beat heart pro

HEARTBEAT HEALTH INSURANCE PLAN

&LITERATURESALES

PROSPECTUS


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OUR PARENT COMPANIES

Your search for high quality health insurance stops here.

Introducing Max Bupa Health Insurance Company Limited, a joint venture between Max India Limited and Bupa

Finance Plc U.K. We believe in nurturing long-term relationships with our customers by providing the highest levels of

quality in service.

Max India Limited: A reputation for excellence

Max Group brings expertise in insurance and

healthcare with a strong presence in Life Insurance

(through Max New York Life Insurance Company

Limited), Healthcare (through Max Healthcare Institute

Ltd.) and Clinical Research (through Max Neeman

Medical International Limited).

A Rs 8500 crore group, it has over 500 offices across

400 locations in India with more than 57,000

employees, all focused on delivering customer

satisfaction to more than 5 million customers(Source

Max India website as on March 31st, 2012)

Bupa - 65 years of Care

Established in 1947 as the British United Provident

Association, Bupa today has group revenue of

£8.0billion, 10.84 million customers in over 190

countries and employs over 52,000 people.(Source –

Bupa Annual Report published in March 2011)

Bupa Group brings in a wealth of experience in serving

customers directly in the health insurance sector across

the world. In addition, Bupa also runs care homes for

older people, operates hospitals, provides chronic

disease management services and offers out of hospital

care.

Recognition and Rewards

Max India Group: • Max New York Life was declared a “Superbrand” by Superbrands India in the 3rd edition of Consumer Superbrands 2008’ • CII-Exim Bank Award for for Business Excellence awarded to Max New York Life in 2008 • CIO 100 Award for technology implementation

Bupa: • The Health Insurance Company of the Year Award awarded at the U.K. Health Insurance Awards 2009 • Best International Private Medical Insurance provider 2008 - awarded at the U.K. Health Insurance Awards • Best Medical Insurer Company (2008, Bupa Arabia) - awarded at the Jeddah Chamber of Commerce and Industry Health Committee Awards • Best Healthcare Provider of the Year - awarded at the U.K. Corporate Adviser Awards 2009 • Best Individual Private Medical Insurance Provider awarded at the U.K Money Marketing Awards 2009

Heartbeat Health Insurance Plan

Start a healthy relationship

Heartbeat Health Insurance Plan from Max Bupa is

*(Source: www.maxindia.com)#(Source - Bupa Annual Report published in March 2012)

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the most comprehensive health insurance cover for you

and your family. It gives you the flexibility to choose just

the right cover for your needs. Apart from giving you a

comprehensive health insurance cover to suit your

needs, we are also committed to provide you the best

quality service when you need it the most.

Which is why Max Bupa is the Healthier Health

Insurance for you and your family:

• You talk to us directly, not through any third

parties. We will be there for you when you need

us. Because you should concentrate on getting

better, not chasing your claims.

• We are with you at every step of the way in your

life. For a happy occasion like the delivery of your

baby, to your child’s vaccinations, or at other

times when there is an illness in the family- we

have it covered. New born babies are

automatically covered till the next renewal

of the policy.

• You can access our cashless facility at quality

hospitals of your city, with the best medical

facilities included in our partner network.

• We cover families across life stages – from

newborns to senior citizens of any age, covering

up to 13 relationships in one policy.

• Our health relationship programme helps you to

nurture and improve your and your family’s

health.

• You can call us anytime for help on our 24/7

health line for easy and friendly access to health

advice when you need it.

• Managing our relationship - As a customer, you

can access your own page onthe Max Bupa

website to keep track of your policy details and

benefits.

• To build a relationship that lasts a lifetime, we

make all efforts to understand your health

profile during enrollment, so that when you need

us, we can provide speedy and efficient support.

• We assure you renewability of your policy for

lifetime, if you pay renewal premium within the

grace period of 30 days of expiry of your previous

policy. You should renew on or before the renewal

date of the policy to ensure you have continued

medical insurance cover even during the grace period.

• As with all health insurance policies, you may save

tax under Section 80D of the Income Tax Act

when you buy a Max Bupa health insurance

policy. (Tax benefits are subject to changes in the

tax laws, please consult your tax advisor for more

details)

Policy Design

• Max Bupa Heartbeat Health Insurance plan can be

issued to an individual customer, a family and/or

extended family.

• The family floater policy may be available in any of

the following combinations:

o 1 Adult + 1Child

o 1 Adult + 2 Children



o 2 Adults

o 2 Adults + 1Child

o 2 Adults + 2Children



• The family includes spouse and dependent

children and can comprise up to a unit of 6

insureds of which up to 4 can be children.

• The premium for family floater policies depends

on the age of the eldest insured customer.

• The Family First may be available in any of the

below relationships with the Proposer

a. Legally married spouse as long as he or she

continues to be married to You; b. Son;

c. Daughter-in-law; d. Daughter; e. Son-in-Law;

f. Father; g. Mother; h. Father-in-law as long as

Your spouse continues to be married to You;

i. Mother-in-law as long as Your spouse continues

to be married to You.; j. Grandfather;

k. Grandmother; l. Grandson; m. Granddaughter

• The premium for Family First policies depends on

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the individual age of each insured customer in the

Extended Family.

• This policy covers persons of any age. There is no

maximum entry age for the insured.

• The maximum entry age of any dependent as a

child in the policy is less than 21 years on the date

of commencement of the initial cover under the

Policy.

Please note all the children whose age exceeds the

maximum entry age would be given an option to

migrate to our retail health insurance offering (for

e.g. Heartbeat Health Insurance Plan, Health

Companion Health Insurance Plan, Health

Assurance) under individual plans.

• There is no maximum cover ceasing age in this

policy.

• The default policy term for all plans is one year. A

two year policy term option is also available for

Heartbeat Individual, Family Floater and Family

First plans. Avail 12.5% discount on second year

premium when you opt for 2 year policy.

• You can also choose an optional aggregate annual

deductible (top-up cover) along with Silver Sum

Insured options of Individual and Family Floater

plans.

Sum Insured

• The sum insured options:

o In case of Individual or Family Floater - range

from Rs. 2 lacs to Rs. 1 cr depending on the

plan you choose. The details of the plans are

available in the product benefits table.

o In case of Family First:

Flexible sum insured per person (one amount

chosen for all family members) as well as a

floating amount that can be utilised once the

sum assured per person is consumed. This

provides flexibility for families to decide their

optimal cover: Choose individual cover from

options given below:

• Individual Base Sum Insured Options for Silver are -

Rs 1L, 2L, Rs 3L, Rs 4L, & Rs 5L

• Individual Base Sum Insured Options for Gold - Rs

1L, Rs 2L, Rs 3L, Rs 4L, Rs 5L, Rs10L and Rs 15L

• Individual Cover Sum Insured Options (for

Platinum)- Rs5L, 10L and Rs 15L

Within the Sum Insured, there is an individual

insurance cover for each Insured Person which shall

be up to the amount specified in the Schedule for

that Insured Person. Our maximum liability for all

claims in respect of an Insured Person under the

Policy during the Policy Period shall be limited to the

Individual Cover amount specified in the Schedule

for that Insured Person.

Choose family floater cover from options given below:

Family Floater Cover Sum Insured

• For Silver – Rs. 3L, Rs. 4L, Rs. 5L, Rs. 10L & Rs. 15L

• For Gold – Rs. 3L, Rs. 4L, Rs. 5L, Rs. 10L, Rs. 15L,

Rs.20L, Rs.30L and Rs.50L

• For Platinum- Rs. 15L, Rs 20L, Rs. 30L and Rs. 50L

Within the Sum Insured, there is a floater insurance

cover up to the amount specified in the Schedule. This

floater cover may be utilized only if the Individual

Cover amount of an Insured Person is fully exhausted

and there is a further claim under the Policy. Our

maximum, total and cumulative liability for any and all

such further claims in respect of all Insured Persons

under the Policy during the Policy Period shall be

limited to the Floater Cover amount specified in the

Schedule.

Illustration for Family First Policy:

The details of the plans are available in the product

benefits table for Family First Policy.Product

Product Features and Benefits – Key Highlights

The policy covers reasonable charges incurred towards

Family Members Age Individual Sum Insured (in lacs) Father 66 2 Mother 65 2 Son 40 2

Daughter-in law 39 2 Total Individual Sum Insured 8 lacs

Family Floater Sum Insured 5 lacs

Total Sum Insured 13 lacs

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medical treatment taken during the Policy Period for an

Illness or an Accident. We cover the following expenses

1. Inpatient Care: Medical Expenses for:

(i) Medical Practitioners’ fees, Diagnostics

procedures, Medicines, drugs and

consumables, Operation theatre charges,

Intensive Care Unit, Intravenous fluids, blood

transfusion, injection administration charges

(ii) The cost of prosthetics and other devices or

equipment if implanted internally during a

Surgical Procedure.

2. Hospital Accommodation:

Reasonable charges for Room Rent for Hospital

accommodation. All Gold and Platinum Policies

can utilise Single Private rooms during

hospitalization.

For Silver sum insured options of Individual and

Family Floater plans, the Insured Persons can

choose between a shared room

category or 1% of their Sum Insured,

at the time of hospitalisation. For Silver Family

First plans, the insured persons can opt for Rs

3,000 or a shared room, depending on their

preference.

3. Pre & Post hospitalization Medical Expenses:

Medical Expenses incurred due to Illness up to

30 days period immediately before an Insured

Person’s admission to a Hospital and 60 days

immediately after an Insured Person’s

discharge from a Hospital. These are payable

for the same illness or treatment as long as we

have accepted an inpatient hospitalization

claim for that treatment or illness. These can

be claimed only as reimbursements. .

4. Day Care Treatment: Medical Expenses for

Day Care procedures/ Treatment where such

treatment are undertaken by an Insured

Person for a continuous period of less than 24

hours, in a Hospital/day care centre, will be

covered. Any procedure undertaken at the

out-patient department of a Hospital will not

be covered. Under Day Care Procedures we

will also cover Chemotherapy, Radiotherapy,

Hemodialysis, or any procedure which needs a period

of specialized observation or care after completion of

the procedure, where such procedure is undertaken by

an Insured Person as an In-patient in a Hospital for a

continuous period of less than 24 hours. Any OPD

Treatment undertaken in a Hospital will not be

covered.

5. Domiciliary Treatment: Medical Expenses for

treatment taken at home if the treatment

continues for an uninterrupted period of 3

days and the condition for which treatment is

taken would otherwise have necessitated

hospitalization as long as either (i) the

attending Medical Practitioner confirms that

the Insured Person could not be transferred to

a Hospital or (ii) Insured Person satisfies us that

a Hospital bed was unavailable.

6. Maternity Benefits:

(i) ‘In-case of Family Floater: This benefit is

available only to you or your spouse under

family floater policy, only when you and your

spouse, are both covered under the same

policy. We pay Medical Expenses for the

delivery of a child, only after 24 months of

continuous coverage since the inception of the

first Policy with Us. There is a sub-limit on

maternity expenses as shown in the Product

Benefit Table. Maternity benefits are paid only

twice during the lifetime of the Policy including

any of its renewals. We will also cover medically

necessary termination of pregnancy. We will

cover the pre-natal & post-natal Medical

Expenses for any covered delivery and

termination. However, expenses in respect of

harvesting and storage of stem cells

are not covered.

(ii) In-case of Family First: This benefit is

available only to adult females covered

under Family First Policy. We pay Medical

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Expenses for the

delivery of a child, only after 24 months of

continuous coverage since theinception of the first

Policy with Us. There is a sub-limit on maternity

expenses as shown in the Product Benefit Table for

Family First Policy. Maternity benefits are paid only

twice during the lifetime of the Policy including any

renewal thereof. We will also cover medically necessary

termination of pregnancy. We will cover the pre-natal &

post-natal Medical Expenses for any covered delivery

and termination. However, expenses in respect of

harvesting and storage of stem cells are not covered.

7. New Born Baby:

The new born baby will be covered as an insured

person from birth. We will cover medical expenses

towards the medical treatment of the Insured Person’s

new born baby while the Insured Person is Hospitalized

as an Inpatient for delivery. We also cover Reasonable

Charges for vaccination of the new born baby until the

new born baby completes one year. If the policy ends

before the baby completes one year, then we will cover

the vaccinations only if the baby has been added as an

insured person at the time of renewal.

8. Organ Donor:

Medical Expenses for an organ donor’s treatment for

harvesting of the organ provided that the Insured

Person has been medically advised to undergo an

organ transplant and the donation conforms to The

Transplantation of Human Organs Act 1994 and the

organ is for the use of the Insured Person;

We will not cover:

(a) Pre-hospitalisation or post-hospitalization Medical

Expenses or screening expenses of the donor or any

other medical expenses as a result of the harvesting

from the donor;

(b) Costs directly or indirectly associated with the

acquisition of the donor’s organ.

9. Health Checkup:

We will cover the cost of Health Check-Up arranged by

us through our empanelled service providers as per

your plan eligibility defined in the product benefit table.

10. Emergency ambulance:

Reasonable charges for ambulance expenses (by surface

transport only) incurred to transfer the Insured Person

following an Emergency, while in India, to the nearest

Hospital, if we accept the in-patient claim. For Out Of

Network Hospitalization our maximum liability for

ambulance expenses is limited to Rs.2,000/- per event.

11. Benefits on Annual Renewals

• Health Relationship Loyalty Program

If the Policy is renewed with us without any break, each

Insured Person will become eligible to participate in the

Health Relationship Loyalty Program announced by us

from time to time. It is a first-of-its kind rewards

program, which rewards customers for their relationship

with Max Bupa and the trust they have reposed in the

brand, irrespective of their claim history. The program is

also designed in a way that the customers can choose

the benefits that are most relevant to them. Under this

program, customers can opt for either of the following:

1. Earn and Redeem: Customers can earn points

worth a percentage of their last paid premium which can

be redeemed against various products and services. These

products and services can be vouchers from various

partner brands. It also includes vouchers for OPD services

within our partner hospital network if the customer wishes

to avail of the same, of the equivalent value.

a. If the Policy Period is one year, we offer

vouchers, in either electronic or physical form, worth

10% of your last premium received

b. If the Policy Period is two years, we offer

vouchers, in either electronic or physical form, worth 5% of

the last premium received on the commencement of each

Policy Year commencing from the second Policy Year.

The Insured Person may avail of the services and

products specified within the period specified in or

along with the voucher, provided that:

• The vouchers are used for health services and

benefits communicated from time to time;

• The conditions or limitations specified in the

vouchers are adhered to;

• The Policy is continuously renewed.

2 . Increase Sum Insured: The customer also has the

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option to opt-for increasing his Sum insured up to a cap

of 50% of his base sum insured. The customer will not

have an option of opting for ‘Earn n redeem’ as

mentioned above once he has opted for increasing his

Sum insured on further renewals

• The option of higher Sum Insured is applicable

for (a) individual Policy on Base Sum Insured, (b) Family

Floater Policy on Base Plan Sum Insured, and (c) Family

First Policy on individual Base Sum Insured

• We offer a 10% increase on the expiring Base Sum

Insured on each Policy Year up to a maximum of 50% of

Base Sum Insured of that Policy Year provided the Policy

is renewed continuously

Illustration:

The Loyalty additional Sum Insured is calculated as 10% of

the expiring policy’s Sum Insured at the time of renewal.

So if a customer has a base Sum Insured of Rs. 200,000

in the beginning, he earns a 10% Loyalty additional Sum

Insured of Rs. 20,000 at renewal which is added with his

base Sum Insured to take his total Sum Insured for the

next year to 220,000. Like this the Total Loyalty

additional Sum Insured can be accumulated till 50%(Rs

100,000) of the base sum insured of Rs 200,000, if the

customer renews the policy for 200,000 continuously.

However, If at the next renewal he increases his base

Sum Insured to Rs 10,00,000 from Rs. 200,000, he

gets Rs. 20,000 Loyalty additional Sum Insured, which

is10% of the expiring base Sum Insured Rs. 200,000.

This takes his total loyalty additional Sum Insured to

40,000 and his total Sum Insured for that policy to Rs.

10,40,000. The Loyalty additional Sum Insured earned

at renewal does not become a part of the base Sum

Insured for any current year. At next renewal the Loyalty

additional Sum Insured is calculated as 10% of expiring

Base Sum Insured of Rs. 10,00,000. The maximum

allowed total Loyalty additional Sum Insured can now be

50% (Rs 500,000) of Rs. 10,00,000 if the customer

renews the policy for Rs. 10,00,000 continuously

Next, If the customer reduces his base Sum Insured

back to Rs. 200,000 at next renewal, the maximum

total Loyalty Additional Sum Insured allowed will be

calculated based on the new sum Insured of Rs.

200,000 and the customer cannot avail of the higher

amounts earned earlier.

12. Consultation and Diagnostic Tests Carry Forward

(for Platinum Policyholders only): We will cover

reasonable charges for Insured Person’s medically

necessary consultation with a Medical Practitioner, as

an OPD Treatment to assess the Insured Person’s

health condition for any illness. We will also pay for

any diagnostic tests prescribed by the medical

practitioner and medicines purchased under and

supported with a Medical Practitioner’s prescription up

to the sub-limits shown in the product benefits table.

If the Policy is renewed with us without any break and

there is a unutilized amount (not used by the Insured

Person) under the applicable sub-limit (as specified in

the product benefit table) in a Policy Year, then we will

carry forward 80% of this unutilized amount to the

immediate succeeding Policy Year. The total amount

(including the unutilized amount available under this

benefit) should not exceed 2.5 times the amount of

the entitlement in respect of this benefit under the

plan applicable to the Insured Person as per the

Product Benefits Table.

Current Base Sum Insured

Loyalty Additional Sum Insured Amount

Cumulative Loyalty Additional Sum Insured Total Sum Insured

1 200,000 - - 200,000 2 200,000 20,000 20,000 220,000 3 1,000,000 20,000 40,000 1,040,000 4 1,000,000 100,000 Rs.140,000 1,140,000 5 1,000,000 100,000 240,000 1,240,000 6 200,000 100,000 100,000 300,000 7 200,000 20,000 100,000 300,000

(All Figures in INR)

Illustration of how the above carry forward works as

follows (All figures in INR):

Illustration 1: Sum Insured:

15 lacs, Out-patient benefits sub-limit Rs. 10,000/-Yr

Sub-limit carried

forward from previous

year

Fresh OPD sub-

limit for the year

Maximum allowed (2.5 times sub-

limit)

Sub-limit available

for the year

OPD claims

made in the year

Unutilized limit at the end of the

year

Sub-limit carried

forward to the next

year 1 - 10,000 25,000 10,000 - 10,000 8,000 2 8,000 10,000 25,000 18,000 - 18,000 14,400 3 14,400 10,000 25,000 24,400 2,500 21,900 17,520 4 17,520 10,000 25,000 25,000 - 25,000 20,000 5 20,000 10,000 25,000 25,000 3,000 22,000 17,600 6 17,600 10,000 25,000 25,000 25,000 20,000

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Illustration 2 (All Figures in INR): Sum Insured: 50 lacs,

Out-patient benefits sub-limit Rs. 20,000/-

13. Co-Payment

If any insured person is 65 years of age or over on the

date of commencement of current policy year, then we

will pay the percentage provided in the table below of

any assessed claim amount

Co-payment contribution table:

The above Co-pay grid means that the Percentage of

any assessed claim amount payable by Us increases by

5% for every continuous renewal.

Illustration of how the above co-pay works:

If the insured person is of the age 63 years at the time

of the first Policy Inception then the Co-pay that would

have applied at the age of 65 years would reduce as

per the table below,

It should be noted that the Co-pay is applicable only

once the insured person is 65 years or age or older.

The reduction in co-pay is a benefit being given to

customers for enrolling before the age of 65 years.

Even after turning 65 the Co-pay continues to reduce

by 5% for every Continuous renewal. So for any

customer Continuously renewing the same plan with

Us for 4 policy years the Co-pay reduces to zero.

Special Benefits to Platinum Customers

Customers who opt for the Platinum plan of the

Heartbeat with Sum Insured ranging from 15 lacs to 1

cr on Individual policies and Family Floater, and Family

First Platinum Plans get additional benefits ranging

from preventive health care, alternative therapies and

outpatient treatments, treatment outside of India,

making it an exhaustive and best quality health cover

for the entire family providing the best quality

healthcare options available. These benefits are

offered within the geographical and sum-insured

sub-limits presented in the Product Benefit table.

14. Consultation and Diagnostic Tests (for Platinum

Policyholders only): Reasonable charges towards

medically necessary consultation as an outpatient with

a doctor to assess the Insured Person’s condition. The

outpatient treatment will also include alternative

treatment like Homeopathy and Ayurveda, within the

same, up to the sub-limits prescribed. We will also pay

for any diagnostic tests and medicines prescribed by

the doctor up to the sub-limits shown in the Product

Benefit Table.

15. Child Care Benefits (for Platinum Policyholders

only): We will cover reasonable charges for specified

vaccination expenses for children who are included as

insured persons until they have completed 12 years

are covered. We will also cover expenses towards one

consultation for nutrition and growth provided to the

child during a visit for vaccination.

16. Emergency Medical Evacuation and

Hospitalization(for Platinum Policyholders only)

Year Sub-limit carried forward

from previous

year

Fresh OPD

sub-limit for the year

Maximum allowed (2.5 times sub-

limit)

Sub-limit available for the year

OPD claims

made in the year

Unutilized limit at the end of the

year

Sub-limit carried

forward to the next

year

1 - 20,000 50,000 20,000 - 20,000 16,000 2 16,000 20,000 50,000 36,000 - 36,000 28,800 3 28,800 20,000 50,000 48,800 - 48,800 39,040 4 39,040 20,000 50,000 50,000 - 50,000 40,000 5 40,000 20,000 50,000 50,000 - 50,000 40,000 6 40,000 20,000 50,000 50,000 17,500 32,500 26,000

No of Years of Continuous renewal at or later than the age of 65 years

Percentage of any assessed claim amount payable by Us

0 year 80%

1yr 85%

2 yrs 90%

3 yrs 95%

4 yrs or more 100% (No Co-payment)

No of Years of Continuous renewal

Age of the Insured person

Percentage of any assessed claim amount payable by Us when the insured person 65 years of age or older

0 yrs (First Policy Year)

63 yrs 100% (no co-pay in this policy year)

1 yr 64 yrs 100% (no co-pay in this policy year)

2 yrs 65 yrs 90% (co-pay starts at the age of 65 yrs, applicable percentage payable by Us is 80% plus the cumulative benefit of 10% for 2 Continuous renewals)

3 yrs 67 yrs 95% (co-pay keeps reducing at each Continuous renewal by 5%)

4 yrs 68 yrs 100% (co-pay reduces to zero after 4th Continuous renewal or in other words in the 5th year of Continuous coverage)

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(i) Emergency Medical Evacuation and

Hospitalization (Outside India) In case of a medical

emergency outside India we will provide assistance in

medical evacuation of the Insured Person and cover the

reasonable charges for transportation of the Insured

Person (and an attending Doctor if this is medically

necessary) following an emergency, to the nearest

Hospital which is prepared to admit the Insured Person

provided that: Necessary medical treatment cannot be

provided at a Hospital where the Insured Person is

situated at the time of emergency; and our service

provider has approved the request for Medical

Evacuation. The medical evacuation has been prescribed

by a Medical Practitioner and is medically necessary.

Further, if the Insured Person is required to be

Hospitalized in an emergency when the Insured

Person is outside India, but within those regions

specified in the Schedule of Insurance Certificate, We

will cover the following medical expenses towards

medical treatment until the Insured Person reaches a

medically stable condition:

(1) Medical Practitioner’ fees

(2) Diagnostics procedures

(3) Medicines, drugs and consumables

(4) Intravenous fluids, blood transfusion, injection

administration charges

(5) Operation theatre charges

(6) The cost of prosthetics and other devices or

equipment if implanted internally during a

Surgical Operation.

(7) Intensive Care Unit charges

(8) Reasonable charges for room rent for Hospital

accommodation

(ii) Specific Exclusions

I. We will not cover any treatment or claims

falling under any exclusions or waiting period

II. The benefit will also not be available after the

first 180 cumulative days of travel outside India

during the Policy Year.

Claims Procedure applicable to Emergency Medical

Evacuation and Hospitalization

a) Claims for Emergency Medical Evacuation

(i) In the event of an Emergency, Our Service

Provider shall be contacted immediately on the

helpline number specified in the Insured Person’s

health card.

(ii) Our Service Provider will evaluate the

necessity for evacuation of the Insured Person and if

the request for Medical Evacuation is approved, the

Service Provider shall pre-authorise the type of travel

that can be utilized to transport the Insured Person

and provide information on the nearest Hospital that

may be approached for medical treatment of the

Insured Person.

(iii) If the Service Provider pre-authorises the

Medical Evacuation of the Insured Person through an

air ambulance, the Service Provider shall also arrange

for the same to be provided to the Insured Person

unless there are any logistical constraints or the

medical condition of the Insured prevents Emergency

Medical Evacuation.

(iv) If the Service Provider pre-authorises the

Medical Evacuation of the Insured Person through air

travel and if the condition of the Insured Person

permits travel by commercial airline as certified by the

treating Medical Practitioner, the Service Provider shall

arrange one-way economy class air tickets or

equivalent by the most direct route from the place of

evacuation to the place to where the Insured Person is

being evacuated.

(v) It is agreed and understood that We shall not cover:

a. Any claims for reimbursement of the costs

incurred in the evacuation or transportation of the

Insured Person while outside India or any claims which

are not pre-authorized by Our Service Provider;

b. Any costs or expenses incurred in relation to

any persons accompanying the Insured Person, even if

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such persons are also Insured Persons.

b) Cashless Hospitalization in Emergency at Network

Hospitals:

The health card We provide will enable the Insured

Person to access medical treatment at any

Network Hospital outside India, but within those

regions specified in the Schedule of Insurance

Certificate, on a cashless basis only by the production

of the card to the Network Hospital prior to admission,

subject to the following:

(i) In the event of an Emergency, the Insured

Person or Network Hospital shall call Our Service

Provider immediately, on the helpline number

specified in the Insured Person’s health card,

requesting for a pre-authorization for the medical

treatment required.

(ii) Our Service Provider will evaluate the request

and the eligibility of the Insured Person under the Policy

and call for more information or details, if required.

(iii) Our Service Provider will communicate

directly to the Hospital whether the request for

pre-authorization has been approved or denied.

(iv) If the pre-authorization request is approved, Our

Service Provider will directly settle the claim with the

Hospital. Any additional costs or expenses incurred by

or on behalf of the Insured Person beyond the limits

pre-authorized by the Service Provider shall be borne

by the Insured Person.

(v) This benefit is available only as cashless facility

through pre-authorization by Our Service Provider. It is

agreed and understood that We shall not cover:


incurred in relation to the Hospitalization of the

Insured Person while inside or outside India or any

claims which are not pre-authorized by Our Service

Provider;

b. Any costs or expenses incurred in relation any

persons accompanying the Insured Person during the period of

Hospitalization, even if such persons are also Insured Persons.

The Medical Emergency Evacuation service is on best

efforts basis and Max Bupa does not make any

guarantee and/or assume the responsibility for the

appropriateness, quality or effectiveness of the

treatment/facilities sought or provided by, or arranged

by the Service Provider while approving the

pre-authorization or providing the evacuation service.

For details refer to the Terms and Conditions of the

Policy Document.

17. International Treatment support for Specified

Illnesses (For Platinum Policy Holders Only)

If an Insured Person suffers a specified illness during the

Policy Period, we will cover reasonable expenses

incurred towards the treatment of the same, provided

the symptoms first occur and are diagnosed by a doctor

within India during the Policy Period after the

completion of the 90 day waiting period. The customers

can undergo treatment on a pre-authorisation basis

outside of India. The base coverage provided under all

Platinum Plans covers treatment outside India excluding

treatment in USA and Canada.

All Platinum Plan customers can enhance their

coverage to include USA and Canada by paying an

additional premium amount.

The specified illnesses covered are listed below:

i. Cancer

A malignant tumor characterized by the uncontrolled

growth and spread of malignant cells with invasion and

destruction of normal tissues. This diagnosis must be

supported by histological evidence of malignancy. The

term cancer includes leukemia, lymphoma and

sarcoma.

Specific Exclusion: All tumors in the presence of HIV

infection are excluded.

10

ii. Myocardial Infarction (Heart Attack)

The death of a portion of the heart muscle as a result

of inadequate blood supply to the relevant area.

iii. Coronary Artery Bypass Graft (CABG)The actual

undergoing of open / keyhole chest surgery for the

correction of one or more coronary arteries, which

is/are narrowed or blocked. The diagnosis must be

supported by relevant diagnostic tests and confirmed

by a cardiologist.

iv. Major Organ Transplant

The actual undergoing of a transplant of:

One or more of the following human organs: heart,

lung, liver, kidney, pancreas, that resulted from

irreversible end-stage failure of the relevant organ, or

human bone marrow using haematopoietic stem cells.

Specific Exclusions: The following are excluded:

(a) Other stem-cell transplants

(b) Where only islets of langerhans are transplanted

iv. Stroke

Any cerebrovascular incident including infarction of

brain tissue, thrombosis in an intracranial vessel,

hemorrhage and embolisation from an extra cranial

source, which would result in neurological sequelae.

Transient Ischemic Attacks (TIA) are excluded.

Treatment of the neurological sequelae is excluded

from the cover if the primary condition is not covered.

v. Surgery of Aorta:

Surgery of aorta including graft, insertion of stents or

endovascular repair.

Specific Exclusion: Wherein the surgery is required due

to underlying congenital condition.

vi. Coronary Angioplasty

Procedures done for widening a narrowed or

obstructed blood vessel of the heart wherein a stent

may or may not be inserted into the blood vessel. The

same is payable only if the procedure is done

subsequent to Myocardial infarction or Anginal attack.

vii. Primary Pulmonary Arterial Hypertension

An abnormal elevation in pulmonary artery pressure

with or without any known cause. The disease has to

be confirmed through cardiac catheter.

viii. Brain Surgery

Any brain (intracranial) surgery required of brain due

to traumatic or non traumatic reasons.

Exclusion: Surgery for treating neurocysticercosis

In addition to the exclusions mentioned specifically for

particular specific illness, all other exclusions and/or

waiting periods specified elsewhere in the Policy

Document shall apply.

Claims procedure for specified illness treatment

Cashless Hospitalization facility for network Hospitals:

i. In the event of specified illness, the Insured

Person should call Our service provider on the

helpline number mentioned in their health card,

requesting for a pre-authorization for the treatment

prior to commencement of travel abroad for

treatment;

ii. After verification of eligibility as per the Policy, our

service provider will evaluate the request and

call for more information, if required.

iii. After evaluation of all information, our service

provider will communicate the decision and details of

the Hospitals where the treatment can be undertaken

to the Insured Person. This could either be an approval

or a denial.

iv. Any additional costs or expenses incurred by or on

behalf of the Insured Person beyond the limits pre-authorized

by the Service Provider or at any non-Network Hospital shall

be borne by the Insured Person.

v. If the pre-authorization request is approved, our service

provider will directly settle the claim with the Hospital.

11

vi. This benefit is available only as cashless facility. It

is agreed and understood that We shall not cover:


incurred in relation to the treatment of the Specified

Illness outside India or any claims which are not

pre-authorized by Our Service Provider;

b. Any costs or expenses incurred in relation to any

persons accompanying the Insured Person during any

period of treatment, even if such persons are also

Insured Persons.

c. Any costs or expenses incurred in relation to the

travel to or from the overseas location where

treatment is being taken.

d. Any costs or expenses incurred in relation to

accommodation or stay or transportation in the

overseas location where treatment is being taken.

e. Any pre-Hospitalization or post-Hospitalization

costs or expenses incurred by or on behalf of the

Insured Person.

f. Any costs or expenses incurred in relation to

transportation of repatriation of the mortal remains of

the Insured Person.

g. Any costs or expenses incurred by any organ

donor in relation to harvesting of organs.

h. Any OPD Treatment taken outside India .

Other optional benefits (Only one of the co-pays or

the deductibles can be chosen for any single policy)

18. Co-payment discount options(optional benefit)

If you are aged less than 65 years you can avail a

discount in premium calculation by opting for any one

of the below co-pay options. This will allow you to

manage your premium costs better.

i. 10% co-pay by the insured for all claims that you

submit to us, cashless or reimbursement.(Applicable

only for Individual and Family Floater)

ii. 20% co-pay by the insured for all claims that you

submit to us, cashless or reimbursement.

19. Optional Aggregate Annual Deductibles

(top-up option):

You can choose from one of three optional deductibles

of Rs 1 lac, Rs 2 Lacs and Rs 3 lacs. By doing so you

will receive a discount in the premium calculation of

your policy as per the table below,

If an annual aggregate deductible is chosen then the

Insured Person shall bear all assessed claim amounts

payable under the policy up to the deductible amount,

under his(her) policy for any Policy Year. Our liability

to make payment under the Policy in respect of any

claim made in that Policy Year will only commence

once the Deductible has been exhausted.

Any claim amount that is assessed to be payable by

Max Bupa under this policy and is borne by the

customer (even if paid for through another Health

Insurance Policy) will be accepted as reason of

deductible exhaustion.

Description (using 2 lacs deductible with 3 Lacs

Sum Insured as example)

By accepting this condition you will agree to pay

yourself or from another health insurance policy the

first 2 lac of the total claim amount assessed for

payment in one policy year. All claims will be assessed

by Us as per the Terms and Conditions of this policy.

Max Bupa will start paying claims as per the policy

Terms and Conditions once the total claim amount

assessed for payment for your policy goes above 2

Deductible Option (top-up) in INR

Available for Sum Insured (INR)

Applicable discount in premium calculation

1 lac Deductible 2 lacs & 3 lacs 25.0%



12

lacs. We will cover you for a Sum Insured of 3 lacs over

and above the 2 lacs deductible.

Please find below the two illustrations for the working

of the aggregate annual deductible(top-up option)

Illustration 1: When a customer already has an

health insurance policy and opts for another policy

from Max Bupa along with the annual aggregate

Deductible (top-up) Option

Heartbeat Health Insurance Plan Opted for Sum Insured:

3 Lacs, with an annual aggregate Deductible: 2 lacs

Health Insurance Policy from any other insurance

company Sum Insured: 2 Lacs

Rules:

Deductible exhaustion will be calculated without use

of Contribution clause. So the first 2 lacs of aggregate

annual claims in this example will be paid for by the

other insurer's policy.

For aggregate claim amounts above the annual

deductible,

Contribution ratio will be calculated as per the ratio of

the Sum Insured above the annual deductible in both

policies. So if the other insurers' policy has Sum Insured

Rs 2 Lacs and the deductible in Max Bupa policy is Rs 2

lacs, Max Bupa will pay 100% of the assessed claim

amount above Rs 2 lacs up to the Sum Insured.

Illustration 2: When there is an overlap of Sum

Insured between the Max Bupa policy and another

HI policy, along with the annual aggregate

Deductible (top-up) option

Heartbeat Policy Plan opted for Sum Insured: 3 Lacs

with an annual aggregate Deductible: 2 lacs

Health Insurance Policy from any other insurance

Claim Amount Assessed by Us

Deductible Exhaustion

Balance Deductible

Available Sum Insured in Heartbeat policy

Claim amount paid by the other insurance policy or the customer

Claim Amount paid by Us

At Inception

- - 200,000 300,000 - -

Claim 1 20,000 20,000 1,80,000 300,000 20,000 0 Claim 2 1,90,000 1,80,000 0 300,000 1,80,000 10,000 Claim 3 3,60,000 0 0 290,000 0 2,90,0000


company Sum Insured: 3 Lacs

In this case there is an overlap of coverage with the

other insurance policy. So in this case customer has an

option to choose the insurance company from which

claim to be settled.

Rules:

Deductible exhaustion will be calculated without use of

Contribution clause. So the first 2 lacs of aggregate

annual claims in this example will be paid for by the

other insurer's policy.

For aggregate claim amounts above the annual

deductible, if the customer chooses Max Bupa to settle

the claim, no contribution clause will be applied

Additional Services

• 24/7 Healthline. This facility has been put in place

to offer you access to health advice when you need it

the most.

• Relationship Managers (For Gold and Platinum

Policyholders): We may assign at our discretion, our

representative who will personally attend to your claims

settlement, leaving you free to concentrate on getting

better or looking after your loved ones.

• Second E-Opinion (For Platinum Policyholders)

for a life threatening medical condition.

• Direct Servicing – All claims are processed directly

by our own customer services team.

Waiting Periods and Exclusions:

Claims for the following are not covered:

• Pre-Existing Conditions: Benefits will not be

available for Pre-existing Conditions for Gold and

Claim Amount Assessed by Us (INR)

Deductible Exhaustion (INR)

Balance Deductible (INR)

Available Sum Insured in Heartbeat policy (INR)

Available Sum Insured in Other Insurer's policy (INR)

Claim amount paid by the other insurance policy or the customer (INR)

Claim Amount paid by Us (INR)

At Inception

- - 200,000 300,000 300,000 - -

Claim 1 20,000 20,000 1,80,000 300,000 300,000 20,000 0 Claim 2 1,80,000 1,80,000 0 300,000 2,80,000 1,80,000 0 Claim 3 2,40,000 0 0 300,000 1,00,000 0 2,40,000


13

Platinum plans until 24 months and for all Silver plans

until 48 months of continuous coverage have elapsed

since the inception of the first Policy with Us.

• 90 Days Waiting Period: We will not cover any

treatment taken during the first 90 days since the

commencement of the Policy, unless the treatment

needed is a result of an Accident or Emergency. This

waiting period does not apply for any subsequent and

continuous renewals of Your Policy.

• Specific Waiting Periods: For all Insured Persons

who are above 60 years of age as on the date of

commencement of the first Policy Period, the

conditions listed below will be subject to a waiting

period of 24 months and will be covered in the

third Policy Year as long as the Insured Person has

been insured continuously under the Policy without

any break:

• Stones in the urinary system (eg kidney/bladder); *

Stones in billiary system (eg gallstones);* Cataract;

*BPH - Benign prostatic hypertrophy; *

Mennoraghia, * Fibromyoma, *Uterine prolapse

including any condition requiring Hysterectomy; *

Piles (Haemorrhoids); * Hernia (Inguinal/umbilical

and gastric); * Degenerative disorders of knee/hip;

* Chronicrenal failure or end stage renal failure; *

Retinopathy; * Diabetes and related treatments

• Personal Waiting Periods: There are certain

conditions mentioned in the Schedule of insurance

certificate. These will be subject to a waiting period of

24 months and will be covered in the third Policy Year

as long as the Insured Person has been insured

continuously under the Policy without any break.

These will be applied only on select Insured Person(s)

basis their health condition which is determined only

after conducting medical tests. For example, after

conducting an ECG if the report is not normal than a

personal waiting period for heart disease will be

applied post risk assessment.

• Permanent Exclusions: Addictive conditions and

disorders; Ageing and puberty; Artificial life

maintenance; Circumcision; Conflict and disaster;

Congenital conditions; Convalescence and

rehabilitation; Cosmetic surgery; Dental/oral treatment;

Drugs and dressings for OPD treatment or take-home

use; Unproven/Experimental treatment; Eyesight;

Health hydros, nature cure, wellness clinics etc;

Hereditary conditions (specified); HIV and AIDS; Items

of personal comfort and convenience; alternative

treatment(except for Consultation and Diagnostic Tests

(For Platinum Policyholders only)); Psychiatric and

Psychosomatic conditions; Obesity; OPD treatment;

Reproductive medicine - Birth control and Assisted

reproduction; Self-inflicted injuries; Sexual problems

and gender issues; Sexually transmitted diseases; Sleep

disorders; Speech disorders; Treatment for

developmental problems; Treatment received outside

India(except for treatment undertaken under

“Emergency Medical Evacuation and Hospitalization (for

Platinum Policyholders only)” or “Specified Illness Cover

for treatment abroad (For Platinum Policyholders only)”

of the Policy Document); Unlawful activity;

Unrecognised physician or Hospital, Genetic disorders;

any other such permanent exclusions as may be

specified in the Schedule, any expenses as mentioned

below for hospitalization treatment.

14

43 BED UNDER PAD CHARGES Not Payable 44 CAMERA COVER Not Payable 45 CLINIPLAST Not Payable 46 CREPE BANDAGE Not Payable / Payable by the patient 47 CURAPORE Not Payable 48 DIAPER OF ANY TYPE Not Payable 49 DVD, CD CHARGES Not Payable (However if CD is specifically sought by Insurer / TPA then payable) 50 EYELET COLLAR Not Payable 51 FACE MASK Not Payable 52 FLEXI MASK Not Payable 53 GAUSE SOFT Not Payable 54 GAUZE Not Payable 55 HAND HOLDER Not Payable 56 HANSAPLAST/ADHESIVE Not Payable BANDAGES 57 INFANT FOOD Not Payable 58 SLINGS Reasonable costs for one sling in case of upper arm fractures should be considered

ITEMS SPECIFICALLY EXCLUDED IN THE POLICIES 59 WEIGHT CONTROL PROGRAMS/ Exclusion in policy SUPPLIES/ SERVICES unless otherwise specified 60 COST OF SPECTACLES/ CONTACT Exclusion in policy LENSES/ HEARING AIDS ETC., unless otherwise specified 61 DENTAL TREATMENT EXPENSES Exclusion in policy THAT DO NOT REQUIRE unless otherwise HOSPITALISATION specified 62 HORMONE REPLACEMENT Exclusion in policy THERAPY unless otherwise specified 63 HOME VISIT CHARGES Exclusion in policy unless otherwise specified 64 INFERTILITY/ SUBFERTILITY/ Exclusion in policy ASSISTED CONCEPTION unless otherwise PROCEDURE specified 65 OBESITY (INCLUDING MORBID Exclusion in policy OBESITY) TREATMENT IF unless otherwise EXCLUDED IN POLICY specified 66 PSYCHIATRIC & Exclusion in policy PSYCHOSOMATIC DISORDERS unless otherwise specified67 CORRECTIVE SURGERY FOR Exclusion in policy REFRACTIVE ERROR unless otherwise specified 68 TREATMENT OF SEXUALLY Exclusion in policy TRANSMITTED DISEASES unless otherwise specified 69 DONOR SCREENING CHARGES Exclusion in policy unless otherwise specified 70 ADMISSION/REGISTRATION Exclusion in policy CHARGES unless otherwise specified

LIST OF GENERALLY EXCLUDED IN HOSPITALISATION POLICY S.No. List of Expenses Generally SUGGESTIONS Excluded ("Non-Medical") in Hospital Indemnity Policy -

TOILETRIES / COSMETICS / PERSONAL COMFORT OR CONVENIENCE ITEMS

1 HAIR REMOVAL CREAM Not Payable 2 BABY CHARGES Not Payable (UNLESS SPECIFIED/INDICATED) 3 BABY FOOD Not Payable 4 BABY UTILITES CHARGES Not Payable 5 BABY SET Not Payable 6 BABY BOTTLES Not Payable 7 BRUSH Not Payable 8 COSY TOWEL Not Payable 9 HAND WASH Not Payable 10 MOISTURIZER PASTE BRUSH Not Payable 11 POWDER Not Payable 12 RAZOR Payable 13 SHOE COVER Not Payable 14 BEAUTY SERVICES Not Payable 15 BELTS/ BRACES Essential and may be paid specifically for cases who have undergone surgery of thoracic or lumbar spine. 16 BUDS Not Payable 17 BARBER CHARGES Not Payable 18 CAPS Not Payable 19 COLD PACK/HOT PACK Not Payable 20 CARRY BAGS Not Payable 21 CRADLE CHARGES Not Payable 22 COMB Not Payable 23 DISPOSABLES RAZORS CHARGES Payable (for site preparations) 24 EAU-DE-COLOGNE / Not Payable ROOM FRESHNERS 25 EYE PAD Not Payable 26 EYE SHEILD Not Payable 27 EMAIL / INTERNET CHARGES Not Payable 28 FOOD CHARGES (OTHER THAN Not Payable PATIENT'S DIET PROVIDED BY HOSPITAL) 29 FOOT COVER Not Payable 30 GOWN Not Payable 31 LEGGINGS Essential in bariatric and varicose vein surgery and should be considered for these conditions where surgery itself is payable. 32 LAUNDRY CHARGES Not Payable 33 MINERAL WATER Not Payable 34 OIL CHARGES Not Payable 35 SANITARY PAD Not Payable 36 SLIPPERS Not Payable 37 TELEPHONE CHARGES Not Payable 38 TISSUE PAPER Not Payable 39 TOOTH PASTE Not Payable 40 TOOTH BRUSH Not Payable 41 GUEST SERVICES Not Payable 42 BED PAN Not Payable

15

92 APRON Not Payable -Part of Hospital Services / Disposable linen to be part of OT/ICU charges 93 TORNIQUET Not Payable (service is charged by hospitals, consumables cannot be separately charged) 94 ORTHOBUNDLE, Part of Dressing GYNAEC BUNDLE Charges 95 URINE CONTAINER Not Payable

ELEMENTS OF ROOM CHARGE 96 LUXURY TAX Actual tax levied by government is payable. Part of room charge for sub limits 97 HVAC Part of room charge not payable separately 98 HOUSE KEEPING CHARGES Part of room charge not payable separately 99 SERVICE CHARGES WHERE Part of room charge NURSING CHARGE ALSO not payable separately CHARGED 100 TELEVISION & AIR CONDITIONER Payable under room CHARGES charges not if separately levied 101 SURCHARGES Part of room charge not payable separately 102 ATTENDANT CHARGES Not Payable - Part of Room Charges 103 IM IV INJECTION CHARGES Part of nursing charges, not payable 104 CLEAN SHEET ^ Part of Laundry / Housekeeping not payable separately 105 EXTRA DIET OF PATIENT Patient Diet provided (OTHER THAN THAT WHICH by hospital is payable FORMS PART OF BED CHARGE) 106 BLANKET/WARMER BLANKET Not Payable- part of ADMINISTRATIVE OR room charges NON-MEDICAL CHARGES 107 ADMISSION KIT Not Payable 108 BIRTH CERTIFICATE Not Payable 109 BLOOD RESERVATION CHARGES Not Payable AND ANTE NATAL BOOKING CHARGES 110 CERTIFICATE CHARGES Not Payable 111 COURIER CHARGES Not Payable 112 CONVENYANCE CHARGES Not Payable 113 DIABETIC CHART CHARGES Not Payable 114 DOCUMENTATION CHARGES / Not Payable ADMINISTRATIVE EXPENSES 115 DISCHARGE PROCEDURE Not Payable CHARGES 116 DAILY CHART CHARGES Not Payable 117 ENTRANCE PASS / VISITORS Not Payable PASS CHARGES 118 EXPENSES RELATED TO To be claimed by PRESCRIPTION ON DISCHARGE patient under Post Hosp where admissible

71 HOSPITALISATION FOR EVALUATION/ Exclusion in policy DIAGNOSTIC PURPOSE unless otherwise specified 72 EXPENSES FOR INVESTIGATION/ Not payable - TREATMENT IRRELEVANT TO THE Exclusion in DISEASE FOR WHICH ADMITTED policy unless OR DIAGNOSED otherwise specified73 ANY EXPENSES WHEN THE PATIENT Not payable as IS DIAGNOSED WITH RETRO HIV/AIDS per VIRUS + OR SUFFERING FROM exclusion /HIV/AIDS ETC IS DETECTED/ DIRECTLY OR INDIRECTLY 74 STEM CELL IMPLANTATION/ SURGERY Not Payable except and storage Bone Marrow Transplantation where covered by policy

ITEMS WHICH FORM PART OF HOSPITAL SERVICES WHERE SEPARATE CONSUMABLES ARE NOT PAYABLE BUT THE

SERVICE IS 75 WARD AND THEATRE BOOKING Payable under OT CHARGES Charges, not payable separately 76 ARTHROSCOPY & ENDOSCOPY Rental charged by the INSTRUMENTS hospital payable. Purchase of Instruments not payable. 77 MICROSCOPE COVER Payable under OT Charges, not payable separately 78 SURGICAL BLADES, HARMONIC Payable under OT SCALPEL, SHAVER Charges, not payable separately 79 SURGICAL DRILL Payable under OT Charges, not payable separately 80 EYE KIT Payable under OT Charges, not payable separately 81 EYE DRAPE Payable under OT Charges, not payable separately 82 X-RAY FILM Payable under Radiology Charges, not as consumable 83 SPUTUM CUP Payable under Investigation Charges, not as consumable 84 BOYLES APPARATUS CHARGES Part of OT Charges, not seperately 85 BLOOD GROUPING AND CROSS Part of Cost of Blood, MATCHING OF DONORS SAMPLES not payable 86 Antiseptic or disinfectant lotions Not Payable -Part of Dressing Charges 87 BAND AIDS, BANDAGES, STERLILE Not Payable -Part of INJECTIONS, NEEDLES, SYRINGES Dressing Charges 88 COTTON Not Payable -Part of Dressing Charges 89 COTTON BANDAGE Not Payable -Part of Dressing Charges 90 MICROPORE/ SURGICAL TAPE Not Payable-Payable by the patient when prescribed, otherwise included as Dressing Charges 91 BLADE Not Payable

119 FILE OPENING CHARGES Not Payable 120 INCIDENTAL EXPENSES / MISC. Not Payable CHARGES (NOT EXPLAINED) 121 MEDICAL CERTIFICATE Not Payable 122 MAINTENANCE CHARGES Not Payable 123 MEDICAL RECORDS Not Payable 124 PREPARATION CHARGES Not Payable 125 PHOTOCOPIES CHARGES Not Payable 126 PATIENT IDENTIFICATION BAND / Not Payable NAME TAG 127 WASHING CHARGES Not Payable 128 MEDICINE BOX Not Payable 129 MORTUARY CHARGES Payable upto 24 hrs, shifting charges not payable 130 MEDICO LEGAL CASE CHARGES Not Payable (MLC CHARGES)

EXTERNAL DURABLE DEVICES 131 WALKING AIDS CHARGES Not Payable 132 BIPAP MACHINE Not Payable 133 COMMODE Not Payable 134 CPAP/ CAPD EQUIPMENTS Device Not Payable 135 INFUSION PUMP - COST Device Not Payable 136 OXYGEN CYLINDER (FOR USAGE Not Payable OUTSIDE THE HOSPITAL) 137 PULSEOXYMETER CHARGES Device Not Payable 138 SPACER Not Payable 139 SPIROMETRE Device Not Payable 140 SP0 2PROB E Not Payable 141 NEBULIZER KIT Not Payable 142 STEAM INHALER Not Payable 143 ARMSLING Not Payable 144 THERMOMETER Not Payable (paid by patient) 145 CERVICAL COLLAR Not Payable 146 SPLINT Not Payable 147 DIABETIC FOOT WEAR Not Payable 148 KNEE BRACES ( LONG/ SHORT/ Not Payable HINGED) 149 KNEE IMMOBILIZER/SHOULDER Not Payable MMOBILIZER 150 LUMBOSACRAL BELT Essential and should be paid specifically for cases who have undergone surgery of lumbar spine. 151 NIMBUS BED OR WATER OR Payable for any ICU AIR BED CHARGES patient requiring more than 3 days in ICU, all patients with paraplegia /quadriplegia for any reason and at reasonable cost of approximately Rs. 200/- day 152 AMBULANCE COLLAR Not Payable 153 AMBULANCE EQUIPMENT Not Payable 154 MICROSHEILD Not Payable 155 ABDOMINAL BINDER Essential and should be paid in post surgery patients of major abdominal surgery including TAH,

LSCS, incisional hernia repair, exploratory laparotomy for intestinal obstruction, liver transplant etc.

ITEMS PAYABLE IF SUPPORTED BY A PRESCRIPTION 156 BETADINE\HYDROGEN PEROXIDE\ May be payable when SPIRIT\DISINFECTANTS ETC prescribed for patient, not payable for hospital use in OT or ward or for dressings in hospital 157 PRIVATE NURSES CHARGES- Post hospitalization SPECIAL NURSING CHARGES nursing charges not Payable 158 NUTRITION PLANNING CHARGES- Patient Diet provided DIETICIAN CHARGES DIET by hospital is payable CHARGES 159 SUGAR FREE Tablets Payable -Sugar free variants of admissable medicines are not excluded 160 CREAMS POWDERS LOTIONS Payable when prescribed (Toileteries are not payable, only prescribed medical pharmaceuticals payable) 161 Digestion gels Payable when prescribed 162 ECG ELECTRODES Upto 5 electrodes are required for every case visiting OT o r ICU. For longer stay in ICU, may require a change and at least one set every second day must be payable. 163 GLOVES Sterilized Gloves Payable /unsterilized gloves not payable 164 HIV KIT Payable - payable Pre operative screening 165 LISTERINE/ ANTISEPTIC Payable when MOUTHWASH prescribed 166 LOZENGES Payable when prescribed 167 MOUTH PAINT Payable when prescribed 168 NEBULISATION KIT If used during hospitalization is payable reasonably 169 NOVARAPID Payable when prescribed 170 VOLINI GEL/ ANALGESIC GEL Payable when prescribed 171 ZYTEE GEL Payable when prescribed 172 VACCINATION CHARGES Routine Vaccination not Payable / Post Bite Vaccination Payable

PART OF HOSPITAL'S OWN COSTS AND NOT PAYABLE 173 AHD Not Payable - Part of Hospital's internal Cost 174 ALCOHOL SWABES Not Payable - Part of

Hospital's internal Cost 175 SCRUB SOLUTION/STERILLIUM Not Payable - Part of Hospital's internal Cost

OTHERS 176 VACCINE CHARGES FOR BABY Payable as per plan 177 AESTHETIC TREATMENT/SURGERY Not Payable 178 TPA CHARGES Not Payable 179 VISCO BELT CHARGES Not Payable 180 ANY KIT WITH NO DETAILS Not Payable MENTIONED [DELIVERY KIT, ORTHOKIT, RECOVERY KIT, ETC] 181 EXAMINATION GLOVES Not Payable 182 KIDNEY TRAY Not Payable 183 MASK Not Payable 184 OUNCE GLASS Not Payable 185 OUTSTATION CONSULTANT'S/ Not payable, except SURGEON'S FEES for telemedicine consultations where covered by policy 186 OXYGEN MASK Not Payable 187 PAPER GLOVES Not Payable 188 PELVIC TRACTION BELT Should be payable in case of PIVI) requiring traction as this is generally not reused 189 REFERAL DOCTOR'S FEES Not Payable 190 ACCU CHECK (Glucometery / Strips) Not payable pre hospitilasation or post hospitalisation / Reports and Charts required / Device not payable

191 PAN CAN Not Payable 192 SOFNET Not Payable 193 TROLLY COVER Not Payable 194 UROMETER, URINE JUG Not Payable 195 AMBULANCE Payable-Ambulance from home to hospital or interhospital shifts is payable/ RTA as specific requirement is payable 196 TEGADERM / VASOFIX SAFETY Payable - maximum of 3 in 48 hrs and then 1 in 24 hrs 197 URINE BAG P Payable where medicaly necessary till a reasonable cost - maximum 1 per 24hrs 198 SOFTOVAC Not Payable 199 STOCKINGS Essential for case like CABG etc. where it should be paid.

16
























Free Look & Cancellation:

1. Free Look Provision: You have a period of 15 days

from the date of receipt of the Policy document to

review the terms and conditions of this Policy. If You

have any objections to any of the terms and

conditions, You may cancel the Policy stating the

reasons for cancellation and provided that no claims

have been made under the Policy, We will refund the

premium paid by You after deducting the amounts

spent on stamp duty charges and proportionate risk

premium for the period on cover. All rights and

benefits under this Policy shall immediately stand

extinguished on the free look cancellation of the

Policy. The free look provision is not applicable and

available at the time of Renewal of the Policy.

2. Cancellation/Termination (other than Free

Look cancellation): You may terminate this Policy by

giving 7 days’ prior written notice to us. We shall

cancel the Policy and refund the premium for the

balance of the Policy Period as per the table below,

provided that no claim has been filed under the Policy

by or on behalf of any Insured Person:

Length of time Policy in force Refund of

premium

up to 30 days 75%

up to 90 days 50%

up to 180 days 25%

exceeding 180 days 0%

Without prejudice to the above, We may terminate

this Policy during the Policy Period by sending 30 days

prior written notice to Your address shown in the

Schedule of Insurance Certificate without refund of

premium if:

a) You or Any Insured Person or any person acting

on behalf of either has acted in a dishonest and

fraudulent manner, under or in relation to this Policy

b) You or any Insured Person has not disclosed the




17

18

material facts or misrepresented in relation to the

Policy; and/or

c) You or any Insured Person has not co-operated

with Us.

For avoidance of doubt, it is clarified that no claims

shall be admitted and/or paid during the notice period

by Us in relation to the Policy.

The Policy will be automatically terminated in the

following circumstances:

a. Individual Policy:

The Policy shall automatically terminate in the event of

death of the Insured Person.

b. Family Floater Policy:

The Policy shall automatically terminate in the event of

death of all the Insured Persons.

c. Refund:

Refund as per table above under

cancellation/termination shall be payable in case of an

automatic cancellation of the Policy provided that no

claim has been filed under the Policy by or on behalf of

any Insured Person.

Portability Benefit

From another company to Our Policy

If the proposed Insured Person was insured

continuously and without a break under another

Indian retail health insurance policy with any other

Indian Insurance company, the customer can avail the

portability benefit provided they have submitted the

application with complete documentation 21 days

before the expiry of their present period of Insurance,

at the time of renewal. The benefit will be available up

to the existing cover. If the Sum Insured is more than

that of the last issued policy, waiting periods will be

applied on the increased Sum Insured amount.

This benefit shall be applied by Us within 45 days of

receiving Your completed Application and Portability

Form and is is subject to submission of all

information/documentation requested, payment of

premium in full and case acceptance is subject to

medical underwriting. We would also need the

database and claim history from the previous

insurance company for review. No additional loading

or charges shall be applied by Us exclusively for

porting the policy.

From Our existing health insurance policies to this

Policy

If the proposed Insured Person was insured

continuously and without a break under another

health insurance policy with Us, they can port to

another policy at the time of renewal, provided the

application and completed Portability Form is received

before the expiry of the present period of insurance.

The benefit will be available only up to the existing

sum insured, and waiting periods will apply on any

additional sum insured. The terms and conditions of

acceptance of a portability application remain the

same as above

The portability benefit guidelines may be modified by

us from time to time depending on the guidance

issued by the Insurance Regulatory and Development

Authority as amended from time to time.

Notification

You will inform Us immediately of any change in the

address, nature of job, state of health, or of any other

changes affecting You or any Insured Person through

the format Annexure A.

We shall allow the enhancement in Sum Assured or

scope of cover only at the time of Renewal, provided

You intimate Us at the time of Renewal. The decision

of acceptance of enhancement of the sum insured or

the scope of cover will be based on our underwriting

policy and shall be subject to payment of applicable

premium for such enhanced cover.

Renewal Information:

Renewal Premium: The renewal premium is payable

on or before the due date as shown in the Schedule.

The premium may change on renewal and will be

notified by Us before completing the Policy Period. The

19

amount of premium is dependent on the age of the

Insured Person and the geographical locations. The

reference of age for calculating the premium for Family

Floater Policies shall be the age of the eldest Insured

Person, and for Family First policies it shall be the

individual age of each Insured Person of the Family.

There will not be any loading at the time of Renewal on

individual claims experience of the Insured Person.

We will allow a grace period of 30 days from the due

date of the renewal premium for payment to us. If the

Policy is not renewed within the grace period then we

may issue a fresh policy subject to Our underwriting

criteria but any new policy issued shall not benefit

from any of the continuity benefits (for example for

Pre-Existing Conditions). Renewal of the Policy will not

ordinarily be denied other than on grounds of moral

hazard, misrepresentation and fraud. Please note that

coverage is not available for the period for which no

premium is received.

For avoidance of doubt, it is clarified that no claims

shall be admitted and/or paid during the Grace period

by Us in relation to the Policy.

2. Waiting Period: The Waiting Periods mentioned in

the policy wording will get reduced by 1 year (2 years

if the expiring policy has a 2 year policy tenure) with

every continuous renewal of your Heartbeat Health

Insurance Policy.

3. This is a life-long renewal product unless the

Insured Person or anyone acting on behalf of an

Insured Person has acted in a dishonest or fraudulent

manner or has misrepresented under or in relation to

this policy or the Policy poses a moral hazard.

4. Maximum Age: There is no maximum coverage

ceasing age in this policy

5. No underwriting on renewal: There will be no

underwriting on policy renewal, without break. The

first year underwriting results will continue to apply

and carry forward.

6. Change in the coverage of the policy including

Sum Insured or additional members in Family Floater

and Family First policies, can be applied for at the time

of renewal. These changes shall be accepted subject to

the renewal terms and as per our underwriting policy.

Obligations in case of a minor

If an Insured Person is less than 18 years of age, the

proposer/adult Insured Person shall be completely

responsible for ensuring compliance with all the terms

and conditions of this Policy on behalf of that minor

Insured Person.

Claims Procedure(Does not apply to Emergency

Medical Evacuation and Hospitalization and

Specified Illness Cover for treatment abroad)

• Cashless Hospitalization Facility for Network

Hospitals: We will provide cashless hospitalization

facility at our network hospitals. We pre-authorise all

cashless in-patient and day care procedure, if

intimated to us in writing 72 hours before

hospitalization (andwithin 48 hours after

hospitalization for emergency). Under cashless

Hospitalization, claims are paid directly to the Network

Hospital and the treatment must take place within 15

days of pre-authorization.

• Out Of Network Hospitals & All Other Claims for

Reimbursement: We will reimburse expenses incurred

outside network hospitals or cases where

pre-authorisation has not been done within the

network hospitals. However, we must be notified in

writing within 48 hours of admission to the hospital,

ideally by the Policy holder/insured person or if

unable, by any immediate adult of the family. All

claims will be adjudicated within 30 days after the

occurrence of the event and further submission of

necessary documents by the Insured Person. To claim

re-imbursements for any Illness or Accident or medical

condition that requires Hospitalization, the Insured

Person should provideus the documents listed below,

within 30 days of the Insured Person's discharge from

Hospital:

(1) Claim form duly completed and signed by the Customer.

(2) Cancelled Cheque

20

(3) Self attested copy of valid age proof (Passport /

Driving License / PAN card / class X certificate / Birth

certificate)

(4) Self attested copy of identity proof (Passport /

Driving License / PAN card / Voters identity card)

(5) Original Discharge summary

(6) Original final bill from Hospital with detailed

break-up and paid receipt.

(7) Original bills of medicines purchased, or of any

other investigation done outside hospital with reports

and requisite prescriptions. .

(8) Invoice of major accessories in case billed and

utilized during treatment (if not included in the final

hospital bill).

(9) For Medicolegal cases (MLC/FIR copy attested by

the concerned hospital / police station (if applicable).

(10) Original self-narration of incident in absence of

MLC / FIR.

(11) Original first consultation paper (in case

disease is first time diagnosed).

(12) Original Laboratory Investigation reports.

(13) Original X-Ray/ MRI / Ultrasound films and

other Radiological investigations

(14) Indoor case paper/OT notes (if required)

- Details of any other insurance policy that may

respond to the claim.

We might request for any other documents or

information that we believe may be required;

• For any medical treatment taken from an

Non-Network Hospital we will pay Reasonable charges

towards medical expenses.

• You are also advised to refer to the list of

unrecognized hospitals, which is available at our

website (www.maxbupa.com).

Nomination Facility: You are mandatorily required at

the inception of the Policy, to make a nomination for

the purpose of payment of claims.

Withdrawal of Product

This product may be withdrawn post receiving prior

approval from Insurance Regulatory and Development

Authority or due to a change in regulations. In such a

case We will provide You an option to migrate to our

other suitable retail product as available with Us.

Revision or Modification

Max Bupa in future may revise or modify this product

post clearance of the authority basis the guidelines

issued by them. We will notify You of any such change

atleast 3 months prior to the date when such revision

or modification will come into effect.

Premium:

• Premium is dependent on age of the insured

and 3 geographical zones.

• Annual premium in INR (excluding service tax

and applicable cess) as per rate tables.

Disclosure:

• All customers’ personal information collected

or held by Max Bupa may be used by Max Bupa for

processing the claims and analysis related to

insurance / reinsurance business.

Product Benefits Tables

Attached as Annexure

How to Buy Max Bupa Policy

The Max Bupa policy is sold, through various channels

like internal telesales team, Max Bupa direct sales

person or independent advisor, our website

www.Maxbupa.com, licensed brokers, agents and any

other channels approved by IRDA.

Sum Insured

(Rs)

Premiums applicable for different ages for a standard healthy life (Rs. per annum) For 25 years

For 30 years

For 40 years

For 50 years

For 60 years

For 65 years

For 70 years

200,000 (Min)

3,204 3,366 4,235 7,340 12,042 16,166 21,103

10000000 (Max)

52,319 53,273 62,955 80,729 105,306 128,410 162,028

21

1. Every Customer will be assigned a unique customer

identification number on the Max Bupa system

2. A Max Bupa proposal form is completed. The

Customer will be required to provide;

• Insureds’ name, date of birth, and address, as well

as proof of ID as necessary.

• As above for all dependants to be covered by the policy.

• Selection of Heartbeat product and sum insured

• Any existing health insurance policy details and

claims history, if applicable.

• Disclosure of any pre-existing medical conditions

with details.

• Medical history report for the proposed insured, if

necessary.

• Height, weight and BMI for the proposed insured.

• Signature and date on application, wherever applicable.

• Premium payment collected and receipted

3. An underwriting process will be followed for every

proposal form submitted, regardless of the distribution

channel.

Checks are made internally to ensure four key

questions in the proposal form are completed, viz;

• Within the last 2 years have you consulted a

doctor or healthcare professional?

• Within the last 7 years have you been to a hospital

for an operation and/or an investigation (e.g. scan,

x-ray, biopsy or blood tests)?

• Do you take tablets, medicines or drugs on a

regular basis?

• Within the last 3 months have you experienced

any health problems or medical conditions which you

have not seen a doctor for?

For telesales, the information about the customer is

gathered on a telephone call instead of a proposal

form. The same four questions are asked on the

telephone and call recorded.

If all questions are answered with “NO” the proposal

form is processed accordingly with acceptance and

issuance of policy certificate.

If the applicant answers “YES” to any of these

questions they will proceed to a further line of enquiry

directly with the Underwriter, providing answers to the

following questions;

• Do you have circulatory disorders e.g. varicose

veins, high cholesterol, deep vein thrombosis, high

blood pressure, venous ulcers?

• Do you have glandular disorders e.g. diabetes,

thyroid, hormonal problems?

• Do you have breathing or respiratory disorders

e.g. asthma, bronchitis, chest infections?

• Do you have ear, nose, throat or eye problems e.g.

hay fever, tonsillitis, sinusitis, cataracts, eye infections,

deafness, ear infections?

• Do you have stomach, intestine, liver or gall

bladder problems e.g. peptic ulcer, colitis, indigestion,

irritable bowel, hepatitis, piles, hernias?

• Do you have cancer, tumors growth, cysts or moles?

• Do you have skin problems e.g. eczema rashes,

psoriasis, acne?

• Do you have brain or nervous system disorders

e.g. migraines, headaches, multiples sclerosis, epilepsy,

nerve pain, fits?

• Do you have muscle or skeletal problems e.g.

arthritis, cartilage and ligament problems, back and

neck problems, sprains, gout, sciatica?

• Do you have urinary problems e.g. bladder or

prostate problems, urinary infections, incontinence,

cystitis?

• Do you have blood disorders e.g. anemia,

abnormal blood tests, HIV/AIDS, leukemia?

• Do you have dental problems e.g. wisdom teeth

problems, abscesses or gingivitis?

• Do you have allergies of any nature?

22

• Do you have undiagnosed symptoms e.g. chest

pain, fatigue, weight loss, dizziness, joint pain, change

in bowel habit, shortness of breath, abdominal pain,

rectal bleeding?

• Are you or any prospective customer taking any

medicines, prescribed or otherwise?

• Has anyone to be covered ever had any past history

of joint replacements, heart conditions or strokes?

• Is there any other information relating to your

health that has not been prompted by the questions

listed above?

If the answer to any of the above questions is “YES”

then further medical assessment and review may be

requested by the Underwriter.

Upon full assessment of clinical and historical facts,

the Underwriter, with possibly second opinion, has

discretion to decide if the proposal submitted presents

a future risk.

Pre-policy health check-up requirements:

For specific ages and sum assured, a medical checkup

is required as part of the underwriting process. The

table below indicates where a medical checkup is

initially required with the proposal form:

Total rated up Sum Insured to be calculated for all

proposed individuals (Individual Sum Insured + Family

floater sum insured + Sum insured under previous or

simultaneous similar product category) to ascertain

the exact medicals to be triggered as per the medical

grid below.

For e.g. A Family First Policy has following members

covered:

Member Individual Cover Sum

Insured (Lacs)

Total Rated up Sum Insured per member for triggering medicals

(Lacs)

Proposer (Self) 2 7

Spouse 2 7

Father 2 7

Mother 2 7

Son 2 7

Family floater Cover Sum Insured

5Lacs

The table below indicates where a medical checkup is

initially required with the proposal form.

* Individual plan – Individual proposal where proposed

insured is below one year of age will be declined unless

the proposed insured is part of a family which is

insured with us.

Family Floater and Family First plans – Discharge

Summary and/or MER will be called for.

The medical check-up are spread in levels depending

on the plan and Age

TMT will be triggered as per Underwriter’s discretion

on case to case basis depending upon the health risk

profile of proposed insured(s). We may require you to

undertake further medical tests based on our

assessment of your health.

These tests will be valid for a period of 3 months (6

months for sub-standard life). The tests can be

conducted only through a Max Bupa empanelled

provider. In case the proposal is accepted the costs of

these tests will be borne by Us for gold and platinum

variants; however for silver variant you will have to

bear 50% of the cost of these tests.

For High Deductible Policies,

For Pre-policy Medicals tests, Sum Insured would be

considered as mentioned above i.e. the Sum Insured

Age (in Years) Individual Plan Family Floater Plan Family First Plan Below 1 Decline* Discharge Summary* No Check-up* Upto 39 No Check-up No Check-up No Check-up 40-44 Level 3 No Check-up No Check-up 45-59 Level 3 Level 3 No Check-up 60 and above Level 3 Level 3 Level 3

Category Tests Level 3 MER, RUA,Hba1c, TCHOL,GGT,HDL, SCREAT,SGOT,SGPT, ECG

23

applied for individual lives.

For e.g. If a proposer chooses Heartbeat Silver plan of

Sum Insured Rs 3 lacs with a deductible option of Rs 1

lac, then Sum Insured considered for triggering

medicals (if any) is Rs 3 lacs (total rated up Sum

insured).

4. Three potential options will be determined by the

Underwriter.

• No Risk - accept application with no condition

exclusion(s)

• Potential Risk – accept application, but special

conditions and exclusion(s) apply.

• Risk – decline policy cover. Max Bupa may decline

policy cover where potential risk cannot be quantified

through the use of best knowledge and expertise. Max

Bupa will consider past medical history, pathological

conditions, acquired disease conditions, deformity or

disability, terminal conditions, and/or a combination

thereof to determine if a risk is uninsurable.

5. All proposals accepted by Max Bupa are internally

processed and enrolled onto the Max Bupa system,

and premium payments are cleared.

6. Customer receives a welcome kit and a follow up

welcome outbound customer service call where the

proposed risk has been accepted by Max Bupa

7. The welcome kit will be delivered direct to the

Customers home.

8. Where proposals are not accepted due to

unacceptable risk then they too receive

communications from Max Bupa advising of the same

and specific reasons for the cover denied.

What to do next: If you wish to know more about Max

Bupa’s Heartbeat Health Insurance plan and/or would like a

personal quote, speak to our specially trained sales team or

your local advisor. They’ll take time to fully understand your

requirements and help you to select the right plan for you.

Phone 1800 3010 3333 (Toll Free) or 3300 3333

24

Policy Number

Name of the

Insured

Date of birth/Age

Relationship with Primary

Insured

City of residence

Previous Occupation or Nature of Work

New Occupation or Nature of Work

Annexure A

Format to be filled up by the proposer for change in occupation of the Insured

Place: _____________ Proposer’s Signature__________________

Date: ______________ Name:__________ Designation__________

(DD/MM/YYYY)

HB/

SP/0

41

4/V

3Registered Office : Max House, 1 Dr. Jha Marg, Okhla, New Delhi 110020Corporate Office :Block B1/I-2, Mohan Cooperative Industrial Estate, Mathura Road, New Delhi -110044

www.maxbupa.com

What to do next

Phone:1800 3010 3333 (Toll Free) or 011-3300 3333

Web: www.maxbupa.com

If you wish to know more about Group Health Insurance plan and/or

would like a personal quote, speak to our specially trained sales team

or your local advisor. They will take time to fully understand your

requirements and help you select the right plan.

Disclaimer: This is only a summary of the product features and is for reference purpose only. For more details on terms and

conditions, exclusions, waiting period and risk factors, please read sales brochure carefully before concluding a sale. The details

of benefits available shall be as described in the policy document, and will be subject to the policy terms, risk factors, conditions

and exclusions. Please call our customer service on the numbers / contact details as provided above if you require any further

information or clarification.

Insurance is a subject matter of solicitation ‘Max’, Max Logo are registered trademarks of Max India Limited “Bupa” and the

HEARTBEAT logo are the registered service marks of the The British United Provident Association Limited. All these marks are

being used under license by Max Bupa Health Insurance Company Limited. UAN No. MB/WB/2014-2015/304 and IRDA

Registration no. 145. For more details on terms and conditions, exclusions, waiting period and risk factors, please read sales

brochure carefully before concluding a sale.

Statutory Warning: Prohibition of rebates (under section 41 of Insurance Act 1938); no person shall allow or offer to allow

either directly or indirectly as an inducement to any person to take out or renew or continue an insurance in respect of any kind

of risk relating to life or property, in India, any rebate of the whole or part of the commission payable or any rebate of the

premium shown on the policy, nor shall any person taking out or renewing or continuing a policy accept any rebate, except such

rebate as may be allowed in accordance with the publishable prospectus or the tables of the insurer. Any person making default

in complying with the provision of this section shall be punishable with fine, which may extend to five hundred rupees.

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