pre-hospitalisation – Expenses prior to 60 days from hospitalisation for the same illness which requires hospitalisation will be covered.
  • Post-hospitalisation – Expenses incurred for treatment post hospitalisation will be covered upto 90 days for Vital plan, 120 days for Superior and 180 days for premier plan.
  • Ambulance expenses – Ambulance charges for emergency hospitalisation covered upto a specific limit.
  • Organ donor expenses – Expenses incurred when donating an organ for transplant is covered.
  • Outpatient medical treatment – Covered for Superior and Premier plan.
  • Day-Care Procedures - The medical expenses for all day-care procedures, which do not necessarily require 24 hours of admittance, will also be covered
  • Domiciliary Treatment – Expenses incurred for treatment of illness at home which would otherwise require hospitalisation is covered
  • Emergency Ambulance–Expenses incurred for emergency ambulance service will be reimbursed.
  • Free Health Checkup–Expenses towards health check-up are covered if there are four claim free years prior to the current period.
  • Restoration of Sum Insured–This policy enables the basic sum assured to be reinstated once it has been exhausted during the year.
  • Accompanying Person Travel - The policy covers travel charge of transferring a patient from one hospital to another via flight.
  • Child vaccination – Coverage offered for reasonable number of vaccinations.
  • New born baby – covered.
  • Medical treatment abroad for listed conditions–Upto certain limits
  • Alternative treatment– Available for alternative treatments AYUSH.
  • E-Opinion–The policy beneficiaries can get a second medical opinion form the company’s network of medical practitioner.
  • Emergency Medical Evacuation –The insured person will be reimbursed for expenses borne to transport from a local hospital to any other hospital.
  • Accidental Hospitalisation – The sum insured will be increased by 25% of the available sum insured in case of hospitalisation resulting from an accident.
  • Cumulative Bonus – Bonus is available for each claim free year with a maximum upto 50%.
Features Vital Superior Premier
Basic Sum insured per insured person per policy year(Rs. in Lacs) 3-10 lacs 15-25 lacs 50-100 lacs
Inpatient treatment Covered Covered Covered
Pre-hospitalisation 60 days 60 days 60 days
Post hospitalisation 90 days 120 days 180 days
Day Care procedures Covered Covered Covered
Domiciliary Treatment Covered Covered Covered
Emergency Ambulance Up to certain limit Up to certain limit Up to certain limit
E-opinion in respect of critical illnesses Covered Covered Covered
Automatic restoration Available Available Available
Bonus Upto 50% Upto 50% Upto 50%
Coverage for Spouse, dependent children (upto 25 years of age) and dependent parents Self, spouse, dependent (unmarried and up to the age of 25 years) or non – dependent children, dependent or non – dependent parents, dependent siblings, daughter in law, son in law, parents in law, grandparents and grandchildren (maximum up to 15 members). Self, spouse, dependent (unmarried and up to the age of 25 years) or non – dependent children, dependent or non – dependent parents, dependent siblings, daughter in law, son in law, parents in law, grandparents and grandchildren (maximum up to 15 members).

2: Future Generali Future Health Suraksha (Individual Plan)
Features Description
Entry age 18-70 years
Type of Plan Individual
Sum Insured Upto 10 lacs for less than 55 years; upto 5 lacs for more than 55 years
Coverage for Policy holder only
Policy term 1 year

Inclusions, Benefits and Features
  • In-patient hospitalisation expenses
  • Pre-hospitalisation – 60 days
  • Post-hospitalisation – 90 days
  • Ambulance charges – Upto Rs. 15,000
  • Day care procedures – Covers upto 130 day care procedures
  • Accidental hospitalisation – Limit can be increased by upto 25% of the available sum insured capped at Rs 1lac
  • Accompanying person’s expenses – UptoRs. 500 per day
  • Patient Care expenses - Up to Rs. 350 per day for those over 60 years
  • Hospital Cash Benefits – Available for Platinum plan.

3: Future Generali Future Health Suraksha (Family Plan)
Features Description
Entry age 18 to 70 years. Dependent child from 3 months and up to 25 years.
Type of Plan Individual / Floater
Sum Insured Upto 10 lacs for less than 55 years; upto 5 lacs for more than 55 years
Coverage for Policy holder, spouse, dependent children.
Policy term 1 year

Inclusions, Benefits and Features
  • In-patient hospitalisation expenses
  • Pre-hospitalisation – 60 days
  • Post-hospitalisation – 90 days
  • Ambulance charges – Upto Rs. 15,000
  • Day care procedures – Covers upto 130 day care procedures
  • Accidental hospitalisation – Limit can be increased by upto 25% of the available sum insured capped at Rs 1lac
  • Accompanying person’s expenses – Upto Rs. 500 per day
  • Patient Care expenses - Up to Rs. 350 per day for those over 60 years
  • Hospital Cash Benefits – Available for Platinum plan.

4: Future Generali Accident Suraksha
Features Description
Entry age 18 to 70 years. Dependent child from 3 months and up to 25 years.
Type of Plan Individual
Sum Insured Upto Rs. 10lacs; Sum Insured is based on the monthly income commensuration and risk class – Class 1,2,3.
Coverage for Individual
Policy term 1 year

Inclusions, Benefits and Features
  • Disability or Death Due to Accident -Permanent Total Disability, Permanent Partial Disability, Temporary Total Disability & Death arising due to Accident
  • Repatriation Benefit -Expenses for repatriation of remains and funeral is available upto a maximum of 1% of Accidental Death Sum Insured, capped at Rs. 12,500.
  • Terrorism - Covered
  • Hospital Cash Allowance – Receive per day cash benefit for hospitalisation resulting from accident.
  • Loan Protector - In the event of accidental death or permanent total disablement, lump sum will be paid
  • Adaptation Allowance - In case of a Permanent Total disablement resulting from an accident, an amount upto 10% of the basic sum insured capped at Rs. 50,000 will be reimbursed to modify house or vehicle.
  • Family Transportation Allowance –In case the insured person is hospitalised in a location 100kms from his place of residence due to an accident, the cost for transportation for family will be covered, upto a maximum of 10% of basic sum insured, capped at Rs. 50,000.
  • Other covers - Child Education Support, Life Support Benefit, Accidental Medical expenses, Accidental Hospitalisation.

5: Future Generali Future Criticare
Features Description
Entry age 18 to 65 years
Type of Plan Individual/Floater
Sum Insured 1-50 lacs (max 20lacs for above 45 years)
Coverage for self, spouse, 2 dependent children, 2 dependent parents
Policy term 1 year

Inclusions, Benefits and Features
  • Lump sum benefit – Upon survival of first 28 days of diagnosis, the insured person and family can claim the entire sum insured in a lump sum payment.
  • Covers Cancer (cancer of specified severity), Kidney failure requiring regular dialysis, Primary pulmonary arterial hypertension, Liver failure, Multiple sclerosis with persisting symptoms
  • Surgical procedures like Major organ/bone marrow transplant, Open chest CABG (coronary artery bypass graft) andAorta graft surgery are also covered.

6: Future Generali Future Hospicash
There are four plans available – Plan A, B, C, D. Income criteria not applicable in Plans A and B. Plans C and D require minimum monthly income of 50,000 and 70,000 respectively.

Features Description
Entry age 6 months to 65 years
Type of Plan Individual / Floater
Sum Insured Upto Rs. 3000 per day as daily hospitalisation benefit
Coverage for Incidental hospital expenses for self, spouse, 2 dependent children.
Policy term 1 year

Inclusions, Benefits and Features
  • ICU Benefit Within the City of Residence - Twice of the per day benefit if the insured person is hospitalised in ICU within city of residence
  • ICU Benefit Outside Your City of Residence - Thrice of the per day benefit if the insured person is hospitalised in ICU outside of city of residence.
  • Additional Convalescence Benefit - Benefit of Rs 5000 for hospitalisation of more than 10 days.
  • ICU Benefit –Available for maximum period of 10 days for each hospitalisation and maximum 20 days during the policy term.

7: Future Generali Future Health Surplus
Features Description
Entry age 18 to 65 years
Type of Plan Individual / Floater
Sum Insured 3-10 lacs
Coverage for Spouse, dependent children. This is a high deductible health policy which acts as a top up plan.
Policy term 1 year

Inclusions, Benefits and Features
  • In-patient hospitalisation
  • Expenses covered for Surgeon, Anaesthetist, Medical Practitioner, Consultants, Specialists Fees,Anesthesia, Blood, Oxygen, Operation Theatre Charges, Surgical Appliances, Medicines &Drugs, Diagnostic Materials and X-ray, Cost of Pacemaker, prosthesis / internal implants andany medical expenses important to the operation
  • Pre–hospitalization expenses – upto 60 days
  • Post–hospitalization expenses – upto90 days

Future Generali Exclusions:
  • Pre-Existing Diseases / Illness: coverage offered after 48 months
  • Pre-acceptance medical screening: Person above 50 years will need to undertake medical tests before being covered
  • Treatments for intentional self injury
  • Any pre-existing diseases will not be covered for a period of 48 months of Continues coverage under the policy, applicable only for critical illness.
  • In case of insured above 65 years of age only 1 year policy will be issued which can be renewed further on annual basis.
  • First occurrence of any medical condition or within 90 days of policy entry
  • Any claim arising or resulting from the Insured Person committing any breach of the law with criminal intent.
  • War, invasion, act of foreign enemy, hostilities
  • Ionising radiation or contamination by radioactivity from any nuclear fuel.
  • Nuclear weapon materials.
  • Usage, consumption or abuse of substances such as intoxicants, hallucinogens, alcohol and/or drugs.
  • Any sexually transmitted diseases, Acquired Immune Deficiency Syndrome (AIDS), AIDS-related complex syndrome (ARCS).
  • While serving in the Military or Armed Forces.
  • Any act of terrorism regardless of any other cause or event contributing concurrently or in any other sequence to the loss

Future Generali Login:
  • For Individuals: Log into the Future Generali Health Insurance website with your User ID and password.
  • You can generate user id and password by registering on the website with your name, phone, email, and password. You can login with your registered email ID and password.

Future Generali Health Insurance Renewal:
  • Visit the Future Generali Health Insurance website renewals page and provide policy number.
  • After such you will be provide the option to take a look at your policy and pay for renewal via online payment.

Future Generali Health Insurance Claim Settlement:
Cashless Reimbursement
Go to hospital and present Future Generali health insurance card Go to hospital (non-empanelled)
Avail cashless facility as application. Upon discharge pay the bills and collect all receipts
After discharge hospital sends bill to FGH Fill claim form and submit the form with all the receipts to Future Generali.
FGH settles bill After claim scrutiny FGH settles bill as applicable

Future Generali Health Insurance FAQs:
1: Where can I download claims form from?
You can download claims form from this link - https://general.futuregenerali.in/forms-and-downloads

2: What are the details to be provided at the time of intimation of claim?
Following are the information required at the time of intimation:
  1. Health card
  2. Duly filled claim form
  3. Doctor's consultation papers
  4. Investigation reports (e.g. X-ray, scans, blood report, etc.)
  5. Pharmacy invoices supported by respective prescriptions
  6. In cases of accidents, Medico Legal Certificate (MLC) and / or FIR
  7. Discharge summary
  8. Other relevant documents
3: Are my existing diseases covered?
Existing diseases covered after 48 months of continuous coverage with Future Generali. There are exceptions in illness specific policies like policies designed for diabetic patients, cancer patients, HIV positive patients etc

4: Does health insurance cover diagnostic charges like X- ray, MRI or ultrasound?
All diagnostic charges like X- ray, MRI, blood tests etc are covered if they are in relation to hospitalisation for at least 24 hours.

5: Is a medical check-up necessary before buying a Health policy?
Medical check-up is necessary for persons aged 50 years and above.

6: What is the maximum number of claims allowed during the year?
Unlimited number of claims is allowed during the year up to the maximum exhaustion of sum insured.

7: How to claim for pre and post hospitalization?
The claim documents for pre and post hospitalization should be submitted within a specific number of days of completion of treatment or period.

8: Does any health policy cover expenses on outpatient treatment also?
Usually policies cover only in-patient treatment but the Future Generali Health Total covers out-patient treatments.

9: Can foreigners avail policy or is it restricted to Indian nationals?
Foreigners living in India can avail policy but the coverage will be limited to India.

10: Does the list of hospitals remain the same?
The list of hospitals may or may not change and Future Generali Health Insurance reserves the right to modify, add or restrict any network hospital for cashless services available under the policy.