FAQs

1. What kind of plan is DHFL Pramerica Dengue Shield?

DHFL Pramerica Dengue Shield is a fixed benefit individual health plan which provides Sum Insured on diagnosis of Dengue Fever subject to meeting the prescribed criteria.

 

2. What should be my age if I want to buy DHFL Pramerica Dengue Shield?

Any individual between age of 91 days and 65 years as on last birthday can be covered under this product

 

3. What are the policy terms and premium payment terms in DHFL Pramerica Dengue Shield?

A fixed policy term of 5 years is available in this product with two premium payment options i.e. Single Pay or Regular Pay

 

4. What is the minimum and maximum Sum Insured available in DHFL Pramerica Dengue Shield?

There are three Sum Insured options available in this plan i.e. 25,000; 40,000 & 50,000

 

5. What is the premium amount I have to pay to purchase in DHFL Pramerica Dengue Shield?

In case of Regular premium option, the minimum and maximum premium ranges from 365 p.a. to 650 p.a.

In case of Single premium option, the minimum and maximum premium ranges from 1,500 to 2,475.

The premium rates are common across all ages and gender. Further, premium rates are exclusive of applicable taxes and cess, if any.

 

6. What all conditions are mandatory to claim the benefit under policy?

All of the following conditions will be applicable in case of diagnosis of Dengue fever (A fever which is diagnosed as Dengue Haemorrhagic fever and/or Dengue Shock Syndrome) for registration of claim:

  • Decreasing platelet levels- less than 100,000 cells/mm3 and
  • Increasing in hematocrit more than 20% of the highest normal value and
  • Immunoglobulins/PCR test showing positive results for Dengue and
  • Attending physician’s certification for diagnosis of Dengue Haemorrhagic fever and/or Dengue Shock Syndrome and
  • Minimum 48 In-patient care consecutive hours of hospitalization in a Hospital for medically necessary treatment of Dengue

 

7. Will I get any discount on my premium amount?

Yes, a discount of 5% on the first year premium in case of Regular Premium and 2% in case of Single Premium for policies sold to its existing policyholders or policy issued under a Family cover. The discount offered under Family cover option shall be given to each of the member covered under the Family cover option including the primary policyholder.

Also attractive discounts are available for employees of DHFL Pramerica Life Insurance or any of the DHFL Group companies.

In case of discounts applicable under multiple categories, the highest applicable discount shall be offered.

 

8. Can I also cover my family under DHFL Pramerica Dengue Shield?

Yes, you can. In fact you will get discounts on adding your family members. Under this option, a maximum of 6 members can be added in a single policy. Each member will be entitled for separate Sum Insured and premium will be charged for each member separately. For this purpose, Family shall include spouse, children, parents, mother-in-law and father-in-law of the primary policyholder.

 

9. What will I get on completion of Policy Term?

This is a fixed benefit individual health plan where no maturity benefit is payable on completion of Policy Term

 

10. What will be paid in case of my death?

This is a fixed benefit individual health plan where benefits are payable in case of diagnosis of Dengue fever only. There is no death benefit

 

11. What happens if I want to surrender my policy?

Policy purchased under Single premium mode will immediately acquire the surrender value. The surrender value will be calculated as 50% of Single Premium paid (excluding taxes, if any) * (Unexpired coverage term in completed months / 60)

However there is no surrender value available on the policies purchased under regular premium payment mode.

 

12. What if I forget to pay my premium?

A grace period of 30 days under Regular Premium payment will be available under this Policy. The policy will remain in-force during the grace period. If the policyholder is diagnosed of Dengue Fever during the Grace Period, the Company will pay the benefit payable after deduction of the Premium due under the Policy.

 

13. What happens if I am unable to pay Premium even after expiry of 30 days?

If the Policyholder discontinues the premium payment for regular pay policies anytime during the policy term then the policy will lapse without any benefit after expiry of grace period.

 

14. Can I revive my policy even after expiry of grace period?

Once the grace period is over the policy will lapse. Revival of a lapsed policy is available up to 2 years from the date of first unpaid premium. The revival of the policy shall be subject to the Board approved underwriting policy, as applicable from time to time. The Company reserves the right to obtain additional information before reviving the Policy and also has the right to decline revival of the Policy. The policyholder would be required to pay all outstanding premiums due till the proposed date of revival together with any applicable interest.

 

15. Is there any waiting period in this plan?

Yes, there will be a waiting period of 15 days from commencement or revival of policy, whichever is later. During this time the Company will not register any claim arising due to diagnosis of dengue.

 

16. Are there any exclusions in this plan?

No benefit will be paid under this plan in case of following:

  • Any Treatment other than for Dengue Haemorrhagic fever and/or Dengue Shock Syndrome
  • Treatment requiring less than 48 hours of hospitalization
  • Diagnosis and Treatment outside India
  • Dengue Fever that is diagnosed by a Physician who does not qualify within the definition of Medical Practitioner.
  • Any claim arising due to diagnosis of Dengue Fever during the waiting period of 15 days from the date of commencement or revival whichever is later.

 

17. How many claims can I register during the entire policy term?

During each Policy year a maximum of 1 claim shall be payable to each life insured and no carry forward to the next year shall be allowed. In case of Family cover option, each individual member covered can make maximum of one claim in each policy year and no carry forward to the next policy year will be allowed.

 

18. What if I want to cancel the policy since I do not agree with the terms and conditions mentioned in the policy?

The policyholder will have a period of 15 days (30 days in case of the policy sold through distance marketing mode) from the date of receipt of the Policy terms and conditions to review the same. Where the policyholder disagrees with any of these terms benefit will be and conditions, the policyholder will have an option to discontinue the Policy stating the reasons for objection. On receipt of the letter, the company will refund the premiums paid, subject to the deduction of proportionate risk premium, any expenses incurred by the Company on insurance medical examination and stamp fee (if any), towards the Policy.

 

19. How can I buy this plan?

This plan requires no lengthy work. You have to fill a simple application form and a declaration saying that any of the persons to be insured is currently not suffering from Dengue fever or showing symptoms of Dengue fever or have suffered from the same in past 1 month. You can buy the plan by walking into our branch or online by visiting our website www.dhflpramerica.com

 

20. What if I am already covered under a different health insurance plan and get diagnosed with dengue one month after purchase of DHFL Pramerica Dengue Shield?

DHFL Pramerica Dengue Shield is a fixed benefit plan where benefits will be paid in case of diagnosis of Dengue fever irrespective of claims made under any other existing health insurance policy.

 

21. How do I register claim and what all documents will be required at the time of claim registration?

To register claim you can visit www.dengueshield.com and fill your details or you can write to us at dengueshield@dhflpramerica.com with your details. Post this you will get a link of claim form on your mobile and email ID which you can download and walk into any of our branch with filled claim form and required documents or alternatively you can walk in any of our branch with required documents to register your claim. In order for the Company to make any payment under the Policy that it is necessary, the following conditions should be met:

a) Company is immediately notified in writing, and preferably within 90 days of the diagnosis of the Dengue Fever. Company may condone the delay in filing a claim beyond 90 days where the claimant can establish that the delay was due to unforeseen circumstances and beyond the control of the claimant.

b) Company is provided with the opportunity of establishing to its satisfaction that a claim is payable.

c) Company receives all reasonable cooperation and is entitled to seek any documentation and information, including but not limited to:

  • The Company’s claim form duly completed.
  • The copy of Policy Document.
  • Evidence of Life Insured’s date of birth if the Company has not admitted the age of the Life Insured.
  • Claimant’s Bank details with proof, identity and residence proof.
  • The copy of medical reports, investigation reports and treatment papers of the Life Insured.
  • The copy of Discharge Summary.
  • Attending physician’s certification for diagnosis of Dengue Haemorrhagic fever and/or Dengue Shock Syndrome
  • Platelet levels and
  • Hematocrit levels and
  • Immunoglobulins/PCR test report

The Company may on a case to case basis and subject to exceptional circumstances may condone the submission of any of the above mentioned documents/ information while processing the claim.

 

22. What will be the procedure if I want to change my name or address or any other detail after purchase of policy?

You have the following options:

  • Download the Service Request Form from the Download section of our website, fill the information as asked and send it to us; Or
  • Write to us at the corporate address mentioned in the Contact Us section of the website.
  • For any assistance please Call our Customer Service Helpline number 1800-102-7070 or mail us at contactus@dhflpramerica.com

 

23. Will my premium remain same during entire policy term or it can change also?

For any regular pay policy the premium rates will remain guaranteed for the first 3 policy years from the commencement of policy. These rates will be reviewable thereafter on prior approval from the IRDAI. In case of any change in rates, the same will be affected from the later of the 3rd policy anniversary or the policy anniversary on or immediately following the effective date of the change. Any revision in the Premium rates shall be notified to the policyholder at least three months prior to the date of such revision by the Company.

 

24. Can I get admitted and get myself treated in any hospital or there are any specific hospitals?

There are no such specific hospitals. It can be any hospital if it is established for in-patient care and day care treatment of illness and/or injuries and which has been registered as a hospital with the local authorities under the Clinical Establishments (Registrations and Regulation) Act, 2010 or under the enactments specified under the Schedule of Section 56(1) of the said Act OR complies with all minimum criteria as under:

  • Has qualified nursing staff under its employment round the clock;
  • Has at least 10 in-patient beds in towns having a population of less than 10,00,000 and at least 15 in-patient beds in all other places;
  • Has qualified medical practitioner(s) in charge round the clock;
  • Has a fully equipped operation theatre of its own where surgical procedures are carried out;
  • Maintains daily records of patients and makes these accessible to the insurer’s authorized personnel

 

25. What if I buy multiple policies? Will I get claim in all the policies?

No, a single life can have a maximum of one in-force policy at any point of time.