Family Floater Mediclaim

A POLICY FOR MEDICAL EMERGENCIES: Family floater health insurance also known as family health insurance covers your entire family under a single plan. The sum insured under this plan floats upon all the family members insured in it. A family floater policy is one where several members of a single family can be covered for a sum assured by paying a premium for a year. In case of multiple illnesses in the family, the sum assured can be distributed between family members, and multiple claims entertained. A family floater health insurance is one of the best options when it comes to safeguarding the health of your loved ones. Since it is a single policy offering family benefits, it relieves you from the task of maintaining and keeping track of several HEALTH INSURANCE policies & offers affordability also. Family floater health insurance plans usually cover the individual, spouse, and children. However, some insurance providers do have provision to cover dependent parents, siblings, and parents-in-law. Hence these kinds of (HEALTH –FAMILY FLOATER POLICIES) is becoming more popular because of the advantages it offers. One of the best parts about a family health insurance policy is that it saves the hassle of maintaining multiple policies. It covers your entire family under one policy including the extended family and your in-laws.


  • Minimum entry age: The minimum entry age is 91 days. Childrens between 91 days and 5 years can be insured provided.
  • Maximum entry age: The maximum entry age is 65 years. There is no maximum cover ceasing age.


  • Pre-Hospitalisation: 60 days
  • Post-Hospitalisation: 90 min days & max 180 days
  • Day Care Procedures: Covered upto SI
  • Domiciliary Treatment: Covered upto SI
  • Organ Donor:  Covered upto SI
  • Restore Benefit: Covered upto SI
  • Multiplier Benefit: Bonus of 10 % , 50 % of basic sum insured for every claim free year , maximum upto 100 % , in case of claim , accumulated bonus will be reduce by 10 or 50 % .
  • Health Check-up: As per limit
  • Coverage: For Advance treatment and Robotic Surgery.


  • Any treatment within 30 days of cover except any accidental injury.
  • Any preexisting disease/ conditions will be covered after a waiting period of 3 or 4 years.
  • 2 Years exclusions for specific disease like cataract, hernia, hysterectomy, joint replacement etc.
  • Hospitalization due to war or an act of war or due to nuclear, Chemical or biological weapon and radiation of any kind.
  • Non allopathic treatment, Congenital external diseases, cosmetic surgery .


Cashless Claim:

  • The insurance company would directly interact with the hospital and take care of the expense.
  • There are two pre-requisites for the same. Firstly, your MEDICAL INSURANCE PLAN must cover the ailment that you or your family member is diagnosed with.
  • Secondly, the hospital you want to visit should be in the list of network hospitals of your insurer.
  • If the above two conditions are fulfilled and it is a planned or emergency hospitalization, you can opt for a CASHLESS CLAIM.

Reimbursement Claims:

  • Reimbursement claim is the opposite of cashless claims. If you fail to opt for the cashless facility or have to be hospitalized in a non-network hospital, reimbursement claim would come into the picture.
  • You can go through your normal hospitalization process and complete the payment. Once you are discharged, ensure that you reach out to your insurer at the earliest and submit a claim along with all the relevant hospital documents. The approved amount will then be submitted to your bank account.
Filing Process
Filing Process Depending on the type of claims that you are opting for, the filing process would vary a bit. In the case of planned hospitalization, you can intimate your insurer about the same. If you do so, they will provide you with a Pre-Authorization Form which you need to fill out and submit at the Third Party Administration counter of the hospital.
Things to Consider
Before you start filing your claim, here are a few things that you must consider. It is advisable to go through the pre-authorization form very carefully and provide all the details as accurately as possible. You are required to submit all the original documents to your insurer, and thus taking photocopies of the same for future reference is recommended. Do not forget to renew your insurance on time or else you might miss out on a few benefits