Reliance General Health Gain (Power)

It is a health insurance policy rendered by Reliance General Insurance Company Limited which covers in-patient hospitalization along with pre-and post-hospitalization expenses. The strong point of the plan is that it offers a free policy renewal in the very first year, subject to the diagnosis of any critical illness. This plan is cost-effective by reducing the premium and offers a reduction of the cooling-off periods for certain pre-existing diseases. The policy will cover expenditures on consultations, pregnancies, and medications. 

A significant disadvantage is that there are no provisions for monthly premiums. Regarding complaints, policy purchase is the major one, whereas fewer complaints on claim settlements.

What are the benefits offered by the Reliance General Health Gain (Power)?

The Reliance General Health Gain (Power) offers numerous benefits for people by covering the costs of consultations, day-to-day expenses, and diagnostic tests. The plan ensures a tailored care plan for the insured with multiple options for premium discounts. 

• In-patient hospitalization coverage: The Reliance General Health Gain (Power) provides provisions for in-patient hospitalization facilities. In-patient hospitalization coverage is enabled during any pre-planned treatments, surgeries, and other medical emergencies. It is provided when the insured has to stay in the hospital for more than 24 hours. This requires staying for an extended period of time. The Reliance General Health Gain (Power) Plan provides in-patient hospitalization coverage for both room and ICU rent. There is no limit for ICU and room rent through in-patient coverage. However, the room rent limit is an add-on to the existing plan.   
• Pre-hospitalization coverage: Pre-hospitalization coverage refers to the medical expenses incurred before the admission of the patient to the hospital. Medical tests like X-rays, MRI, ECG, and CT Scans, along with prescription medications, are necessary components of pre-hospitalization coverage. These tests are important to diagnose the underlying medical condition with the help of the physician. The Reliance General Health Gain (Power) Plan allows to cover the expenses for pre-hospitalization treatment for 90 days as an add-on. The plan ensures to cover all the expenses up to the sum insured. 
• Post-hospitalization coverage: Post-hospitalisation coverage is implemented after the discharge of the patient from the hospital. This comprises expenses of regular follow-ups, medicines, and other diagnostic tests for the full recovery of the patient. The Reliance General Health Gain (Power) Plan ensures to cover all the expenses for 180 days as an add-on. The plan covers expenses up to the sum insured. 
• Daycare treatment coverage: Daycare treatment coverages are the treatment interventions that can be completed within 24 hours of hospitalization. Procedures such as chemotherapy, cataract surgery, angiography, and dialysis often come under daycare treatment coverage. The Reliance General Health Gain (Power) Plan covers all daycare treatments when the insured is admitted to the hospital for a short duration. As per the plan, there is no financial limit to daycare treatment coverage. Furthermore, all treatments are covered under the plan.   
• Domiciliary treatment: Domiciliary treatment, also known as home-based treatment, is when the insured is not admitted to the hospital. The medical interventions are provided in their home rather than the hospital. The Reliance General Health Gain (Power) Plan ensures coverage of the expenses of domiciliary treatments till the sum is insured. However, 15 illnesses are not covered under the plan.  
• Organ donor coverage: Organ donor coverage is the provision through which the medical expenses of the organ donor are covered.  Up to 50% of the sum insured is covered through the organ donor expenses in the Reliance General Health Gain (Power) plan. This can be provided up to a maximum amount of Rs 5 lakhs to the assured. The policy further covers all in-patient expenses for organ donor procedures. Therefore, people requiring organ transplants will be able to receive financial relief through this policy. 
• Modern day treatments: Modern-day treatment coverage is comprised of advanced medical technologies to provide care to all patients. Treatments such as robotic surgeries, oral chemotherapy, and stem cell therapy come under modern day treatments. The Reliance General Health Gain (Power) Plan provides coverage for several modern-day treatments and ultra-advanced technologies. There is no financial limit to modern day treatment as per the plan. However, it is an add-on facility in the plan.  
• Non-medical expenses coverage: Non-medical expenses contain expenses incurred due to oxygen masks, nebulizers, pulse oximeters and other self-care items. The Reliance General Health Gain (Power) Plan policy covers all kinds of non-medical expenses. However, the coverage for non-medical expenses is available as an add-on.  
• No Claim Bonus: No claim bonus is applicable when the insured does not make any claim in that specific policy year. The Reliance General Health Gain (Power) Plan provides a maximum bonus accumulation of 100%. There is no reduction in the accumulated bonus due to the claim. The percentage of bonus every year is 33.33%.    
• Super No Claim Bonus: A super no claim bonus ensures an increase in the coverage for the insured sum in each claim-free year. The Reliance General Health Gain (Power) Plan does not provide any super no claim bonus. 
• Restoration Benefit: The restoration benefit is the feature through additional coverage provided to the insured after the exhaustion of the primary sum insured. The Reliance General Health Gain (Power) Plan provides a few restoration benefits to its clients. The refill is applicable for both related and unrelated illnesses. The refill can be applied for unlimited times in a specific policy year, which is an add-on feature. Further, subsequent claims can also be applied for. Full exhaustion of the sum insured and no claim bonus will trigger the refill. The refill will also be triggered after the exhaustion of the sum insured.  

Reliance General Health Gain (Power): Financial Limits

• Room rent limit: Room lent is the maximum amount paid by the insurance company for the hospital room during the hospitalization of the insured. Per-day room and bed charges are denoted by the room rent limit. There is no room rent limit provided by the Reliance General Health Gain (Power) Plan. This facility is available as an add-on, and the insured can choose any room they prefer. 
• ICU rent limit: The ICU rent limit is the amount paid by the insurance company when the insured stays in the intensive care unit. There is no ICU rent limit in the Reliance General Health Gain (Power) policy.  The entire cost of staying in the ICU is covered through the plan.
• Copayment: Copayment is the specific claim percentage that the insured needs to pay from his own pocket, regardless of the claim amount.  The Reliance General Health Gain (Power) Plan does not have any copayment.  
• Deductible: A deductible is a fixed amount that the insurer pays from his own pocket before the insurance company starts paying to cover the remaining amount. The Reliance General Health Gain (Power) Plan provides a few options for deductibles at 10K/25K/50K/100K as options for the customers.  
• Limits on surgeries/treatments: Different healthcare policies pose limitations on certain medical procedures. The Reliance General Health Gain (Power) Plan has certain limits, especially with joint replacement and cataract surgeries. Their expenses are covered till the sum is insured. Moreover, there is also a limitation on the hospital room as this facility is only available as an add-on facility.  

Reliance General Health Gain (Power): Waiting Periods & Exclusions 

👉 Waiting Periods

The waiting period is the specific period when the insurer needs to wait before they can claim the benefits after purchasing their healthcare policy. It is also known as the cooling period and is different for different insurance agencies. The insurance companies do not pay for any diseases or illnesses during this precise period. 

Let’s discuss the types of waiting periods of the Reliance General Health Gain (Power) health insurance - 

• Initial waiting period: The Reliance General Health Gain (Power) Plan has a 30-day waiting period for all generic illnesses. Any claims for hospitalization cannot be provided during this time. This waiting period is applicable for both emergency and planned healthcare events.  
• Waiting period for pre-existing conditions: A pre-existing condition refers to the medical illness or condition you may experience within 36 months before purchasing the particular health policy. The Reliance General Health Gain (Power) Plan has a waiting period of 12 months for pre-existing diseases. However, this facility is available as an add-on to the policy. The insured will also receive flexibility to reduce the waiting period for certain pre-existing diseases. 
• Waiting period for specific diseases: Different insurance companies have different waiting periods for specific medical illnesses. There can be a longer waiting period for a few diseases, and this is generally determined by the insurer itself. The Reliance General Health Gain (Power) Plan has a waiting period of 24 months for specific illnesses. 

👉Exclusions 

Exclusions are those specific conditions when certain illnesses cannot be covered under any circumstances. Several exclusions are present in the Reliance General Health Gain (Power) Plan, which has been provided below -

• Standard Permanent Exclusions:

A  list of mandatory exclusions has been provided by the Insurance Regulatory and Development Authority that need to be followed by all insurance companies under all costs. They have been provided below -

1. Investigation and evaluation: The process of continuous monitoring and observation during the hospital admission to identify the medical condition. 
2. Rest, rehabilitation, and respite care: Treatment procedures without any requirement of active surgery or treatments. 
3. Obesity/weight control: Treatments and surgical procedures for weight loss. 
4. Gender reassignment: Treatments and surgical procedures to modify gender identity and change to the opposite sex by altering the physical appearance.
5. Plastic/Cosmetic surgery: Any treatments or surgical procedures to change the physical appearance of a person. 
6. Profession in hazardous or adventure sports: Injuries from participating in hazardous sports activities such as mountaineering, rock climbing, trekking, and skiing. 
7. Breach of law: Treatment of a person who has violated and legally convicted for any crime. 
8. Excluded providers: Specific healthcare hospitals and institutes not covered under the insurance companies. 
9. Narcotics: Treatment of substance abuse issues like excessive use of alcohol or drugs. 
10. Treatments in establishments arranged for domestic purposes: Expenditure of treatments received in nursing homes, spas, and other institutes for domestic purposes. 
11. Dietary supplements and substances purchased without subscription: Dietary Supplements for vitamins, minerals, and protein, which are not prescribed by the physicians.
12. Refractive error: Expenses incurred for the treatment of refractive errors up to 7.5 diopters for improving eyesight. 
13. Unproven treatments: Medical procedures and surgeries that are considered ineffective.  
14. Expenses related to birth control, sterility, and infertility: Treatment procedures such as IVF, GIFT, gestational surrogacy, and other methods of artificial insemination and reproductive technologies.  
15. Maternity expenses: Expenses due to childbirth and pre- and post-natal care. 

• Additional permanent exclusions: The exclusions provided under IRDAI must be followed under all circumstances, irrespective of any special situation. However, insurance companies can apply for a few additional permanent exclusions for specific circumstances. If any insurance company thinks that a certain medical illness can be quite risky to cover, they can do so. Additional permanent exclusions are often present for non-medical expenses, pregnancy, and self-inflicted injuries. Conversely, the medical conditions already provided by the IRDAI cannot be claimed by the insurance companies again. 
• Non-Standard exclusions (Specific exclusions): The non-standard exclusions refer to the specific exclusions, which are not provided under IRDAI. The specific exclusion of Reliance General Health Gain (Power) are listed below -

1. Any medical illness directly or indirectly associated with any sexually transmitted disease. 
2. Expenses allied with spectacles, hearing aids and contact lenses.
3. Expenses related to dental treatments, excluding the treatments requiring hospitalization.  
4. Medical equipment such as walkers, wheelchairs, braces, belts, and collars.
5. Treatment procedures such as circumcision, unless and until it is required for treating other specified diseases. 
6. Expenses akin to vaccination, preventative care, immunization, and inoculation, except for treatment of post-animal bite. 
7. Expenses for a ventilator who is already in a brain-dead state without any recovery chances. 
8. Expenses incurred due to transportation and travel costs such as charges for ambulance. 
9. Treatment, screening, and surgical procedures to eliminate organs from a donor. 
10.  Expenses incurred due to non-allopathic medication such as Yoga, Ayurveda, Unani, Homeopathy, Siddha and Naturopathy.
11.  Treatment of any disease where the insured has been hospitalized at home.
12.  Expenses related to treating intentional self-inflicted injuries.
13.  Any organ transplant surgery where the organs have not been harvested from a human body.
14.  Illnesses and injuries due to acts of war-like situations, foreign enemies, and civil war. 
15.  Acts of injuries due to biological, chemical, and nuclear warfare. 

What to expect in terms of claims experience if you buy from Reliance General Health Gain (Power)?

• Speed of claims: The rate of claim experience is quite swift for the Reliance General Health Gain (Power). It has been observed that around 91.69% of claims have been settled within 30 days. This means average service is being provided for all insured people.  
• Claim-related complaints: The Reliance General Health Gain (Power) has around 0.03% of complaints on the overall claims. This rate is quite low compared to similar insurers.   
• Claim incurred ratio: The claim incurred ratio is 89.42% for the Reliance General Health Gain (Power). This ratio helps in determining the financial performance of the insurer. 
• Claim settlement ratio: Reliance General Health Gain (Power) has a claim settlement ratio of 93.14%, which demonstrates the total number of claims effectively settled by the organization. 
• Network hospitals: The policy covers more than 10,000+ hospitals. This facility ensures cashless treatment facilities to the customers without any financial distress.  

How does the customer service of Reliance General Health Gain (Power)?

• Policy purchase-related complaints: From the research conducted, around 0.01% of complaints have been received for after-sales services. This indicates that policy purchase-related complaints are present at a significant rate for the organization.  
• Response on Toll-free: Research suggests that the average response time on toll-free is quick based on other similar insurance companies and agents. 
• Responses on Twitter: As per the research, the response rate on Twitter is slow than other similar insurers.    

About Reliance General Health Gain (Power)

Reliance General Insurance Company Limited was established in 2000 and is a part of the Reliance Anil Dhirubai Ambani Group. The organization is completely owned by Reliance Capital and provides numerous insurance plans for fire, health, care, travel, marine, and two-wheelers. Its headquarters is situated in Mumbai, Maharashtra. There are around 18,09,377 policies with a total 20,17,843 number of claims. The company has a turnover of 557.06 Crores. The CEO and executive director of the company is Mr Rakesh Jain.