Medical Insurance

All that you need to know!

Medical Insurance

Dhani App bring comprehensive Health care plan for all your necessary medical expenses for you powered by GoDigit Health Insurance. This insurance comes with cashless facility across the country in more than 4700+ hospitals. This insurance covers comes with number of features which includes COVID-19 & easy claim process.

Benefits

This medical insurance brings you below mentioned benefits:

  • Sum insured Rs.50,000
  • Covid-19 covered.
  • No Co-payment.
  • Room rent of 1% of Sum Insured per day in case of admission to the hospital
  • ICU charges will be covered up to 2% of Sum Insured per day in ICU.
  • Hospitalization expenses up to 30 days before getting admitted & up to 60 days post discharge are covered
  • Road Ambulance charges of up to 1% of Sum Insured are covered.
  • Pre-Existing Disease waiting period applicable is 4 years.
  • Waiting Period for certain specific illness like cataract, hernia, internal congenital disease, psychiatric illness, joint replacement etc. is 2 years. Details of all diseases are mentioned in the policy wordings.
  • Second Opinion of any illness is covered
  • Psychiatric Illness & Bariatric surgery is covered up to 20% of Sum Insured.
  • No ailment wise capping other than bariatric and Psychiatric illness.
  • All Day Care procedures are covered
  • Annual Health checkup is covered up to 0.25% of Sum Insured on renewal.
  • Organ Donor is covered
  • Emergency Ambulance charges is also covered

List of hospitals:

https://www.paramounttpa.com/Home/ProviderNetwork_GoDigit.aspx

Claim Process:

There are 3 types of claim process that this insurance cover offers Cashless Claim, Reimbursement & Advance Cash. For any type of claim intimation you can reach out to the GoDigit contact center at 1800-258-4242 or you can also drop a mail at healthclaim@godigit.com

Cashless Claim:

For cashless claim you need to follow a simple 3 step process

  • Intimation:
    • – Customer approaches network hospital for cashless treatment & displays the e-health card
    • – Hospital sends cashless request with all the details of medical condition, proposed treatment & estimate expense to TPA
    • – This is done on real time basis
  • Document upload:
    • – Adjudication of the cashless request as per the policy T&C by the TPA
    • – Query is raised for any further clarity/documentation
    • – Hospital furnishes all the required documents
    • – This process takes approximately 4 hours
  • Settlement:
    • – Approval for the treatment is given by Digit through TPA
    • – Amount is settled with the hospital/provider directly
    • – The settlement of the claim takes approximately 4 hours

Reimbursement Claim Process:

If you visit a non-network hospital, then post discharge customer can claim the reimbursement from Digit for the treatment. This takes 3 easy steps & the settlement of the claim is done in approximately 3-4 days.

  • Intimation:
    • – Customer gets admitted to the non-network hospital due to medical emergency/accident
    • – Post discharge customer calls Digit to registered the reimbursement claim
  • Document upload:
    • – Digit registered the claim & triggers a link for document upload
    • – Customer uploads all the relevant documents
    • – Claim team assess the documents & approves/denies the claim
  • Settlement:
    • – Claim teams check if any additional document is required
    • – Claim amount is transferred to customer’s bank account

Advance Cash:

This insurance also provides you the facility for the advance cash, in this facility you can get an advance cash request approved from Digit for medicals procedures which are planned in advance. You just need to follow the 3 steps for getting the advance cash request for claim.

  • Intimation:
    • – Employee chose a hospital (network/non-network) for a planned procedure
    • – Contacts the digit & share the consultation/medical records/estimate
  • Approval:
    • – Digit evaluates on the admissibility
    • – If eligible, approves the Advance Claim payment (if required)
    • – Employee gets admitted in the hospital for procedure
  • Settlement:
    • – On the day of procedure, 50% of the estimate to transferred to the Employee’s bank account
    • – Post discharge, employee share the final bill, Digit transfer the remaining amount to the employee

Disclaimer:

This communication is intended solely for the customers of Dhani Loans & Services Limited to enable them to enroll for Digit Health plus Policy (Revision) UIN: GODHLGP19013V021819 arranged through Go Digit General Insurance Limited

For more details, please read policy terms and conditions carefully before enrolling.

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