First time in India
Health Insurance
Customized by Doctors, Simplified by Kids
Dr. M.C Misra
40+ Experience, Ex-Director, AIIMS, New Delhi
Member French Academy Of Medicine
(Since October 2017)
Dr. Misra’s medical expertise and the 15-year
old kids’ innocent eyes, make sure health
insurance is really beneficial to you and our
policy summaries are simple to understand.
Here’s your Digit Policy Summary
Digit Health Care Plus Policy
(UIN: GODHLIP21486V022021)
Lengthy documents, we can’t avoid, as details are details (after all, we have to abide by legal terms too!). But here’s a short
summary, covering all the important points that you should know before you insure the most important asset, your health.
Before we begin, you should know that for making a claim, all you need to do, is call us at 1800-258-4242 and we will
guide you through. Believe us when we say, we are one call away!
This Summary document is only to aid your understanding of the coverages / benefits offered. In case of dispute, the
terms and conditions detailed in the policy document and policy schedule shall prevail. Such is life :(
Before we tell you what all your policy covers, let’s tell you 4 awesome things about your policy:
No Limit on Room type: We want you to be at ease always, specifically when you are a hospital and not home. So
when you are hospitalized you choose a room without any limit/restrictions.
Sum insured refill benefit: We refill your sum insured as soon you exhaust it, so that you are never unprotected. In
case of Family Floater Policy, the sum insured for each member of the family gets refilled once exhausted. for e.g., if
the total policy is of 5 L, and there are 4 members, on claiming each member will get 5 L Sum Insured for the claim.
This refill can only be taken in case of an unrelated disease up to the number of times mentioned in your policy unless
specifically waived off by us
Additional Sum-insured: Some incidents in life need more cover than the other. So in case of a Critical Illness
hospitalization or Accidental Hospitalization we give you additional sum-insured, which is over and above base sum-
insured you [Link] coverage will only get activated when your base sum-insured has been exhausted.
Cumulative Bonus: If you’ve been safe and healthy and have had No Claims made under Accidental Hospitalization
cover and/ or Accidental & Illness Hospitalization cover and/or Critical Illness hospitalization, you would be eligible for
Cumulative Bonus at the time of renewal. This cumulative bonus, increases your sum-insured without any increase in
premium.
If you happen to claim, the bonus gained till date will reduce by the same percentage as gained the previous year.
Covers that ensure your health is always covered!
Benefits What is covered What is not covered
On an unlucky day, the hospital bed is the only • If you have taken the outpatientbenefit, any
place to go. In times like these, we cover for treatment taken without hospitalization won’t be
everything that you require: covered.
• Room Rent, doctor charges, medicines and • Minimum hospitalization tenure should be 24
investigations hours
Accidental & Illness • Day care procedures, Pre-hospitalization and • We don’t cover nonmedical expenses like food
Hospitalization Post-Hospitalization expenses etc. consumed by visitors, any equipment bought for
• Second Medical Opinion nontreatment purposes etc.
• Dental treatment: If after an accident you require • Home care nursing is not included
a dental treatment and need to be hospitalized • Any treatment outside India
• Road Ambulance
Everything we already spoke about above plus
And we have some special covers for you too some more
• Bariatric Surgery, this is applicable for cases • For Bariatric Surgery the insured person
where obesity causes other health conditions like undergoing the surgery must be at least 18 years
heart diseases, respiratory problems etc. old. Also, the reason should not be cosmetic or
due to a severe untreated hormonal imbalance,
• Mental Illness Cover, in cases like depression,
psychiatric or eating disorders.
bipolar disorder, schizophrenia, anxiety disorders
to name a few • Mental Illness Cover is only applicable for
conditions that require hospitalization
Lumpsum post hospitalization benefit
upto % as mentioned in the policy schedule
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Benefits What is covered What is not covered
Accidents are uncalled for. So, we’ll try and cushion • If you have taken the outpatient benefit, any
you right from the time you cry for help by covering treatment taken without hospitalization won’t be
you for everything above other than the special covered.
covers. • Any condition you get hospitalized for that
doesn’t match with the doctor’s prescription.
Accidental • Any hospitalization due to illness
Hospitalization • Any accident under the influence drugs or alcohol
• Minimum hospitalization tenure should be 24
hours
Organ donation is a gift of life. We honor this • Any other medical treatment for the donor due to
novel gesture and cover: an after effect of the organ transplantation
• For the charges required for organ • Organ transplantation due to overdose of alcohol
transplantation
We pay the donor’s Pre- and Post-
Organ Donation Hospitalization expenses, up to 5% of the
admissible harvesting expenses
• We cover for hospital expenses too in case of • Applicable on critical illness that has occurred
Critical Illness. for the first time in life.
• These expenses include medication, diagnostics,
ICU, doctor’s fees, procedures and consumables.
You have to be hospitalized for more than
Critical Illness the number of days as mentioned in the
Hospitalization Cover policy schedule to avail this cover.
And because we believe in being crystal clear, here’s how the claims process works:
Please call us directly at 1800-258-4242 and we will assist you for both Cashless and Reimbursement Claim process
For Reimbursement claims:
a) You need to call us and intimate within 2 days from admission date. Post our call, we’ll send
you a link where you can upload the soft copies of all original documents (bills, report, etc) and
bank details for your desired bank account.
b) Before uploading, you need to sign all the documents yourself. You also need to write ‘For Digit
Insurance’ on them. Keep all originals handy as we may ask for them if required.
c) Upload the documents within 30 days from the date of discharge or when you receive the link.
d) We will keep you posted for any additional requirements.
e) You will receive the payment within 30 days from the receipt of the last necessary claim
document.
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For Cashless claims, our service partner Mediassist will assist us:
a) Please inform us least 3 days before any planned hospitalization or within 24
Hours of hospitalization in case of an emergency situation.
b) Just show your e-health card and ask for a pre-approval form at Mediassist help
desk/insurance helpdesk at the hospital.
c) Fill & sign the form and submit it at the helpdesk.
d) If all is okay, you can go ahead with the treatment using the cashless facility.
Make sure that the treatment is done within 15 days of approval for cashless.
P.S:Cashless facility can only be availed at our Network hospitals (we have 6,400 of them). You can check the list on
your Mediassist account. Link for it is here.
We know, insurance claims is often a daunting process for people, but we want to make it simple for you by giving all the
details beforehand. So, here’s a list of the documents that would be required at the time of claim.
Note: Wipe that worry from your face as the documents will differ basis the kind of claim. And this is an exhaustive list, we
may not need everything.
Hospitalization Out-Patient (OPD) Critical Illness Daily Hospital
List of Documents / Information
Claim Claim Claim Cash Claim
Duly Filled and Signed Claim form √ √ √ √
Discharge Summary √ × × √
Medical Records (Optional Documents may be
asked on need basis: Indoor case papers, OT √ × √ ×
notes, PAC notes etc.)
Original Hospital Main Bill √ × × ×
Original Hospital Main Bill with breakup √ × × ×
Original Pharmacy Bills with Prescriptions
(except hospital supply) and investigations done √ √ × ×
outside the Hospital)
Consultation & Investigation Papers √ √ √ ×
Digital Images/CDs of the Investigation
√ √ × ×
Procedures (if required)
KYC (Photo ID card), Bank Details with
√ √ √ √
Cancelled Cheque
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There are some more documents that will be needed only in specific cases:
In case of pregnancy related claims- Ante-natal
√ × × ×
Record, Birth discharge Summary
In case of an accident or involvement of police-
√ × √ ×
MLC/FIR Report
In case of death or disability- Post Mortem
Report, Death Certificate or Disability Certificate
Original Invoice/Sticker (If applicable) √ × × ×
Attending Physician Certificate (If applicable) √ × √ ×
In case you wish to know more, you can call us at 1800-258-4242 or
mail us at hello@[Link].
And if you wish to read the policy in detail, click here.
Senior citizens can now write to us at seniors@[Link].
Always count on us when you count your well-wishers!
Go Digit General Insurance Limited Address: 95, 4th B Cross Road, Koramangala Industrial Layout, 5th Block, Bengaluru 560095.
IRDAI Regn. No. 158 CIN: U66010PN2016PLC167410. For details on product T&C, please read sales brochure carefully before
concluding sale.