Future Generali Care Plus

Exclusions

Exclusion under Death Benefit:

Suicide exclusion:

In case of death of Life Assured due to suicide within 12 months from the date of commencement of risk under the Policy or from the date of Revival of the Policy, as applicable, the Nominee or beneficiary of the Policyholder shall be entitled to 80% of the total premiums paid till the date of death or the policy cancellation value available as on the date of death whichever is higher, provided the Policy is in force.

Exclusion under Accidental Death Benefit:

You will not be entitled to any accidental death benefit directly or indirectly due to or caused, occasioned, accelerated or aggravated by any of the following:

• War, terrorism, invasion, act of foreign enemy, hostilities, civil war, martial law, rebellion, revolution, insurrection, military or usurper power, riot or civil commotion. War means any war whether declared or not.
• Taking part in any naval, military or air force operation during peace time.
• Any condition that is pre-existing at the time of inception of the policy. Pre-existing Disease means any condition, ailment, injury or disease:-
  1. That is/are diagnosed by a physician within 48 months prior to the effective date of the policy issued by the insurer or its reinstatement; or
  2. For which medical advice or treatment was recommended by, or received from, a physician within 48 months prior to the effective date of the policy issued by the insurer or its reinstatement.

  This exclusion will not be applicable to conditions, ailments or injuries or related condition(s) which are underwritten and accepted by Us at inception or at reinstatement

• Committing an assault, a criminal offence, an illegal activity or any breach of law with criminal intent.
• Alcohol or Solvent abuse or taking of Drugs, narcotics or psychotropic substances unless taken in accordance with the lawful directions and prescription of a registered medical practitioner.
• Poison, gas or fumes (voluntary or involuntarily, accidentally or otherwise taken, administered, absorbed or inhaled).
• Service in the armed forces, or any police organization, of any country at war or service in any force of an international body.
• Participation in aviation other than as a fare-paying passenger in an aircraft that is authorized by the relevant regulations to carry such passengers between established aerodromes.
• Taking part in professional sport(s) or any adventurous pursuits or hobbies. “Adventurous Pursuits or Hobbies” includes any kind of racing (other than on foot or swimming), potholing, rock climbing (except on man-made walls), hunting, mountaineering or climbing requiring the use of ropes or guides, any underwater activities involving the use of underwater breathing apparatus including deep sea diving, sky diving, cliff diving, bungee jumping, paragliding, hand gliding, parachuting and selfie mishaps.
• Nuclear contamination; the radioactive, explosive or hazardous nature of nuclear fuel materials or property contaminated by nuclear fuel materials or accident arising from such nature.

Non Payment of due premiums

For Regular Pay policy where premium payment term is equal to policy term:

• If any due premium(s) have not been paid within the grace period, the policy shall lapse and will have no value. All risk cover ceases while the policy is in the lapsed status.
• The policyholder has the option to revive the policy within five (5) years from the due date of the first unpaid premium subject to policy term not being over.
• The policyholder has the option to revive the policy within five (5) years from the due date of the first unpaid premium subject to policy term not being over.
• If the policy is not revived during the revival period, no benefit shall be payable at the end of the revival period and the policy stands terminated.

For Limited Pay policy where premium payment term is lesser than policy term:

• If any due premium(s) for the first three (3) policy years have not been paid in full within the grace period:-
  1. The policy shall lapse and will have no value. All risk cover ceases while the policy is in the lapsed status.
  2. The policyholder has the option to revive the policy within five (5) years from the due date of the first unpaid premium subject to policy term not being over.
  3. If the policy is not revived during the revival period, no benefit shall be payable at the end of the revival period and the policy stands terminated.
• If due premium(s) for the first three (3) or more policy years have been paid in full and any subsequent premium(s) is/are not paid within the grace period:-
  1. All risk cover ceases under the policy.
  2. The policyholder has the option to revive the policy within five (5) years from the due date of the first unpaid premium subject to policy term not being over.
  3. If the policy is not revived during the revival period, Policy Cancellation Value shall be payable at the end of the revival period or maturity date, whichever is earlier and the policy stands terminated.

Revival

• You have the option to revive a lapsed policy within five (5) years from the date of the first unpaid due premium.
• A policy cannot be revived once the policy term is over.
• The revival will be considered on the receipt of the application from the policyholder along with the proof of continued insurability of life assured and on payment of all overdue premiums with interest.
• The revival will be as per the Board approved underwriting policy.
• On revival, the interest rate of 9% p.a. compounded yearly (applicable for FY 2020-2021) maybe charged by the company. However, the company may decide to increase the interest charged on revival from time to time with a prior approval from IRDAI.

Paid Up

There is no Paid Up benefit available under this product.

Surrender Value

There is no surrender value available under this product. However, Policy Cancellation Value shall be applicable under this product as defined below.

Policy Cancellation Value

For Regular Premium where premium payment term is equal to policy term: No policy cancellation value is available under regular premium policies.

For Limited Premium Payment Term where premium paying term is lesser than policy term: We encourage you to continue your policy as planned, however, you have the option to cancel the same any time after the payment of first three (3) consecutive full policy years’ premiums i.e. after which the policy acquires a cancellation value.

Policy Cancellation Value for Limited Premium Payment policy is equal to: Policy Cancellation Value Factor * {Total Premium paid till date including extra premium for substandard lives, if any (exclusive of taxes) – (Total Premium Payable/Policy Term in Years) * Policy Year of Cancellation}

Policy Cancellation Value Factor will be as below:

Policy Year of Cancellation	Factor
1-2	0%
3-5	30%
6-9	40%
10-14	50%
15 and above	60%

Policy Cancellation value will not be payable if the policy is cancelled in the last policy year.

The policy terminates on policy cancellation and no further benefits are payable under the policy.

Nomination and Assignment

Nomination shall be in accordance with Section 39 of Insurance Act, 1938 as amended from time to time.

Assignment shall be in accordance with Section 38 of Insurance Act, 1938 as amended from time to time.

Prohibition on rebates:

Section 41 of the Insurance Act 1938 as amended from time to time states

• . No person shall allow or offer to allow, either directly or indirectly, as an inducement to any person to take or renew or continue an insurance in respect of any kind of risk relating to lives 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 published prospectuses or tables of the insurer.
• Any person making default in complying with the provisions of this section shall be liable for a penalty which may extend to ten lakh rupees.

Fraud and Misstatement:

Section 45 of the Insurance Act 1938 as amended from time to time states

• No Policy of Life Insurance shall be called in question on any ground whatsoever after the expiry of 3 years from the date of issuance of the policy or the date of commencement of risk or the date of revival of the policy or the date of the rider to the policy, whichever is later.
• A policy of Life Insurance may be called in question at any time within 3 years from the date of issuance of the policy or the date of commencement of risk or the date of revival of the policy or the date of the rider to the policy, whichever is later, on the ground of fraud.

For further information, Section 45 of the Insurance laws (Amendment) Act, 2015 may be referred.