Life Line MediCash: A defined benefit health insurance plan offering Hospital Cash benefit along with

ICU cash and recuperation cash benefits.

Max New York Life's proposed 3-step processes to avail benefit of hospitalization expenses for our Lifeline-
Medicash customers:
1. Select any of our listed 4000+ network hospitals across the country.
2. Get yourself treated while we will provide financial assistance with fixed benefits to take care of the
hospitalization expenses.
3. Walk out fully treated and without a big hole in your pocket.

Presenting Lifeline- MediCash ™, a health Insurance plan from MNYL that provides support by giving cash
benefit against hospitalization by way of hospital cash benefit, ICU Cash benefit and recuperating cash benefit,
whenever you are Hospitalized, which will help you with your expenses towards such events.

I) Key features of Lifeline - MediCash

• Cashless hospitalization available in over 4000+ network hospitals across the country.
• Fixed daily hospitalization benefit available irrespective of amount of actual billing.
• Benefits are Payable in addition to any other health insurance cover that you may have with us or any other
Insurance Company.
• The premiums are guaranteed for five years from the effective date. After such five years, Company may revise
the premium rates based upon the actuarial review of the claims experience subject to prior
approval of IRDA.
• Guaranteed Long-Term coverage for 10 years subject to payment of premium made by you.
• Premium discount incase no claim is filed during first 5 years of the policy.
• Tax benefit on the premium paid up to Rs.15, 000 under section 80 D of the Income Tax Act.

Scale of Benefit/Units
The scales of benefits as specified in the table below are denominated as "Units". A unit is a representation of the
collective set of benefit that you propose for Lifeline MediCash™ policy.

Benefits Number of Units

1 2 3 4 5
Daily Hospital Cash Benefit Rs. 1000 Rs. 2000 Rs. 3000 Rs. 4000 Rs5000

Daily ICU Cash Benefit Rs. 2000 Rs. 4000 Rs. 6000 Rs. 8000 Rs.10000

Recuperating Cash Benefit Rs. 3000 Rs. 6000 Rs. 9000 Rs. 12000Rs.15000
(Lump-Sum)

Annual Limit (No. of Days)

(Aggregated for all the benefits) 50 days of Hospitalization
Policy Term Limit (No. of Days) 250 days of hospitalization
(Aggregated for all the benefits

When you file a claim for your being hospitalized, then subject to the terms and conditions of the policy, you will
get-
• Hospitalization Cash Benefit of Rs. 2000 per day
• If admitted into ICU, then ICU Cash Benefit of Rs.4000 per day and
• If hospitalized for at least 7 days and advised by doctor, then Recuperating Benefit of lump-sum of Rs. 6000

Lifeline- MediCash Benefits:

1. Hospital Cash Benefit

• In case of an unfortunate event of your being hospitalized for a medically necessary treatment or surgery for any
illness or injury, for a continuous and consecutive period of at least 48 hours, the company shall pay fixed per
diem benefit as per the unit/ scale of benefit applicable, for the period of hospitalization but excluding the first 24
hours of such hospitalization and subject to such limits of the policy.
• This is a fixed amount paid irrespective of your actual hospital bill.
• In scenarios, when you are hospitalized again for the same illness or injury that occurred during previous
hospitalization, within 30 days from the date.

2. ICU cash Benefit

• In case of your being required to and is admitted into an intensive care unit for a medically necessary treatment
or surgery of any illness or injury for a continuous period of 8 hours or more during hospitalization for a
continuous period of 24 hours or more, in addition to hospital cash benefit, an intensive care unit cash benefit
equivalent to 200% of hospital cash benefit will be payable on per day basis as per the unit/scale of benefit
subject to the terms and conditions of the policy.
• Expenses don't stop at hospital discharge, do they? Lifeline - MediCash™ also offers a fixed lump-sum
recuperation cash benefit to help you meet your follow-up investigation costs, consultation fees, cost of medicines
etc.

3. Recuperating cash Benefit

• In addition to hospital cash and ICU cash benefit, a lump-sum recuperating cash benefit equivalent to 300% of
the hospital cash benefit will be payable as per the unit/scale of benefit for a period spent on recuperation during
such hospitalization in respect of which the hospital cash or ICU cash benefit is admissible provided there has
been a continuous and consecutive period of hospitalization of 7 days or more and is discharged alive from the
hospital.

• Maximum benefit in a policy year (Number of Days)

Benefit shall be payable in aggregate across all benefits for a maximum of 50 days of hospitalization of the life
insured in a policy year. The balance days, if not claimed, cannot be carried forward to the following policy year.

• Maximum benefit during the policy term (Number of Days)

Benefits shall be payable in aggregate across all benefits for a maximum of 250 days of hospitalization of the life
insured during the policy term. In case if these 250 days has been claimed, the policy will terminate and insurance
cover would cease.
Advantages of Lifeline- MediCash™ Plan:
1) Multiple Claims:
Medi Cash covers you for 50 days in any policy year and a total of 250 days through the term of the policy.
2) Premium Guarantee for First Five Years:
Even if you have multiple claims, the premium you pay for your policy is fixed for the first five years of the
policy this helps you to remain covered by paying the same premium, in spite of registering any claims with us.
3) Discount for a Claim Free Policy:
Incase you do not file for a claim for the first five years of the policy term, we would offer up to 20% discount on
revised premium (if applicable)the from the 6 Policy Anniversary.
4) Payout In Addition to Other Plans:
You can avail benefit for same duration of hospitalization from this policy as well as
any other medical insurance policy that you may already have. The lump-sum benefit
amount, as per your entitlement will get paid to you, irrespective of the actual expenses
that you incur during hospitalization.
5) Transparency in Coverage Details:
Simple to understand plan-helps you to judge the amount of benefit that is Payable from
our side for any event of hospitalization at the inception of the policy.
6) Easy Claims Process- Fair, Fast and Friendly:
You can take advantage of the cashless hospitalization facility in over 4000 network
hospitals across the country subject to the pre-securitization of your request. Alternatively,
incase you are hospitalized in a non-network hospital; you can submit your bills, reports,
discharge summary etc. at any of our office

Following Flow- Chart depicts the Claims Process:

Network Hospital

Fill and Fax Scrutiny of Authorization Benefit Amount settled

Pre-Authorization Pre- Authorization Letter Faxed With Hospital as per
From request back entitlement

Hospitalization

Policyholder Settles Submits the claims Scrutiny of Entitled benefits

The Hospital Bill documents Post Claims request amount paid back
Himself Discharges to Policyholder

Non-Network Hospital
 ILLUSTRATED CLAIM SCENERIOS FOR YOUR BENEFIT
Example Ailment Number of Units Daily Hospital Benefit paid out Total
Hospital Days purchased Cash Limit (Rs.) (RsXno.of days) Amount

Example 1 Fever 4 days 2 Units 2000 2000 x 3 Room 6000

(Any origin)

Example 2 Pneumonia 3 days in 2Units 2000 (2000 x

2 Room 12000
Room + 2Days
days+4000x)
In ICU =5days = 2 ICU
days

Example 3 Recurrent 4 days in 2 Units 2000

(2000 x 3 Room 24,000
Urinary Room+3 Days days) +
(4000 x
Tract in ICU=7days 3 ICU Days) +
6000- RB *

ELIGIBILITY CRITERIA:

LifeLine MediCash plus Plan

Minimum /Maximum 18 years to 55 years (Age At Last Birthday

Age at Entry

Policy Term 10 years

Maximum

Maximum 65 years
Age at Maturity

Premium Guarantee 5 years

Units
Premium Table
 Age (yrs) Male Female

20 4824 4179

30 5082
4638

40 6105 6288

50 8652 8562

Premium Payment
Frequency Half Yearly and Yearly

Reinstatement Allowed only till 180 days from Lapse Date basis declaration of good health
After lapse

Premium Limits please select Units/Scale of Benefits as per your choice

subject to payment of
A minimum Yearly Premium of Rs. 2,500 and
Minimum Half-Yearly premium
Of Rs. 1300

Waiting Period 90 days from policy commencement apart from

hospitalization due to
Accident

Grace period provision

A grace period of thirty days from the due date for payment of each premium will be
allowed. During the grace period, the Company will accept the premium without interest.

Lapse
If a premium is not received by the company by the end of the grace period, the policy will
lapse. All Insurance cover will end upon lapse of the policy. No benefit is payable for any
hospitalization undertaken during the period when the policy has lapsed even though the
policy may be subsequently revived.

Revival of Policy
Within 180 days from the due date of the premium (period of revival) and before
termination of the policy, the policyholder may apply in writing for revival of the policy