What is the Health Saathi+ Plan? The Health Saathi+ Plan offers you health and wellness benefits along with coverage against personal accidents, floods, earthquakes, civil disruption, and fire. It provides support during unexpected events that might affect you personally or impact your business.

How long does my plan last? Your plan is valid for 12 months from the date you subscribe. You can renew it to maintain continuous coverage.

When can I begin using my benefits? Your health and wellness benefits are available immediately throughout your plan term. For fixed payout benefits related to accidents, floods, earthquakes, civil disruption, and fire, there is a mandatory 15-day waiting period from your subscription date before you can make claims.

What does my subscription fee cover? Your monthly subscription fee covers all benefits described in your plan, including health and wellness services and fixed payout coverage. All applicable taxes are included in this fee.

Am I eligible to subscribe to this plan? You can subscribe if you are a resident of India, at least 18 years old, legally competent to enter into contracts, and a user of the platform either as an individual or as a business owner.

Are there reasons I might not be eligible for this plan? You cannot subscribe if you are an affiliate, agent, officer, director, partner, member, representative or employee of the provider. This restriction also applies if you are a relative of someone in any of these positions.

What happens if my eligibility status changes? The provider may review your eligibility at any time during your plan term. If you are found to be ineligible, your subscription or benefits might be suspended after appropriate verification.

What health and wellness benefits are included in my plan? Your plan includes unlimited teleconsultations with doctors, one dental wellness package, one free consultation at participating hospitals, and discounts on outpatient and inpatient procedures, dental treatments, and blood tests.

What happens if I have an accident? If you have an accident that requires hospital treatment and affects your ability to work, you may receive a fixed daily payout for up to 3 days. The amount depends on your selected coverage level, ranging from INR 1,000 to INR 10,000 per day.

If I run a business, what coverage do I get if my establishment is damaged? If you have a business, you receive coverage of up to INR 3,000 each for earthquakes, civil disruption, and fire that cause physical damage to your business and prevent you from operating for at least three consecutive days.

How does flood coverage work if I have a business? If excessive rainfall causes flooding, you may receive up to INR 3,000 if two conditions are met: the cumulative rainfall over five consecutive days exceeds the established threshold, and your business transactions decrease by at least 75% during that period compared to your normal operations.

How many claims can I make? You may make one claim for each type of fixed payout benefit during your plan term. This means one claim each for accident, flood, earthquake, civil disruption, and fire coverage, if applicable to your plan.

What situations are not covered under my plan? Your plan does not cover pre-existing injuries or conditions you knew about when subscribing, self-inflicted injuries, incidents occurring under the influence of alcohol or illicit substances, or damage resulting from criminal activities or fraud. It also excludes events related to war, terrorism, communicable diseases causing quarantine restrictions, high-risk business activities, and fires caused by government order or industrial processes.

Are there other circumstances where I might not receive benefits? You may not receive benefits if you had knowledge of any circumstances that could result in a claim when you subscribed, if you continue to earn income during the period for which benefits are claimed, or if there is evidence of fraud or misrepresentation in your claim.

How do I make a claim? You must notify the provider within 14 days of the event. When making a claim, you'll need to provide your certificate number, the start and end dates of the event, the reason for your claim, evidence that the waiting period has passed, and confirmation that your subscription is active.

What documents do I need for an accident claim? For accident claims, you need to submit your hospital bill and discharge summary, a medical certificate documenting your inability to work and for how long, and location information about where the accident occurred.

If I have a business affected by floods, what documents do I need? For flood claims affecting your business, you need to submit evidence of reduced transactions on the platform, rainfall data for your business location, photographs showing damage to your business with date and timestamp, and news coverage of the flood event.

If my business is affected by an earthquake, civil disruption, or fire, what documents do I need? You need to submit proof that your business was closed for at least three days, photographs showing damage to your establishment with date and timestamp, a police report for civil disruption or fire (except for strikes without damage), meteorological data for earthquakes, and news coverage of the event.

How long will it take to receive my benefits after making a claim? After verification and acceptance of your claim, benefits are typically provided within 14 working days.

Is there a waiting period before my claim benefits begin? Yes, there is a 1-day deductible for accident claims and a 3-day deductible for earthquake, civil disruption, and fire claims. This means your benefit calculation begins after these initial periods.

Can I cancel my plan? Yes, you can cancel your plan at any time by visiting the platform and following the cancellation instructions.

What happens to my benefits if I cancel? If you cancel, your benefits will remain active until the end of the current billing period. After that, your subscription terminates and no further fees will be charged.

Can I get a refund if I cancel my subscription? No, subscription fees are non-refundable.

Can I transfer my plan to someone else? No, your plan is personal in nature and cannot be assigned, transferred, or subcontracted to another person.

What happens to my plan if I pass away? Benefits terminate automatically in case of your death. The provider is not liable to make any payments or provide benefits to your legal heirs.

How are disputes handled? Disputes are resolved through arbitration in New Delhi according to the Arbitration and Conciliation Act, 1996. The arbitration is conducted in English, and the decision of the arbitrator is final and binding.

Can the terms of my plan change during my subscription period? Yes, the provider reserves the right to extend, cancel, discontinue, withdraw, change, alter or modify the plan and its terms. You will be notified of any changes. If you do not accept the amendments, you have the right to terminate your plan.

How is my personal information used? By subscribing, you consent to the collection, storage, processing, and transfer of your information as necessary for providing your plan benefits. This includes your name, email, phone number, employment history, and other details needed to verify eligibility and process claims.

What should I do if my business location changes during my plan term? If your business location changes, you should contact customer support immediately to update your information, as your coverage is tied to your registered business location.

If I make a claim, will it affect my subscription fee? In case of a claim for fixed payout benefits, the payment will be made after adjusting the monthly subscription fee due and payable for the remainder of your plan term during which the claim was made.