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Do medical policies cover expenses for treating hole in the heart?

Q: My 5 years old son has been diagnosed with Ventricular Septal Defect (VSD) and might require surgery within a year as per the paediatric cardiologist. Do medical insurance companies in India cover VSD surgery and hospitalisation expenses? I have Reliance gold plan (Family floater) for Rs. 2 lakhs and now eligible for pre-existing disease cover. However, general exclusion points of policy (even in other company policies) say that congenital defects are excluded. My office medical insurance from Future Generali also covers pre-existing diseases. Does any policy cover internal congenital defects?

A:VSD (or Ventricular Septal Defect) classify as congenital (ailment since birth) internal ailment. In general group, Mediclaim policies are tailor-made policies and cover congenital external or internal ailments.

However, I request to talk to your Human Recourse department or concerned person who so ever deal in that for your organization - Enquire whether congenital internal ailment is covered or not? If this is covered, then your child treatment expenses are covered.

Similarly enquire with Reliance General Insurance Company whether congenital internal ailment is covered or not. This can be done through their call centre or mail to their help desk.

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