Personal Health Policy – Standard in one table
| Insurer | Acko General Insurance Limited |
|---|---|
| Sum insured | ₹3 lakh to ₹10 crore, in tiers of 3 / 5 / 10 / 15 / 20 / 25 / 50 lakh and 1 / 1.5 / 2.5 / 5 / 10 crore, plus an unlimited sum insured option |
Claim settlement and complaint figures are IRDAI-published and held centrally by NYVO, not taken from the insurer's marketing.
What Personal Health Policy – Standard covers
These are the terms that decide what you are actually paid when you claim. Room rent, co-pay and restoration do more to shape a settlement than the sum insured does, and they are read from Acko's own policy wording.
| Feature | This plan | What good looks like |
|---|---|---|
| Co-payment | Optional. Accept 5% to 30% for a lower premium, or none. A separate 10% to 20% applies if you took the notification or preferred-network discount and then broke its condition | No Co-payment |
| Room Rent Limit | Chosen at purchase: general ward, shared room, single AC room, or up to the sum insured | No room rent capping |
| Disease sub-limit | No illness sub-limits · road ambulance and domestic evacuation carry their own chosen limits | No sub-limit |
| No Claim Bonus | Optional. When taken, adds a fixed percentage of the base sum insured after each claim-free year, as printed on your schedule | 50% each year (Minimum upto 100%) |
| Restoration Benefit | Optional cover. If taken, it refills once or an unlimited number of times a year, whichever your schedule specifies. Not available on the unlimited sum insured option | 100% restoration once in a year |
| Pre-Hospitalization | 30, 60 or 90 days, chosen at purchase | At least 60 days |
| Post-Hospitalization | 60, 90, 120 or 180 days, chosen at purchase | At least 120 days |
| Consumables | Not in the base plan. The Waiver of Non-Payable Medical Expenses option adds them; without it the standard list is excluded | Consumables covered |
| Worldwide hospitalisation | Optional. When taken, in-patient expenses anywhere outside India are covered | Included |
| Day Care Treatment | All necessary day care treatments, up to the sum insured | Covered without a capped list |
| Second Opinion | Covered in the base plan | Included |
| Entry age | From 91 days, with no maximum entry age and no maximum cover-ceasing age | No maximum entry age |
Personal Health Policy – Standard add-ons you can buy with it
Each of these costs extra and each has its own conditions. Some are genuinely worth it; several exist to patch a gap in the base plan. Ask what each one adds before it goes on your quote.
Personal Health Policy – Standard waiting periods: when each part of the cover starts
Waiting periods run from the day cover began, not from the day you fall ill, and they run in parallel rather than one after another.
| Initial Waiting Period | 30 days, waivable with the optional cover |
|---|---|
| Specific Illness | As printed on the policy schedule, reducible with the optional cover |
| Pre-Existing Disease | As printed on the policy schedule |
The named illnesses that wait As printed on your policy schedule
The length of this wait is chosen at purchase rather than fixed by the product, and an optional cover shortens it further. This list is indicative – the prospectus groups the full set by organ system.
Personal Health Policy – Standard exclusions: what the plan will not pay for
Every policy carries exclusions, and they are the clauses people read for the first time at claim stage. These are the ones worth knowing before you buy.
Where Personal Health Policy – Standard falls short
No plan is right for everyone, and a page that only lists strengths is not much use to you. These are the gaps we would raise on a call before recommending it.
Personal Health Policy – Standard questions, answered
Does the Acko Personal Health Policy include restoration?
It is an option, not a base benefit. Restore Sum Insured only applies if it is printed on your policy schedule, and when it is you will have chosen either one refill a year or unlimited refills. It triggers after the base cover, any inflation protect amount and any no-claim bonus amount are all exhausted. On the unlimited sum insured option it is not offered, because there is nothing left to restore. Any claim that this plan comes with unlimited restoration as standard is wrong.
Are consumables covered?
Only if you add the Waiver of Non-Payable Medical Expenses option. Without it, everything on the insurer's non-payable list – crepe bandages, gloves, diapers, food charges, administrative fees – is excluded and comes out of your pocket. It is a single tick box on the quote and it is the difference between a claim that clears the bill and one that leaves a balance behind.
What are the waiting periods?
Thirty days for any illness at the start, which an optional cover can waive entirely. The waits on the named-illness list and on pre-existing disease are not fixed by the product – both are set at purchase and printed on your schedule, and a further option shortens the specific-illness one. Ask for those two numbers in writing before you buy; they are the terms that decide when the policy actually starts working.
Is there a co-payment?
Not unless you choose one. You can accept 5% to 30% of every claim for a cheaper premium. Two other discounts carry conditional co-payments: agreeing to notify Acko within 48 hours of admission, and agreeing to use only preferred-network hospitals. Break either condition and 10% to 20% of the assessed claim is deducted. Those are discounts you must be able to live with, not free money.
What room category will I get?
Whatever you chose at purchase – general ward, shared room, single air-conditioned room, or a room paid up to the sum insured. This is the option people regret most, because a lower category means a proportionate deduction across the rest of the bill if you upgrade on the day. If you would want a private room in a crisis, buy one now.
How high can the sum insured go?
From ₹3 lakh through the usual tiers to ₹10 crore, plus an unlimited option. The unlimited option removes the need for restoration and inflation protect, and both are therefore unavailable on it. There is no maximum entry age and no cover-ceasing age, so the plan can be bought for an elderly parent, subject to underwriting.
Read it from the insurer
We summarise. The policy wording is the contract, and it is the only document that settles a dispute. These links go to the insurer's own pages.
Understand the terms before you commit
A plan page tells you what this policy does. These explain why each term matters and what it costs you when it is missing.