ABSLI Comprehensive Critical Illness Rider

Description	Details
Minimum/ Maximum Entry Age (Age last birthday on the effective date)	18 to 55 years
Maximum CI Cover Ceasing Age (Age last birthday on the effective date)	70 Years
Premium Paying Term (PPT)	Limited 5-20 Years Regular Subject to policy term of base policy
Minimum/Maximum Rider Term*	5 years to 30 years   Limited Pay Min: PPT + 1 Max: Same as policy term of base policy (subject to max rider term boundary conditions) Regular Pay Same as policy term of base policy (minimum of 5 years)
Premium Payment Frequency	All premium payment frequencies shall be available i.e. Annual | Semi-Annual | Quarterly | Monthly Same as for the base plan
Minimum Sum Assured	Rs. 1,00,000
Maximum Sum Assured	Rs. 1,50,00,000 Subject to board approved underwriting policy of the company. The Rider sum assured cannot exceed the sum assured under the base product.
Rider Option	Option 1: Silver  Option 2: Gold Option 3: Platinum
List of Illnesses	Mentioned in “List of Covered CI Conditions” section below.

CI Rider can be attached at inception of the base policy or any time during the PPT of base policy at policy anniversary, subject to meeting minimum PPT criteria of CI Rider as per boundary conditions.
*If the rider is attached at inception of the base policy, the premium paying term of the rider has to be equal to the premium paying term of the base policy. If the rider is attached at any policy anniversary, the premium paying term of the rider has to be equal to the outstanding premium paying term of the base policy. The policy term of the rider can be less than or equal to the policy term of the base policy.

Sr No	Name of CI / Surgery	Major/Minor	Silver (10 CIs)	Gold (25 CIs)	Platinum (64 CIs)
1	Cancer of Specified Severity	Major	✓	✓	✓
2	Myocardial Infraction (First Heart Attack of Specific Severity)	Major	✓	✓	✓
3	Open Chest CABG	Major	✓	✓	✓
4	Coma of Specified Severity	Major	✓	✓	✓
5	Open Heart Replacement or Repair of Heart Valves	Major	✓	✓	✓
6	Multiple Sclerosis with Persisting Symptoms	Major	✓	✓	✓
7	Blindness	Major	✓	✓	✓
8	Deafness	Major	✓	✓	✓
9	End Stage Liver Failure	Major	✓	✓	✓
10	End Stage Lung Failure	Major	✓	✓	✓
11	Major Organ /Bone Marrow Transplant	Major		✓	✓
12	Permanent Paralysis of Limbs	Major		✓	✓
13	Motor Neuron Disease with Permanent Symptoms	Major		✓	✓
14	Loss of Speech	Major		✓	✓
15	Kidney Failure Requiring Regular Dialysis	Major		✓	✓
16	Stroke Resulting in Permanent Symptoms	Major		✓	✓
17	Loss of Limbs	Major		✓	✓
18	Major Head Trauma	Major		✓	✓
19	Primary (Idiopathic) Pulmonary Hypertension	Major		✓	✓
20	Alzheimer’s Disease	Major		✓	✓
21	Aorta Graft Surgery	Major		✓	✓
22	Fulminant Hepatitis	Major		✓	✓
23	Third Degree Burns	Major		✓	✓
24	Loss of Independent Existence	Major		✓	✓
25	Parkinson’s Disease	Major		✓	✓
26	Apallic Syndrome or Persistent Vegetative State (PVS)	Major			✓
27	Bacterial Meningitis	Major			✓
28	Brain Surgery	Major			✓
29	Cardiomyopathy - of specified severity	Major			✓
30	Chronic Adrenal Insufficiency	Major			✓
31	Creutzfeldt-Jakob Disease (CJD)	Major			✓
32	Dissecting Aortic Aneurysm	Major			✓
33	Eisenmenger's Syndrome	Major			✓
34	Elephantiasis	Major			✓
35	Encephalitis	Major			✓
36	Hemiplegia	Major			✓
37	Infective Endocarditis	Major			✓
38	Medullary Cystic Disease	Major			✓
39	Myasthenia Gravis	Major			✓
40	Pheochromocytoma	Major			✓
41	Progressive Supranuclear Palsy - resulting in permanent symptoms	Major			✓
42	Progressive Scleroderma	Major			✓
43	Poliomyelitis	Major			✓
44	Severe Rheumatoid Arthritis	Major			✓
45	Systemic Lupus Erythematous	Major			✓
46	Tuberculosis Meningitis	Major			✓
47	Muscular Dystrophy	Major			✓
48	Benign Brain Tumor	Major			✓
49	Amputation of Feet Due to Complications from Diabetes	Major			✓
50	Crohn's Disease	Major			✓
51	Loss of One Limb and One Eye	Major			✓
52	Myelofibrosis	Major			✓
53	Necrotising Fasciitis	Major			✓
54	Other Serious Coronary Artery Disease	Major			✓
55	Severe Ulcerative Colitis	Major			✓
56	Terminal Illness	Major			✓
57	Pneumonectomy	Major			✓
58	Aplastic Anaemia	Major			✓
59	Chronic Relapsing Pancreatitis	Major			✓
60	Angioplasty	Minor			✓
61	CIS / Early Stage Cancer	Minor			✓
62	Small Bowel Transplant	Minor			✓
63	Brain Aneurysm Surgery or Cerebral Shunt Insertion	Minor			✓
64	Severe Osteoporosis	Minor			✓

We shall not be liable to make any payment under this Rider towards a covered condition/illness/procedure, caused by, based on, arising out of or howsoever attributable to any of the following:

1. Any Illness, sickness, or disease other than those specified as Critical Illnesses under this Rider;
2. Any Pre-existing Disease or any complication arising therefrom.

Pre-existing Disease means any condition, aliment, injury, or disease / critical illness / disability:

1. That is/are diagnosed by a physician within 48 months prior to the effective date of the rider 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 rider issued by the insurer or its reinstatement

In case of enhancement of sum insured the exclusion shall apply afresh to the extent of sum insured increase.
Coverage under the Rider after the expiry of 48 months for any pre-existing disease is subject to the same being declared at the time of application and accepted by Insurer.

3. Any Critical Illness caused due to treatment for, Alcoholism, drug or substance abuse or any addictive condition and consequences thereof.
4. Narcotics used by the Insured Person unless taken as prescribed by a registered Medical Practitioner,
5. Any Critical Illness caused due to intentional self-injury, suicide, or attempted suicide
6. Any Critical Illness caused by or arising from or attributable to a foreign invasion, act of foreign enemies, hostilities, warlike operations (whether war be declared or not or while performing duties in the armed forces of any country during war or at peace time), civil war, public defense, rebellion, revolution, insurrection, military, or usurped power;
7. Any Critical Illness caused by ionizing radiation or contamination by radioactivity from any nuclear fuel (explosive or hazardous form) or from any nuclear waste from the combustion of nuclear fuel, nuclear, chemical, or biological attack.
8. Congenital External Anomalies or any complications or conditions arising therefrom including any developmental conditions of the Insured;
9. Any Critical Illness caused by any treatment necessitated due to participation as a professional in hazardous or adventure sport, including but not limited to, para jumping, rock climbing, mountaineering, rafting, motor racing, horse racing or scuba diving, hand gliding, sky diving, deep sea diving
10. Participation by the Insured Person in any flying activity, except as a bona fide, fare-paying passenger of a recognized airline on regular routes and on a scheduled timetable.

11. Any Critical Illness caused by Medical treatment traceable to childbirth (including complicated deliveries and caesarean sections incurred during hospitalization) except ectopic pregnancy. Any Critical Illness caused due to miscarriages (unless due to an accident) and lawful medical termination of pregnancy during the rider period.

12. Any Critical Illness caused by any unproven/ experimental treatment, service and supplies for or in connection with any treatment. Unproven/ experimental treatments are treatments, procedures or supplies that lack significant medical documentation to support their effectiveness.
13. Any Critical Illness based on certification/diagnosis/treatment from persons not registered as Medical Practitioners, or from a Medical Practitioner who is practicing outside the discipline that he/ she is licensed for.
14. Any Critical Illness caused due to any treatment, including surgical management, to change characteristics of the body to those of opposite sex.
15. Any Critical Illness caused due to cosmetic or plastic surgery or any treatment to change the appearance unless for reconstruction following an Accident, Burn(s), or Cancer or as part of medically necessary treatment to remove a direct and immediate health risk to the insured. For this to be considered a medical necessity, it must be certified by the attending Medical Practitioner.
16. Any Critical Illness caused due to surgical treatment of obesity that does not fulfil all the below conditions:
1. Surgery to be conducted is upon the advice of the Doctor
2. The Surgery / Procedure conducted should be supported by clinical protocols
3. The member has to be 18 years of age or older and
4. Body Mass Index (BMI):

- greater than or equal to 40 or

- greater than or equal to 35 in conjunction with any of the following severe co-morbidities following failure of less invasive methods of weight loss:

1. Obesity related cardiomyopathy
2. Coronary heart disease
3. Severe Sleep Apnea
4. Uncontrolled Type 2 Diabetes
17. Any Critical Illness caused due to treatments received in health hydros, nature cure clinics, spas or similar establishments or private beds registered as a nursing home attached to such establishments or where admission is arranged wholly or partly for domestic reason.
18. Any Critical Illness caused by treatment directly arising from or consequent upon any Insured Person committing or attempting to commit a breach of law with criminal intent.
19. In the event of the death of the Insured Person within the stipulated survival period as set out above.
20. Any Critical Illness caused by sterility and infertility. This includes:
1. Any type of contraception, sterilization
2. Assisted Reproductive services including artificial insemination and advanced reproductive technologies such as IVF, ZIFT, GIFT, ICSI
3. Gestational Surrogacy
4. Reversal of sterilization