Group Mediclaim Base Cover – Salary Account Holders of SBI Bank.
Who can take this insurance?
Any Individual can take this Policy for himself and/or his family those who are Salary Account
Holders of SBI Bank.
**This policy is subject to salary should be credited in SBI account and premium payment for this
policy would be processed through SBI salary account/SBI cards.
Floater option is available for self, spouse and maximum two children.
1. “Family” means the spouse and dependent children.
2. Minimum entry age is 3 months and maximum entry age is 63 years.
Revised Rates with 2 years PED waiting period- (Inclusive of GST)
Rate Chart with Sum Insured Variants and Family combination as below: (including GST)
Per family Rates (inclusive of Tax)
Family combination
2 lakhs 3 lakhs 5 lakhs
2A+2C INR 4,507 INR 4,899 INR 5,977
2A+1C INR 3,697 INR 4,018 INR 4,902
2 Adults INR 3,193 INR 3,471 INR 4,235
1 Adult INR 1,983 INR 2,155 INR 2,629
1A+1C INR 2,221 INR 2,414 INR 2,945
1A+2C INR 2,487 INR 2,703 INR 3,298
Benefit summary & Limits-
• 1 Adult
• 2 Adults
• 2 Adults + 1 Child
Family combinations
• 2 Adults + 2 Children
• 1A+1C
• 1A+2C
Family definition Self, spouse + 2 dependent children up to 25 years
Minimum entry age (Adult) 18 years
Maximum entry age (Adult) 63 years
Children entry age (Min. & Max.) 3 months to 25 years
PED Waiting period 24 Months
First 30 days period 30 Days waiting period
Specific Illness waiting period 24 Months
Day care treatments Covered
Pre-Hospitalization 60 days
Post Hospitalization 90 days
Ambulance Up to Rs 2000/- per hospitalization
Domiciliary hospitalization Covered up to 20 % of SI
Alternative Treatment Covered up to 20% of SI
Modern Treatment Covered up to 50% of SI
Limit on treatment/Illness/Surgery Disease wise sublimit is not applicable
** Migration and portability from any other SBIG product to this product is not allowed.
** Please refer to GMC Policy wordings for detailed understanding on above coverages.
Specific Exclusions:
1. Any medical treatment taken outside India, unless otherwise agreed by Us as Specified in
the Policy Schedule/Certificate of Insurance.
2. Hospitalization for donation of any body organs by an Insured including complications arising
from the donation of organs.
3. Nuclear damage caused by, contributed to, by or arising from ionising radiation or
contamination by radioactivity from:
a. any nuclear fuel or from any nuclear waste or from the combustion of nuclear fuel
(including any self-sustaining process of nuclear fission)
b. nuclear weapons material
c. nuclear equipment or any part of that equipment
4. War, invasion, acts of foreign enemies, hostilities (whether war be declared or not), civil war,
commotion, unrest, rebellion, revolution, insurrection, military or usurped power or
confiscation or nationalisation or requisition of or damage by or under the order of any
government or public local authority.
5. Injury or Disease caused by or contributed to by nuclear weapons/materials.
6. Circumcision unless necessary for treatment of a disease, illness or injury not excluded
hereunder, or, as may be necessitated due to an accident.
7. Prostheses, corrective devices, medical appliances, external medical equipment of any kind
used at home as post hospitalization care including cost of instrument used in the treatment
of Sleep Apnoea Syndrome (C.P.A.P), Continuous Peritoneal Ambulatory Dialysis (C.P.A.D)
and Oxygen concentrator for Bronchial Asthmatic condition, unless agree by Us and as
Specified in the Policy Schedule/Certificate of Insurance.
8. Treatment with alternative medicines like acupuncture, acupressure, osteopath,
naturopathy, chiropractic, reflexology and aromatherapy.
9. Intentional self-injury (including but not limited to the use or misuse of any intoxicating
drugs or alcohol) and any violation of law or participation in an event/activity that is against
law with a criminal intent.
10. Vaccination or inoculation except as post bite treatment for animal bite.
11. Convalescence, general debility, “Run-down” condition, rest cure, Congenital external
illness/disease/defect, unless agreed by Us and as Specified in the Policy
Schedule/Certificate of Insurance.
12. Outpatient diagnostic, medical and surgical procedures or treatments, non-prescribed drugs
and medical supplies, hormone replacement therapy, unless agreed by Us and as Specified
in the Policy Schedule/Certificate of Insurance
13. Dental treatment or Surgery of any kind unless requiring Hospitalisation as a result of
accidental Bodily Injury, unless agreed by Us and as Specified in the Policy
Schedule/Certificate of Insurance
14. Venereal/ Sexually Transmitted disease other than HIV/AIDS.
15. Stem cell storage/preservation unless agreed by Us and as Specified in the Policy
Schedule/Certificate of Insurance.
16. Any kind of service charge, surcharge levied by the hospital.
17. Personal comfort and convenience items or services such as television, telephone, barber or
guest service and similar incidental services and supplies.
18. Standard list of excluded items as Specified in the Annexure II, unless agreed by Us and as
Specified in the Policy Schedule/Certificate of Insurance
19. Any medical procedure or treatment, which is not medically necessary or not performed by
a Doctor/Treating Medical Practitioner.
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