Digit Life Healthy Glow Policy: A Term + Health Combo Plan

(UIN: GODHLIP26044V022526)

The Digit Life Healthy Glow Policy is a unique insurance plan designed to meet the needs of individuals seeking comprehensive insurance solutions, offering peace of mind regarding both health and life coverage. This policy provides financial protection in case of medical emergencies and also pays out a benefit to your family if something happens to you.

The policy offers features such as affordable premiums, cashless health claims, tax benefits, worldwide coverage and an easy claim settlement process. Let us understand the Digit Life Healthy Glow Policy in detail.

Most people opt for either a health plan or a term insurance plan, but the smarter choice is to have both. Here’s why you might need both:

• The combo product offers dual benefits of health insurance and life insurance in a single plan, providing complete healthcare to you and your family, along with financial protection through life insurance coverage
• The health insurance component covers medical expenses related to hospitalisation, while the term life insurance component provides financial security to your family in case of your untimely demise.
• The combo product offers an affordable premium for combined coverage, making it cost-effective compared to purchasing separate policies.
• The health insurance part provides cashless claim facilities, easing the financial burden during hospitalisation.
• Instead of managing two separate policies, you get both benefits in one combo product. It’s easier to track, pay for, and renew.
• The term life insurance offers optional benefits such as protection against accidental death, total permanent disability, and terminal illness, enhancing the overall protection.

1. Hospitalisation Cover

Covers medical expenses for inpatient hospital stays due to illness or injury, including ICU, doctor fees, nursing, medicines, surgery, and diagnostic tests.

2. Day Care Procedure

Day care procedure covers treatments or surgeries that do not require 24-hour hospitalisation, such as chemotherapy, dialysis and cataract surgery.

3. Pre- and Post-Hospitalisation

Pays for medical expenses before hospitalisation (consultations, tests, medicines) and after discharge for follow-up treatments after discharge within a defined period.

4. Road Ambulance

Provides coverage for the expenses of road ambulance services in case of emergency hospitalisation. This includes transportation from home to the hospital or from one hospital to another if required.

5. Bariatric Surgery

Covers bariatric surgery if it is medically necessary and advised by a doctor due to obesity-related conditions like severe diabetes or heart disease, excluding cosmetic bariatric surgery.

6. Health Check-Up

Covers expenses for health check-ups based on the sum insured. This can include tests like ECG, thyroid profile and other routine examinations.

Note: This benefit is applicable provided the customer has continued the policy with us without any break, and will be offered at the end of each block of continuous policy years.

7. Home (Domiciliary) Hospitalisation

Covers treatment expenses if the insured requires hospitalisation at home due to a lack of available hospital beds or if the patient's condition makes it impossible to move to a hospital.

8. Organ Donor Expenses

Covers medical costs for organ donation surgery and related pre- and post-hospitalisation expenses for the donor (up to 5% of sum insured), subject to waiting periods. There is a waiting period as specified in your policy, subject to terms and conditions.

9. Emergency Air Ambulance

It covers the cost of air ambulance transportation to the nearest hospital for life-threatening emergencies that require immediate treatment. This is only within India, and return transport is not covered. T&C prior approval is required, and a road ambulance must be unavailable or unsuitable.

10. Maternity and Newborn Cover

Includes delivery expenses, pregnancy complications, lawful termination, and medical care for newborns up to 90 days, including vaccinations as per the National Immunisation Schedule

11. Worldwide Coverage

Covers medical expenses incurred outside India up to the sum insured. Payments are made in Indian rupees, and prior approval is required for treatment abroad (cashless claims are generally not available abroad; claims are reimbursed).

12. Sum Insured Backup

Provides an additional 100% of the insured amount as a backup for hospitalisation costs if the initial sum insured is exhausted due to related or unrelated claims within the same policy year. The backup won't be used if the first claim exceeds the insured amount.

13. In-Built Personal Accident

Pays 100% of the sum assured to the nominee in case of accidental death within 12 months, including accidents like drowning or missing body cases.

14. AYUSH Hospitalisation Cover

It is an in-built cover under the Hospitalisation section. It pays for medical expenses incurred for in-patient treatment under Ayurveda, Unani, Siddha, or Homeopathy at registered AYUSH hospitals. Coverage is up to the sum insured mentioned in the policy schedule.

15. Optional Benefits in Health

This allows policyholders to enhance their coverage beyond the standard benefits, addressing specific health concerns or financial risks that may not be fully covered under the base plan.

• Consumables Cover: This optional cover reimburses expenses for non-medical items related to hospitalisation, such as walking aids, crepe bandages, belts, and other personal comfort items listed in Annexure A that are otherwise excluded from standard policies.
• Network Hospital Discount: A 10% discount on the policy premium is offered if the insured opts for hospitalisation only in network hospitals. If treatment is taken in a non-network hospital, a co-payment of 20% on the claim applies.
• Pre-existing Disease/Specific Disease/Initial Waiting Period Modification: Allows llows reducing or waiving waiting periods for pre-existing and specified diseases, and the initial waiting period for non-accidental illnesses, subject to terms and continuous coverage.

1. Death Benefit

Provides financial protection to your family by paying a lump sum amount upon the death of the insured person during the policy term. The amount paid is the highest of:

• 105% of total premiums paid (excluding extra premiums, riders, and taxes)
• 10 times the annualised premium
• Sum assured on death

2. Optional Benefits in Life

You can add extra benefits to your policy by paying an additional premium, but these are not available for point-of-sale (POS) policies. The extra benefits include:

• Accidental Death Benefit (ADB) pays an additional 100% of the sum assured if death occurs due to an accident within 180 days of the accident. Once the Additional ADB is paid, the policy terminates.
• Accidental Total and Permanent Disability (ATPD) Benefit pays 100% of the sum assured if total permanent disability occurs due to an accident within 180 days of the accident. Once the ATPD benefit is paid, the policy terminates. On payment of the Additional ATPD Benefit, insurance cover for this specific benefit under the policy terminates. However, the policy will remain active for in-force Death Benefit and other applicable Optional Benefits (if any) for the remaining Policy Term, subject to the terms and conditions of the policy.
• Accelerated Terminal Illness Benefit pays a death benefit if diagnosed with a terminal illness expected to cause death within 6 months of diagnosis. The policy terminates after payout.

3. Wellness Benefits

We offer wellness benefits that encourage you to prioritise your health and maintain a healthy lifestyle through various services. It includes: 

• Doctor on Call
• Wellness Coach
• Lab and Pharmacy Services
• Vital Monitoring
• Medical Wallet
• Home Care
• Ambulance Arrangement
• Mental Wellbeing
• Physiotherapy    
• Childcare and OPD Services

These services are provided through empanelled service providers, and the cost must be borne by the policyholder.

Note: The above cover is subject to terms, conditions, warranties, deductibles, co-payment, limitations and exclusions mentioned in the Policy. Please read your policy documents to understand the terms and conditions clearly.

Like most insurance policies, the Digit Life Healthy Glow Policy has specific exclusions. Here are some standard exclusions you might find in this policy:

• Pre-Existing Diseases: Claimants with pre-existing conditions are subject to a waiting period as specified in their policies.
• Cosmetic and Aesthetic Treatments: Any treatments or surgeries done for cosmetic reasons, such as plastic surgery or weight loss procedures, are not covered unless they are medically necessary due to an accident or illness.
• Self-Inflicted Injuries and Substance Abuse: Injuries resulting from self-harm, alcohol, or drug abuse are excluded.
• Dental and Vision Care: Routine dental treatments and vision correction (like glasses or contact lenses) are not covered unless they result from an accident.
• Experimental or Unproven Treatments: Procedures or treatments that are not medically approved or proven to be effective are not included.
• War or Hazardous Activities: Illness or injuries resulting from war, military activities or professional hazardous sports are not covered.
• Rest and Rehabilitation: Expenses for hospitalisation solely for rest, rehabilitation, or non-medically necessary therapies are excluded.

Please refer to the policy document for a detailed list of exclusions under the Digit Life Healthy Glow Policy.

Cashless Claim Process for Network Hospitals in Digit Life Healthy Glow Policy

The cashless facility is available exclusively at our network hospitals, and we will directly settle the hospital bills if you inform us at least 72 hours in advance. To avail this, follow the procedure below:

• Step 1: Choose from the approved network of hospitals to avail cashless services.
• Step 2: Provide your health card, e-card, and ID proof to the hospital, and get a pre-authorization form.
• Step 3: Fill out and sign the pre-authorization form and submit it to the hospital counter.
• Step 4: Digit will review the pre-authorization request and approve the estimates If the claim is covered under your policy.
• Step 5: Once approved, you can undergo the necessary treatment without having to pay the hospital upfront.

Note: We may change the list of network hospitals at any time. Check the updated list before using the cashless facility.

The Digit Life Healthy Glow Policy offers flexibility when it comes to deductible and co-payment options. Here are the details:

1. Deductible Options

A deductible is the amount you agree to pay out of pocket before the insurance coverage kicks in. The deductible options under this policy range from ₹2,500 to ₹50,000 for various sections, including hospitalisation, organ donor expenses, emergency air ambulance, worldwide coverage, maternity benefits, and personal accident insurance.

2. Co-Payment Options

A co-payment is the percentage of the claim amount you must pay. The co-payment option is only applicable under certain circumstances:

• If you opt for the Networking Hospital Discount, which gives a 10% premium discount, a 20% co-payment will apply if treatment is taken in a non-network hospital.

• No co-payment is required for accidental hospitalisations or treatments at network hospitals.

These options help customize the policy according to your financial preferences and provide the flexibility to manage premiums based on your ability to share the costs.

Yes, you can choose to continue with either the life or health insurance policy if you want to discontinue the other. This flexibility is part of the Digit Life Healthy Glow Policy, which allows policyholders to retain either the health or life insurance coverage while discontinuing the other. 

Here’s a detailed steps along with explanation:.

• Step 1: First, understand the terms and conditions of both the health and life insurance components to ensure that you can discontinue one while retaining the other.
• Step 2: Contact either Digit General Insurance Ltd. (for health insurance) or Digit Life Insurance Ltd. (for life insurance), depending on which policy you want to discontinue.
• Step 3: Submit a formal request for discontinuation of one part of the policy. Through customer service or by visiting the branches of either company.
• Step 4: Once you initiate the discontinuation of one part, you will continue receiving benefits under the remaining policy as per the standard terms of that policy. This means:
  • If you retain health insurance, only the health insurance premium will apply.
  • If you retain life insurance, only the life insurance premium will apply.
• Step 5: After the discontinuation of one part, the premium you pay will reflect the cost of the remaining policy. Ensure that you receive a new premium breakdown from the insurer for the continued policy.

The insurer will provide confirmation of the discontinued policy, and the benefits of the remaining policy will continue as per the policy terms.

If you decide to discontinue one part of the Combi Policy during the Free Look Period (15 - 30 days), this period applies to the product as a whole. However, specific migration rights as per IRDAI (Insurance Regulatory and Development Authority of India) portability norms are applicable for health insurance if you wish to continue with it.

If you surrender any one of the policy after the free look period has passed, the premium refund will be processed based on a short-period scale as per the terms of the policy. This means the insurer will refund a portion of the premium, depending on how long you have held the policy.

For example, if you have used the policy for more than 3-6 months, you might get back 45-55% of the premiums for the discontinued component. If more time has passed, the refund percentage will reduce.

• Single pay policies: You can end the policy anytime before it expires. If you do, you will get a refund based on the remaining term. The refund formula is:

Refund = 60% X Single Premium X Outstanding Policy / Term Policy Term

• Limited pay policies: You can end the policy anytime before it expires, but only if you have paid premiums for at least three years. But you won't get a refund if you haven’t paid premiums for three years. The refund formula is:

Refund = 60% X Total Premium Paid X Outstanding Policy Term / Policy Term X (1 - Premium Payment Term / Policy Term)

• Regular pay policies: No refund will be given if you end the policy early. Once you terminate the policy, all your rights and interests in it will end.

Understanding the various terms and conditions of the policy, such as grace periods, lapsation, early termination, policy revival, free look periods, and suicide exclusions. Each section outlines important details to help you navigate your policy effectively.

Grace Period

If a premium is not paid on time, a grace period of 15 days (monthly payments) or 30 days (other frequencies) is provided. During this time, the policy remains active. If the policyholder dies during this period, the death benefit is paid after deducting any outstanding premiums. This does not apply to single-pay policies.

Premium Payment Lapse

The policy will lapse if premiums are not paid within the grace period, and no benefits will be payable. If at least three years' premiums have been paid for limited-pay policies, a reduced benefit may be payable upon the policyholder's death.

Cancellation by The Policyholder

The policyholder can cancel the policy at any time by giving a 15-day written notice; we will refund the premium for the unused portion of the policy based on a short period scale, which is calculated depending on how long the policy has been active.

Example: If you cancel the policy within 30 days to 3 months, a 60 - 65% refund is given based on the policy duration. If it's more than 9 months, no refund is given for a 1-year policy.

The refund scale is adjusted accordingly for policies with longer tenure (2 or 3 years), with refunds available for unused years.

Free-Look Period

If you cancel the policy within 15 days of receiving the policy documents, you will receive a full refund minus any applicable administrative costs, medical examination costs, or stamp duty. This applies only if no claims have been made during this period.

Cancellation by the Insurer

The insurer can cancel the policy by giving a 30-day notice in case of fraud, misrepresentation, or non-disclosure of material facts by the policyholder. In such cases, the premium will be refunded on a pro-rata basis for the unused period, providing no claims have been made during the policy terms.

Suicide Exclusion

If the policyholder dies by suicide within 12 months from the policy start date or revival, the nominee will receive at least 80% of the premiums paid or the unexpired risk premium, whichever is higher. 

Digit offers additional benefits to maximise your savings with our no-claim bonus and carry-forward options, which reward you for not making claims and help you get the most out of your coverage:

No-Claim Bonus/Cumulative Bonus

If you don’t make any claims during the policy year, you will receive a bonus added to your total sum insured when you renew your policy.

• The NCB increases your sum insured by a certain percentage without increasing the premium.
• Typically, the bonus is 10% to 50% of the sum insured for each claim-free year, with a cap of 100% of the original sum insured.
• If a claim is made, the NCB earned so far may be reduced by the same percentage for the following policy year.
• The NCB is applicable only to the hospitalisation cover (Section 1)

Carry Forward Benefits

If you do not claim in a given policy year, instead of NCB, you can opt for carry forward benefits

• Under this benefit, the unused sum insured from the previous year is carried forward to the next policy year, effectively increasing your coverage.
• The maximum carry forward can be 100% of the base sum insured.
• This benefit ensures that any unused coverage from the previous year can be added to the next year’s sum insured, allowing you to make use of it if needed later.
• However, if you opt for carry forward benefit, you won’t receive a No claim bonus.

Understanding and maximising your insurance benefits for tax purposes is crucial in financial planning. Below are the updated and expanded details concerning health and life insurance premiums' tax benefits:

Health Insurance Premiums

• Tax Deductions: Payments towards the health insurance premium are deductible under Section 80D of the Income Tax Act. The maximum deduction allowed is up to INR 25,000 annually for individuals. This limit is elevated to INR 50,000 for senior citizens, recognising the higher costs associated with healthcare in older age.

Life Insurance Premiums

• Tax Deductions: Contributions towards life insurance policies are eligible for deductions under Section 80C of the Income Tax Act. You can claim a deduction of up to INR 1.5 lakh per annum for the premiums paid towards life insurance for yourself, your spouse, and your children.

• Inclusion in Overall Limit: It's important to remember that the deduction for life insurance premiums falls under the overall cap of INR 1.5 lakh under Section 80C, which includes various other investments and expenses like Public Provident Fund (PPF), home loan principal repayment, and tuition fees, among others.

Tax-Free Claims

• Exemption on Payouts: The proceeds received from a life insurance policy, including any bonuses, are exempt from tax under Section 10(10D) of the Income Tax Act, subject to compliance with certain conditions stipulated therein.

• Exclusions: However, there are exceptions. For example, any sum received under an insurance policy issued after 1 April 2003 but before 1 April 2012, where the premium payable in any year exceeds 20% of the sum assured, is not eligible for exemption. For policies issued on or after 1 April 2012, this threshold is 10% (15% for persons with a disability or certain ailments).

In case of any grievance, the insured person may contact the company through the website or at your nearest branch office.

Website: https://www.godigit.com

Toll Free: 1800-258-4242 / 9960126126

Email: hello@godigit.com

Senior citizens can now write to us at senior@godigit.com

If unsatisfied, escalate to the Chief Grievance Redressal Officer within 8 weeks at grievance@godigit.com