Reliance Personal Loan

Care Insurance Policy

Wording

reliancegeneral.co.in | 1800 3009 (toll free) |

(022 - 4890 3009)
IRDAI Registration No. 103.
Reliance General Insurance Company Limited.
Registered Office & Corporate Office: Reliance Centre,
South Wing, 4th Floor, Off. Western Express Highway,
Santacruz (East), Mumbai - 400 055.
UIN: RELHLIP07002V010607.
Corporate Identity No.: U66603MH2000PLC128300.
Trade Logo displayed belongs to Anil Dhirubhai Ambani
Ventures Private Limited and used by Reliance General
Insurance Company Limited under License.
RGI/MCOM/CO/HL-20/PW/Ver. 1.4/120219..
An ISO 9001:2015 Certified Company
 Preamble "Policy" is the Company's contract of insurance with the
policyholder providing cover as detailed in this Policy Terms &
WHEREAS the Insured / Insured Person designated in the conditions, the Proposal Form, Policy Schedule ,Endorsements,
Schedule to this Reliance Personal Loan Policy having by a if any and Annexures, which form part of the contract and must
proposal and declaration together with any statement, report or be read together.
other document which shall be the basis of the contract and shall
be deemed to be incorporated herein, has applied to Reliance "Policy period" means the period between the start date and the
General Insurance Company Limited (hereinafter called "the end date as specified in the Schedule or the cancellation of this
Company") for the insurance hereinafter set forth and paid policy, whichever is earlier.
appropriate premium for the number of days stated in the
“Pre-existing disease” means any condition, illness or injury or
Schedule.
related condition(s) for which the Insured/Insured person had
NOW THIS POLICY WITNESSETH that subject to the signs or symptoms and/or were diagnosed and/or received
definitions, terms, conditions and exclusions contained, medical advice/ treatment, within 48 months prior to the first
endorsed or otherwise expressed herein, the Company shall policy under which the Insured Person was covered with us.
compensate, indemnify, pay and/or reimburse the Insured /
“Schedule” means the document attached name so and to and
Insured Person or his/her legal representatives, as the case may
the forming part of this Policy mentioning the details of the
be, in respect of insured events occurring during the period of
Insured/ Insured Person/s, the Sum Insured, the period and the
insurance, in the manner and to the extent set forth in this Policy.
limits to which benefits under the Policy are subject to..
Definitions
"Sum Insured" means the sum as specified in the schedule,
“Accident(al)” is a sudden, unforeseen and involuntary event which sum represents the Company's maximum liability for any
caused by external, visible & violent means. or all claims under this Policy during the Policy period.

“Bank Rate” means Bank Rate fixed by the Reserve Bank of "Surgery" Surgery or Surgical procedure means manual and/or
India (RBI) at the beginning of the financial year in which claims operative procedure(s) required for treatment of an illness or
has fallen due. injury, correction of deformities and defects, diagnosis and cure
of diseases, relief of suffering or prolongation of life, performed in
“Personal loan EMI” means the equated monthly installment a hospital or day care centre by a medical practitioner.
payable by the Insured to a financial institution for the Personal
loan. “Standard type of aircraft” means any aircraft duly licensed to
carry passengers (for hire or otherwise) by an appropriate
"Illness" means a sickness or a disease or pathological authority irrespective of whether such an aircraft is privately
condition leading to the impairment of normal physiological owned or chartered or operated by a regular airline or whether
function which manifests itself during the Policy Period and such an aircraft has a single engine or multiengine.
requires medical treatment.
Scope of Coverage
“Injury” means accidental physical bodily harm excluding illness
or disease solely and directly caused by external, violent and Section A - Accidental Death & Permanent Total Disability
visible and evident means which is verified and certified by a
1. What is covered
medical practitioner.
This Section covers the Insured/Insured person up to the Sum
"Insurable/Insured event" means an event, loss or damage for
Insured specified in the Schedule, towards payment of his / her
which the Insured is entitled to benefit/s under this Policy.
personal loan on account of an injury, sustained during the
"Insurer" means Company i.e., Reliance General Insurance Co. Policy Period resulting in death or permanent total
Ltd. disablement, as the case may be, within 12 (twelve) calendar
months of occurrence of such injury.
"Insured Person/Insured" means the person specifically
named as such in the Schedule, who has a permanent place of Additionally, this Section provides for reimbursement, in the
residence in India and for whom the insurance is proposed and event of the death of the Insured due to injury caused, solely
the appropriate premium paid. and directly, by accidental, violent, external and visible means
outside his/her home, of the expenses incurred for
“Outstanding Personal loan” means the amount outstanding transportation of Insured's dead body to his/her place of
on any given day to a financial institution of the principal personal residence subject to a maximum of Rs 2,500/- for the entire
loan and interest thereon payable by the Insured. Policy period.
“Permanent Total Disability” shall mean an injury which shall In case of loans being under joint names of two persons, for
within twelve calendar months of its occurrence be the sole and each of the borrowers, the Sum Insured for the purpose of
direct cause of the total and irrecoverable loss of: claim under this Section, shall be 50% of the total Sum Insured
opted by the Insured and mentioned in the Schedule. Similarly
- sight of both eyes, or of the actual loss by physical separation
in case of loans with more than two persons as joint borrowers,
of two entire hands or two entire feet, or of one entire hand and
the Sum Insured of the outstanding loan amount will be divided
one entire foot, or of such loss of sight of one eye and such loss
amongst all of them in equal proportion of the Sum Insured,
of one entire hand or one entire foot,
subject otherwise to terms conditions of the Policy.
- use of two hands or two feet, or of one hand and one foot, or of
such loss of sight of one eye and such loss of use of one hand
or one foot.

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 The maximum liability of the Company shall in no case exceed pathological disturbances caused by the mental reaction
the Sum Insured as mentioned in the Schedule. to the same.

2. Basis of settlement 3. Accidental death or permanent disability caused by

curative measures, radiation, infection, poisoning except
Subject to the Sum Insured specified in the Schedule, where these arise from an accident.
coverage under this Section shall be as follows:
4. Any other claim after a claim for death due to accidental
Nature of Disablement % of Sum Insured injury has been admitted by the Company and becomes
1. Death 100% payable.

2. Total and irrecoverable loss of 5. Any payment in case of more than one claim under the
Policy during any one period of insurance by which the
i) Sight of both eyes or of the actual 100%
loss by physical separation of the maximum liability of the Company in that period exceeds
two entire hands or two entire feet the available sum payable.
or one entire hand and one entire 6. Death or permanent disability resulting, directly or
foot or of such loss of sight of one
indirectly, caused by, contributed to or aggravated or
eye and such loss of one entire
hand or one entire foot. prolonged by child birth or from pregnancy or in
consequence thereof.
ii) Use of two hands or of two feet or 100%
of one hand and one foot or of 7. Any claim in respect of accidental death or permanent
such loss of sight of one eye and disablement of the Insured from:
such loss of use of one hand or
one foot. i. intentional self-injury, suicide or attempted suicide
For the purpose of items 2 i & ii above, physical separation of ii. whilst under the influence of liquor or drugs or other
one entire hand shall mean separation at or above wrist intoxicants
and/or of the foot at or above ankle, respectively
iii. whilst engaging in aviation or ballooning whilst
3. Permanent total and absolute 100%
mounting into, dismounting from or traveling in any
disablement disabling the Insured
from engaging in any employment or aircraft or balloon other than as a passenger (fare
occupation of any description paying or otherwise) in any duly licensed standard type
whatsoever. of aircraft anywhere in the world
iv. directly or indirectly, caused by venereal disease, AIDS
- The disablement / death must occur within one year of the or insanity
accident.
v. arising or resulting from the Insured committing any
- The disablement must be confirmed and claimed for prior to breach of law or participating in an actual or attempted
the expiry of a period of 3 months since occurrence of the felony, riot, crime, misdemeanor or civil commotion
disablement.
vi. whilst engaging in racing, hunting, mountaineering, ice
The Sum Insured under this Section is limited to the personal hockey, winter sports.
loan amount availed by the Insured on the date of claim plus
interest accrued thereon. Where the Policy is taken after 8. Any consequential loss or damage cost or expense of
payment after payment of one or more EMIs of personal loan, whatsoever nature.
the Sum Insured shall be limited to the principal personal loan
9. Death or permanent disablement due to accidental injury
amount outstanding as on the date of taking the Policy plus
arising out of or directly or indirectly connected with or
interest to accrue thereon. Pre-closure charges if any payable
traceable to war, invasion, act of foreign enemy, hostilities
to the Financial Institution concerned due to foreclosure of the
(whether war be declared or not), civil war, rebellion,
loan will also be covered under the Policy.
revolution, insurrection, mutiny, military or usurped
In the event the outstanding personal loan amount of the power, seizure, capture, arrests, restraints and
Insured, inclusive of interest, if any, as on the date of accident detainments of all Kings, Princes and people of
is less than the Sum Insured, the outstanding personal loan whatsoever nation, condition or quality.
amount inclusive of interest, if any, as on the date of accident
10. Death or permanent disablement due to accidental injury,
will be paid to the financial institution concerned and the
directly or indirectly, caused by or contributed to by or
balance of the Sum Insured, if any, will be paid to the Insured or
arising from -
his/her legal heir as the case may be.
i. ionizing radiation or contamination by radioactivity
3. What is not covered
from any nuclear fuel or from any nuclear waste or from
The Company shall not be liable under this Section for: the combustion of nuclear fuel and for the purposes
hereof, combustion shall include any self-sustaining
1. Any pre-existing disability / accidental injury. process of nuclear fission;
2. Accidental death or permanent disability due to mental ii. nuclear weapons material.
disorders or disturbances of consciousness, strokes, fits
or convulsions which affect the entire body and 11. Insured whilst engaging in speed contest or racing of any

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 kind (other than on foot), bungee jumping, parasailing, Aorta graft surgery
ballooning, parachuting, skydiving, paragliding, hang
gliding, mountain or rock climbing necessitating the use of The actual surgical repair of an aortic aneurysm (an abnormal
guides or ropes, potholing, abseiling, deep sea diving bulge in the wall of the aortic blood vessel causing the aorta to
using hard helmet and breathing apparatus, polo, snow dilate or widen and the aortic valve to leak leading to bursting
and ice sports. of arterial wall) for the first time by a surgeon. The diagnosis to
be evidenced by any two of the following:
12. Insured whilst flying or taking part in aerial activities
(including cabin crew) except as a fare-paying passenger - Computerised tomography (CT) scan
in a regular scheduled airline or air Charter Company. - Magnetic resonance imaging (MRI) scan
4. Special Condition - Echocardiography (an ultrasound of the heart)
In the event of permanent disablement, the Insured will be - Abdominal ultrasound (for associated abdominal
under obligation to: aneursysms) - Angiography (an x-ray of the blood
a. Have himself/herself examined by the Panel Doctors vessels)
appointed by the Company and the Company will pay the Cancer of specified severity
costs involved thereof.
I. A malignant tumour characterized by the uncontrolled
b. Authorize doctors providing treatment or giving expert growth & spread of malignant cells with invasion &
opinion and any other authority to supply the Company destruction of normal tissues. This diagnosis must be
any information that may be required on the condition of supported by histological evidence of malignancy &
the Insured. confirmed by a pathologist. The term cancer includes
If the above obligation is not met with due to whatsoever leukemia, lymphoma and sarcoma.
reason, the Company shall be relieved of its liability to II. The following are excluded -
compensate under this benefit.
(i) Tumors showing the malignant changes of
Section B – Critical Illnesses carcinoma in situ & tumors which are histologically
1. What is covered described as pre-malignant or non invasive,
including but not limited to: Carcinoma in situ of
This Section covers the Insured up to the Sum Insured breasts, Cervical dysplasia CI N-1, CI N-2 & CIN-3.
specified in the Schedule, towards payment of his / her
personal loan on being diagnosed as contracting any of the (ii) Any skin cancer other than invasive malignant
critical illnesses, during the Policy Period as stated herein melanoma
below and surviving for more than 30 days post such (iii) All tumors of the prostrate unless histologically
diagnosis, at any time during the Policy period. classified as having a Gleason score greater than 6
The Sum Insured under this Section is limited to the personal or having progressed to atleast clinical TNM
loan amount availed by the Insured on the date of claim plus classification T2NOMO
interest accrued thereon. Where the Policy is taken after (iv) Papilary Micro-carcinoma of the thyroid less than 1
payment of one or more EMIs of personal loan, the Sum cm in diameter
Insured shall be limited to the principal personal loan amount
outstanding as on the date of taking the Policy plus interest to (v) Chronic lymphocyctic leukaemia less than RAI
accrue thereon. Pre-closure charges if any payable to the stage 3
Financial Institution concerned due to foreclosure of the loan
(vi) Microcarcinoma of the bladder
will also be covered under the Policy.
(vii) All tumors in the presence of HIV infection
In the event the outstanding personal loan amount of the
Insured, inclusive of interest, if any, as on the date of accident Major Organ/ Bone Marrow Transplant
is less than the Sum Insured, the outstanding personal loan
amount inclusive of interest, if any, as on the date of accident I. The actual undergoing of a transplant of:
will be paid to the financial institution concerned and the
(i) One of the following organs: heart, lung, liver, kidney,
balance of the Sum Insured, if any, will be paid to the Insured or
pancreas, that resulted from irreversible end- stage
his/her legal heir as the case may be.
failure of the relevant organ, or
The maximum liability of the Company shall in no case exceed
(ii) Human bone marrow using haematopoietic stem
the Sum Insured as mentioned in the Schedule.
cell. The undergoing of a transplant has to be
For the purposes of this Policy and the determination of the confirmed by a specialist medical practitioner.
Company's liability under it, the Insured Event/Critical
II. The following are excluded:
Illness in relation to the Insured, shall mean any illness,
medical event or surgical procedure as specifically defined (i) Other stem-cell transplants
below whose signs or symptoms first commence more than
90 days after the commencement of Period of Insurance and (ii) Where only islets of langerhans are transplanted
shall only include:
Multiple Sclerosis With Persisting Symptoms

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I. The definite occurrence of multiple sclerosis. The the diagnosis of Acute Myocardial Infarction (for eg.
diagnosis must be supported by all of the following: Typical chest pain)
(I). Investigations including typical MRI and CSF (ii) New characteristic electrocardiogram changes
findings, which unequivocally confirm the diagnosis (iii) Elevation of infarction specific enzymes, Troponins
to be multiple sclerosis or other specific biochemical markers
(ii). There must be current clinical impairment of motor or II. The following are excluded:
sensory function, which must have persisted for a
continuous period of atleast 6 months, and (i) Non ST-segment elevation myocardial infarction
(NSTEMI) with elevation
(iii). Well documented clinical history of exacerbations
and remissions of said symptoms or neurological (ii) Other acute Coronary Syndromes
deficits with atleast two clinically documented (iii) Any type of angina pectoris
episodes atleast one month apart.
Stroke Resulting in Permanent Symptoms
(iv). Other causes of neurological damage such as SLE
and HIV are excluded. I. Any cerebrovascular incident producing permanent
neurological sequelae. This includes infarction of brain
Open Heart replacement or Repair of Heart Valves tissue, thrombosis in an intracranial vessel, haemorrhage
The actual undergoing of open-heart valve surgery is to and embolisation from an extracranial source. Diagnosis
replace or repair one or more heartvalves, as a consequence has to be confirmed by a specialist medical practitioner
of defects in, abnormalities of, or disease –affected cardiac and evidenced by typical clinical symptoms as well as
valve(s). The diagnosis of the valve abnormality must be typical finding in CT scan or MRI of the brain. Evidence of
supported by an echocardiography and the realization of permanent neurological deficit lasting at least 3 months
surgery has to be confirmed by a specialist medical has to be produced.
practitioner. Catheter based techniques including but not II. The following are excluded:
limited to balloon valvotomy/ valvuloplasty are excluded.
(i) Transient ischemic attacks (TIA) –
Quadriplegia/Paralysis of four limbs
(ii) Traumatic injury of the brain
- Total and irrecoverable loss of use of all four limbs as a
result of injury or disease of the brain or spinal cord. A (iii) Vascular disease affecting only the eye or optic nerve
specialist medical practitioner must be of the opinion that vestibular functions
the paralysis will be permanent with no hope of recovery End Stage Liver Disease
and must be present for more than 3 months.
End stage liver disease resulting in cirrhosis
Kidney Failure Requiring Regular Dialysis
The cirrhosis must be confirmed by a Consultant
I. End stage renal disease presenting as chronic Gastroenterologist by all of the following :
irreversible failure of both kidneys to function, as a result
of which either regular renal dialysis (hemodialysis or a) permanent jaundice, b) ascites, c) encephalopathy, d)
peritoneal dialysis) is instituted or renal transplantation is portal hypertension and e) Liver biopsy or if no liver biopsy
carried out. Diagnosis has to be confirmed by a specialist available a non-invasive test for fibrosis or medical imaging
medical practitioner. consistent with the diagnosis

Open chest Coronary Artery Bypass Graft Liver disease secondary to alcohol or drug misuse is excluded

II. I. The actual undergoing of open heart chest surgery End Stage Lung Disease
for the correction of one or more coronary arteries, Advanced stage emphysema or other chronic lung disease,
which is/are narrowed or blocked, by coronary artery resulting in all of the following:
bypass graft (CABG). The diagnosis must be
- There is dyspnea at rest with markedly abnormal
supported by a coronary angiography and the
pulmonary function tests
realization of surgery has to be confirmed by a
specialist medical practitioner. - The need for regular oxygen treatment on a permanent
basis.
III. II. The following are excluded:
IV. - Angioplasty and/or any other intra-arterial - The permanent impairment of lung function tests as
procedures follows;
• Forced Vital Capacity (FVC) and
V. - Any key-hole or laser surgery
• Forced Expiratory Volume at 1 second (FEV1) being
First Heart Attack – Of Specified Severity
less than 50% of normal
I. The first occurrence of myocardial infarction which means
2. What is not covered
the death of a portion of the heart muscle as a result of
inadequate blood supply to the relevant area. The The Company shall not be liable to make any payment for any
diagnosis for this will be evidenced by all of the following claim directly or indirectly caused by, based on, arising out of
criteria: or howsoever attributable to any of the following:
(i) A history of typical clinical symptoms consistent with 1. All pre-existing disease/ condition/injuries which are

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 existing when this insurance cover incepts for the first time imposed on him/her by the firm / body corporate /
establishment in compliance with any law relating to the
2. Any critical illness contracted by the Insured at the time of
employment for the time being in force or any directives by
inception of the Policy or within first three months of
any Public Authority.
inception of this Policy.
3. Diagnosis of any critical illnesses not evidenced by a c. Any retirement scheme of compulsory nature if the firm /
certificate issued by the attending Doctor. body corporate / establishment is closing down one
division and a minimum of 20 employees are availing the
4. Medical Certification of contracting of critical illness by a retirement scheme.
family member or from persons not registered as Medical
Practitioners under recognized medical councils. The Sum Insured under this Section is limited to the number of
personal loan EMIs as opted by the Insured or the outstanding
5. Any critical illness contracted by the Insured in personal loan amount whichever is lower at the time of claim.
performance of duties as serving member of a military or a
police force 2. What is not covered:

6. Any critical illness contracted due to alcohol or drug The Company shall not be liable under this Section for:
abuse. 1. In the event of termination, dismissal, temporary
7. Any critical illness contracted due to Ionizing radiation or suspension or retrenchment from employment of the
contamination by radioactivity from any nuclear fuel or Insured which is being attributed to any dishonesty or
from any nuclear waste from the combustion of nuclear fraud on the part of the Insured or his willful violation of any
fuel. rules of the employer or laws for the time being in force.

8. Any critical illness, directly or indirectly, caused by or 2. In connection with or in respect of:
contributed to by nuclear weapons/materials or a. Self employed persons
radioactive contamination.
b. Any claim relating to unemployment in respect of a
9. Any critical illness, directly or indirectly, caused by or job which is casual, temporary, seasonal or
arising out of any criminal act of the Insured. contractual in nature or any claim relating to an
10. Any critical illness directly or indirectly, caused by or employee not on the direct rolls of the employer.
arising from or attributable to foreign invasion, act of c. Unemployment at the time of inception of the period
foreign enemies, hostilities (whether war be declared or of insurance or arising within first three months of
not), civil war, rebellion, revolution, insurrection, military or inception of the period of Insurance.
usurped power, riot or civil commotion, act of terrorism.
3. Termination, dismissal, temporary suspension or
11. Any critical illness, directly or indirectly, arising whilst the retrenchment from employment of the Insured which does
Insured being engaged in speed contest or racing of any not commence during the period of insurance.
kind (other than on foot), bungee jumping, parasailing,
ballooning, parachuting, skydiving, paragliding, hang 4. Termination, dismissal, temporary suspension or
gliding, mountain or rock climbing necessitating the use of retrenchment from employment of the Insured which is
guides or ropes, potholing, abseiling, deep sea diving less than a period of thirty (30) days at a stretch.
using hard helmet and breathing apparatus, polo, snow
and ice sports. 5. Termination, dismissal, temporary suspension or
retrenchment from employment of the Insured which is
12. Any critical illness, directly or indirectly, arising whilst the attributed to poor performance of the Insured.
Insured is flying or taking part in aerial activities (including
cabin crew) except as a fare-paying passenger in a 6. Termination, dismissal, temporary suspension or
regular Scheduled airline or air charter company. retrenchment from employment of the Insured where
insured was aware of the circumstance leading to such
Section C – Loss of employment termination, dismissal, temporary suspension or
retrenchment beforehand at the time proposing for this
1. What is covered insurance.
This Section covers the Insured up to the Sum Insured 7. Unemployment of the Insured that is purely voluntary.
specified in the Schedule against default in payment of his /
her personal loan EMIs due to loss of employment on account 8. Resignation, Superannuation, early retirement of the
of: Insured.
a. Termination of the Insured from employment on account 3. Special Condition
of closure of the firm / body corporate / establishment
wherein the Insured is employed, due to poor financial Eligibility for claim under this Section:
health or any merger/acquisition of the firm / body - The Insured shall be out of his current job on account of
corporate / establishment leading to the termination, the reasons mentioned herein above and shall be out of
dismissal or retrenchment of the Insured. any job at least for thirty days consecutively from the time
b. Termination or dismissal, lay off, temporary suspension or of losing his / her current job.
retrenchment of the Insured from the employment - The benefit under this Section will stop once he / she gets

09 10
 another job. Company may adjust the scope of cover and/or premium, if
necessary, accordingly.
- In case of joint borrowers coverage under this Section will
be available to that person whose name appears first 5. Records to be maintained
among the joint borrowers. The Policyholder/ Insured Person shall keep an accurate
Section D – Child Care Allowance record containing all relevant medical records and shall allow
the Company or its representative(s) to inspect such
What is covered records. The Policyholder/ Insured Person shall furnish such
This Section provides for payment of allowance to the dependant information as the Company may require under this Policy at
child(ren) of the Insured up to the limits of the Sum Insured as any time during the Policy Period and up to three years after
specified in the Schedule, in the event of death or permanent total the policy expiration, or until final adjustment (if any) and
disablement of the Insured, due to accidental injury for which resolution of all Claims under this Policy.
there is a valid claim under Section A of this Policy. 6. No constructive Notice
The allowance will be payable to the dependant children of the Any knowledge or information of any circumstance or
Insured (limited to a maximum of two children below the age of 21 condition in relation to the Policyholder/ Insured Person
years) towards their educational expenses, provided that the which is in possession of the Company and not specifically
children are pursuing their education at the time of claim under informed by the Policyholder / Insured Person shall not be
this Section. held to bind or prejudicially affect the Company
The Sum Insured is subject to a limit of 2% of the outstanding notwithstanding subsequent acceptance of any premium.
personal loan at the commencement of this Policy. 7. Complete discharge
All the exclusions applicable to Section A of this Policy above, Payment made by the Company to the Policyholder/ adult
shall apply to this Section also. Insured Person or the Nominee of the Policyholder or the
General Exclusions legal representative of the Policyholder or to the nominee or
Financial Institution, as the case may be, of any
Any default due to any event not provided under Sections A to C compensation or benefit under the Policy shall in all cases be
above shall be specifically excluded from the cover granted by complete and construe as an effectual discharge in favor of
this Policy the Company.
General Conditions (applicable to all Sections of this Policy) 8. Special Provisions
1. Duty of disclosure Any special provisions subject to which this Policy has been
The Policy shall be void and all premium paid hereon shall be entered into and endorsed in the Policy or in any separate
forfeited to the Company, in the event of misrepresentation, instrument shall be deemed to be part of this Policy and shall
mis-description or non-disclosure of any material fact. In the have effect accordingly.
event of untrue or incorrect statements, misrepresentation, 9. Electronic Transactions
mis-description or non-disclosure of any material particulars
in the proposal form, personal statement, declaration and The Policyholder/ Insured Person agrees to adhere to and
connected documents, or any material information having comply with all such terms and conditions as the Company
been withheld, or a Claim being fraudulent or any fraudulent may prescribe from time to time, and hereby agrees and
means or device being used by the Policyholder/ Insured confirms that all transactions effected by or through facilities
Person or any one acting on his/ their behalf to obtain a for conducting remote transactions including the Internet,
benefit under this Policy, the Company may cancel this World Wide Web, electronic data interchange, call centers,
Policy at its sole discretion and the premium paid shall be tele-service operations (whether voice, video, data or
forfeited in its favor. combination thereof) or by means of electronic, computer,
automated machines network or through other means of
2. Observance of Terms and Conditions
telecommunication, established by or on behalf of the
The due observance and fulfillment of the Policy Terms & Company, for and in respect of the Policy or its terms, or the
Conditions and Endorsements of this Policy in so far as they Company's other products and services, shall constitute
relate to anything to be done or complied with by the legally binding and valid transactions when done in
Policyholder / Insured Person, shall be a condition precedent adherence to and in compliance with the Company's terms
to any of the Company's liability to make any payment under and conditions for such facilities, as may be prescribed from
this Policy. time to time.
3. Reasonable Care 10. Duties of the Insured on occurrence of loss
The Policyholder/ Insured Person shall take all reasonable On the occurrence of any loss, within the scope of this Policy
steps to safeguard the interests against any Illness / Injury the Insured shall:
that may give rise to a Claim.
a) Forthwith file/submit a Claim Form together with the
4. Material Change personal loan particulars and personal loan EMI details
The Policyholder shall immediately notify the Company in b) Allow the Medical Practitioner appointed by the
writing of any material change in the risk on account of Company to inspect the medical records and to examine
change in occupation / business at his own expense and the the Insured.

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c) Assist and not hinder or prevent the Company or any of f. First Information Report/ Final Police Report, if
its agents in pursuance of their duties. applicable

If the Insured does not comply with the provisions of this g. Any other document as required by the Company to
Condition, all benefits under this Policy shall be forfeited, at assess the Claim
the option of the Company.
In case of Loss of Employment
i. If the Insured shall sustain any bodily injury in respect of
which a claim is or may be made hereunder prompt a. The letter of the employer terminating, dismissing or
written notice thereof shall be given to the Company and suspending the Insured from the present job
the financial institution, as soon as possible but in any b. Proof towards not having any employment
event within fourteen days of the date of injury.
c. Any other document as required by the Company to
ii. If the Insured shall die, notice of death shall be given by assess the Claim
the legal representative(s) forthwith. All certificates,
information and evidence whether from a Medical In case of Child Care Allowance
Attendant or otherwise required by the Company shall
a. Age proof of the Dependent Children of the Insured
be furnished at the expense of the Insured or legal
representatives, as the case may be, and shall be in b. Dependency Proof/Proof towards the Dependent
such form and of such nature as the Company may Children of the Insured being enrolled in any educational
prescribe. The Insured must immediately after the institution
occurrence of any accident which may be the subject of
a claim hereunder obtain medical treatment failing c. Any other document as required by the Company to
which the Company will not be liable for any assess the Claim
consequence thereof. The documents required are:
The Insured shall forward to the Company forthwith every
For all claims written notice or information of any verbal notice of claim and
shall send to the Company any writ, summons or other legal
1. Claim Form process issued or commenced against the Insured and shall
give all necessary information and assistance to enable the
2. Loan Statement and Confirmation of Principal
Company to settle or resist any claim or to institute
Outstanding from Bank/FI
proceedings. The Insured shall not incur any expenses in
In case of Personal Accident Death / Disability claims making good any claim without the written consent of the
Company and shall not negotiate, pay, settle, admit or
- Death Certificate ( in case of Death Claim) repudiate any claim without such consent.
- Disability Certificate ( in case of Disability Claim) The Company shall settle the claim within 30 days from the
date of receipt of last necessary document.However, where
- Duly completed and signed Claim Form, in original
the circumstances of a claim warrant an investigation in
- Medical Practitioner's referral letter advising Company’s opinion it shall initiate and complete such
Hospitalization investigation at the earliest, in any case not later than 30
days from the date of receipt of last necessary document. In
- Medical Practitioner's prescription advising drugs / such cases, Company shall settle the claim within 45 days
diagnostic tests / consultation from the date of receipt of last necessary document.
- Original bills, receipts and discharge card from the 11. Position after a claim
Hospital / Medical Practitioner
The benefit of claim under Sections A and B together is
- First Information Report/ Final Police Report applicable only once during the Policy Period. Accordingly if
the Insured / legal representatives report a claim under
- Post mortem report, if available
Section A and B and the same is acknowledged by the
- Any other document as required by the Company to Company, then the Policy becomes in-operative for both
assess the Claim. these Sections and no further claim can be reported under
the Sections A or B of the Policy.
In case of Critical Illness
At all times during the period of this Policy the insurance
a. Duly completed and signed Claim Form, in original cover will be maintained to the full extent of the respective
b. Medical Practitioner's referral letter advising Sum Insured in consideration of which upon the settlement
Hospitalization of any loss under this Policy, pro-rata premium for the
unexpired period from the date of such loss to the expiry of
c. Medical Practitioner's prescription advising drugs / period of insurance for the amount of such loss shall be
diagnostic tests / consultation payable by the Insured to the Company.

d. Original pathological / diagnostic test reports and The additional premium referred above shall be deducted
payment receipts from the net claim amount payable under the Policy. This
continuous cover to the full extent will be available
e. Indoor case papers notwithstanding any previous loss for which the Company

13 14
 may have paid and irrespective of the fact whether the forfeited for all Insured Persons and all sums paid under this
additional premium as mentioned above has been actually Policy shall be repaid to the Company by the Policyholder /
paid or not following such loss. The intention of this condition all Insured Persons who shall be jointly liable for such
is to ensure continuity of the cover to the Insured subject only repayment.
to the right of the Company for deduction from the claim
15. Feature of Claims
amount, when settled, of pro-rata premium to be calculated
from the date of loss till expiry of the Policy. If a claim is made and rejected and no Court action or suit is
commenced within twelve months after such rejection or, in
Notwithstanding what is stated above, the Sum Insured shall
case of arbitration taking place as provided therein, within
stand reduced by the amount of loss in case the Insured
twelve (12) calendar months after the Arbitrator or Arbitrators
immediately on occurrence of the loss exercises his option
have made their award, all benefits under this Policy shall be
not to reinstate the sum insured as above.
forfeited.
12. Subrogation
16. Cancellation/termination
Subrogation shall mean the right of the Company to assume
The Company may at any time, cancel this Policy on grounds
the rights of the Insured Person/Policyholder to recover
as specified in Clause 1 above, by giving 7 days' notice in
expenses paid out under the Policy that may be recovered
writing by Registered Post Acknowledgment Due / recorded
from any other source.
delivery to the Policyholder at his last known address.
The Policyholder/ Insured Person shall at his own expense
The Policyholder may also give 7 days' notice in writing, to
do or concur in doing or permit to be done all such acts and
the Company, for the cancellation of this Policy. In such case
things that may be necessary or reasonably required by the
the Company shall from the date of receipt of the notice,
Company for the purpose of enforcing and/or securing any
cancel the Policy and retain the premiums for the period this
civil or criminal rights and remedies or obtaining relief or
policy has been in force at the Company's short period scale
indemnity from any other party to which the Company is/or
as mentioned below, provided no Claim has been made
would become entitled upon the Company paying for a Claim
under the Policy by the Policyholder/ Insured Person
under this Policy, whether such acts or things shall be or
become necessary or required before or after its payment. Table of Short Period Scales
Neither the Policyholder nor any Insured Person shall
prejudice these subrogation rights in any manner and shall at Period of Risk 1 Year 2Year 3Year 4Year 5Year
his own expense provide the Company with whatever (Not exceeding)
assistance or cooperation is required to enforce such rights. 15 days 10%
Any recovery the Company makes pursuant to this clause
shall first be applied to the amounts paid or payable by the 1 Month 15% 30%
Company under this Policy and any costs and expenses 2 Months 30%
incurred by the Company of effecting a recovery, where after
the Company shall pay any balance remaining to the 3 Months 40% 30%
Policyholder. This clause shall not apply to any Benefit 4 Months 50%
offered on fixed benefit basis.
5 Months 60% 50%
13. Contribution
6 Months 70% 30% 30%
Contribution is essentially the right of the Company to call
upon other Insurers liable to the same Insured to share the 7 Months 75%
costs of an indemnity claim on a rateable proportion of Sum 8 Months 80%
Insured.
9 Months 85% 75%
If at the time when any Claim arises under this Policy, there is
any other insurance which covers (or would have covered Exceeding 9 Months 100% 50%
but for the existence of this Policy), the same Claim (in whole 12 Months
or in part), then the Company shall not be liable to pay or
contribute more than its ratable proportion of any Claim. 18 Months 100% 50%
24 Months 75% 50%
This clause shall not apply to any Benefit offered on fixed
benefit basis. 30 Months 100% 75%
This provision, however, shall not be applicable to benefits 36 Months 75%
under Sections A, B & D of the Policy.
42 Months
14. Fraudulent claims 48 Months 100% 100%
If a Claim is in any way found to be fraudulent, or if any false Exceeding 48 Months
statement, or declaration is made or used in support of such
a Claim, or if any fraudulent means or devices are used by 17. Cause of Action / Currency for Payment
the Policyholder / Insured Person or anyone acting on his/
No claim shall be payable under this Policy unless the cause
their behalf to obtain any benefit under this Policy, then this
of action arises in India.
Policy shall be void and all claims being processed shall be

15 16
 All claims shall be payable in India and in Indian Rupees only. not be eligible for any new similar policy(es) if a claim is
paid or admitted under this Policy or if there no
18. Policy Disputes
outstanding loan for which this Policy was issued
Any and all disputes or differences under or in relation to g. If the customer desires to continue to avail of the Critical
validity, construction, interpretation and effect to this Policy Illness insurance benefits then he will have the option to
shall be determined by the Indian Courts and subject to migrate to a suitable Critical Illness policy of the
Indian law. Company as per the existing guidelines and rates
19. Arbitration clause applicable for that Policy with continuity benefits
provided such migration happens within 30 days of
If any dispute or difference shall arise as to the quantum to be expiry of this Policy
paid under this Policy (liability being otherwise admitted)
such difference shall independently of all other questions be 23. Notices
referred to the decision of a sole arbitrator to be appointed in Any notice, direction or instruction given under this Policy
writing by the parties thereto or if they cannot agree upon a shall be in writing and delivered by hand, post, or facsimile to-
single arbitrator within 30 days of any party invoking
- in case of the Insured, at the address specified in the
arbitration, the same shall be referred to a panel of three
Schedule
arbitrators, comprising of two arbitrators, one to be
appointed by each of the parties to the dispute/difference - in case of the Company, to the Policy issuing office /
and the third arbitrator to be appointed by such two nearest office of the Company
arbitrators and arbitration shall be conducted under and in 24. Free Look Period
accordance with the provisions of the Arbitration and
Conciliation Act,1996. The Policyholder would be given a period of 15 days (Free
Look Period) from the date of receipt of the Policy to review
It is clearly agreed and understood that no difference or the entire Policy. Where the Policyholder disagrees to any of
dispute shall be referable to arbitration, as hereinbefore those terms or conditions, the Policyholder has the option to
provided, if the Company has disputed or not accepted return the Policy stating the reasons for his objection and the
liability under or in respect of this Policy. Policyholder shall be entitled to a refund of the premium paid,
It is hereby expressly stipulated and declared that it shall be a provided no Claim has been incurred under this Policy,
condition precedent to any right of action or suit upon this subject only to a deduction of the expenses incurred by the
Policy that the award by such arbitrator/arbitrators of the Company on medical examination and the stamp duty
amount of the loss or damage shall be first obtained. charges. In cases where the risk has already commenced
when the option of returning this Policy is exercised, within
22. Renewal Notice
the free look period, by the Policyholder, the refund of the
a. This Policy will automatically terminate at the end of the premium paid will also be subject to a deduction for
Policy Period. All renewal applications should reach the proportionate risk premium for the period on cover. Where
Company before the end of the Policy Period. only part of the risk (e.g. only accidental hospitalization risk)
b. Every renewal premium (which shall be paid and has commenced, such proportionate risk premium shall be
accepted in respect of this Policy) shall be so paid and calculated as commensurate with the risk covered during
accepted upon the distinct understanding that no such period.
alteration has taken place in the facts contained in the This clause shall not be applicable on renewal of this Policy
proposal or declaration herein prior mentioned and that
25. Withdrawal/Revision/Modification of the Product
nothing is known to the Policyholder/ Insured Person(s)
that may result in enhancing the Company's risk. The Company reserves the right to withdraw, revise or
modify this product /policy in the future.
c. This Policy may be renewed by mutual consent and in
such event the renewal premium shall be paid to the The revision/modification may be in respect of Benefits,
Company on or before the date of expiry of this Policy coverages, premiums, policy terms and conditions &/or
and in any case not later than the expiry of the Grace exclusions.
Period. In the event of any such withdrawal of product the company
Grace period refers to a period of 30 days immediately will notify in advance to the policyholder providing him the
following the premium due date during which a payment option to port to the specified existing health products of the
can be made to renew this Policy without loss of company with continuity benefit.
continuity benefits such as Waiting Periods and In the event of any revision or modification of the
coverage of Pre-existing Disease. Coverage is not product/terms of policy/premium, the company will notify the
available for the period for which Premium is not policyholder 3 months in advance of such changes.
received by the Company and the Company shall not be
liable for any Claims incurred during such period. 26. Payment of Interest
d. Ordinarily renewals will not be refused by the Company In the case of delay in the payment of a claim,the Company
except on ground of fraud, moral hazard or shall be liable to pay interest from the date of receipt of last
misrepresentation. necessary document to the date of payment of claim at a rate
of 2 % above the bank rate.
e. Renewal premium can vary subject to prior regulatory
approval. 27. Customer Service
f. This policy shall not be renewed and the Insured shall If at any time the Insured requires any clarification or

17 18
 assistance, the Insured can contact the Policy issuing office
Ombudsman Office
of the Company. Alternatively the Insured may also contact
our customer service desk at 1800-3009 or write to us a Jurisdiction Office Address
[email protected].
In respect of any disputes or difference which remain Gujarat, AHMEDABAD - Shri Kuldip Singh
unresolved and where the claim amount is not more than Rs. Dadra & Nagar Office of the Insurance Ombudsman,
20 lakhs, the individual Insured can approach the Insurance Haveli, Jeevan Prakash Building, 6th floor,
Daman and Tilak Marg, Relief Road,
Ombudsman set up at different territorial locations for
Diu. Ahmedabad – 380 001.
resolution. The details of the Insurance Ombudsman and Tel.: 079 - 25501201/02/05/06
their jurisdiction is available in their websites Email: [email protected]
www.ombudsmanindia.org / www.gbic.co.in
28. Communication Karnataka BENGALURU - Smt. Neerja Shah
Office of the Insurance
Any communication meant for the Company must be in Ombudsman,Jeevan Soudha Building,PID
writing and be delivered to its address shown in the Policy No. 57-27-N-19Ground Floor, 19/19, 24th
Schedule. Any communication meant for the Policyholder Main Road,JP Nagar, Ist Phase,
will be sent by the Company to his last known address or the Bengaluru – 560 078.
address as shown in the Policy Schedule. Tel.: 080 - 26652048 / 26652049
Email: [email protected]
All notifications and declarations for the Company must be in
writing and sent to the address specified in the Policy
Madhya BHOPAL - Shri Guru Saran Shrivastava
Schedule. Agents are not authorized to receive notices and Pradesh Office of the Insurance Ombudsman,
declarations on the Company's behalf. Chattisgarh Janak Vihar Complex, 2nd Floor,
Notice and instructions will be deemed served 10 days after 6, Malviya Nagar, Opp. Airtel Office,
posting or immediately upon receipt in the case of hand Near New Market, Bhopal – 462 003.
delivery, facsimile or e-mail. Tel.: 0755 - 2769201 / 2769202
Fax: 0755 - 2769203
29. Overriding effect of Policy Schedule Email: [email protected]
In case of any inconsistency in the terms and conditions in
Orissa BHUBANESHWAR -
this Policy vis-a-vis the information contained in the Policy
Shri Suresh Chandra Panda
Schedule, the information contained in the Policy Schedule Office of the Insurance Ombudsman,
shall prevail. 62, Forest park,
30. Grievances Bhubneshwar – 751 009.
Tel.: 0674 - 2596461 /2596455
If the Policyholder has a grievance that the Policyholder Fax: 0674 - 2596429
wishes the Company to redress, the Policyholder may Email: [email protected]
contact the Company with the details of his grievance n
through:
Website : https://reliancegeneral.co.in Punjab, CHANDIGARH -
Haryana, Dr. Dinesh Kumar Verma
e-mail : [email protected] Himachal Office of the Insurance Ombudsman,
Telephone : 1800-3009 Pradesh, S.C.O. No. 101, 102 & 103, 2nd Floor,
Post/Courier : Any branch office, the Jammu Batra Building, Sector 17 – D,
correspondence address, during &Kashmir, Chandigarh – 160 017.
normal business hours Chandigarh Tel.: 0172 - 2706196 / 2706468
Fax: 0172 - 2708274
Write to us at : Reliance General Insurance, Email: [email protected]
(Correspondence Only) Correspondence Unit, 301-302,
Corporate House RNT Marg, Tamil Nadu, CHENNAI - Shri M. Vasantha Krishna
Opp. Jhabua Tower, Indore, Pondicherry Office of the Insurance Ombudsman,
Madhya Pradesh, India – Town and Fatima Akhtar Court, 4th Floor, 453,
452001 Karaikal (which Anna Salai, Teynampet,
For further details on Grievance redressal procedure please are part of CHENNAI – 600 018.
refer: https://reliancegeneral.co.in/Insurance/About- Pondicherry) Tel.: 044 - 24333668 / 24335284
Us/Grievance-Redressal.aspx Fax: 044 - 24333664
Email: [email protected]
If the Policyholder is not satisfied with the Company's
redressal of the Policyholder's grievance through one of
the above methods, the Policyholder may approach the
nearest Insurance Ombudsman for resolution of the
grievance. The contact details of Ombudsman offices are
mentioned below:

19 20
Ombudsman Office Ombudsman Office

Delhi DELHI - Shri Sudhir Krishna Districts of LUCKNOW -

Office of the Insurance Ombudsman, Uttar Pradesh : Shri Justice Anil Kumar Srivastava
2/2 A, Universal Insurance Building, Laitpur, Jhansi, Office of the Insurance Ombudsman,
Asaf Ali Road, Mahoba, 6th Floor, Jeevan Bhawan, Phase-II,
New Delhi – 110 002. Hamirpur, Nawal Kishore Road, Hazratganj,
Tel.: 011 - 23232481/23213504 Banda, Lucknow - 226 001.
Email: [email protected] Chitrakoot, Tel.: 0522 - 2231330 / 2231331
Allahabad, Fax: 0522 - 2231310
Mirzapur, Email: [email protected]
Assam, GUWAHATI - Shri Kiriti .B. Saha Sonbhabdra,
Meghalaya, Office of the Insurance Ombudsman, Fatehpur,
Manipur, Jeevan Nivesh, 5th Floor, Pratapgarh,
Mizoram, Nr. Panbazar over bridge, S.S. Road, Jaunpur,Varan
Arunachal Guwahati – 781001(ASSAM). asi, Gazipur,
Pradesh, Tel.: 0361 - 2632204 / 2602205 Jalaun,
Nagaland and Email: [email protected] Kanpur,
Tripura Lucknow,
Unnao,
Sitapur,
Andhra HYDERABAD - Shri I. Suresh Babu Lakhimpur,
Pradesh, Office of the Insurance Ombudsman, Bahraich,
Telangana, 6-2-46, 1st floor, "Moin Court", Barabanki,
Yanam and Lane Opp. Saleem Function Palace, Raebareli,
part of Territory A. C. Guards, Lakdi-Ka-Pool, Sravasti,
of Pondicherry. Hyderabad - 500 004. Gonda,
Tel.: 040 - 67504123 / 23312122 Faizabad,
Fax: 040 - 23376599 Amethi,
Email: [email protected] Kaushambi,
Balrampur,
Rajasthan JAIPUR - Smt. Sandhya Baliga Basti,
Office of the Insurance Ombudsman, Ambedkarnaga
Jeevan Nidhi – II Bldg., Gr. Floor, r, Sultanpur,
Bhawani Singh Marg, Maharajgang,
Jaipur - 302 005. Santkabirnagar
Tel.: 0141 - 2740363 , Azamgarh,
Email: [email protected] Kushinagar,
Gorkhpur,
Deoria, Mau,
Ghazipur,
Kerala, ERNAKULAM - Ms. Poonam Bodra Chandauli,
Lakshadweep, Office of the Insurance Ombudsman, Ballia,
Mahe-a part of 2nd Floor, Pulinat Bldg., Sidharathnagar
Pondicherry. Opp. Cochin Shipyard, M. G. Road,
Ernakulam - 682 015. Goa, MUMBAI - Shri Milind A. Kharat
Tel.: 0484 - 2358759 / 2359338 Mumbai Office of the Insurance Ombudsman,
Fax: 0484 - 2359336 Metropolitan 3rd Floor, Jeevan Seva Annexe,
Email: [email protected] Region S. V. Road, Santacruz (W),
excluding Navi Mumbai - 400 054.
Mumbai Tel.: 022 - 26106552 / 26106960
&Thane Fax: 022 - 26106052
West Bengal, KOLKATA - Shri P. K. Rath Email: [email protected]
Sikkim, Office of the Insurance Ombudsman,
Andaman Hindustan Bldg. Annexe, 4th Floor,
&Nicobar 4, C.R. Avenue,
Islands. KOLKATA - 700 072.
Tel.: 033 - 22124339 / 22124340
Fax : 033 - 22124341
Email: [email protected]

21 22
 Ombudsman Office

State of NOIDA - Shri Chandra Shekhar Prasad

Uttaranchal Office of the Insurance Ombudsman,
and the Bhagwan Sahai Palace
following 4th Floor, Main Road,
Districts of Naya Bans, Sector 15,
Uttar Pradesh: Distt: Gautam Buddh Nagar,
Agra, Aligarh, U.P-201301.
Bagpat, Tel.: 0120-2514250 / 2514252 / 2514253
Bareilly, Bijnor, Email: [email protected]
Budaun,
Bulandshehar,
Etah, Kanooj,
Mainpuri,
Mathura,
Meerut,
Moradabad,
Muzaffarnagar,
Oraiyya,
Pilibhit,
Etawah,
Farrukhabad,
Firozbad,
Gautambodha
nagar,
Ghaziabad,
Hardoi,
Shahjahanpur,
Hapur, Shamli,
Rampur,
Kashganj,
Sambhal,
Amroha,
Hathras,
Kanshiramnag
ar,
Saharanpur.

Bihar, PATNA - Shri N. K. Singh

Jharkhand Office of the Insurance Ombudsman,
1st Floor,Kalpana Arcade Building,,
Bazar Samiti Road,
Bahadurpur,
Patna 800 006.
Tel.: 0612-2680952
Email: [email protected]

Maharashtra, PUNE - Shri Vinay Sah

Area of Navi Office of the Insurance Ombudsman,
Mumbai and Jeevan Darshan Bldg., 3rd Floor,
Thane C.T.S. No.s. 195 to 198,
excluding N.C. Kelkar Road, Narayan Peth,
Mumbai Pune – 411 030.
Metropolitan Tel.: 020-41312555
Region. Email: [email protected]

The updated details of Insurance Ombudsman are available on

IRDA website: www.irdai.gov.in, on the website of General
Insurance Council: www.giccouncil.in, our website
www.reliancegeneral.co.in

23 24