Documente Academic
Documente Profesional
Documente Cultură
Product Presentation
February, 2014
Confidential, unpublished property of CignaTTK, Do not duplicate or distribute. Use and distribution limited solely to authorized personnel.
Copyright 2014 (CignaTTK Health Insurance Company Limited)
Overview
CignaTTK Its Mission & Strength
Introducing ProHealth
A Plan to Cover You Completely
ProHealth at a Glance
ProHealth Features, Waiting Period and Exclusions
Plan Options and Benefit Structure
ProHealth USP
Premium
Confidential, unpublished property of CignaTTK, Do not duplicate or distribute. Use and distribution limited solely to authorized personnel.
Copyright 2014 (CignaTTK Health Insurance Company Limited)
What is CignaTTK?
Mission Statement
Confidential, unpublished property of CignaTTK, Do not duplicate or distribute. Use and distribution limited solely to authorized personnel.
Copyright 2014 (CignaTTK Health Insurance Company Limited)
Introducing
CignaTTK
ProHealth
Insurance
Policy
At Cigna TTK our aim is to encourage you to stay healthy
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Copyright 2014 (CignaTTK Health Insurance Company Limited)
Emotional Well-Being
We understand life is not always a easy ride. We are there at
every stage of your life with benefits ensuring your Emotional
Well-Being.
Financial Well-Being
We always strive to bring a smile on your face and what better
way then to celebrate with your Financial Well-Being.
Confidential, unpublished property of CignaTTK, Do not duplicate or distribute. Use and distribution limited solely to authorized personnel.
Copyright 2014 (CignaTTK Health Insurance Company Limited)
ProHealth at a Glance
Physical Well-Being
Emotional Well-Being
Financial Well-Being
In-Patient Hospitalization
Pre & Post Hospitalization
Day Care Treatment
Health Maintenance Benefit
Healthy Rewards
Health Check-up
Domiciliary Treatment
Restoration of Sum
Insured
Cumulative Bonus
Critical Illness Add-on
Cover
Discounts on Premium
Deductible
Tax Benefit
Domiciliary Treatment
If situation requires treatment to be taken at home & condition for treatment continues for 3 days, same is
covered under this benefit provided that the patient cannot be shifted to the hospital or there is no bed
available in the hospital.
Ambulance Cover
If an Insured is required to be transported to the hospital for treatment during emergency, same will be
covered under Ambulance Cover up to the amount eligible under the plan
Confidential, unpublished property of CignaTTK, Do not duplicate or distribute. Use and distribution limited solely to authorized personnel.
Copyright 2014 (CignaTTK Health Insurance Company Limited)
Confidential, unpublished property of CignaTTK, Do not duplicate or distribute. Use and distribution limited solely to authorized personnel.
Copyright 2014 (CignaTTK Health Insurance Company Limited)
Cumulative Bonus
We will increase the SI by 5%/10% as per the plan opted in case of no claim in the expiring policy with us.
Maximum of 50% CB can be accumulated. There will be no reduction in CB for subsequent claims.
Healthy Rewards
You can earn reward points from the time you buy the policy- equal to 1% of premium paid. In addition, reward
points can be earned by opting for our Online Wellness programs. Maximum of 5 programs can be opted by an
insured in a policy year. Earned points can be redeemed for a discount in premium or as Health Maintenance
Benefits from year 3 onwards.
Voluntary Co-Pay
Under Protect and Plus plan insured can choose co-pay option of 10%/20% whereby we will pay only
90%/80% of the admissible claim amount.
10
30 days
from expiry
date
Mandatory Co-pay
Grace Period
Protect
2.5L/3.5L/4.5L
Plus
4.5L/5.5L/7.5L/10L
Preferred
15L/30L/50L
Premier
1Cr
Renewals
will be
available
for life
time
Renewability
Allowed as
per IRDA
guidelines
Portability
1&2
Years
Policy Term
Cancellation can
be intimated to
company giving
15 days notice.
Refund will be on
short period scale
Cancellation
Eligibility
Individual Policy
covering Self, Spouse,
Parents, Siblings, Inlaws and Grand
Parents/Grand Children
Floater Policy with Max
2 adults and 3 children
(self, spouse,
dependent children,
parents)
Free look
Policy Type
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11
Inpatient
Hospitalization
Prehospitalization
Ambulance
Cover
Domiciliary
Treatment
Donor
Expenses
Expert
Critical Opinion on
Critical
Illness
Illness
Cover
(add-on)
Healthy
Rewards
Health
Check
Up
Posthospitalization
Worldwide
Emergency
Cover
Cumulative
Bonus
Day Care
Treatment
Restoration Of
Sum Insured
First Year
Vaccination
New Born
Baby Cover
Health
Maintenance
Benefits
Maternity
Expenses
Deductible
Reduction
in
Maternity
Waiting
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Voluntary
Co-pay
12
The Premium charged on the Policy will depend on the Plan, Sum Insured, Policy Tenure, Age,
Policy Type, Gender, Zone of Cover, Optional Covers and Add On Benefits opted.
To calculate premium, the country has been divided into Zone 1, Zone 2 and Zone 3.
Zone I: Mumbai, Thane & Navi Mumbai and Delhi & NCR
Zone II: Bangalore, Hyderabad, Chennai, Chandigarh, Ludhiana, Kolkata, Gujarat
Zone III: Rest of India excluding the locations mentioned under Zone I & Zone II
Identification of Zone will be based on the City of the proposed Insured Persons.
(a) Persons paying Zone I premium can avail treatment all over India without any sub limits.
(b) Persons paying Zone II premium
i) Can avail treatment in Zone II and Zone III without any Co-pay.
ii) Availing treatment in Zone I will have to bear Co-pay of 10% of each and every claim.
(c) Person paying Zone III premium
i) Can avail treatment in Zone III, without any Co-pay.
ii) Availing treatment in Zone II will have to bear Co-pay of 10% of each and every claim.
iii) Availing treatment in Zone I will have to bear Co-pay of 20% of each and every claim.
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Policy Discounts
Family Discount 10% for covering more than 2 members of the same family under a single policy
Long Term Discount 7.5% for opting a 2 year policy
Copay Discount 7.5% for opting a 10% Copay
15% for opting a 20% Copay
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14
First 30 days WP: From policy inception date a period of 30 days will apply for hospitalization
claims except for accidents.
Two Years WP: 24 months WP will apply on specific ailments like
Cataract
Knee Replacement surgery
Urinary Stones
All type of Hydrocele
Sinusitis, Surgery on Tonsils
Gastric, Cysts, Polyps, Internal/Skin tumors, Breast lumps
Maternity Waiting Period: 48 months WP will apply unless Reduction of MWP opted in which
case it will be 24 months.
Personal Waiting Period : A Maximum of 48 months of WP can apply as per UW decision for
specific ailments as declared at the time of proposal or subsequent diagnosis during Medical
Tests.
CI Waiting Period: 90 days WP will apply on CI add on cover
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We will not pay any claims arising out of or attributable to any of the following:
1. Genetic Disorder
2. Dental treatment.
3. Circumcision
4. Birth control procedures, contraceptive supplies and services
5. Routine medical check-up and diagnostic tests
6. AIDS and all diseases/illnesses caused by or related to HIV
7. All sexually transmitted diseases
8.Mental Illnesses
9. Aliments arising out of alcohol and drug abuse
10. Cosmetic surgery except reconstructive surgery for burns and accidents.
11. Any form of non-allopathic treatment
12.Any robotic or remote surgery
13. Any amount which falls under the deductible or co-pay
14. Non Medical Expenses Listed as per IRDA
Above List is only indicative and not exhaustive and does NOT apply to Health
Maintenance Benefits
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16
Sum Insured
Protect
2.5 Lac,
3.5 Lac,
4.5 Lac
In-patient
Covered up to
Hospitalization Shared room
Pre Covered up to 60 days before date of hospitalisation
Hospitalization
Covered up to 90
Post
Basic
days post discharge Covered up to 180 days post discharge from hospital
Hospitalization
Covers
from hospital
Day Care
Covered up to full Sum Insured
Treatment
Domiciliary
Covered up to full Sum Insured
Treatment
Up to 2000 per
Ambulance
Up to 3000 per hospitalization event
Actual expenses paid per hospitalization event
hospitalization
Cover
event
Donor Expenses Covered upto full Sum Insured
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17
Restoration Of
Available once in a policy year for unrelated illnesses in addition to the Sum Insured opted
Sum Insured
Health
Basic Maintenance
Covers Benefits
Maternity
Expenses
Premier
Reimbursement of
500
Not Available
Reimbursement of 2000
Covered upto 15,000 for normal delivery and
25,000 for C- Section per event
After a Waiting Period of 48 months
Not Available
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18
Health CheckUp
Expert Opinion
on Critical
Available once during the Policy Year
Value illness
added
Cumulative 5% Increase in Sum Insured, maximum
10% Increase in Sum Insured, maximum upto 50%
covers
upto
50%.
Bonus
Healthy
Rewards
Not
Available
Reward Points to be earned for each year of premium paid & accumulated for 2 years. Points can also be earned for
enrolling & completing Our Online Wellness Programs. These earned Points can be used to get a discount in premium from
the 3rd Annual premium or can be redeemed aganist Health Maintanance Benefits.
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19
Plus
Preferred
Premier
Deductible Options for Protect Plan Deductible Options for Plus Plan
2.5
Lac
3.5
Lac
Optional
covers
4.5 Lac
2 Lac
1 Lac
1 Lac
Deductible*
1 Lac
NA
4.5
Lac
2 Lac
5.5
Lac
2 Lac
7.5
Lac
2 Lac
Not Available
3 Lac
Not
available
3 Lac
10 Lac 3 Lac
* Voluntary Co-pay and Deductible cannot be taken under a single plan
Reduction in
Maternity
Not Available
Waiting
Voluntary Co- 10% or 20% voluntary co-payment for each and every claim as opted on
Not Available
Payment*
the Policy
Add on cover Critical Illness Lump sum payment of 100% of Basic Sum Insured Opted
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Not
Available
Not
Available
20
Confidential, unpublished property of CignaTTK, Do not duplicate or distribute. Use and distribution limited solely to authorized personnel.
Copyright 2014 (CignaTTK Health Insurance Company Limited)
Restorati
on
Healthy
Rewards
Cumulati
ve Bonus
Health
Maintena
nce
Benefit
Deductibl
e
Critical
Illness
Cover
Worldwid
e Cover
Maternit
y New
Born &
Vaccinati
on Cover
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22
CignaTTK ProHealth
When the basic SI is insufficient due to claims paid or accepted as payable,
the same will be restored to 100% of basic SI. This does not require the
Basic SI + CB to be exhausted completely.
Example 1:
Mr. Ram has taken an individual Protect plan for 2.5 L. Policy term 1 year.
He has already received a claim for 2.4 lac under hospitalization due to
accident. In the same policy year he is admitted to hospital for Jaundice
where the claim amount is Rs 50,000 and claim is accepted.
Under Restoration, the Basic SI will be restored to 100% to honor the
claim.
Restoration
Restoration benefit available with competitors only restores once the Sum
Insured + earned CB is fully exhausted. However at CignaTTK we will
restore even when the balance Sum Insured is insufficient.
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CignaTTK ProHealth
For any claim free year, the expiring SI will be increased by 5 % (Protect plan) /
10 % (Plus & Preferred plans). The CB can accrue upto a Max of 50%.
CB will not accrue in the year in case of a claim.
Example 1:
Ms. Sheena has taken an individual Plus plan for 10 L. Policy term 2 year.
No claim is registered in the 1st Policy year. Accordingly in the 2nd Year she will
be eligible for 10% CB on Basic SI of 10L. CB accrued will be Rs.1L.
If she renews policy after expiry of 2nd year and there is no claim in the 2nd year
also. She further receives a CB of 10 % on Basic SI. So Total CB is 20% of
Basic SI (2L).
In this fashion, she will be eligible for a maximum of 50% CB.
However if there is a claim in the 2nd year, the CB bonus will remain as 10%. We
will not reduce the earned CB which is her reward. No CB will be given for 2nd
year as there is a claim.
CB will start accruing again from the year in which no claim has been made.
Cumulative
Bonus
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CignaTTK ProHealth
A Deductible Plan offers the customer to bear the expenses on any claim up
to the amount of opted Deductible.
Deductible Plans will be best suited for persons with existing cover or persons
who can share part of the expenses. It enables you to top up your existing
cover with much lower premium outgo as compared to a fresh cover.
Deductible
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CignaTTK ProHealth
Maternity benefit available for max of 2 deliveries/lawful terminations for
insured aged between 18-45 years.
Maternity &
New Born
Cover
Market Practice
Most retail plans in the market do not offer Maternity & New Born Cover. Where the plans are offered
they have a waiting period of 48 months and Vaccination costs are not payable. The Vaccination expenses
(if available in plan) is included within the maternity benefit SI.
With ProHealth we provide an option to reduce this waiting period to 24 months and cover Vaccination
expenses over and above the Maternity Sum Insured
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CignaTTK ProHealth
In Worldwide Emergency Cover we will reimburse Inpatient hospitalization
expenses for illness and injury outside India.
The cover will be limited to the SI of the plan and sub limit specified. Insured
can avail this benefit once in policy year.
Worldwide
Emergency
Cover
Example: Mr. Rajan has a Plus plan with SI Rs.10 L. On his trip to Malaysia
he meets with an accident and incurs $25000 (Malaysian) as Hospitalization
expenses.
He registers a claim for reimbursement of the expenses.
RBI exchange rate on the date of payment of expenses: $1 (Malaysian)=
INR. 20.
The inpatient expenses = $20000.
Total claim amount: Rs.400000
SI under the plan Rs.10L
The admissible claim amount under WWEC is Rs.4L.
Market Practice
All health policies cover only admission within India. Even where offered the
same is available for specified Critical Illnesses.
Under ProHealth the benefit is available for all kinds of emergency
treatments .
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27
CignaTTK ProHealth
Critical Illness
Cover
CI benefit as in Market
Floater Policies in the marker offer Critical Illness on Floater basis, hence
once a claim is made by any one Insured Person the coverage under Critical
Illness section will cease.
At CignaTTK we will Reinstate the Sum Insured for Critical Illness for floater
policies for the 2nd Adult Insured.
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CignaTTK ProHealth
Benefit can be used to cover costs for Diagnostic tests, drugs, prosthetics,
medical aids, prescribed by a doctor as per limit under the plan.
They can also be used for Dental Treatments and Alternative Forms of
Medicines.
Health
Maintenance
Benefit
We will connect with you to ensure that you use the benefit.
Market Practice
Most health policies do not offer any cover for such expenses. At Cigna TTK
we would like you to make sure you take care of your health even when
they are minor ailments which do not require hospital admission.
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CignaTTK ProHealth
Healthy
Rewards
Reward Programs
Currently no player offers a reward program of this nature which aims at
motivating customers to maintain a healthy lifestyle.
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30
Age 25 yrs.
Term 1 yr.
Plus Plan
Sum Insured
2.5Lac
3.5 Lac
4.5 Lac
4.5 Lac
5.5 Lac
7.5 Lac
10 Lac
1 Adult
(Male/Female)
3610/3170
4030/3510
4410/3810
6160/6600
6390/6780
7300/7520
7940/8040
2 Adult
5210
5850
6440
9630
9980
11370
12320
12180
12670
14590
15910
14320
14920
17250
18870
2A + 1 Kid
2A + 2 Kid
6800
7710
8540
9320
8200
10360
Preferred Plan
Premier Plan
Sum
Insured
15 Lac
30 Lac
50 Lac
100 Lac
1 Adult
(M/F)
21370/
24050
26110/
27910
28960/
30230
34640/
34840
2 Adult
31740
41150
46810
58080
2 A+1K
39180
51440
58810
73620
2A+2K
45830
60340
69070
86730
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35 yrs.
Term 1 yr.
Plus Plan
Sum Insured
2.5Lac
3.5 Lac
4.5 Lac
4.5 Lac
5.5 Lac
7.5 Lac
10 Lac
1 Adult
(Male/Female)
4210/3740
4700/4140
5130/4490
7370/7970
7640/8180
8890/9620
9680/9920
2 Adult
5930
6660
7290
11360
11750
13350
14440
14030
14560
16680
18140
16370
17020
19570
21340
2A + 1 Kid
2A + 2 Kid
7510
8950
8490
9370
10150
11240
Preferred Plan
Premier Plan
Sum
Insured
15 Lac
30 Lac
50 Lac
100 Lac
1 Adult
(M/F)
25830/
29180
31510/
33900
34920/
36730
41710/
42380
2 Adult
40990
54450
62530
78640
2 A+1K
49110
65300
75030
94770
2A+2K
56880
75530
86740
109790
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45 yrs.
Term 1 yr.
Plus Plan
Sum Insured
2.5Lac
3.5 Lac
4.5 Lac
4.5 Lac
5.5 Lac
7.5 Lac
10 Lac
1 Adult
(Male/Female)
6540/5790
7610/6700
8660/7600
13100/12360
13630/12800
16050/14870
18000/16550
2 Adult
8600
9990
11400
16060
16680
19340
21200
10230
11860
19020
19780
22970
25200
21890
22780
26450
29040
2A + 1 Kid
2A + 2 Kid
11880
13490
13750
15590
Preferred Plan
Premier Plan
Sum
Insured
15 Lac
30 Lac
50 Lac
100 Lac
1 Adult
(M/F)
36350/
35860
46860/
44810
53170/
50180
65770/
60900
2 Adult
50250
67740
78250
99210
2 A+1K
59040
79160
91260
115930
2A+2K
67940
90720
104410
132860
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55 yrs.
Term 1 yr.
Plus Plan
Sum Insured
2.5Lac
3.5 Lac
4.5 Lac
4.5 Lac
5.5 Lac
7.5 Lac
10 Lac
1 Adult
(Male/Female)
11400/11090
13710/12130
15770/13920
22710/20420
23760/21320
28430/25390
33140/29520
2 Adult
14570
17570
20220
25350
26520
31720
35440
28520
29790
35380
39360
32380
33780
39900
44230
2A + 1 Kid
2A + 2 Kid
16000
17660
19140
21940
21050
24070
Preferred Plan
Premier Plan
Sum
Insured
15 Lac
30 Lac
50 Lac
100 Lac
1 Adult
(M/F)
50200/
46700
69440/
63450
80980/
73500
104050/
93580
2 Adult
68190
95540
111950
144730
2 A+1K
76780
106140
123780
159650
2A+2K
86430
118550
137840
177690
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This material is not a public document and it is meant solely for internal use of CignaTTK Health Insurance Company Limited
(CignaTTK). This material shall be used solely for the training, recruitment, and education of personnel, intermediaries,
counselors, and solicitors of CignaTTK and the same shall not be used to induce the public to purchase, increase, modify, or
retain a policy of insurance.
Offered by: Connecticut General Life Insurance Company or Cigna Health and Life Insurance Company.
Cigna, the Tree of Life logo and GO YOU are registered service marks of Cigna Intellectual Property, Inc., licensed for
use by Cigna Corporation and its operating subsidiaries. All products and services are provided by or through such
operating subsidiaries and not by Cigna Corporation. Such operating subsidiaries include Connecticut General Life
Insurance Company, Cigna Health and Life Insurance Company, and HMO or service company subsidiaries of Cigna Health
Corporation and Cigna Dental Health, Inc. All models are used for illustrative purposes only.
000000 00/13
V_1.0_19/02/2014
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