Jain International Organisation|

A NEW Innovative Subscription Offer With Medical Benefit

For all Shravak-Shravika members of JIO

( For all JAIN Sects, like Shwetamber, Digamber, Sthanakwasi, Terapanthi etc.)

JIO – Shravak Arogyam

Group Health Subscription Offer

Khushhal Pariwar

Health Subscription Terms KP-KENKO : (JAN 2023-2024):

For October 2022 lot Members : Your cover benefit already expired on 30th October, 2022. Multiple mails & SMS were sent on your registered email id and on your registered contact number to pay on time to avail continuity benefit of cover during the last two months. Your enrolment will be considered now as fresh / new since payment not received within the provided time limit. 1st year waiting period and 1st year exclusion clause will be applicable to you. Your cover benefit will start as a fresh / new member from 31st January 2023 to 14th January 2024.

For November 2022 lot Members : Your cover benefit already expired on 29th November, 2022. Multiple mails & SMS were sent on your registered email id and on your registered contact number to pay on time to avail continuity benefit of cover during the last two month. Your enrolment will be considered now as fresh / new since payment not received within the provided time limit. 1st year waiting period and 1st year exclusion clause will be applicable to you. Your cover benefit will start as a fresh / new member from 31st January 2023 to 14th January 2024.

For January 2023 lot Members : Your cover already expired on 14th January, 2023. Membership benefit will start from 31st January, 2023 to 14th January 2024. Since your payment received after expiry of your cover, no cover benefit will be provided for pre-hospitalisation and hospitalisation from 15th January 2023 to 30th January 2023.

For New Members : Membership benefit will start from 31st January 2023 to 14th January 2024.

Specialised Health Subscription in which member will get 25% discount on Prescribed Medicine, Doctor consultation, Diagnostic test order through Kenko Health app.

In case of hospitalisation eligible initial amount (Preauth) will be transferred in members account after uploading requisite documents in app. At the time of discharge final amount will be transferred in member’s account after uploading requisite documents.

1. Entry AGE is up to 90 Years and Renewal till LIFETIME

2. Family floater Subscription offer with medical benefit for 8 members. This includes Self, Spouse, 4 unmarried Dependent Children up to 25years, 2 Dependent Parents or Parents-In-Laws (No cross combination will be covered in the Subscription). All covered members have to be Jain only

3. Family floater for 4 members. This includes Self, Spouse, 2 Dependent Unmarried Children up to 25years.

4. NO Health Check-Up Required prior to Subscription.

5. Home care treatment for COVID allowed on reimbursement basis only. Maximum limit for home care COVID treatment is 25,000 per person on reimbursement basis only.

6. Hospital ROOM RENT & ICU CHARGES limitation (Per Day):

Sum Insured	Room, Boarding Expenses in Rs. (including Nursing, RMO Expenses and all associated charges)
Sum Insured	Normal Room	ICU
2,00,000	2000	4000
5,00,000	5000	10000
10,00,000	7500	13000
In case, the insured person is admitted in a room with rent HIGHER than the eligible room rent limit, the total hospitalization claim shall be deducted in proportion of eligible room rent limit. e.g. If you are admitted in 4000 Room and you are eligible for 2000 Room rent, then your all claim will get deducted by 50%.

7. PRE-EXISTING DISEASE will cover after 1 year. (In 2nd year 75% of admissible claim amount & then after, 100% of admissible claim amount will be payable.) subject to ailment capping , reasonable, customary and Medically Necessary charges***.

For Khushhal Pariwar policy member, renwable benefit will be given

Knee Replacement / Cataract / Other Chronic disease which are mainly Pre-Existing or the treatment for same can be delayed (the list given in point no. 30 cover starts after 1 year as per T & c even if they are diagnosed after Subscription inception.

Pre-Existing Disease Definition :

Any condition, ailment or injury or related condition(s) for which you had signs or symptoms, and / or were diagnosed, and / or received medical advice / treatment within 48 months to prior to the first issued by the insurer.

8. 1st Year Exclusion Disease :
For New members 1st year exclusion applicable ,
For Renewal Member 2nd Year 75% and from 3rd Year 100% ( Except procedure mentioned in capping list )
The detail list of 1st Year exclusion disease is given under point no. 30

9. DAY CARE PROCEDURES: covered

10. Internal Congenital diseases are covered maximum up to Rs. 50,000 per family.

11. Domiciliary Hospitalisation is NOT COVERED.
12. Emergency Ambulance Charges: up to Rs.2,500 or actuals whichever is less.

13. 90 Days Pre- Hospitalisation & 90 Days Post Hospitalisation expenses covered.

14. MATERNITY BENEFIT (for self & Spouse) : Maternity benefits, applicable ONLY AFTER 1 YEAR for new members and for renewal members same is covered subject to overall limit of Rs.25,000/- for normal and Rs.35,000/- for caesarean delivery (for first 2 live children). In case the member has already 2 or more living children, then they will not be eligible for Maternity Benefit. No Pre-post claim allowed in Maternity claims. No Maternity benefit for individual Subscription.

15. NEW BORN BABY COVER: Request for addition of New Born Baby under the shall be allowed provided birth intimation received in mail within 30 days from Date of birth of child on service@jio.net.in email id with child birth proof, Any delay / request coming after 30 days from DOB for addition of New Borne baby, shall not be considered.

Any hospitalization within this period i.e. from DOB of baby to 30 days shall be considered subject to receipt of the timely intimation to Insurance Company

New born baby expenses related to Hospitalization shall be covered from Day One of the birth up to 90 days up to 35000 limit and thereafter up to Family Sum-Insured limit.

16. NEWLY MARRIED SPOUSE COVER: Request for addition of Newly married Spouse under the subscription shall be allowed within 30 days from marriage date provided written mail is received on service@jio.net.in email id within 30 days from the date of marriage with marriage proof, Any delay / request coming after 30 days from marriage date for addition of Newly married Spouse, shall not be considered.

17. Subscription to be renewed as it is with same JIOJAC id and members who were covered in last year. If found any changes done, all covered members will be considered as a fresh members and all clause and terms applied for fresh member will be applied on all members.

Only new born baby or newly married spouse name can be added if new born birth or marriage is after 31.10.2021.

18. CASHLESS and REIMBURSEMENT both facility available in subscription for Medical benefit.

19. As per INCOME TAX Act, Proposer will be not eligible for exemption under Sec 80D for Health Subscription amount.

20. Dental treatment covered if due to ROAD ACCIDENT ONLY and requiring 24 hours Hospitalisation. Police MLC / FIR is compulsory.

21. In all claim due to Accident (whatever cause, police MLC / FIR is compulsory)

22. MID-TERM ADDITIONS allowed only for newly married spouse and natural additions (new born baby) subject to intimation received within 30 days of marriage or birth (for newly married SPOUSE & new born BABY) in mail on service@jio.net.in. Any delay / request coming after 30 days shall not be considered.

23. Any person CAN’T BE COVERED MORE THAN ONCE under whole group in JIO KP . If declared more than once, benefit would be payable under one Sum Insured only.

24. Member will be considered as fresh member if subscription amount received after expiry of current . No grace period will be considered as this is a group Subscription offer.

25. All covered Member will be considered as fresh member if renewed using different JIOJAC ID or any changes in covered members name / relation detail of expiring , Continuity benefit will be lost for all covered members.

26. Kindly read Terms & Condition properly, if required then only call to call centre number 1800 1211 63177

27. REASONABLE AND CUSTOMARY CHARGES mean the charges for services or supplies, which are the standard charges for the specific provider and consistent with the prevailing charges in the geographical area for identical or similar services, taking into account the nature of the Illness / Injury involved. Insurance company will process claim as per reasonably and Customarily and Medically Necessarily charges.

28. If proposer had died then please renew enrol for subscription offer as it is and informed service@jio.net.in with death certificate of proposer within 5 days from payment. Respective team will get JIOJAC number transferred to Spouse of the deceased name. This will ensure continuity under the . Your continuity under the is tracked by JIOJAC number only.

Any claim in deceased proposer’s family, amount will be released in sequence covered Spouse, covered Elder child, father, mother name.

29. The insured can make a claim if her/his hospitalized stay is for over 24 hours. However, for certain treatments, such as dialysis, chemotherapy, cataract surgery, etc. the stay could be less than 24 hours.

30. CLAIM INTIMATION Require in each claim in advance

If Intimation given through Kenko App 7 days in advance, then Benefit Payable is 100% of Benefit.(Admissible Claim amount).
If Intimation given other than Kenko App (email, etc.) 7 days in advance, then Benefit Payable is 90% of Benefit.(Admissible Claim amount).
If member prefer Reimbursement through Kenko App, then Benefit Payable is 80% of Benefit.(Admissible Claim amount).
If member prefer Reimbursement other than Kenko App (email, etc.), then Benefit Payable is 70% of Benefit.(Admissible Claim amount).

Waiting period applicable for COVID claims for all newly covered members. Patient should be diagnosed COVID positive after 30 days from subscription cover start date. All renewal member will not have waiting period.

e) In case of claim for Corona treatment, patient’s diagnosis report should be from Government approved laboratory is compulsory and patient’s report should be COVID POSITIVE. Also note that treatment should be only taken in Government approved hospital to treat COVID Positive patient.
f) COVID treatment claims will be settled as per GIC guidelines or Govt. notification issued by the State Govt. where the hospital is situated.

31. Subscription Amount

Khushhal Parivar Annual subscription amount as per Highest Member’s age in the family per Year ##

Health Subscription for Kushhal Parivar – January 2023-2024									Total Subscription fees
Plan	Policy Type	Max. Person	Max. Age	Family Details				Sum Insured	Without GST	GST	With GST
A	Family Floater	8 members	90 years	Self	+ Spouse	+ 4 unmarried children	+2 Parents / In Laws	10 lacs	31,795	5,723	37,518
B								5 lacs	25,244	4,544	29,788
C			60 years	Self	+ Spouse	+ 4 unmarried children	+2 Parents / In Laws	10 lacs	26,720	4,810	31,530
D								5 lacs	19,002	3,420	22,422
E		4 Members	45 years	Self	+ Spouse	+ 2 unmarried children		10 lacs	19,505	3,511	23,016
F								5 lacs	13,862	2,495	16,357
G	Individual	1 member	65 years	Self				2 lacs	9,161	1,650	10,811
H			45 years	Self					4,636	834	5,470

*Rs 2000/- + GST (non-refundable/non-transferrable) will be charged additional per financial year for JIO Membership fees, if not paid

Notes :

• Children in the are defined as unmarried dependent children up to the age of 25 years.
• Either Parents or Parents-in-law covered (Cross combination not allowed)
• Single person can also opt for subscription up to age of 65 years. Without maternity benefit.
• Family members to be covered as per acceptable age of specific plans only
• Individual Subscription (Plan G & Plan H) is available only for members without any living spouse, children, Parents or parent in law (self-affidavit or certificate from JIO Director mandatory). No Maternity benefit for individual Subscription.
• Subscription amount to be transferred to JIO account by members and JIO will subsequently make consolidated payment to Insurance Company. Hence, considering the time required for reconciliation and requisite processes, request members to pay subscription amount at the earliest
• subscription amount to be paid through Online Payment only. No changes or cancellation allowed after payment.
• Additional Payment Gateway fees shall be charged by Gateway Company for providing safe & secure online money transfer facility.
* For detail terms and condition, rejections and sub-limits refer JIO website.

https://jio.net.in/KPK22.php

** Subscription terms and rates shall be reviewed annually and necessary corrective action shall be taken (if required) to keep the portfolio viable

• PARTNERS for JIO-KENKO offer
• Insurance Company: Go Digit General Insurance Limited

32. GENERAL EXCLUSIONS (Not Payable ) JIO-KENKO Subscription with Medical benefit.

In Patient Hospitalisation (This exclusion is related to IPD - Hospitalisation benefit)

1. WAR like situation etc. :Treatment directly or indirectly arising from or consequent upon war or any act of war, invasion, act of foreign enemy, war like operations (whether war be declared or not or caused during service in the armed forces of any country), civil war, public defence, rebellion, uprising, revolution, insurrection, military or usurped acts, nuclear weapons / materials, chemical and biological weapons, ionizing radiation, contamination by radioactive material or radiation of any kind, nuclear fuel, nuclear waste.

2. SUICIDE attempt, CRIME etc.: An Insured Person committing or attempting to commit a breach of law with criminal intent, intentional self-Injury or attempted suicide while sane or insane.

3. Risky Sports, Military :Wilful or deliberate exposure to danger , intentional self-Injury, participation or involvement in naval, military or air force operation, circus personnel, racing in wheels or horseback, diving, aviation, scuba diving, parachuting, hang-gliding, rock or mountain climbing, bungee jumping, paragliding, parasailing, ballooning, skydiving, river rafting, polo, snow and ice sports in a professional or semi-professional nature.

4. Alcohol, Addiction etc.: Abuse or the consequences of the abuse of intoxicants or hallucinogenic substances such as intoxicating drugs and alcohol, including alcohol withdrawal, smoking cessation programs and the treatment of nicotine addiction or any other substance abuse treatment or services, or supplies, impairment of Insured Person's intellectual faculties by abuse of stimulants or depressants

5. Weight management programs or treatment in relation to the same including vitamins and tonics, treatment of obesity (including morbid obesity).

6. Correction of eyesight: Treatment for correction of eyesight due to refractive error including routine examination.

7. Health check-ups: All routine examinations and preventive health check-ups, including corona virus when hosptizalation is not done

8. Cosmetic surgery, aesthetic and re-shaping treatments and Surgeries. Plastic Surgery or cosmetic Surgery or treatments to change appearance unless medically necessary and certified by the attending Medical Practitioner for reconstruction following an Accident, cancer or burns.

9. Circumcision (unless necessitated by Illness or Injury and forming part of treatment); aesthetic or change-of-life treatments of any description such as sex transformation operations.

10. Hospitalisation not required: Conditions for which treatment could have been done on an outpatient basiswithout any Hospitalization.

11. Experimental treatment: Investigational treatments, Unproven / Experimental treatment , or drugs yet under trial, devices and pharmacological regimens.

12. Diagnostic Only: Diagnostic tests/procedures/treatment/consumables not related to Illnessfor which Hospitalization has been done.

13. REST CURE :Convalescence, cure, rest cure, sanatorium treatment, rehabilitation measures, private duty nursing, respite care, long-term nursing care or custodial care, treatment taken in a clinic, rest home, convalescent home for the addicted, detoxification centre, home for the aged, mentally disturbed remodelling clinic or any treatment taken in an establishment which is not a Hospital.

14. PREVENTIVE CARE/Vaccination including inoculation and immunizations (except in case of post-bite treatment); any physical, psychiatric or psychological examinations or testing.

15. Admission for enteral feedings (infusion formulas via a tube into the upper gastrointestinal tract) and other nutritional and electrolyte supplements unless certified to be required by the attending Medical Practitioner as a direct consequence of an otherwise covered claim.

16. Hearing aids & contact lenses or spectacles including optometric therapy, multifocal lens.

17. Baldness: Treatment for alopecia, baldness, wigs, or toupees, and all treatment related to the same.

18. Diabetic test strips etc.: Medical supplies including elastic stockings, diabetic test strips, and similar products.

19. External durable medical equipment: Any expenses incurred on prosthesis, corrective devices, external durable medical equipment of any kind, like wheelchairs crutches, instruments used in treatment of sleep-apnea syndrome or continuous ambulatory peritoneal dialysis (C.A.P.D.), devices used for ambulatory monitoring of blood pressure, blood sugar, glucometers, nebulizers and oxygen concentrator for bronchial asthma/ COPD conditions. Cost of artificial limbs, crutches or any other external appliance and/or device used for diagnosis or treatment (except when used intra-operatively). Sleep-apnea and other sleep disorders.

20. External Congenital Anomalies or diseases or defects.

21. Stem cell therapy etc. : Genetic disorders and stem cell implantation /Surgery, or growth hormone therapy.

22. Venereal disease, all sexually transmitted disease or Illness including but not limited to HPV, Genital Warts, Syphilis, Gonorrhoea, Genital Herpes, Chlamydia, Pubic Lice and Trichomoniasis.

23. "AIDS"(Acquired Immune Deficiency Syndrome) and/or infection with HIV (Human Immunodeficiency Virus) including Opportunistic infections but not limited to any conditions related to or arising out of HIV/AIDS such as ARC (AIDS Related Complex), Lymphomas in brain, Kaposi's sarcoma, tuberculosis, Pneumocystis Carinii Pneumoniae etc.

24. Voluntary termination, miscarriage (except as a result of an Accident or Illness)

25. Infertility: Treatment for sterility, infertility, sub-fertility or other related conditions and complications arising out of the same, assisted conception, surrogate or vicarious pregnancy, birth control, and similar procedures; contraceptive supplies or services including complications arising due to supplying services.

26. Organ donor screening: Expenses for organ donor

27. Illegal Organ Transplantation: Admission for Organ Transplant but not compliant under the Transplantation of Human Organs Act, 1994 (amended).

28. Spinal subluxation: Treatment and supplies for analysis and adjustments of spinal subluxation, diagnosis and treatment by manipulation of the skeletal structure; muscle stimulation by any means except treatment of fractures (excluding hairline fractures) and dislocations of the mandible and extremities.

29. Dental Treatment: Dentures, implants and artificial teeth, Dental Treatment and Surgery of any kind, unless requiring Hospitalization due to an Accident.

30. Cost incurred for any health check-up or for the purpose of issuance of medical certificates and examinations required for employment or travel or any other such purpose.

31. Artificial life maintenance including life support machine use, where such treatment will not result in recovery or restoration of the previous state of health.

32. Treatment for developmental problems , learning difficulties eg. Dyslexia, behavioural problems including attention deficit hyperactivity disorder (ADHD).

33. Treatment for Age Related Macular Degeneration (ARMD), Rotational Field Quantum Magnetic Resonance (RFQMR), External Counter Pulsation (ECP), Enhanced External Counter Pulsation (EECP), Hyperbaric Oxygen Therapy, high intensity focused ultrasound, balloon sinuplasty, Deep Brain Simulation,

34. Non-Medical Expenses (1):Expenses which are medically not necessary such as items of personal comfort and convenience including but not limited to television (if specifically charged), charges for access to telephone and telephone calls (if specifically charged), food stuffs (save for patient's diet), cosmetics, hygiene articles, body care products and bath additives, barber expenses, beauty service, guest service as well as similar incidental services and supplies, vitamins and tonics unless certified to be required by the attending Medical Practitioner as a direct consequence of an otherwise covered claim.

35. Treatment taken from a person not falling within the scope of definition of registered Medical Practitioner with any state medical council/ medical council of India.

36. Treatment charges or fees charged by any Medical Practitioner acting outside the scope of license or registration granted to him by any medical council.

37. Treatments rendered by a Medical Practitioner who is a member of the Insured Person's family or stays with him, except if pre- approved by Us.

38. Any treatment or part of a treatment that isnot of a reasonable charge, not medically necessary , drugs or treatments which are not supported by a prescription.

39. Non-Medical Expenses :(2) Administrative charges related to a Hospital stay not expressly mentioned as being covered, including but not limited to charges for admission, discharge, administration, registration, bio-medical, linen, documentation and filing, including MRD charges (medical records department charges).

40. Non-Medical Expenses : (3)including but not limited to RMO, CMO, DMO charges, Bio-Medical waste charges , Infection Control Charges etc. surcharges, night charges, service charges levied by the Hospital under any head are not payable because they are part of Nursing Charges and as specified in the Annexure for Non- Medical Expenses Click Here for more details

41. Treatment taken outside India

42. Insured Person whilst flying or taking part in aerial activities except as a fare-paying passenger in a regular scheduled airline or air charter company.

43. Robotic surgery (whether invasive or non-invasive) and Any form of Laser Surgery

44. All forms of Bariatric surgery.

45. Use of Radio Frequency (RF) probe for ablation or other procedure.

46. Admission primarily for diagnostic purposes not consistent with the treatment taken.

47. Blacklisted Hospital, Doctor: Treatment in any Hospital or by any Medical Practitioner or any other provider of services that We have blacklisted as listed on Our website.

48. Treatment provided by anyone with the same residence as Insured Person or who is a member of the Insured Person's immediate family.

49. Holmium Laser Enucleation of Prostate, KTP Laser Surgeries, Femto laser surgeries, bio-absorbable stents, bioabsorbable valves, bioabsorbable implants, oral chemotherapy, Hormonal Chemotherapy, Adjuvant Chemotherapy, Neo-adjuvant Chemotherapy, Immuno-therapy, use of Monoclonal antibody e.g. Trastuzumab , Antibody cocktail , Infliximab, rituximab, avastin, lucentis group of drugs.

50. Domiciliary Hospitalisation, OPD treatment is not covered.

51.Consumables are not payable

OPD: (This exclusion is related to OPD benefit only not for IPD Hospitalization Benefit )

Vision Corrections, Contact lens, and cost of spectacles

All Dental treatments

Mental health consultations

Any Cosmetic treatments

Non prescription medicines and diagnostic tests

Consultation, Medicines or diagnostic tests purchased out of network unless agreed in advance

Physiotherapy sessions

Medicines, diagnostic tests on prescriptions written before scheme start date

Cost of Insulin

Medicine, doctor consultation or diagnostic test cost covered by any insurance of beneficiary are outside the scope

Cost of equipment for disabled people

Orthopaedic equipment cost

Cost of dialysis (excluded for OPD but is included in In Patient as Day Care)

Cost of Oral Cancer Drugs and cancer related diagnostics

Abortion, Mis-carriage, Termination of Pregnancy (Voluntary/Accidental)

Medicines administered at hospital or medical facility

33. Treatment not covered in 1st Year: Even if diagnosed after Subscription Inception.
For 2nd Year benefits capped at 75% of payable, except capped ailment which are paid up to capping limit mentioned below from 2nd year.

Sl No.	Body System	Illness	Treatment/ Surgery
1	Eye	Cataract	Cataract Surgery
		Glaucoma	Glaucoma Surgery
		Other Eye Surgeries	Other Eye Surgeries
2	Ear Nose Throat (ENT)	Serous Otitis Media
		Sinusitis	Sinus Surgery
		Rhinitis	Surgery for the nose
		Tonsillitis	Tonsillectomy
		Tympanitis	Tympanoplasty
		Deviated Nasal Septum	Surgery for Deviated Nasal Septum
		Otitis Media	Surgery or Treatment for Otitis Media
		Adenoiditis	Adenoidectomy
		Mastoiditis	Mastoidectomy
		Cholesteatoma	Resection of the Nasal Concha
3	Gynecology	All Cysts & Polyps of the female genito urinary system	Dilatation & Curettage
		Polycystic Ovarian Disease	Myomectomy
		Uterine Prolapse	Uterine prolapsed Surgery
		Fibroids (Fibromyoma)	Hysterectomy unless necessitated by malignancy
		Breast lumps	Any treatment for Menorrhagia
		Prolapse of the uterus
		Dysfunctional Uterine Bleeding (DUB)
		Endometriosis
		Menorrhagia
		Pelvic Inflammatory Disease
4	Orthopedic / Rheumatological	Gout	Joint replacement Surgery
		Rheumatism, Rheumatoid Arthritis	Surgery for Prolapse of the intervertebral disc
		Non infective arthritis
		Osteoarthritis
		Osteoporosis
		Prolapse of the intervertebral disc
		Spondylopathies

5	Gastroenterology (Alimentary Canal and related Organs)	Stone in Gall Bladder and Bile duct	Cholestectomy / Surgery for Gall Bladder
		Cholecystitis	Surgery for Ulcers (Gastric / Duodenal)
		Pancreatitis
		Fissure, Fistula in ano, hemorrhoids (piles), Pilonidal Sinus, Ano-rectal & Perianal Abscess
		Rectal Prolapse
		Gastric or Duodenal Erosions or Ulcers + Gastritis & Duodenitis
		Gastro Esophageal Reflux Disease (GERD)
		Cirrhosis
		Acute & Chronic Appendicitis, Appendicular lump, Appendicular abscess
6	Urogenital (Urinary and Reproductive system	Stones in Urinary system (Stone in the Kidney, Ureter, Urinary Bladder)	Prostate Surgery
		Benign Hypertrophy / Enlargement of Prostate (BHP / BEP)	Prostate Surgery
		Hernia, Hydrocele,	Surgery for Hydrocele, Rectocele and Hernia
		Varicocoele / Spermatocoele	Surgery for Varicocoele / Spermatocoele
7	Skin	Skin tumour (unless malignant)	Removal of such tumour unless malignant
7	Skin	All skin diseases	Removal of such tumour unless malignant
8	General Surgery	Any swelling, tumour, cyst, nodule, ulcer, polyp anywhere in the body (unless malignant)	Surgery for cyst, tumour, nodule, polyp unless malignant
		Varicose veins, Varicose ulcers	Surgery for Varicose veins and Varicose ulcers
		Congenital Internal Diseases or Anomalies	Surgery for Varicose veins and Varicose ulcers
9	Cardiac Surgeries	CABG	Thoraco Vascular / Cardiac Surgeries
		Angioplasty
		Other Heart Surgeries / Thoraco Vascular Surgeries
10	Other Treatments	Chemotherapy/ Cancer Surgeries	Cancer treatment
		Radiotherapy	Cancer treatment
		Dialysis	kidney / Liver Failure

Maximum Amount payable per person for Ailments/ procedure. (INCL. Pre/post expenses)	Sum Insured – 200000	Sum Insured - 500000	Sum Insured - 1000000
Cataract per eye	15,000	21,000	25,000
All expenses related to CABG/ Angioplasty/ Stroke - Per Ailments	1,20,000	2,20,000	2,80,000
Expenses related Radio therapy / chemotherapy & Dialysis - Per Ailments	75,000	1,00,000	2,00,000
Expenses related to Prostate enlargement, Hysterectomy & stone removal - Per Ailments	40,000	50,000	60,000
Joint & or Knee Replacement and implants (Maximum payable - per family per year)	1,00,000	1,50,000	2,00,000

Co-pay not applicable on capped ailment.

Hospitalization (IPD Claims)

हास्पिटलिज़ेशन (आईपीडी क्लेम्स)

Intimation through Kenko App 7 days in advance, Benefit Payable is 100% Benefit.(Admissible Claim amount)
केनको ऐप के माध्यम से 7 दिन पहले सूचना देने पर, देय लाभ (Admissible Claim amount) 100% मिलेगा
Intimation other than Kenko App (email, etc.) 7 days in advance, Benefit Payable is 90% Benefit. (Admissible Claim amount)
केनको ऐप के अलावा (ईमेल, आदि) सूचना 7 दिन पहले, देने पर, देय लाभ (Admissible Claim amount) 90% मिलेगा
Reimbursement through Kenko App, Benefit Payable is 80% Benefit. (Admissible Claim amount)
केनको ऐप के माध्यम से Reimbursement करने पर, देय लाभ (Admissible Claim amount) 80% मिलेगा
Reimbursement other than Kenko App (email, etc.) Benefit Payable is 70% Benefit. (Admissible Claim amount)
केनको ऐप के अलावा (ईमेल, आदि) से Reimbursement करने पर देय लाभ (Admissible Claim amount) 70% मिलेगा

To avail of Hospitalization (IPD) benefits, a minimum of 24 hrs of hospital admission is required except day Care Procedure.

हास्पिटलिज़ेशन (आईपीडी) लाभों का लाभ उठाने के लिए, कम से कम २४ घंटे अस्पताल में भर्ती होना आवश्यक है।

Each subscription plan has different tiers of hospitalization benefits. Subscribers will be able to claim their benefits, as offered by their subscription plan.

प्रत्येक सदस्यता योजना में अस्पताल में भर्ती होने के लाभों के विभिन्न स्तर होते हैं। सब्सक्राइबर कर सकेंगे क्लेम उनके लाभ, उनकी सदस्यता योजना द्वारा दिए गए लाभों के अनुसार।

Note: If the subscriber has multiple plans, they can choose any of their active plans to avail themselves of the respective benefit. At the time of claims, customers can claim from only 1 plan and multiple plans cannot be clubbed together for the same order.

टिप्पणी: यदि ग्राहक के पास कई योजनाएं हैं, तो वे संबंधित लाभ का लाभ उठाने के लिए अपनी कोई भी सक्रिय योजना चुन सकते हैं। क्लेम के समय, ग्राहक केवल १ प्लान से ही क्लेम कर सकते हैं और एक ही ऑर्डर के लिए कई प्लान्स को एक साथ नहीं जोड़ा जा सकता है।

Online/Offline Claims Process (Via App or Email/Call )

ऑनलाइन/ऑफलाइन क्लेम प्रक्रिया (ऐप या ईमेल/कॉल के माध्यम से)

1.The employee/ patient will log-in to their Kenko app (Android / iOS) and create a Hospitalization

(IPD) ticket on the app (Under Hospital Admission). Kenko’s Customer Delight team will get in touch with the employee/ patient and guide them with next steps.

कर्मचारी/रोगी अपने केनको ऐप (एंड्रॉइड/आईओएस) में लॉग-इन करेंगे और अस्पताल में भर्ती होंगे (आईपीडी) ऐप पर टिकट (अस्पताल प्रवेश के तहत)। केनको की कस्टमर डिलाइट टीम इसमें शामिल होगी कर्मचारी/रोगी से संपर्क करें और अगली प्रक्रिया के साथ उनका मार्गदर्शन करें

Alternatively, the employee/ patient can also notify their Kenko Relation Manager (Kenko-RM) either by calling at our toll free number - 1800 1211 63177 OR by sending an email to care@kenko-health.in at least 5-7 days in advance of the hospitalization event.

वैकल्पिक रूप से, कर्मचारी/रोगी अपने केनको रिलेशन मैनेजर (केन्को-आरएम) को भी सूचित कर सकते हैं। या तो हमारे टोल फ्री नंबर - 1800 1211 63177 पर कॉल करके या ई-मेल भेजकर care@kenko-health.in अस्पताल में भर्ती होने की घटना से कम से कम ५-७ दिन पहले।

The employee/ patient will need to share the following documents (only soft copies) by sending an email to care@kenko-health.in

कर्मचारी/रोगी को निम्नलिखित दस्तावेज (केवल सॉफ्ट कॉपी) भेजकर साझा करने की आवश्यकता होगी care@kenko-health.in इस ईमेल पर

• Doctor's Diagnosis on Doctor's letterhead mentioning the need for hospitalization and an estimated cost of treatment.
• Any (and all) test reports supporting the need for the treatment or hospitalization, and
• Any other documentation, incase there is a specific need for it, though it will not be a part of the standard process

• अस्पताल में भर्ती होने की आवश्यकता का उल्लेख करते हुए डॉक्टर के लेटरहेड पर डॉक्टर का निदान और उपचार की अनुमानित लागत।
• उपचार या अस्पताल में भर्ती होने की आवश्यकता का समर्थन करने वाली कोई भी (और सभी) परीक्षण रिपोर्ट
• कोई अन्य दस्तावेज, यदि इसकी कोई विशिष्ट आवश्यकता है, हालांकि यह नहीं होगा मानक प्रक्रिया का हिस्सा

3. Insurance company will give the customer 3 choices of hospitals from their Network list. Insurance company ग्राहक को उनकी स्वीकृत सूची से अस्पतालों के ३ विकल्प देगा।

4.When the employee/ patients goes to the hospital, he/ she will be required to take a selfie in which the name and surrounding of the hospital are visible and share the same at care@kenko- health.in
जब कर्मचारी/मरीज अस्पताल जाते हैं, तो उन्हें वहां एक सेल्फी लेनी होगी जिसमें अस्पताल का नाम और आसपास दिखाई दे रहा है और उसे care@kenko-health.in पर साझा करें

5.Once the claim documentation is validated by the Insurance company, a payment link will be sent to the employee/ patient via SMS to their registered mobile number, where the employee/ patient will have to fill up their Bank Account number and IFSC code. [For deposit and initial payments]
एक बार Insurance company द्वारा दावा दस्तावेज की पुष्टि हो जाने के बाद, एक भुगतान लिंक कर्मचारी/रोगी को उनके पंजीकृत मोबाइल नंबर पर एसएमएस के माध्यम से भेजा जाएगा, जहां कर्मचारी/रोगी को अपना बैंक खाता संख्या और IFSC कोड भरना होगा। [जमा के लिए और प्रारंभिक भुगतान]

6.40% of the estimated amount will be transferred to the employee/ patient's account as security deposit/initial payments for hospitals.
अनुमानित राशि का ४०% कर्मचारी/रोगी के खाते में इस प्रकार अंतरित किया जाएगा: अस्पतालों के लिए सुरक्षा जमा/प्रारंभिक भुगतान।

7. At the time of discharge, the following documents will have to be shared from employee/ patient at care@kenko-health.in
डिस्चार्ज के समय, निम्नलिखित दस्तावेजों को कर्मचारी से साझा करना होगा care@kenko-health.in पर
• Deposit Slip
• Discharge card/summary,
• Full itemized bill,
• Any other documentation, incase there is a specific need for it, though it will not be a part of the standard process
• जमा पर्ची
• डिस्चार्ज कार्ड/सारांश
• पूर्ण मदयुक्त बिल
• कोई अन्य दस्तावेज, यदि इसकी कोई विशिष्ट आवश्यकता है, हालांकि यह नहीं होगा मानक प्रक्रिया का हिस्सा

8. Once the claim documentation is validated by insurance company, a payment link will be sent to the employee/ patient via SMS on their registered mobile number, where the employee/ patient will have to fill up A/C no and IFSC code [For final payments]
एक बार क्लेम दस्तावेज मान्य हो जाने के बाद, कर्मचारी/रोगी को भुगतान लिंक भेजा जाएगा उनके पंजीकृत मोबाइल नंबर पर एसएमएस के माध्यम से, जहां कर्मचारी/रोगी को खाता भरना होगा नहीं और IFSC कोड [अंतिम भुगतान के लिए]

9. The total claim amount will be credited to the employee/ patient's account.
कुल दावा राशि कर्मचारी/रोगी के खाते में जमा की जाएगी।

Emergency Hospitalization
आपातकालीन अस्पताल में भर्ती
1. The employee/ patient will call a 24/7 dedicated emergency hotline (+91 91138-39585) or click on the Emergency Button on Kenko App.
कर्मचारी/रोगी २४/७ समर्पित आपातकालीन हॉटलाइन (+९१ ९११३८-३९५८५) पर कॉल करेगा या क्लिक करें केनको ऐप पर इमरजेंसी बटन पर।

2.An ambulance will be arranged if required.
जरूरत पड़ने पर एंबुलेंस की व्यवस्था की जाएगी।

Scenario 1 - The employee/ patient is not at a hospital and requires an ambulance
>> Kenko customer care team will take up this request on priority and arrange an ambulance at the location specified by the employee/ patient
परिदृश्य 1 - कर्मचारी/रोगी अस्पताल में नहीं है और उसे एम्बुलेंस की आवश्यकता है
>> केनको कस्टमर केयर टीम इस अनुरोध को प्राथमिकता पर लेगी और एम्बुलेंस की व्यवस्था करेगी कर्मचारी/रोगी द्वारा निर्दिष्ट स्थान

Scenario 2 - The employee/ patient is already at a hospital and undergoing treatment
>> In these cases, the employee/ patient will be required to share a soft copy of the “hospital admission form” at care@kenko-health.in — a payout link will be sent to the employee/ patient by insurance company based on the deposit amount being asked by the hospital.
परिदृश्य 2 - कर्मचारी/रोगी पहले से ही अस्पताल में है और उसका इलाज चल रहा है
>> इन मामलों में, कर्मचारी/रोगी को "अस्पताल प्रवेश फॉर्म" की एक सॉफ्ट कॉपी care@kenko-health.in पर साझा करने की आवश्यकता होगी - जमा राशि के आधार पर कर्मचारी/रोगी को Insurance company द्वारा एक पेआउट लिंक भेजा जाएगा। अस्पताल से पूछा जा रहा है।

3. At the time of discharge, the following documents will have to be shared from employee/ patient at care@kenko-health.in -
डिस्चार्ज के समय, निम्नलिखित दस्तावेजों को कर्मचारी से साझा करना होगा care@kenko-health.in पर
• Deposit Slip
• Discharge card/summary,
• Fullitemized bill,
• Any other documentation, incase there is a specific need for it, though it will not be a part of the standard process
• जमा पर्ची
• डिस्चार्ज कार्ड/सारांश,
• पूर्णतया बिल,
• कोई अन्य दस्तावेज, यदि इसकी कोई विशिष्ट आवश्यकता है, हालांकि यह नहीं होगा मानक प्रक्रिया का हिस्सा

4. A final payment link will be sent for final settlement.
अंतिम भुगतान के लिए एक अंतिम भुगतान लिंक भेजा जाएगा।

OPD and Wellness Discount Benefits
ओपीडी and Wellness छूट

Customers can raise the order request either through the Kenko App.
ग्राहक या तो केनको ऐप के माध्यम से ऑर्डर अनुरोध बढ़ा सकते हैं।

For Doctor Consultation –
डॉक्टर परामर्श के लिए
• Plan Name and Member Name
• Date & Time of consultation
• Doctor Specialization
• Address & Location details
• Confirmation is sent through an email & SMS to the customer on the Doctor Consultation Appointment
• The benefit amount will be discounted value as per the subscription plan
• योजना का नाम और सदस्य का नाम
• परामर्श की तिथि और समय
• डॉक्टर विशेषज्ञता
• पता और स्थान विवरण
• ग्राहक को डॉक्टर के पास ईमेल और एसएमएस के माध्यम से पुष्टि भेजी जाती है परामर्श नियुक्ति
• लाभ राशि को सदस्यता योजना के अनुसार छूट मूल्य दिया जाएगा
For Medicine Order
मेडिसिन ऑर्डर के लिए
• Plan Name and Member Name.
• Medicine Name
• Prescription Upload
• Address & Location details
• Confirmation is sent through an email, SMS and Whatsapp to the customer on medicine Delivery
• The benefit amount will be discounted value as per the subscription plan
• योजना का नाम और सदस्य का नाम
• दवा का नाम
• प्रिस्क्रिप्शन अपलोड
• पता और स्थान विवरण
• दवा वितरण पर ग्राहक को एक ईमेल, एसएमएस और व्हाट्सएप के माध्यम से पुष्टि भेजी जाती है
• लाभ राशि को सदस्यता योजना के अनुसार छूट मूल्य दिया जाएगा
For Diagnostic
निदान के लिए
• Plan Name and Member Name
• Date & Time of sample collection
• Test Name
• Address & Location details
• Confirmation is sent through an email, SMS and Whatsapp to the customer on the Diagnostic Order
• The benefit amount will be discounted value as per the subscription plan
• योजना का नाम और सदस्य का नाम
• नमूना संग्रह की तिथि और समय
• परीक्षण का नाम
• पता और स्थान विवरण
• ग्राहक को ईमेल, एसएमएस और व्हाट्सएप के माध्यम से पुष्टिकरण भेजा जाता है नैदानिक आदेश
• लाभ राशि को सदस्यता योजना के अनुसार छूट मूल्य दिया जाएगा

Note:
टिप्पणी:
• For medicine order, after an invoice is generated, a payment link would be shared with the customer. Post payment, medicines will be delivered within 24 hours. A delivery fee is applicable.
• If Kenko is unable to process doctor consultations and diagnostics, customers can get it done by themselves and upload the documents on the Kenko app for reimbursement. We do not reimburse medicines bills.
• Incase of grievance or dissatisfaction, you can reach out to us at grievance.jio@kenko-health.in

• दवा ऑर्डर के लिए, इनवॉइस जनरेट होने के बाद, भुगतान लिंक को के साथ साझा किया जाएगा ग्राहक। भुगतान के बाद, २४ घंटे के भीतर दवाएं वितरित की जाएंगी। एक डिलीवरी शुल्क है लागू।
• यदि केनको डॉक्टर के परामर्श और निदान को संसाधित करने में असमर्थ है, तो ग्राहक इसे स्वयं कर सकते हैं और प्रतिपूर्ति के लिए केनको ऐप पर दस्तावेज़ अपलोड कर सकते हैं। हम दवाओं के बिल की प्रतिपूर्ति नहीं करते हैं।
• शिकायत या असंतोष के मामले में, आप शिकायत पर हमसे संपर्क कर सकते हैं। grievance.jio@kenko-health.in

Some Useful Links:
कुछ उपयोगी लिंक्स:
How to Claim on App : https://www.youtube.com/playlist?list=PLQ1e7DbiLFva7H5atyVhHfMajaTX6e1DF
ऐप पर क्लेम कैसे करें : https://www.youtube.com/playlist?list=PLQ1e7DbiLFva7H5atyVhHfMajaTX6e1DF

Kenko Health

Who is Kenko Health?

Kenko Health is your health insur-tech partner offering comprehensive health plans focused on OPD expenses. We offer financial solutions for doctor consultations, medicines, lab tests and other healthcare services with our affordable plans. Our benefits also include planned hospital treatments, emergencies, dental care, selected preventive care and more.

List down the key benefits given by Kenko Health?

We offer prepaid benefits on all your medical expenses. OPD expenses include doctor consultation, medicines, lab tests, dental care etc.

Hospital expenses are provided by an insurance company which takes care of planned hospital treatment and emergencies.

For more information, please look at your plan benefits document.

Why should we go with Kenko? List down the benefit of Kenko care

With Kenko, you get:

Great Discounts on medicines, doctor fees, lab tests and more.
First time dental treatment discounts including Root canal
No hidden clauses. What you see is what you get.
Paperless benefits - you don’t need to send us any physical documents.
Hassle-free advance settlements of benefits at the tap of your finger (through the Kenko app).

How to avail Kenko Benefits?

Just subscribe to a Kenko plan, download the app and you’re done. All your health benefits are available at your fingertips.

Is this an Annual Subscription?

Yes, it’s an annual subscription.

Who would be the Insurer in this arrangement?

Kenko is not an insurance company. We are a healthcare subscription platform. Our subscribers help us partner directly with health and wellness services to deliver the best health financing solutions for you. While your OPD benefits discounts are provided by Kenko.

Hospital benefits are provided by an insurance company.

What is the difference between traditional Mediclaim Policy and Kenko Health Scheme?

Kenko Health is a subscription plan that provides discounts on OPD expenses in a quick, easy and efficient process- with all your healthcare needs covered in a few clicks.

What would be the Benefit utilisation process?

For OPD:All your OPD benefits like medicines, doctor fees, lab tests and more can be booked, ordered and processed via our app.

For Hospitalisation benefit:

If it's an emergency, visit any hospital nearby and inform us as soon as possible. Team will guide you through the next steps.

If it's a planned treatment, inform at least 2 days in advance through the app.

At the time of discharge, share your itemised bills on the app, and the insurance company will transfer the requisite amount.

Whom to contact for benefit utilisation?

You can inform us on the app that is available on the play store and app store or email us at care@kenko-health.in or connect with us on our toll-free number 1800 1211 63177.

What documents would we get post purchasing the Kenko subscription?

You get a subscription docket on your phone once your plan is active. But you don’t need anything more than that. Just download the app and you are all set.

Whom to approach in case of Grievance or dissatisfaction?

You can reach out to us at grievance.jio@kenko-health.in

How benefits are Utilised -Reimbursement basis ?

We are one step ahead. We do prepaid benefits transfer.

Name the office address?

Redkenko Health Tech Pvt Ltd

16 Floor, 1608 B & C Wing, One

BKC C/66 G Block, JIO Trade Centre Road, Bandra East, Mumbai,

Mumbai Suburban, Maharashtra, 400051

How to pay the Health Subscription?

Your subscription fees can be paid by visiting this website JIO website

Click on apply now and proceed to payment.

When will the Kenko medical benefit start?

Your subscription will start on a common date notified by JIO & not from the payment of subscription amount.

Whom to contact in case of addition/deletion & Correction?

Please write on service@jio.net.in

Is it advisable to close our existing medical policy and enroll in Kenko Health?

Choice is entirely yours. it is always good idea to continue the old policy and kenko subscription can be used for OPD and dental benefits.

How to avail OPD benefits?

All your OPD benefits can be availed via the Kenko app. You can order your medicines, book lab tests, doctor consults and more.

Any blacklisted hospitals which are debarred by an Insurance company ?

Insurance company has preferred network but benefit can be taken at any hospital

Where to send our Physical papers later on post completion of treatment?

We don’t expect our subscribers to send us any papers. Just upload everything on the app.

Who would process our benefits? Is there any TPA?

OPD and dental benefits are processed by Kenko through the app and Hospital benefits are processed by Insurance company

What is Room Rent Eligibility?

Charges of a single private AC room for hospital benefit.

JIO

JIO is a Health / Wellness Company?

- No. JIO is not a Health / Wellness company and does not give any type of Plan. JIO is the Group Manager of this Plan. JIO has only played the role of negotiator for benefit of its Shravak/ Shravika Members

Is JIO is making profits from the policies / Health plans?

NO
JIO is not a profit making organization and is formed with a noble objective of serving its Shravak / Shravika members as well as society at large. Under the Wellness Plan scheme, the Subscriptions are collected individually from the members and then full amount is transferred as a group Subscription to the Wellness Provider company. In-fact, Gurudev has inspired several Jain Shravaks to donate partly towards the Subscriptions for members of their respective Samaj / Gnyati, who are financially troubled. Hence the health security could be availed by members of their Samaj at further discounted Subscriptions. This will immensely help such families to face the additional financial burden of medical expenses, if any.

Is the Enrolment process very complex?

NO
The enrolment process requires registering accurate details of the member and their family so that they do not face any trouble during the full year or at time of claim. The forms have been designed in a way to get the important details only and no un-necessary details are to filled.

Why so much importance is given to online process which may be difficult for a common man ?

JIO has pioneered in adopting to the latest technologies and online tool for your convenience and better service. The online enrolment process has the following major advantages:

The data entry and processing time is saved.

Accuracy of the data entered. This will also help in hassle free claims to the members.

Enrol anytime from anywhere

Immediate confirmation of enrolment completion.

Why JIO JAC number is compulsory?

JIO JAC is required not only for group Mediclaim but also for other JIO schemes. JIO introduced the Jain Advantage Card (JAC) as a comprehensive scheme for benefit of its members through bulk buying.

JIO JAC is a unique and permanent identification for availing benefits of various schemes launched by JIO. Members can easily participate in the programs of JIO without having to provide various details every time.

JAC members can also connect with fellow Shravaks and take full advantage of the JIO Global network.

Why does the plan coverage starts very late after payment ofSubscription to JIO?

JIO Group Health Plan is negotiated with Provider Company for the Best TERMS and Lowest Subscription based on a commitment of certain Minimum NUMBERS of enrolment.

For enrolling the members, messages are sent to Shravaks residing all over India. An enrolment window period is kept open for members to fill forms and make Subscription payment.

In case the numbers fall short of the minimum target, then the enrolment period is extended for few days. After the closure of enrolment period, a list is compiled for all the forms received and payments are reconciled. Any errors found at the stage of validation and verification are corrected by contacting the members.

JIO pays Subscription to the Wellness Company through a single payment for all the members together for commencing policy. Upon payment, the cover period starts on common date for all the members. A single group document is issued in the name of JIO with the list of enrolled members and their families.

The above process takes lot of time and efforts, hence the commencement of plan is after necessary period from the date of payment.

Whether JIO is responsible for answering queries on claims disbursal and deductions?

JIO has played a role of Group Leader to the policy issuance. All the queries regarding the claims process, status of claims, reasons of deductions from claim etc., are handled by the concerned Wellness Company.

In cases, where the grievances of the policy members remain unresolved by the Wellness / Insurance Company, the members can escalate such urgent / important issues with the JIO officials. JIO in turn will take up these issues with the concerned authorities. However the claims will be decided on merits of the case and within the terms of the policy.

When do the new phase are introduced and how will the Shravaks be informed about the same?

The introduction of new phases is not as per a planned schedule. JIO receives proposals from different Wellness Provider companies and if JIO is convinced about the suitability of the terms, the new phase will be announced through SMS, e-mails and website to all JIO JAC members.

Whether the Health plan is a temporary affair or will continue for several years to come?

The JIO group policy is NOT a temporary affair and will continue in future like all other Plan.

However, as discussed earlier, the terms of the policies and the Subscriptions are subject to change at the time of each renewal based on previous year experience & analysis.

JIO group Mediclaim policy was started with a noble vision of giving financial security in medical emergency to all the Shravak / Shravika families. Therefore JIO will never think about discontinuing the scheme.

How is theSubscription calculated for group policy?

If a group policy is issued for the first time then the general claim ratio of individual policies is considered. Further the fact that the company receives huge number of policy holders at one time, the reduced advertisement costs can be passed on by way of discount on Subscription.

For renewal of group policy, the Subscriptions are decided on the basis of past claim ratio, age composition of the policy holders, types of claims made earlier and assumptions made for future claims.

What is the procedure for renewal?

A member is required to visit the designated website for renewal and login with JIO JAC ID. The details of proposer, family members will be reflected for last year Existing Members Only. The member is required to confirm the complete details before proceeding. The member can also read the detailed terms and conditions of the new policy. On acceptance of the terms of the policy the member can make payment of Subscription and complete the process.

Whether Physical Submission of forms is allowed?

Physical forms will not be accepted at all for the renewal of policy. All the information has to be provided online.

What are the options for making payment ofSubscription amount?

The members can choose to make payment of Subscription amount only from following options

Online payment through credit / debit card or net banking

If a member is not aware about the online process or the working on internet and computers, how will they be able to renew?

In this age of digitization, internet and computer facility is easily available. The members who are not very conversant with use of computers are advised to approach young members in their family for help in completing the online process.

I am a Jain but my wife is not a Jain? Can I insure my wife?

Under the family floater policy you can cover your wife as long as the proposer is Jain and because now she is a part of the Jain family. All covered members has to be Jain.

If I have only 3 members in my family can I buy a Family Floater Policy?

Family Floater Policy is available for family size ranging between 2 to 8 members i.e. Proposer + Spouse + 4 Unmarried, Dependent Children up to 25 years of Age + Parents/or Parents or Laws (jain only) up to 90 years

Can I and my brother / sister cover our parents under our individual family floater schemes?

Yes you can but any person can't be covered more than once under whole group in JIO Policy. If declared more than once, benefit would be payable under one Sum Insured only

We are two brothers & we have two different policies, Can we enrol our Parents in both policies?

No. One person can be covered only once in a JIO policy.

Can I take my married daughter in policy?

No. As she is now not part of your family.

Is this Applicable on Pan India basis?

Yes this policy is for Pan India, Jain population only. All covered members has to be Jain.

What if I am or my family member is already suffering from a disease? Can I yet get myself or my family members covered?

Pre-Existing Diseases are covered since day 1, however Co-pay of 50% will be applicable for PRE-EXISTING Ailments in first year thereafter no Co-Pay.

In my family few are having Jain certificate but my parents don't have any proof? Then what I can do?

Please get a confirmation from your Sangh / Gyati that you are a Jain.

What are the major changes in the revised terms of policy?

Co-pay of 50% will be applicable for Pre-existing Ailments / Diseases

No co- pay will applied on Non-PED Cases for Sum Insured of 2 Lacs, 5 Lacs & 10 Lacs

How do I renew?

Please follow the below mentioned steps

Please go on

https://Jio.net.in/KPK22.php

Read revise Terms & Conditions carefully

Select "Apply Now"

Enter JIOJAC ID

Fill your enrolment details

Make payment ONLINE

Can I submit physical form?

You can't submit Physical Form. The process of enrolment and payment is online only through JIO website.

What are the options for making payment I am not aware of online procedure?

You need to Enrol Online only, however payment can be done via Online through Easebuzz after completing Online Enrolment Procedure.

If I don't have JIO JAC Id, can I opt for Mediclaim Policy ?

No, JIOJAC ID is compulsory for proposer. Please register online for JIOJAC ID.

What is theSubscription?

Subscription details are available in T & C section.

When will I be eligible for my maternity claim?

For Existing Members, Maternity Benefit is covered from Day 1 up to 2 live children only. However for New Members, Maternity benefit is available after completion of 9 months from the date of enrolment in JIO - Shravak Arogyam scheme. This benefit is not available for Individual Policy Holder with 2 Lakh Individual sum insured.

Are pre & post-natal expenses under Maternity benefits covered?

Pre & Post Natal expenses on OPD/IPD bases are not covered

What shall be the next yearSubscription?

The next year Subscription will be decided after the end of the policy tenure based on the Claim Experience of the current Policy

Do we get no claim bonus if we do not claim in the existing year?

No, as this is a Group scheme you will not get NO Claim Bonus

If my wife is the proposer can she cover her parents?

Yes, only if she is a Jain by birth.

Will location of dependent family matter in availing services under TPA?

No, Location does not affect the operational activities, main member or the dependent member can avail same and equal benefits irrespective of their location. TPA Network of Healthcare Service Providers is across the country. These accredited healthcare providers would assure qualitative healthcare delivery to TPA members.

I am Thankful

I appreciate JIO for being a facilitator for this highly beneficial Group health & OPD Wellness Subscription Plan for the social and health upliftment of the Community.
Jain International Organization (JIO) is NOT an Agent, a Broker, or an Insurer but JIO is an organization who has selected Mediclaim and Wellness Service Partners (Insurance Company & Health Care Company) for the well-being of its members.
The policy will be issued by the Insurance Company in the main name of JIO i.e. JIO is the primary Insured. I and my family members would be beneficiaries under the Health Subscription plan.
OPD benefits are processed by Kenko Health Tech, JIO has no role in benefit processing. If any need arises, I can take assistance from JIO and its service partner to guide me in the benefits process and/or legal solution.
This is a Group health subscription plan. It will start from a common date and not from the date you pay the subscription fee.
For October 2022 lot Members : Your cover benefit already expired on 30th October, 2022. Multiple mails & SMS were sent on your registered email id and on your registered contact number to pay on time to avail continuity benefit of cover during the last two months. Your enrolment will be considered now as fresh / new since payment not received within the provided time limit. 1st year waiting period and 1st year exclusion clause will be applicable to you. Your cover benefit will start as a fresh / new member from 31st January 2023 to 14th January 2024.
For November 2022 lot Members : Your cover benefit already expired on 29th November, 2022. Multiple mails & SMS were sent on your registered email id and on your registered contact number to pay on time to avail continuity benefit of cover during the last two month. Your enrolment will be considered now as fresh / new since payment not received within the provided time limit. 1st year waiting period and 1st year exclusion clause will be applicable to you. Your cover benefit will start as a fresh / new member from 31st January 2023 to 14th January 2024.
For January 2023 lot Members : Your cover already expired on 14th January, 2023. Membership benefit will start from 31st January, 2023 to 14th January 2024. Since your payment received after expiry of your cover, no cover benefit will be provided for pre-hospitalisation and hospitalisation from 15th January 2023 to 30th January 2023.
For New Members : Membership benefit will start from 31st January 2023 to 14th January 2024.

I UNDERSTAND THIS AND ACCEPT that if the services of Insurer and/or Kenko are found to be improper, I will not blame JIO and will not take any legal action against my own organization JIO.

JIO – Khushhal Parivar - 2022-23 | Group Health Subscription Offer With Medical Benefit